Morning Medical Update - Sleep Health Awareness

Morning Medical Update – Sleep Health Awareness

Good health means good sleep. We ask what’s keeping us from a restful night in bed? Learn from the expert.

coming up today good health means good sleep we explore what's keeping so many of us from achieving [Music] that good morning I'm Alexis delid welcome to the morning Medical Update how well do you sleep can you fall asleep as soon as your head hits the pillow do you toss and turn in the morning do you wake up feeling refreshed and rested or do you feel like you're walking through quicksand does springing forward and losing that hour of sleep send you into a tail spin if you have trouble with any of those things today's episode is for you we are talking about sleep medicine with Sleep Experts and the most common barriers to you getting a good night's sleep we are so pleased to have Dr SAR of luthra joining us via webcam we're also hoping to get Dr Nancy Stewart in the studio in a little bit we have our fingers crossed for that Dr luthra is asleep medicine specialist here at the University of Kansas Health System thank you so much for joining us now Dr Stewart was recently interviewed on km bz's Dana and Parks the radio show devoted a couple of different episodes to sleep problem so let's listen to a few of the issues mentioned on that show thanks for listening to The Dana and Parks podcast let's go to Caroline Ian OA hello hi hi there this so resonated with so many people they were calling in they were texting in saying oh I haven't slept in years listeners shared what worked for them everything from supplements to medications she'll sleep 8 to 10 hours and she's in a way better mood in the morning so I went to my doctor and I told her about the problems I was having and she prescribed a medication for me it's non-habit for me and I fall asleep like a baby and I stay asleep there's an old boy that keeps talking about the vitamin suppl I think it's calcium magnesium that does such a wonderful job in getting you to sleep I haven't heard anybody mention that yet Dana opened up about her own struggles I would do all the things they say to do I drank warm tea and I couldn't get to sleep and I certainly couldn't stay asleep she shared what worked for her like a lot of Americans every time you turn on the TV they're trying to get you to buy something or get something prescribed for sleep and I started taking zequel it's basically NyQuil without the medicine component that is in Nyquil it's just called zil and it tastes good since that January show Dana has slowly tapered off that medicine and worked on her sleep hygiene she also cut out Diet Coke about a month ago I took my last SE equil and I have not taken it since it's still in my medicine cabinet but I have not taken it since Dr luthra I got to ask you before we get to the bulk of the discussion how did you do with the time change do you sleep well or does it throw you into a tail spin hi good morning everybody good morning U it did it did throw me in a little bit of a tail spin I got 1 hour less sleep um I was prepping for it but again with uh routine work schedule you really cannot um sleep an hour earlier when you want to so yeah I was a bit more tired uh that morning but I still went to for went for my workout and I just uh stayed out got a lot of sun and uh feeling a little better now you just powered through it it's good to know even the sleep specialists struggle with this yes so you heard so many people saying they use supplements or they take medicine to sleep like melatonin magnesium ambient zil so does it make sense to try those things or are there any people who shouldn't be trying them so I think all of these uh Mets the they work to certain extent and they work in specific situations uh I think the problem arises when a lot of people will take them without understanding what uh each one of them uh is possible possibly doing so for example melatonin is more helpful for jet lag or shift work disorder and um when you use it in that context it is much more helpful um similarly you know if you're talking about zq it has an anti-histamine component which once in a while if you take it it can make you a bit more groggy so if if you're just not feeling tired or your mind is racing you just want to take one uh it might be fine but then uh it cannot work as a chronic sleep aid because we always have to look at the underlying sleep situation and what is causing the insomnia and all of them have certain degree of side effects uh even with magnesium it can help you relax a little bit uh but if you have bigger problems uh that are not letting you sleep um it won't be very effective and some of it is Placebo because you know something works and you take it and your mind calms down and it can help you sleep so a lot of it uh especially with overthe counter medication could be a placebo effect to people can you build up tolerance to those things like melatonin for example so melatonin uh you can build up tolerance uh the other thing with melatonin is the overthe counter dosing is quite big uh and the companies want to put as much compound as FDA would allow them to put in it because they want consumers to take it and feel like it worked wonders uh but you can take too much of melatonin which will leave you with a sort of a grogginess and hangover type feeling and over a period of time you may find that it's not working and it can actually uh when you take a big dose suppress your internal melatonin secretion um and that can actually lead to uh bigger sleep problems when we talk about sleep hygiene what we really mean is good sleep habits right so the basics of good sleep habits include a nighttime routine consistent