CCF Sleep

3 possible causes to understand

Catching up on sleep on the weekend after a run of short sleep during the week has health benefits if not over-done. But for most young and middle-aged adults, sleeping more than 9-10 hours on a routine basis is too much.

Oversleeping has some of the same consequences as under-sleeping, such as waking up feeling groggy or cognitively impaired. Oversleeping is also associated with depression, which is linked to a host of other health problems.

On top of all that, studies suggest oversleeping increases the risks of cardiovascular disease, diabetes and obesity as much as under-sleeping, due to the build-up of toxins and inflammatory markers.

3 possible culprits to your excessive snoozing

1. Narcolepsy is a rare sleep disorder that affects roughly 1 in 2000 people and usually shows up in teens and young adults (ages 15-25 years old). People with narcolepsy often feel extremely sleepy during the day and might have irresistible sleep attacks, along with feeling paralyzed and having hallucinations while falling asleep or waking up. In some cases, a sudden loss of muscle tone while the person is still awake can be brought on by strong emotions. Usually, patients with narcolepsy can take short, refreshing naps and then feel alert for the next few hours.
2. Idiopathic hypersomnia is another disorder that arises in young adulthood and can make you feel extremely sleepy during the day, which leads you to oversleep. However, unlike people with narcolepsy, those with idiopathic hypersomnia have long, unrefreshing naps that don’t make them feel better when they wake up.
3. Medications such as sedatives, psychotropics, antiepileptics, and antihistamines can increase sleepiness, especially in older people.

If you feel like you’re sleeping too much or that the amount of sleep you’re getting is interfering with your life, talk to your healthcare provider to help get your sleep back on track.

What to expect

So you’ve talked to your healthcare provider about your sleep problems, and you’ve been scheduled for an overnight sleep study to figure out what’s going on. What should you expect and how should you prepare?

During an overnight sleep test (called a polysomnogram, or PSG), sensors are placed on your body to record brain activity, eye movements, muscle activity, and breathing patterns. These sensors can vary depending on what problems your provider suspects. You will be allowed to go to sleep at your usual bedtime in a private sleep room, with a private bathroom and shower, in most cases. Here’s what you should do to prepare:

• Avoid napping the day of the study
• Avoid alcohol, caffeine, sedatives, and stimulants for 24 hours, unless otherwise directed by your physician
• Eat like you would normally
• Let the Sleep Disorders Center know in advance if you need any accommodations for dietary restrictions or a disability
• Bring your regular medications, comfortable two-piece sleep attire, and your PAP therapy mask, if applicable
• Make sure your hair is oil- and product-free on the day of the study
• Bring your sleep questionnaire and sleep log (if applicable), along with a list of current medications
• Bring a parent or guardian if you’re younger than 18
• Shift workers should discuss with their physicians the best timing to conduct the sleep test

What to expect during narcolepsy testing

If you have excessive daytime sleepiness and your provider suspects narcolepsy, you might be asked to stay the next day for a multiple sleep latency test (MSLT). This test measures the time it takes for you to fall asleep when given the opportunity to nap, providing an objective measure of daytime sleepiness. If you know you’ll have daytime testing as well, please follow these additional instructions:

• Wear comfortable clothing

• Bring reading materials or other activities to occupy free time
• Double check which medications you should be taking prior to the test. Your referring provider might advise you to discontinue certain medications up to two weeks before testing.
• Complete a two-week sleep log prior to the test
• Provide a urine sample for testing prior to the MSLT (this will likely be asked of you)

12 ways to practice good “sleep hygiene”

You brush your teeth and wash your face every night, but what other hygiene routine might you be missing? If you have a hard time sleeping, you might need to brush up on your good sleep habits. These 12 habits, also called sleep hygiene, can help you get a good night’s sleep:

