Let’s talk sleep….. zzzz…..

Let’s talk sleep.
Seems we don’t get enough.
Studies show most of us need 8-9 hours of uninterrupted sleep yet the average American adult sleeps only 6.9 hours per night. One survey found nearly 70% of primary care patients complained of insomnia. About a third of patients who slept less than 7 hours during the work week were more likely to report difficulty concentrating than those patients who slept 7-9 hours each night.
The amount of sleep we need is evaluated by how refreshed we feel after sleep and our daytime functioning. The actual amount of time needed to sleep varies by individual. Some can routinely sleep less without impaired daytime functioning– such as poor alertness, performance or health during waking hours–some require as much as 9 hours.
Daytime functioning matters: Poor quantity or poor quality sleep (poor sleep despite adequate time allotted for sleep) can have devastating consequences. Sleepiness is the second leading cause of car crashes in the US; major disasters such as the Space Shuttle Challenger disaster have been attributed to poor judgment by sleep-deprived staff. Poor sleep affects respiratory, cardiovascular and immune system health.
Sleep problems fall into two groups: sleep deprivation and insomnia. Both may be the result of poor quality or inadequate duration of sleep. Sleep deprivation is typically volitional: the sleeper chooses to sleep less perhaps due to work or home stresses. Deprivation can be acute—choosing to sleep less for one or two days—or chronic, when the sleeper routinely sleeps less than needed for alertness and health in the daytime. Sleep deprived patients will readily fall asleep when given an opportunity. The patient suffering from insomnia will still have difficulty falling or staying asleep even when afforded the opportunity to sleep.
Sleep deprivation or insomnia can accompany many disorders and patients suffering sleep problems should be in contact with their physicians to rule out external factors, such as restless leg syndrome, sleep apnea or other metabolic or psychological disorders. But many patients do not discuss their poor sleep with their physicians, and help is available!
The most common treatments for improving sleep are improving sleep hygiene (cognitive behavior therapy or CBT) and medications. Both are effective for short-term management, but CBT is superior to medication for reducing the time to fall asleep and long term improvement of sleep quality.
Here are some of the basics of this good hygiene:
Maintain a similar schedule for sleep and wake times every day (as long as the time is adequate)
Keep the bedroom cool and dark
Review your daily activities and plans well before bedtime.
Avoid caffeine, nicotine, alcohol, heavy meals or exercising within a few hours of bedtime
Stay in the bed only for sleep; if you only sleep 6 hours despite 8 hours in bed, restrict your sleeping time to 6 hours. If you don’t fall asleep within 20 minutes, go elsewhere for quiet activity until you are sleepy and then return to the bed
Eighty % or more of insomnia problems can be managed safely by following these behaviors. Imagine! Better sleep in your reach without medications or cost!
To sleep, perchance to dream….

Dr Hoffman

Dr. Rebecca Hoffman is a Family Practitioner and works at Kaiser Permanente in Salmon Creek, which is in Vancouver, Washington. Interests include using diet and healthy living to stay healthy and attending to mental health and its physical manifestations. Personal interests include hiking, jogging, music (she plays the harp), dance, theater, storytelling and writing. She lives with her husband and two daughters.

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