One hundred years ago, Americans slept for an average of 9 hours per night. Today, while the CDC recommends at least 7-9 hours of sleep each night, over 30% of American adults don’t get enough sleep.
Sleep is a basic human need (like drinking, eating, and breathing). It is not negotiable as it affects every system, every organ, and every cell within the body. A lack of sleep can have profound immediate and long-term repercussions, leading to cardiometabolic diseases like diabetes mellitus, hypertension, cardiovascular diseases, stroke, coronary heart diseases, obesity, depression, dyslipidemia, hormonal dysregulation, and increased risk of dementia later in life.
Sleep Disorders and Other Barriers to Adequate Sleep
Americans face several barriers to proper sleep, ranging from poor sleep environments and sleep disorders to obesity and co-occurring medical and mental health issues. Another piece of the puzzle: we don’t prioritize sleep. We skip naps, go to bed late, and wake up early. Our culture is fast-paced, with the advancement of lights and the internet enabling round-the-clock work and play. The result is an estimated 50-70 million Americans with chronic or ongoing sleep disorders.
A sleep disorder is a problem with sleep, whether it is insomnia (trouble falling or staying asleep), REM behavioral sleep disorder (acting out dreams/sleepwalking/sleep talking), narcolepsy (falling asleep inappropriately and entering REM sleep immediately), or breathing disorders (sleep apnea).
With the rise of obesity over the last two decades, sleep apnea has become a public health burden. Moreover, other sleep disorders are on the rise and negatively impact brain and heart health across patient populations.
How Does Sleep Affect Your Patients’ Health
During sleep, our bodies rest, repair, and rejuvenate. Sleep is vital for the brain and heart to work properly. Sleep supports healthy immune functioning and healing after illness or injury. Recent research suggests that sleep allows the brain to clear cellular and protein debris that would otherwise build up, causing inflammation and the accumulation of senescent cells.
Metabolic Diseases: Researchers have long been unraveling the link between sleep and metabolic diseases. A strong relationship exists between sleep duration, weight, and cardiometabolic conditions, like diabetes. Specifically, a lack of sleep reduces the ability of insulin to control blood sugar due to impaired fat metabolism and increased hormones that regulate appetite. Poor sleep is also linked to higher resting heart rate, higher blood pressure, heart attack, and stroke.
Immune Function: Sleep deprivation is associated with changes in innate and adaptive immune parameters, resulting in a chronic inflammatory state. Without adequate, high-quality sleep, patients are at an increased risk of infectious/inflammatory pathologies.
Cognitive and Mental Health: The brain needs sleep after learning to save new memories and before learning to prepare to soak up new information. Without sleep, you can’t absorb new information. The hippocampus, the informational inbox of the brain, receives and holds new memory files. Sleep deprivation shuts down this inbox, and you can’t effectively commit new experiences to memory.
How to Support Your High-Risk Patient Populations
Helping Night Workers Develop A Safe Sleep Routine
The IARC (International Agency for Research on Cancer) has classified night shift work as “probably carcinogenic to humans.” You can mitigate the harmful effects of night shift work for your patients through patient education and flexible strategies.
Primarily, it would help if you had an honest conversation about the health hazards of night shift work and the drastic disruption to the natural circadian rhythm. Then, you can review their current routine and identify areas for improvement. Three key focus areas are:
Lighting Hacks: Increase light at the beginning of the shift to stimulate alertness and decrease towards the end. Patients can use blue-light glasses for the sunlit ride home.
The Sanctuary of Sleep: Promote high-quality sleep with black-out curtains, a noise machine, a comfortable bed, and cooler bedroom temperatures (a cool room helps your core temperature drop, preparing your body for sleep).
Eating for Sleep: Encourage eating a normal portion at dinner time, a light meal during the night, and a high-quality carb and protein breakfast.
The best routine will be personalized to the unique needs of your patient. It may be helpful to have a follow-up appointment, discuss what’s working and not working for them, and tweak the routine accordingly.
Helping New Parents Get Enough Shut-Eye
Beyond healthy diet, gentle exercise, sprinkling in self-care, and the adage’ sleep when the baby is sleeping, your patients can benefit from innovative tools and the latest insights on sleep:
High-Tech Monitors: Advanced baby monitors give parents peace of mind without waking up. Smart monitors will capture critical data points and harness the data for actionable steps to improve a baby’s sleep.