1. Think positive. Avoid thoughts like “If I don’t sleep for 8 hours, I will feel terrible tomorrow.”
2. Try to go to sleep at the same time each night and get up at the same time each morning.
3. Try not to take naps during the day because naps may make you less sleepy at night.
4. Avoid caffeine, nicotine, and alcohol late in the day, since caffeine and nicotine will keep you up and alcohol interferes with sleep quality.
5. Get regular exercise, but try not to exercise too close to bedtime.
6. Don’t eat a heavy meal late in the day. A light snack before bedtime, however, may help you sleep.
7. Make your sleeping place comfortable. Be sure that it is dark, quiet, and a comfortable temperature. If light is a problem, try a sleeping mask. If noise is a problem, try earplugs or a fan.
8. Relax before going to bed by reading a book, listening to music, taking a bath, or enjoying another relaxing activity.
9. Avoid using your bed for anything other than sleep or sex.
10. If you can’t fall asleep and don’t feel drowsy, get up and read or do something that is not overly stimulating until you feel sleepy.
11. If you have trouble lying awake worrying, try making a to-do list before bedtime. This may help you to not focus on those worries overnight.
12. Stop clockwatching. Turn the clock around and only use the alarm.

Next time you have difficulty sleeping, try some of these easy, effective sleep hygiene tips.

How much sleep should you aim for?

If you eat well and exercise regularly, but don’t get at least seven hours of sleep every night, you may undermine all your other efforts to be healthy. It’s important to focus on getting enough sleep, something many of us lack. But how much sleep do you actually need?

Thanks to a report from the National Sleep Foundation, you can aim for a targeted sleep number tailored to your age. Here are the Foundation’s updated recommendations, broken down into nine age-specific categories with a range for each, allowing for individual differences:

• Older adults, 65+ years: 7-8 hours
• Adults, 26-64 years: 7-9 hours
• Young adults, 18-25 years: 7-9 hours
• Teenagers, 14-17 years: 8-10 hours
• School-age children, 6-13 years: 9-11 hours
• Preschool children, 3-5 years: 10-13 hours
• Toddlers, 1-2 years: 11-14 hours
• Infants, 4-11 months: 12-15 hours
• Newborns, 0-3 months: 14-17 hours

Why it’s important to get enough sleep

Genetic, behavioral and environmental factors help determine how much sleep an individual needs, but a minimum of seven hours of sleep for adults is a step in the right direction to improve your health.

Your doctor urges you to get enough sleep for good reason. Shorting yourself on shut-eye not only impairs school and work performance and quality of life, but also contributes to serious health issues, like diabetes, heart failure, and stroke, and increases automotive accidents that can be deadly.

Even though our 24/7 society robs many of us of sleep, understanding the importance of getting adequate shut-eye and knowing how much you really need is the first step in improving your health.

Three stats that will wake you up

One of the most striking consequences of sleep disorders is drowsy driving. The social and economic burdens of drowsy driving are staggering. These statistics should get your attention:

1. A recent American Automobile Association Foundation for Traffic Safety study found a drowsy driver was involved in 13% of non-fatal crashes that resulted in hospital admission and 21% of fatal crashes.   
2. The National Highway Traffic Safety Administration estimated that from 2009 to 2013, there were 72,000 police-reported crashes involving drowsy drivers, injuring more than 41,000 people and killing more than 800.
3. The 2014 AAA Traffic Safety Culture Index showed that 96% of sampled drivers considered it unacceptable for someone to drive when they are so sleepy that they have a hard time keeping their eyes open, yet a whopping 29% of them did just that in the prior 30 days.

 Most drowsy driving accidents occur between two to six AM and two to four PM and after driving continuously for more than two hours. Younger drivers have the greatest risk. Drowsy driving is more common in those who do not get enough sleep, use medications that cause drowsiness (sleep aids, some antidepressants and antihistamines), drive commercial vehicles, have sleep disorders, and/or drive for many hours at night without a break.

Tips to avoid drowsy driving

Drowsy driving countermeasures include:

• Get 7 to 8 hours of sleep before driving
• Avoid driving late at night
• Avoid driving alone
• If feeling drowsy while driving, pull over at a rest stop, take a 15-30 minute nap and/or drink a cup of coffee
• Avoid alcohol
• On a long trip, share the driving with another passenger

You might be surprised that some common wake-promoting strategies are actually not so effective behind the wheel. Opening a window, listening to music, slapping one self and hitting a rumble strip are at the top of this list. Of course, the best countermeasure for drowsy driving is sufficient restorative sleep.

