Being Well 20 leep Issues



>Lori Case f you're not getting a good night sleep then stay tuned for being well. My guest this week is Rachelle Hendrickson from the sleep disorder center at Sarah Bush Lincoln Health System. Well learn more about the most common types of sleep disorders like sleep apnea and restless leg syndrome. Rachel will also give us some helpful tips on how to give us a good night sleep. That's just ahead on being well so don't go away or to sleep. > Lori Case 02Well today we are talking about a topic we can all relate to that's sleep or lack there of sometimes. Talk about what is the recommended hours of sleep for the average adult. >Rachelle Henderickso he average adult should get around seven to nine hours of sleep but of course everyone is different some people need more or some people need less. >Lori Case 21How do you know if you are not getting enough sleep that might sound like an obvious question but Rachelle Henderickso 27Usually in order to tell that you are not getting enough sleep it's how you feel the next day if you wake up feeling refreshed, or wake up feeling like your functioning very well throughout the day, if you don't have to nap during the day then you are getting enough sleep. So if your person is waking up very droggy, you're having a hard time functioning, you feel like you have to have a nap then that means that you need to get more sleep at night. Lori Case 48Okay. Is there any reason why some people can function just fine on four hours of sleep than people like me need eight. Rachelle Henderickso 57There's really no answer to that everyones different that is the many reason for how much sleep someone gets. Lori Case 04Let's talk about some of the side effects if you are not getting enough sleep there's a lot of things that sleep does for the body. Let's start with that what does sleeping do for the body? Rachelle Henderickso 14Well sleeping of course improves your memory and mood. Sleep will also just naturally enhance the functioning of your body. All your body systems work accorrding to how much sleep you get. Your hormones are affected by sleep also that too can cause different body problems such as diabetes, weiight gain, obesity, if you are not getting enough sleep. Lori Case an you explain the obesity lack of sleep connection cause that's an interesting? Rachelle Henderickso 48Weight gain and obesity can occur if you are not getting enough sleep due to the hormone leptin is producced well your sleeping and the hormone leptin is the hormone that makes us feel full whenever we eat so if you're sleep deprived that whole hormone will start to level off it will drop off and that dropping off will cause us to eat more and also choose more unhealthier foods. Lori Case 11Okay so sleep is a lot more than getting rest it sort of restores the body and gets you ready for the next day and prevents us from gaining weight. Talk about before we get more into the sleep disorders. What are some things that you can reccommend so that we can get a general good night sleep? You probably see people doing some things that are not helping theiir sleep. Rachelle Henderickso 34Correct. The best thing to do is to always try to maintain your seven and nine hours or sleep every night. Try to maintain the same wake and sleep schedule so that means go to bed the same time every night and every morning no matter what always do that the same day and night. You also want to try to maintain the same relaxing bedtime routine such as maybe taking a nice warm bath before you go to sleep, read a book, maybe relax and listen to some soft music. However you do not want to sleep with the T.V. or music on and that's because they will both produce sound and that sound actually changes throughout time so the changing of the frequencey of sound will actually arose the brain to wake up. Same way with the T.V. with the light the light changing will cause the brain to arouse and that will make the brain think that it is day time so that it needs to wake up. So that's why it's bad to sleep with the T.V. or music on. Now if your are someone that needs to have noise when you sleep it is okay to have a fan on or a light noise machine. That is because the sound stays constant so it won't wake you up. Lori Case kay and what about what are the recommendations for caffeine? Rachelle Henderickso 41You should stay away from caffenie, alcohol and nicotine in the late afternoon evening hours just cause that sort of stimulant they will wake you up, they'll keep you awake and also what will happen is some people they feel like they can fall aslee immediately after drinking a cup of coffee but what will happen is that two or three hours later that caffenie will kick back in and will wake up the brain. Another thing to try to do to maintain sleep is to exercise daily, try to get exercise in around three hours before bed time. They have found that people who exercise three hours before bed time it actually enhances their sleep. That's because whenever you exercise your body temperature increases and so whenever you quit exercising the body temperature will actually fall and that falling of your body termperature actually is what enhances the sleep and whenever you are ready to go to sleep that's what happens is your