Sleep & Sleep Hygiene

By David Baron

Shhhhh! Don’t wake the Doctor!

Our society is obsessed with sleep. We ask, “How did you sleep last night?” We wish people “sweet dreams” and say “sleep tight.” We complain about our lack of sleep all the time. Think of all the mattress ads you see and hear every day, the infomercials for fancy adjustable beds, and the ads for sleeping pills. This stuff is BIG business and BIG money.

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First of all, why does it matter? Who needs sleep anyway? You’ve heard people say “I can rest when I’m dead.” That’s true, but you can actually shorten your lifespan if you’re sleep deprived enough to cause some of the medical conditions with known associations to lack of sleep.

Here’s one you might not have thought of: motor vehicle accidents. The number one cause of daytime sleepiness is poor quality or insufficient nighttime sleep. The number

one cause of car accidents is not alcohol; it’s drowsy driving. One study published in 2000 found that people who drive after being awake for 17 to 19 hours performed worse than those with a blood-alcohol level of .05 percent.

Sleep deprivation is associated with higher incidences of stress, anxiety and depression, poorer cognitive function (sexual function too), obesity, difficulty

controlling high blood pressure, and even cardiovascular risks, not to mention feeling tired all the time. Military studies on total sleep deprivation have shown that people become frankly not themselves, occasionally even psychotic, after only 72 hours without sleep.

Yet many of us actually brag about having “pulled an all-nighter” to finish some work or project or prepare for an exam. Trust me on this, all wake and no sleep makes Joe or Jane Doe lousy company and really unhealthy. So what’s a work-hard/play-hard, multitasking, over-extended, not-so-well-rested person to do?

I’ve got two words for you: Sleep hygiene. You may not have a lot of time for sleeping, but if you’d pay half as much attention to taking care of your sleep as you do to how you look and smell (i.e. personal hygiene), sleep you do get would be more restful and more beneficial.

Good sleep hygiene includes a reasonably comfortable bed in a dark, quiet location that isn’t too hot or too cold accompanied by strategies that promote sleep.

Avoid eating large meals too close to bedtime. Vigorous exercise too close to bedtime revs you up and makes it harder to fall asleep, while moderate exercise in the late afternoon or early evening can help you sleep. Alcohol can also help you fall asleep but will often wake you up a few hours later (it has a two-phase effect on the brain – first sedating, then activating). It’s the same deal with marijuana, which also disrupts normal sleep stage progression (i.e.not as much R.E.M. or Stage IV deep sleep). Behaviorally, save the bed for sleeping and snuggling. Try not to eat, read, watch TV, text, or talk on the phone in bed.

I know this is asking a lot, but please give these strategies a try before you contact your health care provider about sleeping pills. I suspect your doctor will want to talk to you about the behavioral (sleep hygiene) approach before writing the prescription. And they should. Sedatives stop working pretty quickly and are generally addictive.

In most cases, you can learn to get to sleep and get enough rest without them. If you don’t believe me, sleep on it.

At Primary Caring of Malibu, we have returned to old-fashioned style family medicine to bring our patients the personal care and attention they deserve. It’s not a new idea — it’s just an old concept brought up to date, with modern methods and technology making it even better.

Primary Caring of Malibu | 22601 Pacific Coast Highway | Suite 240 | Malibu | CA | 90265