How a Sleep Diary Can Improve Your Health

The last time you may have written in a diary was when you were a kid, but a sleep diary can help you with more than just getting thoughts off of your mind. If you’re having a hard time sleeping or feel sleepy during the day, a sleep diary can provide useful insights as to why that might be. Your healthcare provider or sleep specialist can give you a template, but keeping a sleep diary is as easy as recording these few things each day:

As you get ready to go to bed, answer these 8 questions:

1. Naps: how many did you take today? When? How long?
2. Alcoholic drinks: how many did you have today? When?
3. Caffeinated beverages: how many did you have today? When?
4. What were your stressors today?
5. How did you feel today?

• • 1: Very tired
  • 2: Somewhat tired
  • 3: Fairly alert
  • 4: Wide awake

1. How irritable did you feel today?

• • 1: Not at all
  • 2: Somewhat
  • 3: Moderately
  • 4: Very
  • 5: Extremely

1. Sleeping medications: did you take any? Which ones? How much?
2. Did you try using anything, like relaxation or not eating before bed, to try to help you sleep?

5 questions to think about in the morning:

1. What time did you go to bed?
2. How long did it take you to get to sleep?
3. How many times did you wake up in the night?
4. What time did you wake up?
5. How many hours of sleep do you think you had?

Just answering these simple questions can help your healthcare provider understand your situation and help you find a solution to bring the sandman back around each night and feel refreshed each day.

The hidden dangers of going without

If you aren’t getting enough sleep, it’s important to understand the effects it may have on you. Intense sleep deprivation — a full 24 hours without sleep — can result in symptoms similar to intoxication. Sleep deprivation impairs your judgment, and you may struggle to make decisions or stay alert.

More common, however, is chronic, poor sleep quality. Several consecutive nights of bad sleep due to a new baby, a snoring partner or a sleep disorder like sleep apnea can also result in this “intoxicated” experience.

Impact of sleep deprivation on cognitive function:

Sleep should be refreshing and restorative, and when it isn’t, you can struggle with mental changes. When you are lacking in sleep, it can affect various parts of the brain. This can result in:

• Difficulty staying on task
• Lack of ability to focus in monotonous situations or on repetitive tasks
• Falling asleep in school or during meetings at work
• Difficulty learning
• Mood changes like anxiety, depression or paranoia
• Decreased alertness while driving or operating dangerous machines

Impact of sleep deprivation on the body:

The verdict isn’t completely in on how a lack of sleep affects the body. There is, however, research showing a relationship between poor sleep and a higher risk of:

• Heart disease
• High blood pressure
• A weakened immune system
• Cancer
• Inflammation
• Weight gain

In the end, keeping a regular schedule and avoiding certain habits can go a long way toward improving sleep and decreasing your risk of health problems. If this doesn’t work and the problem lingers, don’t hesitate to talk to your doctor.

The pros and cons of caffeine

For most of us, caffeine is part of our daily lives, whether it’s a cup of java to get us going in the morning or a diet soda on our afternoon break. It can be a great pick-me-up, as 200 mg of caffeine has been shown to improve alertness and has comparable effects to taking a 20-30 minute nap.

However, as with all potentially good food and drinks, there’s such a thing as too much caffeine. There are no official guidelines, but the American Medical Association Council on Scientific Affairs defines “moderate” caffeine intake to be about 250 milligrams per day. For reference, here’s how some of your favorite caffeinated beverages measure up:

• Coffee and tea: One cup of brewed coffee has about 60-120 milligrams of caffeine, and one cup of white, green, or black tea has about 20 to 80 milligrams of caffeine.
• Soft drinks: The caffeine limit for a 12-ounce soft drink is 71 milligrams per 12 ounces.
• Energy drinks: The caffeine in energy drinks can exceed 200 milligrams per serving. It is easy to be misled by the heavy caffeine content in small drinks — or the number of servings in a container — and inadvertently consume too much.

