About 50 to 70 million US adults have sleep or wakefulness disorder, says the CDC, and sleep deprivation is a growing public health issue.
A Nation in Need of a Good Night’s Sleep:
45% of Americans say poor or insufficient sleep affected their daily activities at least once in the past 7 d.
• Good sleep
quantity
-but not
quality.
•
Average sleep:
7 hr, 36 min/night (+ 40 min on weekends).
• 35%: sleep quality “poor” or “only fair.”
• 20%: did not wake up feeling refreshed on any of the past 7 d.
Pain Widens Sleep Gap:
Pain is key factor in gap between the sleep Americans say they need and the sleep they’re getting.
•
Average sleep debt:
chronic pain, 42 min; acute pain in past wk, 14 min; no pain, 0 min.
• Chronic pain, 21%; acute pain in past wk, 36%.
• Even with no pain, 1 in 3 don’t always/often get a good night’s sleep.
• Pain joins stress and poor health as key correlates of shorter sleep durations and worse sleep quality.
Obesity Weighs Heavily on Sleep Apnea:
â 65% of Americans are overweight or obese.
•
20-year review:
significant rise in hospital discharges for obesity-related medical conditions-discharges for sleep apnea up by 436%.
• â 18 million Americans have sleep apnea-often linked with overweight.
• Obesity contributes to sleep problems; sleep problems contribute to obesity.
•
Good way to treat obesity:
treat underlying sleep problem.
Short Sleep Duration Affects Insulin Sensitivity, Diabetes:
Insufficient sleep reduces body’s sensitivity to insulin, impairing ability to regulate blood sugar and increasing diabetes risk.
• Reduced insulin sensitivity was compensated by increased insulin secretion.
• 3 d of adequate sleep restored oral glucose insulin sensitivity to baseline.
• Circadian timing of food intake during sleep loss may elevate diabetes risk.
Mood Killers: Sleep Interruptions Worse Than Reduced Sleep
Partial sleep loss from sleep continuity disruption is more detrimental to positive mood than partial sleep loss from delaying bedtime.
• Forced awakenings study subjects had significantly less slow wave sleep than restricted sleep opportunity controls after 1 night of sleep deprivation and significantly lower positive mood after 2 nights.
• Putative biologic mechanism (slow wave sleep deficit) could help explain strong comorbidity between insomnia and depression.
Epilepsy Seizures Linked to Sleep or Awakening:
Sleep and epilepsy closely related.
•
When patients have seizures:
only during night, â 20%; only during day, â 40%; during day and night, â 35%.
• In some syndromes, seizures strongly related to sleep or awakening.
• Sleep EEG recordings may help in patients with suspected epilepsy and nonconclusive awake EEG.
• Perform sleep recordings during nap (natural sleep or drug induced), during night, or after sleep deprivation
Driving Under the Influence of Sleep Deprivation:
Drowsy driving contributes to several thousand automobile accidents each yr.
•
Drowsy Driving Prevention Week (November 1-6):
a campaign to educate the public about the risks of drowsy driving and improve safety.
•
Drowsy Driving Consensus Workgroup:
Drivers who slept for ⤠2 hr in the preceding 24 hr not fit to operate a motor vehicle.
Guidelines to Avoid Health Risks, Recover From Sleep Debt: New sleep recommendation:
adults obtain ⥠7 hr/night to avoid health risks of chronic inadequate sleep.
• No upper limit on hr/night-> 9 hr/night on regular basis may be appropriate for young adults, persons recovering from sleep debt, and those who have illnesses.
• Benefits of healthy sleep require adequate sleep duration plus right timing, daily regularity, good sleep quality, and absence of sleep disorders.
Don’t Sleep on Sleep Hygiene:
Sleep hygiene tips (adapted from the National Sleep Foundation) to improve sleep:
• Go to bed at the same time each night, rise at the same time each morning.
•
Avoid:
large meals before bedtime, caffeine and alcohol close to bedtime, nicotine.
Practicing “Traditional” Sleep Medicine: Natural Environment:
How did humans sleep before the modern era?
• Researchers investigated sleep in 3 preindustrial societies.
•
Average durations:
5.7-7.1 hr-
They do not sleep more than “modern” humans.
•
Findings:
Temperature may be a major regulator of human sleep duration and timing, also light exposure.
•
Conclusion:
Mimicking aspects of natural environment may help in treating modern sleep disorders
PreviousNext“I slept like a baby-I woke up every 2 hours and cried” is a popular joke, but the consequences of poor and inadequate sleep are not a laughing matter. About 50 to 70 million US adults have sleep or wakefulness disorder, says the CDC, and sleep deprivation is a growing public health issue. Persons with sleep insufficiency are more likely to have chronic diseases-hypertension, diabetes, depression, and obesity-and a variety of other health problems, including cancer and increased mortality. And, quality of life and productivity are diminished.Click through the slides above for a fast refresher on some key facts about sleep and sleep deprivation and then share them with your patients.
References:
1. A Nation in Need of a Good Night’s Sleep
2. Pain Widens Sleep Gap
3. Obesity Weighs Heavily on Sleep Apnea
4. Short Sleep Duration Affects Insulin Sensitivity, Diabetes
5. Mood Killers: Sleep Interruptions Worse Than Reduced Sleep
6. Epilepsy Seizures Linked to Sleep or Awakening
7. Driving Under the Influence of Sleep Deprivation
8. Guidelines to Avoid Health Risks, Recover From Sleep Debt
9. Don’t Sleep on Sleep Hygiene
10. Practicing “Traditional” Sleep Medicine: Natural Environment