Monday, March 13, 2017

Sleep: A Preventative Measure

By: Amita Chhabra M.D
Brookwood Baptist Health, Primary Care - Hoover

At one point or another, everyone has had a two cup coffee day. What makes you reach for that second cup? Perhaps it’s the belief that the extra caffeine may jolt us into having a more productive and efficient day. That may just be a tale some live by. However for most, night time has become a cycle of sleep deprivation and poor sleep patterns. Unfortunately, there is no amount of caffeine that will be able to compensate. In the outpatient setting, we see patients that would like to address complaints of fatigue, anxiety, obesity, hypertension and the list goes on in our every day practice. Oftentimes we preform extensive workups of thyroid, mood, and other organic causes to explain causes of ongoing fatigue. We could avoid testing by asking a simple question: How is your sleep?

The CDC recommends adults get between seven to eight hours of continuous sleep. In some cases, that is just not possible. If you’re anything like me, I’m happy to have four continuous hours of sleep after the birth of our daughter. However, there are some glorious nights when a full night’s sleep changes your entire day. It has been studied 40% of adults report falling asleep during the day, without realizing it, at least once a month. This is called microsleep. It typically occurs when a person will momentarily fall asleep in a conversation, while listening to a lecture, or even while driving. Microsleep is different than narcolepsy. It is typically characterized by not understanding an explanation, or having to repeat phrases, or even “zoning out” while driving. A person who does not have restorative sleep falls victim to a continuous sleep deprivation. They can experience these episodes of microsleep without carrying the diagnosis of narcolepsy. The same person, that experiences an episode of microsleep, may not have those symptoms the next day after a full night’s rest.

Poor sleep is linked to many chronic health conditions. Patients can be evaluated by asking a few simple questions to aide in their overall health. What time do you go to bed? Do you wake up feeling refreshed? How many times is your sleep interrupted during the night? Have you been told that you snore? These key questions that can lead to the diagnosis of sleep deprivation or sleep deficiency without invasive testing.

 If patients aren’t getting the required amount of sleep, providers should introduce recommendations regarding sleep hygiene. Put simply, sleep hygiene prepares the brain for sleep. Sleep hygiene consists of having a routine at bedtime that should be consistent on the weekday and weekends. Avoid screen time, strenuous exercise, and heavy meals at least one hour before bed. It’s important to note that alcohol, nicotine, and caffeine are stimulants that work against the winding down of the brain and body. These kinds of stimulants should be strictly avoided before bed. It is no secret that cardiovascular disease, diabetes, obesity, and depression can all be exacerbated when sleep is compromised. A sufficient amount of sleep may just be a preventative measure for many patients.

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