Side effects of too much caffeine

While a cup of coffee or two per day can keep you refreshed, consuming more than 300 milligrams of caffeine in a day can increase your risk of nausea, anxiety, sleeplessness, restlessness and other side effects. The milder adverse effects of caffeine include palpitations, tremor, agitation, heartburn, headaches, and diarrhea, and the following severe effects have been reported with doses of caffeine exceeding 480 milligrams a day:

• Arrhythmias (heart rhythm disturbances)
• Rapid heart rate
• Cardiac ischemia (reduced blood flow and oxygen to the heart)
• Seizures
• Hallucinations
• Muscle breakdown (rhabdomyolisis)
• Death

It’s important to be aware that if you drink three or four cups of coffee within a short period of time, you could potentially put yourself at risk, so drink up, but in moderation.

How poor sleep can slow you down

Missing small amounts of sleep may not make or break your marathon time, but it can change your performance in small ways that add up.

While adequate sleep can give you extra energy, lack of sleep or poor quality sleep can hinder athletic performance. Light in the evening hours and mental stimulation from social media prior to bedtime are additional culprits in compromising your performance.

Sleep loss or poor sleep quality can impact performance in all sports, from slowing down marathoners to decreasing free throw percentages in basketball players, which can impact how you place in a game or race. But, because sleep greatly impacts motivation and decision-making, healthcare providers often see the biggest detriment in poor sleep for those in endurance and high-vigilance sports, such as:

• Running
• Cycling
• Tennis
• Sailing
• Aiming sports, like darts, basketball, and football

With these sports, athletes often hit a wall at some point and motivation helps them push through. Without good sleep, that motivation often is not what it needs to be. Also, sleep loss can decrease vigilance, concentration, and decision-making, taking a toll on aim and quick-thinking. And studies have shown that these effects can show up after just one night of poor sleep.

But there is good news!

But there’s no need to despair if you’re worried that sleep problems will forever change your game. Studies have shown that just a few weeks of improved sleep can drastically up your game. In basketball players, free throw percentages have shown to increase almost 10% after a period of sleep extension, and in tennis players, first serve accuracy improved up to 42%.

By treating your sleep disorder and getting better, consolidated sleep, you’ll be less fatigued, feel more motivated, and be ready to cross the finish line.

What all seniors should know

There are many reasons that getting a good night’s sleep may become more difficult as you age.

Some people find they need less sleep as they age, but most still aim for seven or eight hours each night — about right for adults beyond age 65. However, disrupted sleep and still feeling tired when you wake up every day are not normal parts of aging.

So what’s keeping you up?

As you get older, several factors can influence your sleep:

• Physiological changes and medical conditions, like arthritis, gastrointestinal issues, lung disease and heart failure, can cause difficulty falling asleep and staying asleep
• Alzheimer’s disease and other forms of cognitive impairment can lead to circadian rhythm changes and night awakenings
• A decline in slow-wave sleep; the deeper, more restful stage of sleep; can make you feel more tired
• Obstructive sleep apnea, often indicated by snoring, causes a complete or partial obstruction of your airway, which prevents you from breathing and may cause you to be sleepy during the day and to wake up intermittently during the night
• Restless legs syndrome, an irresistible urge to move your limbs which prevents you from falling asleep increases with age

Here’s what you can do about it

When it comes to insomnia, sometimes simple steps can change bad habits and pave the way for better sleep. Try limiting napping, turning off screens an hour before bedtime, limiting alcohol and caffeine, and getting regular exercise. For post-menopausal women who experience hot flashes, try keeping the thermostat at a lower temperature while you sleep.

Over-the-counter sleep aids and prescription medications are not recommended for older adults, as they often are associated with serious side effects. If your sleep troubles are persistent after habit adjustments, it’s a good idea to see your doctor or a sleep specialist who can help pinpoint the problem, since sleep testing may be required.