times for waking up up and going to bed a dark quiet environment one hour away from Electronics before your head hits the pillow avoiding fatty meals before bed less stress more exercise less caffeine that's a long list of a lot of things that a lot of people do Dr luthra can most sleep problems though be solved with good sleep hygiene so I think think about uh good sleep hygiene as exercising um as we think about a better lifestyle uh as we focusing in medicine on longevity uh these good sleep habits could should be your lifestyle and then uh they'll help your sleep tremendously but they'll not take care of every medical sleep problem so if you have one Lang sleep apnea restless legs uh circadian rhythm disorder uh hypersomnia then you would uh need to seek uh and see a sleep medicine person uh but just like you know when we exercise when we eat better we follow good sleep hygiene we are overall doing better uh in our health and sleeping better uh and it can take care of a lot of sleep issues but not all of them you mentioned hypersomnia can you explain to our viewers what is hypersomnia so hypersomnia is something which um is uh underappreciated in society I feel um because in hypersomnia patients are actually sleeping okay they are sleeping enough or they are sleeping more than enough but they are still not feeling rested uh they don't have energy during the day they can take naps easily and it can also become a dangerous situation if you're driving or doing something that requires hyperacute focus and you cannot maintain that uh that could be a dangerous work situation so it's your brain needing more amount of sleep than uh a usual uh amount which would be 7 to 8 hours and how do you treat hypersomnia so we'll need to uh evaluate what type of hypersomnia one has but basically the treatment involves U medic ations where we try to either suppress uh the Sleep creating hormones in the body or we give them medications that promote wakefulness uh during the daytime so when it comes to consistency we hear you've got to be consistent with when you go to bed and when you wake up but so many people have a different schedule on the weekends than they have during the weekday what does your basic weekend inconsistency or those two days off you have do to the rest of your sleep hygiene so um I tell patients that typically on weekends try not to change your schedule by more than 1 to two hours uh there is some elasticity in our system so we can tolerate one or one or two hours of change over the weekend and still bounce back to a regular schedule but if we go beyond that let's say we are a 10 p.m. sleeper and 1 weekend we are up till 2: a.m. uh this will then have a downstream impact on your coming week and and you'll take a longer time to bounce back to a consistent schedule after that because it affects the timing of your melatonin secretion in the brain when we talk about daylight saving time there are two camps people who like it people who hate it I've never found anyone who is ambivalent about daylight saving time so if you could wave a magic wand and keep it or do away with it what would you do I would do away with it uh permanent stand Standard Time the time we have in Winters um Studies have so shown that it aligns a lot better with our natural circadian rhythm um and so there is data behind keeping the permanent Standard Time as our only time because it prevents us from having a lot of uh issues when we change to Daylight savings like we have darker mornings uh which is not uh conducive for our brain to wake up uh we do gain a little bit extra light in the evening um but that does not help uh with our internal rhythms so so if it were up to me I'll keep the permanent Standard time I always wonder if people in Arizona are healthier sleepwise because they never change they're the ones on that standard time it would be interesting to see long term so one of the Sleep hygiene tips was to avoid fatty meals does that mean avoid fatty meals right before bedtime or a fatty snack what is what is something fatty have to do with how you sleep so uh I think uh you know avoiding any heavy meal is probably a better term avoid any heavy meal uh 2 or 3 hours before the bed you want your GI system to settle down uh taking a heavy fatty meal will get your GI system to work your gastrointestinal system uh there will be a release of acid and secretions that can increase night burn fatty meal in particular can also lower the tone of your esophagal spincter the the food pipes opening uh into the stomach so that also increases the chances of you getting heartburn uh and and cause more discomfort to you at night time it can cause bloating um so you just want your gastrointestinal system to calm down so my advises 2 or 3 hours before bedtime uh no heavy meal what about an hour away from Electronics before bed I asked this because my husband loves to scroll on his phone right before bed what is it about that screen time that could be hurting his sleep or people watching who like to do that their sleep yeah so so there are many angles to that too uh one would be the light and especially the blue spectrum of light entering eyes uh an hour or two before bed can suppress your internal uh melatonin secretion so you won't feel sleepy as easily uh but also it is distracting I mean if you think of what you see when you are scrolling uh it will get your mind thinking and you don't want that kind of psychological stimulation uh right before bedtime what you're hoping for is that your mind calms down you put the glass down I would recommend keep the phone away so if you thinking and you have a habit of grabbing it all the time you cannot reach it just put it somewhere away an hour before bedtime and