From our collaborators at Johns Hopkins Medicine International | The Sleep Fix: Fresh clues to why we need it

And when to ask for professional help to get more of it

Poor sleep is a global pandemic estimated to affect more than 20 percent of people worldwide. Canadians are among those sacrificing their sleep to keep up in our 24/7, plugged-in culture. According to a study by the research group RAND Europe, an estimated 1.35 percent of the Canadian GDP—or 21.4 billion dollars—is lost every year due to sleep disorders. About 40 percent of adult Canadians suffer from sleep disorders, most commonly insomnia.

Sleep medicine research suggests that most adults function at their best emotionally, physically and mentally if they routinely receive seven to nine hours of quality sleep each night. Evidence shows Canadians struggle to achieve that goal. A recent study reported that more than one-third of Canadian men between the ages of 30 to 49 report an average of just four to six hours of nightly slumber. Another study found that one-third of all Canadian children were sleep-deprived.

Robust evidence shows that sleep is not just a luxury. It is a critical element of wellness that all health-conscious individuals should incorporate into their routines.

Achieving “good sleeper” status starts with awareness

New research points to sleep as a potential strategy for prevention of some common medical conditions, including depression and anxiety. The risk of obesity is higher in those with a history of disrupted or reduced sleep, and some studies show that even a single night of disrupted sleep can increase the craving for fatty and calorie-dense foods. Data also are mounting that show good sleep habits may allow the brain to clear some of the byproducts and toxins associated with certain forms of dementia.

Poor sleep patterns can trigger certain conditions

For those at higher risk for irregular heartbeat disorders, high blood pressure, Type II diabetes, depression and anxiety, research shows that unhealthy sleep habits might trigger these conditions. Research has shown that Canadian adults with sleep apnea were about twice as likely as the general population to have diabetes, high blood pressure, heart disease, or depression.

Good sleep health can help manage common, chronic diagnoses

For instance, chronic pain patients are more likely to rank pain intensity higher the day after a poor night’s sleep compared to the day after getting a solid night of shut-eye. Patients with a history of atrial fibrillation who are successfully converted back to a normal heart rhythm are more likely to convert spontaneously back to an abnormal heart rhythm if they have an untreated sleep disorder. Stroke patients with sleep disorders including sleep apnea are at higher risk for heart attacks and strokes. Evidence also suggests that poor sleep may have direct health implications not only for the poor sleeper but also for individuals sharing the same home and sleeping environment. For instance, studies of caretakers for people living with dementia often list sleep disruption as the primary reason the caretaker must transition the patient into a full-time care facility.

Follow-up action is the true answer to sleep health awareness.

Know your ideal sleep zone

Most adults require seven to nine hours of sleep to function at their best. Both sleep quality and quantity are critical to optimizing the full health benefits of sleep. The natural sleep drive and internal sleep clock are the two genetic factors that determine the amount of sleep each person needs nightly. The circadian rhythm determines the time of night at which the brain would like to sleep. I recommend that each of my patients conduct an experiment to identify an ideal “sleep zone.” This is the time period in which they can naturally fall asleep within 30 minutes at night and wake in the morning—without the aid of an alarm clock—feeling rested, restored, alert and mentally engaged throughout the day.

Create a sleep-conducive environment

  • Avoid heavy exercise and heavy meals within three hours of sleep.
  • Try a warm bath one to two hours before sleeping.
  • Develop a relaxation ritual before bed (for example, read a book).
  • Keep your sleeping environment cool, dark, and quiet (unplug the TV, phone, smart pad, computer).
  • Use the bedroom only for three S’s—sleep, sex and sick (not work).
  • Set a routine bedtime and wake-up time (this should not deviate more than 30 minutes, even on weekends and holidays).
  • Don’t use night-lights (if needed, use flashlights).
  • Choose pajamas made of breathable natural fabrics such as cotton.

Know when to seek help

The three most common sleep disorders worldwide are insomnia (inability to fall asleep or stay asleep), chronic insufficient sleep, and sleep apnea (breathing difficulty while sleeping, often associated with snoring, gasping or choking while sleeping). Almost 900,000 Canadian adults have been diagnosedwith sleep apnea, 75 percent of whom are older than 45. About 25 percent of Canadian adults are at high risk for having obstructive sleep apnea.

If you have set the stage with a solid sleep environment and sleep opportunity, yet still wake up feeling unrested, it is time to consider a formal sleep evaluation. Often, it is worthwhile to take a step back and honestly reflect on the following questions:

  • Lately, have I been struggling to concentrate?
  • Do I feel more down and sad than usual?
  • Am I more irritable with my family, friends, and workmates?
  • Am I falling asleep in work meetings, at the dinner table or while watching a movie in the evening with family?

If the answer to any of these questions is yes, then it may be the right time to chat with your health-care provider about your sleep.

Content courtesy of Charlene Gamaldo, M.D., associate professor of neurology at the Johns Hopkins University School of Medicine and Medical Director of the Johns Hopkins Center for Sleep. The content was reproduced with permission of the Office of Marketing and Communications for Johns Hopkins Medicine International. Additional reuse and reprinting is not allowed. The information aims to educate readers and is not a substitute for consultation with a physician.

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