The start of the new year often motivates us to set goals or resolutions for improving our lives in the upcoming year. Did you know that the most popular “New Year’s Resolutions” have a positive impact on the quality of sleep that a person gets? Furthermore, did you know that some sleep disorders can make it almost impossible for a person to meet their goals for the new year without seeking help from a sleep specialist first?
 
Weight loss is the most common new year resolution among friends, family, coworkers, neighbors, and perhaps, even yourself. Did you know that sleep effects your ability to reach your resolution goals? A lifestyle of healthy eating, exercising, and appropriate weight control leads to a better quality of sleep for people of all ages. Quality sleep in turn helps control weight and mood. When we are getting enough quality sleep, our hormone levels and metabolism remain more stable and constant. Therefore, it is easier for our bodies to utilize the fats and sugars in our blood in a healthy way, keeping us from gaining weight.
 
For some, an undiagnosed sleep disorder makes it impossible to stick to their new year’s resolution of losing weight. An estimated 18 million Americans have sleep apnea, which is often associated with people who are overweight. Sleep Apnea is a sleep-related breathing disorder in which a person quits breathing for at least 10 seconds or longer while they are sleeping. If a person is overweight and suffering from undiagnosed and untreated sleep apnea, he/she may not be as motivated to exercise or to diet. Sleep apnea leads to daytime sleepiness. Excessive daytime sleepiness makes it that much harder to begin and stay with an exercise program. Sleep apnea also contributes to obesity by making it more difficult for a person to process glucose (sugar) in the blood, much like a person with diabetes.
 
Sometimes the best way to treat obesity and stick to your goal can be to treat an underlying sleep problem. Successful treatment of sleep apnea will often motivate patients to effectively lose weight, which will in turn help their challenge of obesity and the sleep apnea.

If you are overweight or obese and sleep poorly or feel tired during the day, you should talk to your primary care clinician about a referral to a sleep center or contact the Sleep Disorders Center directly by calling 901-683-0044. For more information, visit us online at www.methodisthealth.org/sleep.

The connection with daytime behavior and performance

A growing number of studies confirm what parents and teachers have known for generations:  good sleep is vitally important for children.  In the past decade, the field of sleep medicine has made great progress in documenting the important link between a child’s quality and quantity of sleep and daytime function. Pediatric sleep specialists have established beyond doubt that how a child sleeps has tremendous impact on cognitive performance including learning, memory, attentiveness, and organizational skills.

In contrast to adults, children with daytime sleepiness may manifest hyperactivity, fidgety behavior and impulsivity. These problems may cause some parents or teachers to wonder if the child has the Attention Deficit/Hyperactivity Disorder (ADHD), when the underlying problem may be inadequate sleep or a sleep disorder.

Examples of common sleep problems in children include insufficient sleep, insomnia (which can be associated with a variety of other issues), obstructive sleep apnea, restless legs syndrome, and medications that affect sleep or daytime alertness. Key observations that may suggest a sleep problem include difficulty awakening the child in the morning, excessive sleepiness or fatigue, irritability or moodiness, especially later in the day as the child becomes sleepy, and difficulty focusing for sustained periods. 

In older children and adolescents, parents are sometimes not aware of sleep issues because the child has not shared this information. Examples include the teenager with insomnia who is surfing the internet, playing video or computer games, or texting for hours after “lights out” time. Many children today are over-scheduled and there is no time left to allow the child to transition from the high-speed activities of the day to a more tranquil time to help prepare for sleep. Caffeine overuse can contribute to insomnia. Habitual snoring, especially when combined with observed pauses in breathing during sleep, suggests obstructive sleep apnea.

When there are concerns about a child’s sleep or daytime alertness, parents should begin by consulting with the child’s primary care provider so that an appropriate evaluation can be performed and treatment begun. In some cases consultation with a sleep medicine specialist may be necessary. As parents and teachers have known for years, children learn and perform best when they sleep well.

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Merrill Wise is a sleep specialist at the Methodist Healthcare Sleep Disorders Center. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Please call the Sleep Disorders Center for more information at 901.683.0044.

In today’s busy, 24/7 society, many of us fail to allocate sufficient time or attention to our sleep. Healthy sleep is a fundamental aspect of our physical, emotional and spiritual well-being. When sleep problems occur, the impact on our quality of life is significant and we may experience problems with alertness, productivity, safety, mood regulation, and physical health. 