just relax and try to go to sleep would that go be the same for reading magazines or a disturbing book or something of that nature is there something about the scrolling that really triggers people and and disrupts their relaxation yeah I think uh I mean if you think about how social media companies have uh designed these reals uh they uh they learn your behaviors they know what you're interested in so that media feed is always giving you stuff which is uh you know getting your mind attached to that you are having surge of uh dopamine other uh neuros stimulatory hormones which you don't want during sleep time um it would also lead to an addiction if you're doing that every night and your brain expects that kind of stimulation around bedtime and then it can also become sort of an addiction where you want to do that every time so um yes I think scrolling has uh a especially bad uh effect on sleep I think reading magazines reading something which is calm uh you don't want to read a thriller novel right before bedtime that keeps your mind guessing uh but reading something calm something uh relaxing without having too much light coming to your eyes is fine you can do that more people are starting to wear smart watches I just got a I just got a smartwatch myself so I'm constantly I wake up grab my phone I press a little heart icon and I try to see how much I've slept what kind of sleep I've gotten in addition to tracking how many hours of sleep you get is there valuable information on your Smartwatch when you do the sleep tracker that people can gather I think um yes I think especially if you feel like you are not getting enough sleep and you're trying to get into a good sleep hygiene is really helpful because uh you cannot always track okay what time I went to bed when I woke up how many hours I actually slept um so I think while in the phase of improving your sleep overall it can really be helpful gives you important feedback that yes you are now sleeping you know 7 hours you used to sleep five but if you get into a rhythm where you have a consistent routine um you are sleeping s seven uh 7 to 8 hours um you don't need to wear a watch because I also feel like they they add some discomfort to your wrist uh there could be some light some notifications coming on so it could be disruptive uh but I think uh if you just want to use it to get yourself to the right amount of sleep uh then they are helpful one of the um the they have some categories where they break it down of what kind of sleep that you get and I actually I recently asked you about this you can track your deep sleep or your remm sleep or just your basic sleep does it matter if you're getting Less in the deep sleep or less in the remm do do you have to do those categories matter just as much as how many hours of basic sleep you're getting yeah they do matter I think uh and different companies use um different algorithms to calculate your deep sleep uh some include the slow wave or the stage three sleep plus the REM sleep and they call it the Deep Sleep uh some keep it separate REM separate so whatever that is but yes I think the if you get the healthy amount of deep SLR sleep um it is good for your mental and your um brains uh psychological recovery um because this is where all the memories are being Consolidated especially your emotional memory happens in Ram sleep uh this is also where a lot of toxic proteins get cleared up from the brain um so there is a concept that uh if those are not cleared up for a long period of time uh neurodegenerative diseases like Alzheimers um Can Happen more in patients with sleep deprivation so it does help and I think um different companies track it differently uh but you should have a healthy amount of deep sleep I've heard those described as the the brain's way of washing washing out toxins is when you're dreaming or getting that really deep sleep I know that people have a lot of questions about sleep so if you're watching and you'd like to share a comment or you have a question for Dr luthra just use the chat on YouTube or Facebook or you can email the medical News Network all that information is right there on your screen and if you're not sleeping well and you're watching this and feeling groggy you're really good company because sleep health.org reports 50 to 70 million Americans have Sleep Disorders one in three adults don't regularly get the recommended amount of sleep to protect their health one out of three Dr luthra have you seen an increase in people with Sleep Disorders over the course of your career I think um I think Sleep Disorders have always existed um definitely over the last 10 years since I've been practicing uh in medicine and then in sleep uh there has been an increase uh with the tech uh getting closer to our bed times uh smartphones social media companies uh using your behavior patterns your interest uh to provide you the reels and the shots um that has definitely uh I think eroded a good amount of sleep hygiene uh but also I think I also see a increased uptake in sleep patients because there's more awareness uh We've also noticed that in the last couple of years uh Health influencers uh people who talk about longevity um overall health H or you know your athletes that you might um idolize they're all talking about sleep a lot more because they're all understanding that sleep is a vital part of your recovery and um um and that I think has also put a greater empet on sleep and now people want to uh improve their sleep that's super interesting cuz my dad has Alzheimer's and ever since then my family and I have really taken a deep dive into brain health and I recently heard sleep described as you should view sleep as an activity just like you view um e