Don’t Cheat Your Sleep

Proper shuteye is essential for good health



Illustration by Arthur Budak

We all do it. The clock says it’s bedtime, but we can’t resist watching yet another round of “The Big Bang Theory,” scrolling through the latest updates on Facebook or finishing up something on the computer.

And for the estimated 50 to 70 million Americans who suffer from sleep disorders, a good night’s rest can remain an elusive pipe dream, regardless of the time they hit the sack.

Is getting enough sleep really such a big deal?

Oh, yes, experts say. “It’s a basic physiologic need,” says Anne Magauran, MD, medical director of the Center for Sleep Disorders at Exeter Hospital. The amount of sleep we get — as well as the quality of our sleep — affects virtually every system in our body and can have serious implications for our health.

Sleep’s restorative powers touch our physical, mental and emotional health, says Kimberly Badessa, APRN, a nurse practitioner at St. Joseph Hospital Pulmonary Medicine, and can affect our basic day-to-day safety. “Work accidents increase when we don’t sleep well,” Badessa says. “Driving accidents, same thing ... It’s really important to get the proper amount of sleep.”

That amount is different for everyone, but experts generally recommend seven to nine hours per night for adults. Very few people need more than nine or less than seven hours, Magauran says, and those who think they can function on less often use caffeine or some other means to compensate for sleep deficiency.

Many factors in addition to ignoring the clock can influence our sleep. In fact, pinpointing the origins of sleep trouble “is sometimes the hardest part” of treatment, Badessa says. “So many times with sleep, there is more than one answer,” she says, “and more than one change to make. It’s not as simple as, ‘Here, do this one thing and your sleep will miraculously improve.’”

Sometimes a sleep disorder, such as obstructive sleep apnea, can stem from basic anatomy — a person might have a small jaw, for instance, or enlarged tonsils. But lifestyle makes a difference too. Alcohol consumption can interfere with sleep, as can eating a big dinner. Excessive weight, along with narcotic use, medications and menopause, can affect the quality of our slumber.
Psychological health can also affect sleep; about 40 percent of people with chronic insomnia have some type of underlying emotional issue, Magauran says.

And as we age, most of us can expect to experience changes in our sleep. Older adults often find that it takes them a bit longer to fall asleep than it used to, and that they wake more often during the night. The stages of sleep — known as “sleep architecture” — change as we age, and older adults often shift to an earlier bedtime and wake time. These are natural adjustments, Magauran says. “What matters is that you’re getting good quality sleep, you’re waking up refreshed [and] you’re not tired during the day.”

Medication can sometimes help people who struggle with sleep, but it’s best not to routinely rely on it. A better approach, Magauran says, is to identify and correct — using no or very little medication — the underlying problem that is interfering with sleep, and perhaps begin psychological treatment such as cognitive behavioral therapy. Depending on the nature of the problem, simple tricks of the trade can help. Light sleepers, for example, can often benefit by investing in a white-noise machine, perhaps along with room-darkening shades and an adjusted bedroom temperature that is more conducive to sleep.

Individuals who use an activity tracker to review and maximize the quality or quantity of their sleep, however, should be careful not to pay too much heed to what the tracker reports. The popular Fitbit, for example, “doesn’t truly measure sleep,” Magauran says. “What it truly measures is movement. If you were lying still, awake, it would record it as sleep but you could just be lying there, not moving.”

Indeed, while such devices can provide some useful information, they are far from perfect, Badessa notes, and can cause undue anxiety. Although some people wake up feeling good and well-rested, Badessa says, they worry if their Fitbit indicates that they had a restless night. Her advice? “Take it with a grain of salt,” she says. “It’s not necessarily a bad tool, but it’s not the only piece of information that matters.” 

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