body temperature is at its lowest so that's why it is ready for sleep. Lori Case 36Okay. Rachelle Henderickso 37So along with that that is why you need to keep your bedroom cool, dark and comfortable because a cool bedroom will help you enhance sleep because that way your body temperature stays lower and the temperature I mean the room needs to be dark because the light of course will arouse the brain and make it think it is day time and of course you need a nice comfortable bed in order for your body to relax enough to be able to sleep. Lori Case ight. Talk about we were chatting before we taped the show. Why do alot of us get tired at around two oclock in the afternoon? Rachelle Henderickso ot of times at two oclock in the afternoon that's when your body temperature will start to drop off again and thats what will enhance the sleep. That's why at two oclock it's probably a good time to go out and get some exercise and get your body temperature back up. Maybe do a nice little walk maybe not do your full exercise routine at that time but just go out and get a walk and maybe eat an apple. A crunch, you know eating something that crunches actually arouses the brain to stay awake. So that is good things to do around two if you are someone that then needs to be able to enhance sleep then of course you want to exercise the three hours before bedtime. Lori Case nd you said that say phenomenia happens to people who work a night shift they get that around two a.m. Rachelle Henderickso he same thing happens around two a.m. their body temperature starts to drop off so they get a little tired around that time too. Lori Case kay so as we start talking that's general sleep alot of people have sleep disorders talk about the most common types of disorders you see. Rachelle Henderickso 11The main ones is sleep apena, insomnia and restless leg syndrome. Lori Case kay go through all of these and kind of give us an explanation of what they are and the symptoms. Rachelle Henderickso leep apnea of course thats what happens whenever your airway becomes blocked due to excessive tissue in the airway such as enlarger tonsils an enlarger uvula or sometimes the tongue will slip back into the airway and block it. Another reason for a blockage is that your airway will just cloaspe and that is due to the muscles in your throat getting nice and relaxed whenever you fall asleep. That bloackage will then cause snoring or the gasping for breath or the stopping of breathing. Now when that happens your oxygen levels will drop off which will send a singal to the brain to make the brain try to arouse the body in order to wake up and start breathing again. So whenever you have that stopping in breathing thats when an apnea is. An apnea can occur for about ten to sixty seconds at a time or more and it can occur up to forty times or more per hour. Lori Case 12Wow so what if you think you have sleep apnea what are some of the symptoms of that? Rachelle Henderickso he main thing is excessive day time sleepness so if you're having a really hard time functioning throughout the day you're really tired, notice that you are snoring, gasping for breath or even stopping breathing at night. However some people don't realize that they are doing that stuff during the night and what they are told is by their bed partner. Hey you were snoring really bad I have noticed that you have quit breathing some times during the night and that means you probably need to go get checked out because you probably have sleep apnea. Lori Case kay and sleep apnea is that something you can die from? Rachelle Henderickso 47Yes Lori Case 47And just quit breathing all together Rachelle Henderickso 48If you keep going with having this problem of sleep apnea it will just keep getting more and more servere as you age because as we age the tissues in our throat get more relaxed same way with if you become overweight which like I said earlier if you don't get enough sleep that can actually cause you to gain even more weight. So those people just keep getting more excess tissues in the airway to block. And what will happen is when you are not getting enough oxygen to your heart and brain that will end up causing a heartattack and stroke which will then lead to death. Lori Case 20So that's a pretty serious case. Are men more susceptible than women with sleep apnea. Rachelle Henderickso t's mainy because they usually have the bigger necks so that is what is causing the airways to collaspe more is because men have large necks. Lori Case 33And being overweight is another risk factor? Rachelle Henderickso 35Yes so that is why we are starting to see more women with sleep apnea is because of being overweight. Lori Case 40And just because you snore doesn't necessarily mean you have sleep some people are just snorners. Rachelle Henderickso eah but there is usually some sort of struction going on. Lori Case 51Okay Rachelle Henderickso 51Yeah Lori Case 52Okay lets talk about insomnia Rachelle Henderickso 57Insomnia there's three categories of insomnia. What happens with insomnia is that the first1 category and second category everyone has had some point in their life. Everyone experiences1 insomnia at some point in their time. Trasient insomnia that's when you only experience insomnia1 symptoms for less