exercise exercise and sleep are two important activities and I think I've never viewed sleep as an activity before but that's what I hear you saying as well yeah exactly so it's just like you know you're tracking your steps you want to get 10,000 steps uh you want to track your sleep get to your 7 hours of Healthy sleep maybe 30% or so 30 to 40% of D plus REM sleep if you can achieve that and so it's become that kind of a tracking uh mechanism for your overall health just like you track your steps your calories your heart rate variability you want to track your sleep because all of this contributes to uh Better Health in later years there are people who have perfect sleep hygiene I don't know who they are but they have perfect sleep hygiene and even some people who keep perfect sleep hygiene still have disorders like sleep apnea insomnia narcolepsy if someone watching is concerned that they have a sleep disorder how do they reach out to a sleep specialist and what does that look like so you can reach out to us directly uh but I would recommend uh talk to your primary care doctors uh if you have any sleep disorders they are very simple testing that uh every Primary Care uh physici can order for you starting with as simple as a home sleep apnea test where you don't have to spend any time in a sleepb lab you basically get a very simple kit that has a pulse meter something on your wrist and a chest band to uh monitor your breathing and and that's it uh you get a study done that rules out a number of sleep disorders and then if there is something beyond that the study comes back normal but you are still struggling then you can ask your primary care doctors to uh refer you to us uh in sleep medicine it won't surprise you Dr luthra that we have plenty of questions coming in from our viewers because sleep is such an important topic so let's get right into this Stu who is just waking up wants to know is 10 milligrams too much to take regularly of melatonin this is actually a question we've gotten from a couple different people 10 Mill I think I think 10 is too much uh I think uh start low with melatonin I tell patients to start with maybe 2 or 3 Mig go up to five uh but really Beyond six there's not much data that Beyond 6 mgram uh is more helpful but I feel like that actually can lead to more side effects like hangover grogginess in the morning um so I would say somewhere between three and five is probably an ideal dose Jean has a great question he wants to know are 20 minute power knps better than longer naps so they don't interfere with your nighttime sleep yeah I think naps under 30 minutes so 20 minutes sounds perfect uh can be really helpful um if you are feeling tired it I prefer that over drinking caffeine uh especially in the afternoon time instead of drinking caffeine if you can take a 20-minute power app um that's healthier for your system uh but then also focus on why are you needing that power nap uh if this is a consistent habit uh also evaluate are you getting enough sleep at night time and if that sleep is restful Jeremy wants to know well he writes I always feel like I wake up feeling like sludge that's a great description me but the idea of doing a sleep study to dig more into this makes me think of missing days of work or people with clipboards in a facility watching me sleep what's it really like yeah so like I just mentioned home sleep applea study could be a great start for him uh just talk to your primary care doctor they'll put an order to a sleep lab the lab will call you in a week or two uh they are covered by Insurance most insurance plans will cover you a home sleep study and you just basically pick up a kit from the lab take it home sleep with it for one single night remove the kit in the morning send it back to the lab you get your results in about 1 to two weeks and you don't have to be in any lab and be around any person with a clipboard I have a question about dreams um yes I noticed that I went through this phase where I liked eating chips and salsa right before bed don't judge me I just really would do that when I'd come home from work when I worked a night shift but I noticed I would have the weirdest most trippy dreams when I'd have spicy salsa before bed like Fantasia it was like I was in a cartoon what causes that so we don't know exactly but I think uh if your GI system is working and it's creating different type of Sensations uh in the body that can affect your uh uh neurotransmitters can lead your subconscious to believe certain things and can lead into that type of dreaming uh but there's no U there's no uh straight scientific explanation for that dreams are just you know dreams are just manifestation of your subconscious they are never they they they can always be connected with something going on uh or has happened to you um so but there's no straightforward scientific um reasoning behind that what's that there's no there's no scientific reasoning behind what type of dream we will get with food Karen wants to know I don't she's writes I don't remember my dreams does that mean I'm not dreaming possibly uh there are two types of dream dreams that happen in rapid eye movement sleep if you do not have enough REM you will not have dreams that you would recall easily uh some dreams happen in the non-rem sleep but they are not uh as much as the REM and those dreams even if they're happening we don't recall um but in general if you're feeling tired and you're not remembering your dreams then then then it could be because you're not getting enough REM sleep and and there may be a sleep disorder behind that Denise has a question about lights right before you go to bed she wants to know uh if her Kindle is disrupting her her um relaxation