How do you sleep at night?
Don’t worry, no one is passing judgement on you! This is actually a very important question when it comes to your health. And if your answer to that question is anything less than “great,” you should talk to your primary care provider (PCP) about it.
“Sleep isn’t a luxury or something you do only when you have time,” says Dr. Catherine Bevan, an obstetrician and gynecologist in Fort Worth. “Sleep is a vital part of our overall health and well-being, right up there with drinking water, eating food and breathing air. We literally need sleep to live.”
Too many people don’t get enough sleep, unfortunately. There are many possible reasons for this, and many of them can be resolved by simply changing some habits.
However, some people may have a health condition that is interfering with their sleep. Sleep apnea is one such condition, one that often requires medical treatment. The last few years have seen exciting new advances in the treatment of sleep apnea.
How Much Sleep Do We Need?
How much sleep do we need? The answer largely depends on age – our sleep needs change throughout our lives. Here’s a chart from the U.S. Centers for Disease Control and Prevention that breaks it down:
Why is Sleep So Important?
“Think about how you feel after a good night’s sleep versus how you feel after a night when you didn’t get enough sleep,” says Dr. Kathleen Cammack, a Fort Worth OB/GYN. “A good night’s sleep likely leads you to feel rested, energetic and alert the next day. Conversely, a poor night’s sleep leaves you tired and groggy. You probably don’t have the energy and mental sharpness to perform well throughout the day.”
In addition to affecting how we feel, extended periods of inadequate sleep can contribute to chronic disease and underlying health conditions.
Here’s how sleep improves our health: when we sleep, our brains prepare themselves for the workload the following day. Sufficient sleep promotes learning, creativity, concentration and problem-solving; lack of sleep hinders those things. Chronic insufficient sleep can adversely affect the brain and contribute to depression, risk-taking behavior and even suicide.
As we sleep, not only does our brain benefit, but the rest of our body does also. Sleep helps the heart and blood vessels repair themselves. It fortifies the immune system, helping us fight off germs that cause illness.
Additionally, sleep promotes balance in the hormones that affect our appetite. Inadequate sleep can lead to a person feeling hungry, even when the body does not need more food. Sleep also helps regulate insulin levels, essential to keeping our blood sugar and diabetes risk in check.
The Dangers of Inadequate Sleep
Not getting enough sleep is not just unhealthy – it can be dangerous. According to the National Institutes of Health, it is estimated that sleepiness while driving is a factor in 100,000 car wrecks each year, resulting in roughly 1,500 deaths annually.
Insufficient sleep over time is a risk factor for:
- More frequent illness
- Obesity or overweightness
- Stress and depression
- Type 2 diabetes
- Hypertension (high blood pressure)
- Stroke
- Heart disease
Tips for a Good Night’s Sleep
For many people, improving the duration and quality of their sleep is well within their control. Some of the easiest ways to improve your sleep are:
- Prioritize getting enough sleep. Adults should sleep between 7-8 hours per night.
- Go to bed and wake up at the same time every day. If you go to bed later and wake up later on weekends, try to keep the variance from your weekday schedule to one hour or less.
- Keep your bedroom dark and quiet, with the temperature at a comfortable, cool level.
- Don’t eat a large meal right before going to bed.
- Avoid drinking fluids in the hour before bed so that you don’t have to go to the bathroom in the middle of the night.
- Turn off the TV and put your phone, tablet and computer away. Doctors recommend that you avoid any screen time for at least 30 minutes before going to bed: “Darkness triggers the release of melatonin, the hormone that helps us sleep,” explains Dr. Douglas Decker, an OB/GYN in Fort Worth. “Light – including light from a device – can suppress melatonin, making it more difficult to fall asleep.”
Sleep Apnea
One of the more common sleeping disorders, sleep apnea occurs when a person’s breathing is paused during sleep. The pause may last for several seconds and ends when the person snorts or gasps. Sleep apnea is often passed off as someone who snores a lot, but it is a serious health condition. In fact, some people who have sleep apnea don’t actually snore that much.