than one week. Acute insomnia that's when you experience insomnia for one1 to three weeks and these typically occur because of something that has recently happend so1 you're studying for a test or have an important job interview coming up. Those are something1 that is stressing you out causing you to have difficulity falling alseep or maintaning sleep.1 Those two you really don't have to typically worry about cause like I said it is only occuring1 for a short period of time. Now when you need to worry about insomnia is when it is more1 chronic lasting for longer than three weeks at a time. That is when you need to contact1 your doctor, get a sleep study schedule to see what is causing the insomnia.1 Lori Casey Insomnia is just you don't sleep at all or1 maybe it's categorized by so many hours of sleep at night or how do you say you have1 insomnia? Rachelle Henderickson1 They really don't have a category for how long it is just people who complain that they1 are having a hard time falling asleep their maybe waking up to freuquently throughout1 the night or they are just having a hard time once they wake up in the middle of the night1 then going back to sleep. Lori Case :19So a symptom of that would be you're sleeping and keep waking up suddenly in a slight panic1 and then you fall back asleep. That could be1 Rachelle Henderickson That could be insomnia. However that could1 type of problem that is occuring throughout the night that could be due to sleep apnea.1 So that is why doctors like to get a sleep study done to see if it is something else1 causing the insomnia. Lori Case :40Then the last one you brought up is restless legs that is something we have probably never1 heard about ten years ago. Explain what that is.1 Rachelle Henderickson Restless legs is just where you have an unpleasant,1 tingling, creeping feeling or nervousness in the legs and it happens during inactivity1 or sleep. When you have an uncontrollable urge to move your legs in order to relieve1 those symptoms and so because you are constantly moving your legs or even kicking your legs1 at night that is causing you to have some sleep deprivation. So you feel like you are1 excessively tired during the day. Restless legs can be genetic or can be caused by a1 medical condition such as deficent in iron. A lot of people also have restless legs due1 to having to much nicotine or caffenie because they are stimulants and the stimulants is1 just constantly keeping the legs active. So people that have restless legs due to nicotine1 or caffenie the doctor of course tells them to quit that and see if that will make the1 symptoms go away. Otherwise if that doesn't help what they do is come in for a sleep study1 to see if there is some other reason that is causing the legs to jerk at night. We see1 that some people have sleep apnea that is causing the legs to jerk after they have an1 apnea in order to wake themselves up to start breathing again. So of course those people1 can just get put on CPAP in order to control it. Now if they are just constantly jerking1 their legs at night than they just have true restless legs and they get put on some sort1 of medication to help control the symptoms. Lori Case :04Is it usually like a muscle relaxer kind of medicaiton?1 Rachelle Henderickson Yes1 Lori Casey You mentioned the CPAP and we should have1 talked about this. If you are diagnosised with sleep apnea that is the treatment for1 it, correct? Rachelle Henderickson1 That is the most known treatment that tends to work for everyone is CPAP1 Lori Casey Okay and what is that exactly1 Rachelle Henderickson What it is is a machine that is going to continuously1 force room air down into your airways to keep the airway open cause like I said was sleep1 apnea the airway collapses or the tissues block the airway. So with the CPAP forcing1 that air in it will open up the airway and keep it open. So it kind of acts like a splint1 of the airway. You wear a mask over your nose or even masks that cover the nose and mouth1 and that will attached with a hose to the CPAP machine. Like I said it doesn't produce1 oxygen just room air into the airway. Lori Case :52Is that really the only treatment for sleep apnea1 Rachelle Henderickson No there is also surgery. Surgery is just1 mainly if you're a good canidate for it. An ENT doctor an ear, nose and throat doctor1 would have to look in the persons throat to see what type of excessive tissue they have1 to see if they are able to remove it. Some people just aren't canidates for the surgery1 at all and of course insurance likes for people to be able to try CPAP before they even think1 about surgery. CPAP works they tell them not to go for the surgery.1 Lori Case enerally in your line of work does the CPAP1 machine seem to be pretty affective for most people.1 Rachelle Henderickson I would say like eighty-five to ninty percent1 of people do perfectly fine on the CPAP machine. Lori Case :32Lets talk a little bit about sleep aids and how they really work? Talk about some over1 the counter things. What does that do? Rachelle Henderickson1 Sleep techs we personally do not like sleep aids. Mainly because sleep aids will not make1 a person go into their deep stages of sleep. I mean you can still but they tend to just1 try to put you to sleep