as much as the light from a phone would yeah I would say a lot less with Kindle I would prefer people use Kindle uh over tablets or phone uh because because the light uh emission is a lot less from a Kindle's uh e-reader type of screen and then that leads me to a question my friend Caroline set my phone to go to a red light setting after a certain hour can I get away with looking at my phone if I'm not scrolling Twitter if it's on the red light setting yeah you do get less blue light with those uh adjustments on the screen uh but any light is not great so blue light is particularly bad so it's better to keep it on that setting in the evening hours you should you should actually adjust it so as the day goes down it automatically adjusts to warmer tones uh but still an hour before bed if you could just avoid that would be better Jo Allen mcgranahan has a question for you Dr luthra if you could only do one thing to improve sleep what would that be if you had to pick the most important thing bedtime consistent bedtime uh if I could only pick one thing would be going to bed the same time and it may and it may differ for every individual some people depending upon their work schedule might want to go to bed at 11:00 some might want to go to bed at 9:30 depending upon how your body works and what your work schedule is if you pick one consistent bedtime and just stick to that I think that would be the simplest thing Stuart wants to know does extra sleep end up making you more tired man I would say no I feel like superwoman when get more sleep but what's your Professional Medical take so it depends upon your uh requirement see every individuals sleep requirement is different in the population we are like on this bell-shaped curve so there are people majority of them they require 7 to 9 hours of sleep on different edges one can require 6 hours one can require 8 to 9 hours so if a 6 hour person sleeps 8 to 9 hours they may feel more tired uh but if your requirement is eight and you're getting SI and you get a couple of extra hours one morning you will feel a lot more rested but in general I think I say don't sleep more than 9 hours don't spend more than 8 to 9 hours in bed uh because uh it's typically not helpful after that time and if you are needing that then there is some hyposmia condition okay Gretchen would like to know what is what does it mean when you're a short sleeper I heard Margaret Thatcher was a short sleeper and it's some sort of sleep disorder yeah is that so short so short sleeper uh is actually not a sleep disorder short sleeper uh when we use the term we mean that somebody's sleep requirement can be shorter and and they don't need to sleep longer than that and they are still fully rested and functional um so there was a study conducted on a on a family uh not too far from us uh in US that only required 4 hours of sleep and multiple family members in that family will sleep 4 hours and were fully functional after that and they were all a high functioning employed people so they did a study they studied their genome and they found a gene uh that all of them had uh which gave them that short sleep uh type of capability so almost like a superpower but uh uh but yeah that's what we mean when we say short sleepers what a great Jean they must feel that must be amazing to to not have to worry about getting the eight hours of sleep you only need four um Jean wants to know oh this is good Jean Ren says is any sleep position better than another for good sleep in uh in majority of people side sleep is better with regards to your breathing compared to the back or the sleeping on the tummy or or sleeping on your stomach M interesting and one more question from Jim Jim wants to know if there's a specific temperature that is better to sleep at cooler temperatures are better uh for your uh cortisol secretion uh and nighttime hormonal uh secretion so I would say more like 66 to 68 uh don't keep it warmer than 68 at night time okay so a cool room pitch black no lights for today's takeaways U Dr luthra what do you want people to know who are watching because so many people have anxiety when you start talking about sleep so I want people to understand that sleep is one of the most powerful things that you already have um that you are probably underutilizing for your health uh we focus so much on eating healthier taking our cholesterol medications uh steps similarly you have sleep uh which is just available to you uh just follow a good sleep hygiene think of sleep as uh something that can improve your brain health your immune Health uh improve your metabolism uh and improve your mental well-being so use sleep in that context use sleep as uh something that is freely available no medications needed and just don't underappreciate sleep and then uh if you sleep better you are going to have a better health sharper thinking and a happier life overall Dr luthra thanks for taking the time to join us this morning we really appreciate your expertise and your Insight and thank you so much for our viewers for being with us today we'll see you back back here tomorrow morning coming up tomorrow on the morning Medical Update her dad her uncle then herself when Lori Chavez learned they all three shared the same cancer diagnosis she wondered what it would mean for her kids I'm Jessica level on the next morning Medical Update we explore Lynch syndrome where symptoms don't appear until cancer develops the importance of understanding your genes plus the research that could prevent cancer spreading with a vaccine Tuesday dat subscribe to our morning Medical Update and open mics with Dr ste's podcast Now everywhere podcasts are available [Music]

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