Blocked airways can occur for different reasons, but one common cause of sleep apnea is obesity, as added fat tissue can constrict the windpipe. Another possible cause is the tongue relaxing too much and falling back in the mouth. No matter the cause of the blockage, when the brain realizes that the airway is blocked, it sends a signal to the throat to choke or snort to get air moving again.
Diagnosing Sleep Apnea
People are often first alerted to a potential sleep disorder by a partner who lets them know they are snoring loudly or that they observed an interruption in breathing. But you don’t have to wait for someone to tell you. If you find yourself waking up tired and frequently getting drowsy during the day, those are signs you should see your PCP.
Sleep apnea is diagnosed through a sleep study. Your physician may refer you to a sleep specialist, who can conduct the sleep study to determine the correct diagnosis. A sleep study is generally conducted in a “sleep lab” where patients go to sleep while sensors monitor heart rate, oxygen levels, brain activity and other vital signs. This data helps the physician determine if there is a sleep disorder that needs to be addressed.
Your provider may also prescribe a home sleep test, in which you wear a device for a couple of nights that records your sleep patterns.
No matter the method of the test, the study will calculate the severity of sleep apnea by calculating the apnea/hypopnea index (AHI). The AHI score is a representation of how many times an hour someone stops breathing (apnea) or is under-breathing (hypopnea).
The classifications for sleep apnea are:
- Mild: AHI of 5-15 (5-15 apnea or hypopnea events an hour). This may not require treatment.
- Moderate: 15-29 events an hour.
- Severe: 30 or more events an hour. For a full night’s sleep of eight hours, this would mean the person stops breathing or wakes up 240 times or more every night.
Treatment for Sleep Apnea
Sleep apnea can be treated in a variety of ways. In obese or overweight patients, losing extra weight can sometimes resolve the problem without further treatment. Losing just 10% of your body weight can make a positive difference, i.e., a 200 lb. person losing 20 lbs.
Sleeping on the side instead of the back helps keep the airways open; there are special pillows available that promote side-sleeping. A sleep specialist may prescribe a mouthpiece to help keep the airway open.
For moderate to severe cases of sleep apnea, a Continuous Positive Airway Pressure (CPAP) device may be used. With a CPAP device, the patient wears a mask that gently blows air into the throat, preventing the airway from closing during sleep.
CPAP devices are effective, yet some people do not tolerate them well and end up abandoning them. According to a Cleveland Clinic study, only 44% of patients on CPAP treatment were still using the device three years after it had been prescribed.
Airway Stimulation Treatment
Ten years ago, the U.S. Food & Drug Administration (FDA) approved a revolutionary new treatment for certain patients who suffer from sleep apnea: the Inspire® upper airway stimulation device.
This device resembles a heart pacemaker. It is implanted underneath the collarbone in an outpatient procedure, with the patient under general anesthesia. The device has two leads attached to it. One lead senses breathing – if it detects breathing obstruction, the other lead stimulates the nerve that controls the tongue. This signals the tongue to move forward, opening the airway.
The patient controls the device with a remote control, turning it on at bedtime and off upon waking up in the morning. There is a smartphone app available that tracks your sleep metrics, allowing you and your PCP to monitor your results.
Inspire® therapy for sleep apnea is covered by most commercial insurance, as well as Medicare and Veterans Affairs health coverage.
To be eligible for the Inspire® device, a patient must be:
- 22 years of age or older
- Have an AHI between 15 and 65
- Have a body mass index (BMI) lower than 32
- Have failed the use of CPAP
If you have previously used a CPAP and are not satisfied with the results, consider talking to your PCP about Inspire® sleep therapy.
Sleep For Good Health
“Just like drinking water and eating food is not optional, neither is sleep!” says Dr. Cynthia English, an OB/GYN in Fort Worth. “You need sleep to survive and to thrive. Too little sleep doesn’t just make you drowsy – it can put your health and safety at serious risk.”
If you’re having trouble getting enough sleep, make an appointment to see your PCP to talk it over. We can help you get on track to get a good night’s sleep.
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
This article contains information sourced from:
U.S. Centers for Disease Control & Prevention