The following Ten Steps to Better Sleep provide a good place to begin assessing sleep health:

1. Make sleep a priority in your life. Establish a consistent sleep/wake schedule that provides adequate sleep every night. Most adults function best with 7-9 hours of sleep. Teens and young adults generally require 8.5-9.5 hours per night.
2. Avoid activities or habits that work against good sleep: avoid caffeine after 3-4 p.m., avoid strenuous exercise in the evening, and avoid stressful activities such as paying bills or emotional family discussions during the 2 hours prior to bedtime.
3. Maximize your exposure to bright light in the morning and minimize your exposure to bright light in the evening. Bright light has a significant impact on timing and quality of sleep and alertness.
4. Discuss concerns regarding medication side effects that involve sleep with your healthcare provider. Certain medications may cause daytime sleepiness or affect ability to fall asleep or stay asleep at night.
5. Avoid using alcohol to help fall asleep. Alcohol may help hasten sleep onset but it also fragments or disrupts nighttime sleep.
6. Learn how to recognize sleep problems in your life. For example, excessive daytime sleepiness can present with difficulty focusing or completing tasks, irritability, poor memory, and difficulty with brief “lapses” or micro-sleeps.
7. Insomnia (difficulty falling asleep or staying sleep) is a common sleep problem that can occur due to many different factors. Discuss insomnia concerns with your healthcare provider and seek help from a sleep specialist if initial interventions do not help.
8. Breathing problems such as loud habitual snoring, or gasp-like sounds during sleep may signal the presence of a sleep disorder called obstructive sleep apnea (OSA). OSA is an important medical disorder that can be associated with a variety of other chronic health problems such as high blood pressure, diabetes, obesity, stroke, chronic headache, and depression. This problem requires evaluation in a sleep center, followed by development of a treatment plan.
9. Drowsiness while driving is a potentially life-threatening problem. Recognize and acknowledge your drowsiness, and avoid driving when you are sleep deprived or if you are experiencing drowsiness due to medication effects or a sleep disorder.
10. If you or a family member is struggling with a chronic sleep problem, gather information by keeping a calendar or sleep log, and seek help by consulting with your primary care provider or a sleep specialist!

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Merrill S. Wise, M.D. is a neurologist and Board-certified sleep medicine specialist affiliated with the Methodist Healthcare Sleep Disorders Center. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Please call the Sleep Disorders Center for more information at 901.683.0044.

Insomnia, which is Latin for "no sleep," is the inability to fall asleep or remain asleep. Insomnia is also used to describe the condition of waking up not feeling restored or refreshed.

Symptoms of insomnia include:

• difficulty falling asleep
• waking up frequently during the night
• difficulty returning to sleep
• waking up too early in the morning
• unrefreshing sleep
• daytime sleepiness
• difficulty concentrating
• irritability

TREATMENT:

If you are experiencing difficulty sleeping, consider whether an event or particular stress could be the cause.  If so, the problem may resolve in time.  If not, and the problem persists for a few weeks or more, or if you experience distress and discomfort as a result of the insomnia, talk to your doctor about your symptoms.  Bring with you a record of your sleep, fatigue levels throughout the day, and any other symptoms you might be having.

There are a number of approaches to treating insomnia.  A health care professional will ask about your sleep experience, your sleep schedule, and your daily routine.  A thorough medical history and physical examination may be called for.

COPING:

Regardless of what's causing your sleep problems, it is important to establish and maintain healthy sleep habits.  Here are some tips that will help you sleep well:

At night:

• Use the bed and bedroom for sleep and sex only
• Establish a regular bedtime routine and a regular sleep-wake schedule
• Do not eat or drink too much close to bedtime
• Create a sleep-promoting environment that is dark, cool and comfortable
• Avoid disturbing noises – consider a bedside fan or white-noise machine to block out disturbing sounds

During the day:

• Consume less or no caffeine, particularly late in the day
• Avoid alcohol and nicotine, especially close to bedtime
• Exercise, but not within three hours before bedtime
• Avoid naps, particularly in the late afternoon or evening
• Keep a sleep diary to identify your sleep habits and patterns that you can share with your doctor

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Jim Donaldson is the supervisor at the Methodist Healthcare Sleep Disorders Center. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Please call the Sleep Disorders Center for more information at 901.683.0044.