and they just let you maintain your lighter stages of sleep.1 Now the main problem with sleep aids is that if you have sleep apnea your sleep apnea will1 be more severe with sleep aids and that's because sleep aids relax the muscles of your1 throat even further than what they would normally do. So that relaxing of your tissues and throat1 is collasping the airway even more causing you to have more sleep apneas.1 Lori Case o when you take a sleep aid does that mean1 you are not going into that deep sleep the rem sleep?1 Rachelle Henderickson Right it can. Like I said some people will1 stil have their deep stages of sleep but it probably won't be occuring as often as it1 should throughout the night. Lori Casey1 So Rachelle I should ask why is REM sleep so important to our body why do we need that?1 Rachelle Henderickson REM sleep is when the memory consolidates1 itself and that is when the brain will kind of repair itself so that is why REM sleep1 is very important. Lori Case :47And do you as you said before don't get in to REM sleep if you take a lot of sleep aids?1 Rachelle Henderickson Yes1 Lori Case kay. So are perscription sleep aids just1 a stronger version of what you can get over the counte, they kind of do the same thing?1 Rachelle Henderickson Correct. Yes.1 Lori Casey I know some people that you know if they can't1 sleep will take a swig of cold medicine. That does not have a sleep aid it in that's just1 alcohol probably? Rachelle Henderickson1 Yeah it is the alcohol that is in cold medicine that will do that to people. But yeah you1 shouldn't take that either. Lori Case :17It's a temporary kind of fix Rachelle Henderickson1 Yeah Lori Case :20Do you find that sometimes people can't get to sleep because they are thinking to much1 about trying to get to sleep? Rachelle Henderickson1 Yes that is an insomnia issue to. That's why we try to tell people if you are having that1 problem try to get out of bed for awhile do something else, maybe do some light reading1 or listen to soft music Lori Case :37Rather than lay there Rachelle Henderickson1 Right. If you lay there and stress about it you are just going to stress about it even1 more. Lori Case :42Let's talk a little about as we get older. My mom has said you know I use to be able1 to sleep so well and as I have gotten older I just don't sleep that long. What are some1 of the reasons that make us not sleep quite as good or as good as long the older we get?1 Rachelle Henderickson The older we get of course we deal with arthritis1 and just general muscle aches and pains. So because of the pains and the muscle aches1 that will cause a person to wake up throughout the night. Another thing is a lot of older1 people don't realize they have sleep apnea. Sleep apnea occurs more as we age just because1 the tissues get more relaxed and cause the airway to block off. So because of that it1 will cause the person to wake up a lot and so a lot of older people if they find themselves1 laying there awake for a little bit just get up and go ahead and get out of bed.1 Lori Casey Lets talk about younger people what is the1 recommendation for kids I know we will talk about infants, kids, teenagers. Recommended1 hours of sleep for those age groups. Rachelle Henderickson1 Infants they recommend like sixteen to eighteen hours of sleep. Children like toddlers up1 to ten years old should get anywhere from twelve to sixteen hours of sleep. Now of course1 the little toddlers are going to be closer to the fourteen sixteen hours of sleep and1 as you age it's more of the twelve to fourteen. And then teenagers they need around eight1 to about twelve hours of sleep. Now once they hit more of the adult version of the teenager1 once they hit around sixteen then they can do more of the adult sleeping like seven to1 nine hours of sleep. Lori Casey1 That is usually the population that sleeps till noon.1 Rachelle Henderickson Exactly.1 Lori Case hich brings me to my next question. Is over1 sleeping and getting to much sleep you would think oh that would be a good thing. Is it?1 Rachelle Henderickson No. It is not a good thing you need to try1 to maintain more of the seven to nine hours of sleep now if you need a little bit more1 thats fine like the ten hours, but especially teenagers that will tend to sleep normal during1 the week, they will have a normal bedtime routine but then on the weekends they are1 going to bed at around twelve or one in the morning and not waking up till noon the next1 day. They are sleeping longer usually because they are not sticking with that same bedtime1 routine so that is what will make them oversleep. So that is why you need to stick with the1 same wake and sleep schedule. Lori Case :06It can be, what does having to much sleep that can be not a good thing either. In general1 that seems to affect your sleep later. Rachelle Henderickso :14Yeah it can cause some insomnia issues the next night1 Lori Case o in other words I was I was going to ask1 you can't make up slee, can you? Rachelle Henderickson1 Correct you cannot make up sleep. Lori Case :23I try and it just doesn't work. Rachelle Henderickson1 Well maybe take a nap but then you have to worry that sometimes the nap can actually1 affect your sleeping that following night as well.1 Lori Case ell lets, that's