If you struggle to wake up in the morning or catch yourself nodding off during the day, you’re not alone. Nearly 40 percent of people between the ages of 20 to 59 report getting less than enough sleep.
In this video, San Diego Health host Susan Taylor talks with Steven Poceta, MD, a neurologist and sleep medicine specialist at the Scripps Clinic Viterbi Family Sleep Center, and Derek Loewy, PhD, a clinical psychologist and sleep medicine specialist at Scripps Clinic, about why you need sleep and what to do if you’re not getting enough of it.
According to the Centers for Disease Control and Prevention, you need at least seven hours of sleep each night for optimal health. Sleep gives your body the opportunity to rest, repair cellular damage and refresh the brain. Lack of sleep can cause daytime sleepiness, fatigue, headaches and problems concentrating, which in turn can lead to accidents, poor performance at work or school, irritability and other issues.
Over time, insufficient sleep can contribute to significant health problems, including high blood pressure, obesity, diabetes, heart disease and even dementia.
“One of the leading theories as to why we sleep is to clear metabolic byproducts from the brain and in theory, not getting enough sleep leads to build up of some of these negative byproducts,” says Dr. Poceta. “Dementia may be linked to inadequate sleep, either from sleep disorders or not sleeping long enough.”
Insomnia, which is difficulty falling or staying asleep, is one of the most commonly reported sleep problems. However, insomnia may be more of a learned behavior than a true disorder, especially since people often go to bed thinking about everything they need to do the next day.
“Patients often say that they feel sleepy while watching television but as soon as they go to bed, they’re wide awake,” says Dr. Loewy. “It doesn’t make sense to them, but in terms of conditioning, the bedroom is where they’ve been suffering with insomnia. So as soon as they go in there, the pressure is on to go to sleep.”
If insomnia becomes chronic, it is considered a sleep disorder.
Often, simply adjusting your daily routine can make a major difference in how well you sleep.
Technology may make life easier during the day, but it can make sleep more difficult at night. If you use your tablet, laptop or phone close to bedtime, the blue light from these devices can suppress the production of melatonin, which is the hormone that helps you fall and stay asleep. If you can’t avoid using a device before bed, change your settings to set the screen display to “night time” which reduces the amount of blue light or replaces it with yellow, which is less stimulating.
“Another potential risk of these devices is that the content you’re looking at can keep you awake,” says Dr. Poceta. “If you’re watching your favorite Netflix show or checking the news or work email, that’s keeping you mentally stimulated and probably preventing you from relaxing into a sound sleep.”
Caffeine can perk you up when you’re tired, but its lasting effects may keep you awake. If you’re sensitive to caffeine, avoid coffee and other caffeinated beverages after lunch.
Alcohol may help you fall asleep more quickly, but staying asleep may be a challenge. The body metabolizes alcohol rather quickly; once that happens, sleep often becomes restless. Wine with dinner may not be a problem, but try to avoid alcohol close to bedtime.
Exercising during the day can help you sleep better. However, working out close to bedtime may leave you too stimulated to sleep. Aim to exercise no later than two to three hours before bed.
“Probably the best time to exercise, if you have the time, is first thing in the morning. We often recommend a morning workout in association with a lot of bright light,” says Dr. Loewy. “Those two events, physical activity and light in the morning, are a great signal to your internal sleep clock that this marks the beginning of the waking part of your cycle. And that will have an impact on when you fall asleep that night.”
If lifestyle changes don’t work, should you try medications to help you sleep? It’s probably better not to. Over-the-counter sleep aids can leave you feeling groggy or spacey in the morning. Some natural supplements, such as melatonin and magnesium, may be safer and more effective choices. Prescription medications are available, but may be habit-forming and have unwanted side effects.
Dr. Loewy treats patients who have insomnia using cognitive behavioral therapy for insomnia, or CBTI.
“CBTI is a pretty well-established method for helping people sleep better without medication by strengthening that natural ‘sleep muscle’ through things like sleep scheduling, light therapy, and managing cognitive arousal so that their sleep muscle is working again,” explains Dr. Loewy. “Once we see evidence of that, then we introduce a tapering program to stop the medication. It’s a very successful approach.”
At the Scripps Clinic Viterbi Family Sleep Center at Scripps Green Hospital in La Jolla, sleep specialists evaluate and treat a range of sleep disorders. If necessary, patients will have an overnight “sleep test” to monitor and evaluate their breathing, movements, brainwaves, sleep quality and more.
Finally, try not to stress too much about sleep.
“Sleep is kind of Zen-like. It comes passively to you,” says Dr. Poceta. “You want to do what you can to help it, but you can’t worry about it because then you’re in a negative cycle.”