Sleep to better health: How to combat sleep disorders

Neil Bartlett

If you're shorting yourself on sleep, you're in good company. According to a 2013 Gallup study, the average American gets 6.8 hours of sleep a night – a full hour less than in the 1940s.

If you're consistently sleeping fewer than seven hours a night, you might not notice it for a while --but over time, it can put your physical and mental health at risk.

combat sleep disorders To learn more, spoke to Dr. Robert S. Rosenberg, medical director of the Sleep Disorders Center of Prescott Valley, Arizona, and medicine consultant for Mountain Heart Health Services in Flagstaff, Arizona.

He's board certified in medicine, pulmonary medicine and internal medicine and is the author of Sleep Soundly Every Night, Feel Fantastic Every Day.

We asked him about sleep deprivation and its effects, and how you can get consistent and restful sleep.

Q. How can you know if you're sleep-deprived?

A. Consistently sleeping fewer than seven hours a night on average could be the first sign that you're sleep-deprived.

There's also often a change in emotional stability. If you're extremely moody, have trouble focusing and concentrating, and you're gaining weight, these can all be symptoms.

It can creep up on you. As the years go by, folks who are sleep-deprived show a highly increased incidence of heart disease and stroke. Because it's often gradual, you may not make the correlation with a lack of sleep.

A small group of people -- 5 percent or less -- can get by with six or fewer hours of sleep a night and not experience sleep deprivation. But people who sleep more than nine hours often show the same signs as the sleep-deprived individual. When it comes to sleep, too little and too much can both be harmful.

Q. What should you do if you're not getting enough sleep?

A. Re-evaluate your lifestyle. Are you burning the proverbial candle at both ends? Count back the number of hours from when you need to wake up. If you need to be at work by 7 a.m., you should be in bed by 11 p.m. the night before.

Your environment is one of the main causes. Too much cellphone, tablet, computer use and TV are culprits. They all suppress the production of melatonin, which your brain creates to help you fall asleep.

The 90 minutes before you go to bed are critical. Shut things down and make your environment quiet and dark.

Q. What is sleep apnea, and what are the signs you have it?

A. Apnea is more common as we age and with those who are obese. Studies show that 70 percent of those with apnea are obese. It often shows up in women after menopause.

Snoring is the main indicator. But not everyone who snores has sleep apnea. Most folks who have sleep apnea snore. Most of us pause when we’re breathing during sleep. The person with apnea has pauses that occur more often – as much as once or twice a minute.

During an apnea episode, oxygen levels fluctuate wildly. This produces oxidative stress which generates free radicals, and can destroy your blood vessel linings. So over time, everything breaks down and we see a very high incidence of heart attacks and strokes.

If you suspect you or your bed partner might have sleep apnea, there are two ways to treat it. One is to stay overnight at a sleep center where you'll be tested for it. The other option is an in-home test. It's not as comprehensive as an overnight stay, but it's less intrusive.

Q. Are there certain groups more susceptible to not getting enough sleep?

A. Adolescents are very susceptible. They go through a shift in their circadian rhythms, which means their natural bedtime comes later and later.

A 2013 study by the Madigan Army Medical Center in Tacoma, Washington, revealed that 40 percent of active military service members get five or fewer hours of sleep a night. Insomnia is part and parcel with individuals in the military and others suffering PTSD (post-traumatic stress disorder). If you don't address the sleep issue, the underlying psychiatric condition is unlikely to improve.

Q. Does a typical health insurance plan cover the cost of medication and sleep aids?

A. If you have a good insurance plan, sleep medication should cover it. For sleep apnea, most plans will cover the cost of tests and treatment. Insurers know it's much less expensive to pay for a CPAP machine – a device that pushes a constant stream of air that keeps your throat and airway open -- than a heart attack or stroke down the road.

I'm a believer in trying not to use sleep medications. When you stop taking them, the insomnia returns. I've tried low doses of melatonin with many of my patients. I advocate cognitive behavioral therapy (CBT) which teaches you to unlearn distorted thought patterns that fuel insomnia. It  works well over a long period of time.

Q. What are the top ways readers can establish good habits that will help them get regular, restful sleep?

A. First, set a sleep-wake schedule. The more consistent you are, the better sleep you should get. On weekends, don't go crazy with sleep. Wake up on Saturday and Sunday no more than an hour past when you get up during the week. Try to drink anything with caffeine by noon at the latest. Also, well before bedtime, shut off all cellphone and tablet screens.