Doctor’s Orders: Sleepless in Chicago
By Dr. Gena Vennikandam
At the time of this writing, it’s 2 a.m. in the dead of winter. I’m feeling a little tired, but there are only so many hours in a day, right? In today’s fast-paced world, I have often heard the expression, “I’ll sleep when I’m dead.” Many of us try to pack in our responsibilities and obligations, pushing ourselves to the limit into the wee hours. While it can be deemed admirable or simply part of being an adult, we all feel the consequences of skimping on sleep and often forget—or ignore—the detrimental health effects it can lead to.
Since we spend about one-third of our lives asleep, our sleep health should be a priority. There are modifications we can make to the way we sleep—what’s known as sleep hygiene—that will have us both dozing and feeling better. When sleep hygiene habits are followed regularly, the results will, well, put you right to sleep.
Time. The most important recommendation is allotting adequate time for sleep. The National Sleep Foundation recommends seven to nine hours for adults ages 18–64 and seven to eight hours for ages 65+ for optimal cognitive performance and alertness.
“Everybody needs to figure out how many hours of sleep they personally need,” says Smita Patel, DO, a board-certified physician in neurology and sleep medicine at NorthShore University HealthSystem.
Regularity. Establish and prioritize a sleep/wake cycle—even on the weekends. “Having a routine is what seems most helpful for patients,” says David Berdy, MD, associate director of Clinical Affairs and Graduate Medical Education at Presence Saints Mary and Elizabeth Medical Center. “Set a bedtime, set a wake time and then institute that routine.”
Habits. Good sleep hygiene requires breaking the bad habit of bringing technology to bed with us. The LED backlight on our computers, mobile phones, tablets and TVs disturb our bodies’ internal clock. It’s better to sign off and wake up early to limit exposure to the bad light (LEDs) and bask in the good light (the sun).
Heavy meals, spicy foods, caffeine, alcohol and nicotine are stimulants that can steal your sleep and keep your body up, as it must work to digest and metabolize. However, experts say that going to bed hungry is just as counterproductive, so a light snack consisting of complex carbohydrates should not affect your sleep. And, for obvious reasons, limit the amount of liquid you consume before bed.
Exercise. Research shows that those who exercise regularly have a higher quality of sleep, but exercise near bedtime is not for everyone. “In general I would recommend exercise is best done in the morning or the early afternoon,” Patel says. Exercise can be stimulating, and working out prior to bedtime can prevent you from being relaxed, she explains.
Naps. Naps have become a favorite pastime for many. While power naps are OK and may help those struggling with sleep debt to get through their day, proper timing of the nap is important. The Division of Sleep Medicine at Harvard Medical School recommends short naps, preferably before 5 p.m., otherwise it may put you at risk of a diminished sleep drive by taking away from your nighttime sleep.
Regimen. Create a relaxing bedtime routine. Practice detaching yourself from noise, lights and anything that may develop anxiety and stress. Soothing activities such as meditation, a warm bath or light reading may help you wind down.
Setting. Your bedroom should be calm, quiet, dark and follow the Goldilocks Principle—neither too hot nor too cold; just right should be around 65 degrees Fahrenheit. And, of course, a comfortable mattress and pillow help, too.
Sleep experts suggest associating your bed with nothing other than sleep (or intercourse) in order to strengthen the relationship of bed to sleep. So exclude using your bed for any other activities and avoid excess time spent in bed.
If you still find yourself counting sheep after 15 minutes, get up and move to another room. Do a light activity and unwind some more until you feel sleepy again.
If your sleep pattern does not improve after implementing sleep hygiene recommendations, then the next step is to discuss additional measures with your physician.
“Medications are the last resort. If three or four weeks of following a sleep hygiene regimen does not help their sleep habits, I first ask patients to supplement [with] melatonin,” Berdy says. “Boosting the melatonin in their system, which is the normal hormone produced at night to regulate your sleep/wake cycle, has shown to be helpful for many people.”
Experiencing additional symptoms that disrupt sleep, such as snoring, labored breathing, gasping for air while sleeping, extreme daytime drowsiness, uncomfortable leg sensations (tingling or cramping) or any other alarming and unusual symptoms may be an indicator of an underlying medical condition, which requires prompt medical attention by your physician or a sleep specialist.
Barring any major issues, if you can commit to the recommendations above, you should feel the difference. Sweet dreams are made of these.
Dr. Gena Vennikandam is an Illinois native, born and raised in Skokie. She completed medical school at American International Medical University. Her sense of adventure took her to India, where she received her Bachelor of Health Sciences degree from Manipal University and completed her basic sciences portion of medical school, and subsequently her clinical rotations, at a variety of hospitals and clinics throughout Chicagoland.
Originally published in the Spring 2016 print edition.
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