Apps: The right app on their smartphone will allow patients to track feeding, sleep, and more. Using age-appropriate tips and tools, they get reports that predict sleep and naps. Other apps can play white noise and lullabies to promote sleep.
Nightlight: A night light that emits warm red or yellow light (not blue light) will allow patients to check on their baby, change diapers, and feed without triggering wake-up signals.
Infant Massage: Studies have shown that light, gentle infant massage can help a baby sleep deeply and soundly. Infant massage is a harmless, practical, and cost-free method!
Baby Yoga: Besides promoting bonding, aiding digestion and colic, and strengthening limbs, baby yoga can improve a baby’s sleep, so parents get much-needed rest!
Wakeful Sleep Patterns: Understanding a baby’s sleep and wake windows and how they change as the baby gets older can help parents build a successful sleep routine.
Post-Partum Doula: While post-partum doulas aren’t new, they are increasingly more popular and accessible. Unlike a baby nurse, a post-partum doula supports the whole family and helps with the adjustment of a new baby in the house.
While it can be difficult for new parents to ask for help, talking about it and offering a wealth of resources can help parents get the sleep they need to be healthy.
Helping Caregivers Conquer Sleep Deprivation
It can be extremely challenging for caregivers of seniors and individuals with special needs to get enough sleep. A caregiver’s job can be 24/7, and often, they don’t get the help they need. As a result, they are at an elevated risk for sleep deprivation due to internal stress/anxiety and external disruptions at night.
Sleep Hygiene: Creating an environment for a good night’s sleep is essential for caregivers and those they care for. This includes low lighting, comfortable beds, cooler temperatures, and peace and quiet.
Remote Monitoring: Setting up a monitor can give caregivers peace of mind. Monitors can include bed and chair pads, floor mats, motion sensors, door monitoring systems, pull string monitors, and baby video and sound monitors.
Identifying Cause: Homing in on the root cause of nighttime disruptions can help. Suggest that patients look for common issues like bedwetting and discomfort (bed or sheets).
Dysregulated Sleep: Seniors and individuals with special needs often have dysregulated sleep, and getting a sleep consultation can uncover deeper insights into their unique needs.
Diet: Newer research suggests changes in diet can promote high-quality sleep. Booking a nutritional consultation can give caregivers personalized recommendations to best care for and promote sleep.
Prepare for Appointments: As a primary caregiver, your patients may be responsible for managing demanding medical schedules. To limit stress and promote sleep, patients can create a checklist, including necessities like water, snacks, and medication, and write out questions for the care team.
Mouth Breathing: Open mouth breathing may be a symptom of sleep apnea in adults and children and even lead to behavioral problems. If caregivers suspect mouth breathing, refer to a sleep specialist for diagnostic testing.
Helping Those with Co-occurring Medical or Mental Health Conditions Get a Full Night’s Rest
The most transformative way to help patients get a full night’s rest is to get other medical and mental health issues under control.
Root Cause: Getting to the root causes of other health issues can improve sleep. In present-day practices, we treat all the symptoms without unearthing the root problem. Once we identify the root cause, we can delete the diagnosis from the charts and improve sleep!
Weight Loss: The interconnection of sleep and weight loss means that individuals with obesity are more prone to sleep apnea and trouble sleeping. At the same time, a good night’s sleep can help weight loss. Simultaneously addressing sleep and weight loss will enhance sleep and overall health. There are many advancements in weight loss, including new pharmacological methods, but these are more complex fixes. For lasting results, patients need a comprehensive plan that involves lifestyle modifications and counseling.
There is an unmet need for sleep education to address this looming public health issue. You can make sleep education meaningful for patients by emphasizing sleep’s role in memory, learning, and overall health. To tackle the silent sleep loss epidemic, routinely screening all patients for sleep disorders will be key.
Love learning about sleep with BRAINWeek and looking for more opportunities to expand your knowledge of sleep disorders and brain health? Then we hope you join us at BRAINWeek, GAPS IN BRAIN HEALTH: Putting Together the Pieces in Scottsdale, AZ, between May 9-11, 2024!