my last question lets talk1 about the naps. What you recommend? When is a nap good? When is a nap not?1 Rachelle Henderickson A nap is good as long as you stick to less1 than thirty minutes at a time and that is mainly because if you sleep longer than that1 you are going to go into your deeper stages of sleep which is just going to make you more1 droggy, because then if you don't get your full eight hours of sleep your body is just1 going to not go through the sleep stages like it should. So if you let yourself sleep to1 long you are going to fall into the deeper stages of sleep, and get to droggy. Now if2 napping can be harmful if you are finding it is hard to fall asleep at night or if you2 are having a difficult time maintaining sleep at night. Then if you're one of those people2 you just need to completely avoid naps all together.2 Lori Case kay. Alright so you have mentioned several2 things times gettng a sleep study when would you go to your doctor?2 Rachelle Henderickso f you notice that you are having symptoms2 longer than three weeks. However if you already notice your snoring, gasping for breath, stopping2 breathing then you already have a problem and you need to go see your doctor immediately,2 Lori Case ost likely they will say head to a sleep2 center. Rachelle Henderickso :41Correct. Lori Case :42Which we are going to take you to in just a minute to find out what happens when you2 go to a sleep center. Give us a little preview of what sort of processes before we see it.2 Rachelle Henderickso hat happens when a person enters sleep lap2 they come in and go through some paper work, go through a little bit of their history with2 the sleep technison. After that the technison then sits the patient down and hooks them2 up. You're pretty much hooked up from your head down to your legs. The wires on your2 head measure any sleep stages that you are in. You're going to have some wires by your2 eyes so they can see the eyes move that way they can tell if you are dreaming. If you2 are going through that rapid eye movement. You are going to have some wires on your chin2 to see if you grind your teeth. You are going to have wires on your nose to see if you quit2 breathing at all. A microphone in your throat to see if your snore or talk in your sleep.2 You're going to have sensors on your chest for heart rate and heart rhythum. Belts across2 your chest and stomach to see if you quit breathing also and then you are going to have2 some sensors on each leg to see if you jerk your legs that way you can tell if you have2 restless legs or not. And then an oxygen probe on your finger to measure your oxygen saturation2 in your blood. So they will hook those sensors up takes like a good forty-five minutes to2 do so and then around ten oclock is when we do lights out and people will go to bed. They2 go through some little exercises with the patient just to make sure all the equipment2 works fine and then the person is just asleep all night. And then they typically wake them2 up around five thirty six oclock in the morning. Lori Case :03Alright well stay tuned we are going to head out to the Sarah Bush Lincoln sleep center2 in just a bit so don't go away there is more being well right after this.2 Unknow heck out all the episodes plus demonstration2 segments from being well series. Visit us on youtube.com/weiutv2 Unknow or an inside look at what happens during2 s sleep study we headed to the sleep disorder center at Sarah Bush Lincoln Health System.2 Katie Marti henever you get here we wil go through some2 paper work. You can ask any questions then if you whatever you need to know. We will2 go through all the paperwork, have you change get into whatever you're going to be wearing.2 Then I will come back in start hooking you up, that will take about depending on your2 tag about thrity to forty-five minutes. After that you are free to sit around, watch T.V.2 do whatever you want. Then we put you to bed around anywhere from 9oclock to 10oclock.2 Unknow wenty-five different sensors are placed on2 the head, chest and legs. The sensors send information to the techs in the monitor room2 with the results being analyzed the next day. We will run the study from the tech room.2 Katie Marti e will see we watch you whenever you sleeping2 if you're not sleeping or breathing. We can up your events if you met enough events for2 the night then we will come in and put a CPAP machine on you if you have stopped breathing2 a severe amount of time. We will do that all in the same night. Otherwise we just let you2 sleep the whole night and watch what you do. Unknow :37Caregivers or family members who need to spend the night can do so in a separate room. If2 you have got a sleep study scheduled here are a few things that you should do before2 you arrive. Katie Marti :47Make sure you don't have any kind of lotions on you or that sort of thing. Just cause our2 sensors won't stick very well to lotion so defintely shower, make sure your hair is clean,2 no oily hair cause the sensors will slide right out of that. And yes defintely wear2 loosing fitting clothing. Unknow :07With the study complete and the results analyzed hopefully you will be on your way to a better2 nights sleep. Thanks for watching this edition of being well. We'll see you next time.