June 20, 2022 By Judy A. Dunal, MD, a Hingham resident and an internal medicine primary care provider at Brigham and Women’s Harbor Medical Associates
Work obligations, attending to family needs, completing household chores, and trying to stay connected with friends and family – especially during this pandemic – are important and time consuming for many of us, and what is not prioritized is sleep. We attend to sleep with minimal thought or effort, expecting this to be automatic, when in fact, proper sleep can take some work.
Sleep physicians feel sleep efforts should be prioritized, as proper sleep is key to a healthy body and mind.
Sleep deprivation can contribute to high blood pressure, mood swings, daytime stress, reduced concentration, anxiety, and depression, and it can even interfere with our ability to lose weight.
How much sleep we need may vary with the individual, but the American Academy of Sleep Medicine and the Sleep Research Society advise that adults should aim for at least 7 consecutive hours of sleep a night in order to be well rested. Here are suggestions for getting a good night’s sleep:
1. Make sleep a priority, as with exercise or proper nutrition; try to generate a good sleep routine with regular and stable bedtime and awakening hours, not only during the week but also during the weekends. Regularity in sleep effort helps to generate reinforcement of sleep hours, can make going to sleep and getting up in the morning easier, and reinforces our circadian rhythms. Think about how we train our babies to get to sleep; maintaining these patterns is important for successful and deep sleep.
2. Create a bedtime routine: this can include reading, gentle stretches, or meditating. Try not to drink a lot of fluid prior to bed to avoid nighttime awakenings that can interfere with sleep.
3. Avoid screen/ blue light for about 60 min prior to bed for optimal sleep, as exposure to devices that emit blue light may negatively impact our ability to fall asleep. Additionally, screen time can seem addictive, so we may become more interested in what we are reading or viewing, and become more engaged, rather than more relaxed.
4. Routine exercise can be very beneficial for better sleep, with goal of exercising 20 min per day or 30-40 minutes 4 times a week. If you exercise at night, try to finish this at least 2 hours prior to bedtime, as exercise can raise our adrenaline levels and accidentally make us feel more awake and less likely to sleep.
5. Sleep medicines are not the #1 treatment, and many practitioners try to avoid products due to side effects including daytime drowsiness, possible confusion, inappropriate nocturnal awakening (including cooking and eating and driving activities while sleeping), and habituation leading to the need for higher and higher doses. Additionally, there are also the sobering statistics that some older adults who use sedating sleep medications may succumb to accidents as falls, fires, medication interactions, overdoses, or even lethal consequences. Cognitive Behavioral Therapy or CBT is considered first line treatment for chronic insomnia, and NOT medication. The goal is to learn or relearn how to get to sleep by rewiring our brains, not putting a chemical band aid on our nervous system. While certain individuals do need medications to attain proper sleep, prescription meds are not the first choice for most. Be cautious of herbal sleep aids – which are also drugs and chemicals and frequently not properly screened for safety and lack of contamination - and always check with your practitioner about potential medication interactions.
Please reach out to your primary care physician if you have persistent problems with sleep, including going to bed and or waking up.
You can learn more about how to get a better night’s sleep from the experts at Brigham and Women’s Hospital on the Brigham Health Hub.
By Judy A.Dunal, MD, a Hingham resident and an internal medicine primary care provider at Brigham and Women’s Harbor Medical Associates.