If sleep is food for the brain, then American brains are starving. A third of the adult population reports getting less than six hours of sleep a night. In a recent KET program, host Renee Shaw and guests separate fact from fiction and offer advice on proper sleep hygiene in Health Three60/Sleepless in Kentucky. The guest panel: Dr. Barbara Phillips of the University of Kentucky Sleep Center; Dr. Phillip Bale of Glasgow Primary Care; and Dr. Mohamed Saad, director of the University of Louisville Physicians Sleep Center.
The Price of Sleep Debt
Sleep promotes brain and body health in different ways. “Sleep is not all the same. Sleep is divided into stages, and probably each stage serves a different function,” said Dr. Barbara Phillips of the University of Kentucky Sleep Center. REM (rapid eye movement) sleep, which is when we dream, probably regulates memory, while deep sleep promotes growth and metabolism.
Research shows those aged 12-24 need 9 hours of sleep each night. Those 9 hours, however, don’t naturally occur between 10 pm and 7 am, because an adolescent’s production of melatonin, the hormone that regulates the sleep cycle, is on a different schedule.
“Their melatonin production doesn’t kick in until 2 or 3 hours after ours does, ” says Dr. Phillip Bale of Glasgow Primary Care. This difference means that it’s normal for a teen to fall asleep from 11 pm to midnight and wake up at 9 am.
People normally go into deep sleep early in their sleep cycle, and REM sleep is the longest between the 7th and 8th hours of sleep, said Bale. “If you’re getting 6 hours of sleep as an adolescent in America, you’re being shortchanged.”
Inside a Sleep Clinic
Sleep apnea occurs when there’s a pause in breathing at night or during very shallow breathing, disrupting deep sleep. The resulting oxygen deprivation takes a toll on the cardiovascular system, putting patients at risk for heart attack and stroke.
Patients at the University of Louisville Physicians Sleep Center come in with complaints about daytime sleepiness or nighttime disruptions like leg movements and breathing problems, according to Jay McGuire, manager of the center. A total of 80 percent are referred for sleep apnea, and 90 percent of those are confirmed to have the disorder.
“We have a lot of patients that have reported stopping at stop lights and they have to put their car in park, because they know that in that time they will fall asleep,” says McGuire. “And they wait for the horn from the person behind them to wake them up.”
According to the National Institutes of Health, obstructive sleep apnea happens when the airway collapses or becomes blocked during sleep. Central sleep apnea, which is less common, is when your brain doesn’t send the correct signals to your breathing muscle while you’re sleeping.
Patients with severe sleep apnea use a CPAP (continuous positive airway pressure) device at night to keep airways open. Elizabeth Krauss’ son Alex had excessive daytime sleepiness and continued having problems sleeping even after his tonsils and adenoids were removed. “He would sit at the playground instead of play,” she said.
Diagnosed with central sleep apnea, Alex began using a CPAP at night. “Now that he’s on the CPAP he a totally different child,” she says.
Getting Smart About Sleep
Adolescents are more vulnerable to sleep deprivation than are older people. “You can sleep deprive a 12-year-old and you can sleep deprive a 55-year-old, and the detriment in performance and in mood is much worse for the 12-year-old than it is for the older person,” said Dr. Phillips.
School start times should be adjusted to adolescents’ needs, doctors say. Fayette County schools mandated later start times for high schools and teenager traffic accident rates fell.
Also at risk for sleep problems are night-shift workers. The sleep technicians at the UofL Physicians Sleep Center who stay up all night recording other people’s sleep problems often struggle with their own sleep issues.
People suffering from physical and mental illnesses also suffer from sleep problems, due to pain or medicine side effects. Juan Guardiolo, chief of pulmonary and sleep medicine at the Robley Rex VA Medical Center, said veterans with Post-Traumatic Stress Disorder have trouble sleeping because of persistent nightmares and need treatment.
What advice do doctors have for best sleep hygiene? Doctors say eating nutritious food, watching weight, and getting enough exercise all help promote good sleep. Dr. Mohamed Saad, director of the University of Louisville Physicians Sleep Center, says give yourself just 30 minutes to fall asleep. “Go to bed only when you’re sleepy,” he said.
Catherine B. Graham, sleep technologist at UofL, makes her bedroom dark. Night-shift workers also have to monitor their eating, because people tend to consume more calories–and caffeine–when working the night shift.
Should you take naps? Some doctors say no, because then you won’t fall asleep easily at night. However, Dr. Phillips says half of those over 65 take regular naps. The optimal duration should be an hour or less, to avoid interfering with nighttime sleep.
Sleeping pills are not recommended for long-term use.
How do you know if you’re getting enough sleep? “We always say to the patient, if you can awaken without having to be wakened, then you’re probably getting enough sleep,” said Saad.
