November 27, 2018

Nursing Professor Carol Baldwin believes a good night’s sleep is worth its weight in gold

Have more sex. Sleep alone. Drink less caffeine. Get more exercise. Turn off the electronics and dispense with all negative thoughts.

Sleep studies seem to be a dime a dozen these days and often spur curious tips and confusing advice from experts across the board. One recent takeaway from a study at a university in the Southwest: Make a to-do list before going to bed.

The good news is that Americans are getting on average 17.3 more minutes of sleep  per night, according to a recent study that looked at data from 2003–2016. The bad news is they still aren’t getting enough. And even worse is that sleep deprivation is costing the United States approximately $411 billion a year, about 2.28 percent of our country’s gross domestic product.

Carol BaldwinBaldwin is also a Southwest Borderlands Scholar; deputy director, WHO/PAHO Collaborating Centre to Advance the Policy on Research for Health; and past director for the Center for World Health., a professor emeritus from Arizona State University’s College of Nursing and Health Innovation and an expert on sleep and sleep promotion, takes a more practical and commonsense approach to catching Z’s. Her view? “Without sleep, we get sick, fat and stupid,” Baldwin recently told ASU Now.

Woman in red striped shirt and glasses
Carol Baldwin

Question: Why is it essential to get a good night’s sleep?

Answer: Missing one night of sleep or having a poor night’s sleep can affect mood, energy, efficiency and the ability to manage stress. Sleep disorders can lead to poorer health outcomes, work/home/traffic-related accidents, poor job performance and stress in relationships. For health workers, it means insufficient, nonrestorative sleep and fatigue can compromise patient safety. Healthy sleep is as important as diet and physical activity and is essential for physical health and emotional well-being.

Q: What is sleep apnea, and how is it treated?

A: Sleep apnea is a serious sleep disorder that can lead to chronic illnesses, like heart disease and diabetes, or even death. It is generally more common in men, especially if they are overweight or obese. A person with sleep apnea can be recognized by very loud snoring, followed by stopping of breathing that lasts for at least 10 seconds called “apnea.” Apneas can happen up to 400 times per night. People with suspected sleep apnea need to see a sleep specialist, who generally orders a sleep study to determine the severity of the sleep apnea. Oftentimes, sleep apnea is treated with a machine attached to a mask placed over the nose that forces air in during the night so that the airway stays open. This treatment is called continuous positive airway pressure breathing. Green Bay Packer Reggie White died of complications of sleep apnea. Basketball player Shaquille O’Neal was diagnosed with sleep apnea and encourages people to learn about the disorder and get treated for it.

Q: Snoring without apnea is also an obvious roadblock to getting a good night’s sleep. What are some interventions to reduce snoring?

A: Avoid alcohol — it relaxes the throat muscles during sleep, making snoring more likely to occur. If the nose is obstructed or stretched, snoring is more likely to occur; a steamy shower at bedtime could help open nasal passages. Also, change your pillows out every year and vacuum them every few weeks. Dust allergens in the bedroom or mites can contribute to snoring; skin cells from pets may be irritants. Lastly, drink water! Drinking the recommended eight glasses of water a day helps reduce thickness of nasal secretions, which can improve airflow.

Q: What are causes of acute and chronic insomnia?

A: Acute insomnia is usually caused by significant life stress, and it can vary from a loss or change of employment, death of a loved one, divorce, graduation, illness or physical or emotional pain. Certain medications used for allergies, depression, high blood pressure and asthma can also interfere with sleep. Acute insomnia may not require treatment and can often be prevented or treated by practicing good bedtime/sleep habits. Chronic insomnia is usually triggered by depression, anxiety, stress or chronic pain or discomfort. Behavioral treatments and relaxation techniques can limit the worsening of insomnia and can teach new ways to promote healthy sleep.

Insomnia is generally more common in women and often contributes to substance abuse, poorer health-related quality of life and functional impairment. Primary care providers usually do not ask people about how well they sleep, or if they have trouble sleeping. Because of this lack of knowledge about sleep, it usually takes 11 years before the person with insomnia is diagnosed. Insomnia, which reduces the amount of sleep a person needs, can also result in chronic diseases, like heart disease, diabetes and daytime fatigue that can lead to home, work and traffic accidents. The economic impact to insomnia accounts for approximately $411 billion a year in the United States alone through reduced worker productivity, high blood pressure and early death, according to the Rand Corporation.

Q: What about sleep needs for children and adolescents?

A: Children and adolescents today have more distractions: Electronic devices such as television, smartphones, video games, text messaging and social networking all contribute to reducing the number of hours of sleep. School-age children need at least 11 hours of sleep each night, including weekends. They need a set time for bedtime and for waking up. Adolescents require around nine hours of continuous, uninterrupted sleep seven nights a week, and it’s important for them to establish a specific routine for bedtime. All electronic devices should be kept outside of the bedroom, so the brain can relate the bedroom with sleep. When children, adolescents and adults do not get enough sleep, we are more likely to eat “junk” food that is high in sugar, fat and carbohydrates and drink sugared beverages that are high in caffeine, like cola drinks. These behaviors have been leading to the epidemic of overweight and obesity that we have been seeing in the United States. 

The impact of sleep deficiency in children has many repercussions and can lead to behavior problems at home and school, including inattention, hyperactivity, poor school performance or daytime fatigue. Obesity can lead to chronic diseases in children and adolescents, just as in adults, including heart disease and diabetes. Sleep specialists are now recommending that children be tested for a sleep disorder even before they are tested and treated for attention deficit hyperactivity disorder.

Given the links between sleep disorders, poor nutrition, fatigue and inattention, the bottom-line summary is: Without sleep, we get sick, fat and stupid.

Q: What are some healthy sleep behaviors?

A: Avoid products like tea, coffee, cocoa, chocolate and soda at least four hours before bedtime because they have caffeine, which is a stimulant and a diuretic. Nicotine products, like patches, gum and cigarettes, should be avoided at least four hours before bed as they contain nicotine, a stimulant. The same goes for alcohol, which might help people fall asleep at first, but within two weeks contributes to “rebound insomnia.” Alcohol also has diuretic properties and can interrupt sleep. Other common-sense behaviors include avoiding a large meal immediately before bed, particularly spicy foods. A light snack like a banana, almonds, tart cherries and chamomile tea can help promote sleep.

Daily activity such as walking, dancing, running, swimming, gardening and sports helps with sleeping, but avoid doing it in the evening if exercise is stimulating for you, which could result in your having trouble falling asleep. “Worriers” might make a list of concerns before bedtime to worry about in the morning. (One could also) learn relaxation, meditation, guided imagery techniques, or take a warm relaxing bath or shower. Adults need seven to eight hours of restful sleep on weekdays — and weekends.

Top photo courtesy of alyssafilmmaker/Flickr