Hey everyone, it’s Medicine Mondays. Today, I’m going to be talking about something that falls by the wayside. We’re going to talk about “Sleep Hygiene“.
This is kind of an uncommon topic to talk about. The reason for this is because it’s “not a problem until it’s a problem.”
What do I mean by that? Well, when you’re young, even if your sleep hygiene is bad in general you can compensate just because you’re young and don’t need to have “perfect rest” in order to function. However, as you get older, this becomes more difficult.
I don’t think any research has been done on it, but I think just about everyone can anecdotally remember pulling all-nighters in college or med school. Not only that, you could do it and then “bounce back” the next day just by getting a little more sleep. However, if I was to pull an all-nighter now it would probably kill the rest of the my week as I tried to get back on a normal sleep cycle.
Additionally, sleep is different for different people. Some people only need 6 hours of sleep and that’s it. Others, if they get less than 9 hours of sleep, are zombies. Sleep is complex.
Why talk about this now?
There are a couple of reasons. The primary one is just because it interests me. Way back when I was in medical school, I was interested in eventually specializing in sleep medicine. There are many routes to a sleep fellowship. However, when I was a medical student, the most common routes were through medicine/pulmonology and neurology. Psychiatry also has some paths to go into sleep medicine as well. The original plan I had in mind was to do neurology and then eventually either do stroke/neuroIR or sleep, depending on how my residency went. However, since I went into radiology instead, any path to sleep medicine kind of ended there. Nowadays, there are a lot of paths to do a sleep medicine fellowship:
“Applicants must have completed a residency in Neurology, Internal Medicine, Pediatrics, Psychiatry, Otolaryngology, Anesthesiology, or Family Medicine.” – Sleep Medicine Match
The other reason is that I’ve had some problems sleeping in the last few months. I’ve talked about Trimming the Fat, Falling off the Wagon, and then Trimming the Fat Again. With the changes to my coffee drinking, I was having swings in my caffeine intake. More so than that, sometimes I end up finishing my coffee way too late, after even 9 pm. For some this may not make a difference, but this was enough to wreak havoc on my sleep cycle. There would be nights where I would get home at midnight or so and not fall asleep until past 2 or 3 am. Then I would get up at 6am to help my wife get the kids ready and try to go back to sleep again.
However, since my last vacation where I was on a more reasonable sleep schedule (and off coffee), I was able to “reset” things I think. I’ve figured out that for me, the best way to maintain my attention span for my 10 hour shifts is to drink a cup of coffee at 1:30 pm, a half cup around 6:00 pm, and then sip some tea at around 8:00 pm. By the time 11:30 pm rolls around I’m ready to go home and go to sleep. However, my attention span is optimal for that 10 hour span. Just to clarify, this is coffee brewed at work, not Starbucks coffee.
By the time I get home and in my bed, it’s about midnight. But I can usually fall asleep within 5-10 minutes. Then when 6 am comes around, I’ve had my 6 hours of sleep and can help the kids get ready, and then maybe get another hour or two once they’re out the door. Or, if there is something going on that morning, like swimming or hula or something, I can usually still go to the event without being overly tired.
It may seem like a small change, but over a long arc of time, I think this small change helps.
For those of you doing night float and overnight shifts, please be careful driving afterwards. I used to do my 2 weeks of night float and then drive 5 hours to go see my girlfriend (now wife) for that “golden weekend”. It was very difficult, and thinking back on it, probably not very safe. I don’t think I’ll be able to stop anyone from doing it, but please be safe.
Don’t just “push through” the sleepiness when driving. Listen to your body. Go and utilize a rest stop. You don’t want to get into an accident or get hurt.
Also, sleep apnea is probably way more common than we think, and it probably occurs in people younger than we think. However, because of their young age, they don’t manifest the symptoms of being tired because they can get by on less sleep.
I should probably get tested for sleep apnea because my wife says I snore too loud.
Some people just have problems sleeping their whole lives and need to use sleep aids. However, I think it’s a good idea to see a dedicated sleep doctor first before utilizing a sleep aid.
I didn’t know about this entity, however, my wife told me it’s helpful for kids with autism and ADHD. Supposedly there is a calming effect to the added weight, similar to a baby being swaddled or just being hugged in general. To be honest, I don’t know much about it, but it seems to help some people. However, they are pretty expensive for what you get, here’s an example I found for ~$70:
However, there are a ton of different Weighted Blankets (of varying quality) and I’ve seen them mostly between $100-200. Note that the size and weight you need will be different based on how much you weigh. In general, it seems to be ~10% of your body weight is what is considered “suitable”. For example, if you weigh 120 lbs, you probably want a 12 lb blanket.
From my understanding these blankets are usually breathable and won’t make you feel “hot”. Their major purpose is their weight, not insulation. It seems some people use these weighted blankets in addition to their own blankets. However, it’s still “extra material”, so you probably won’t want to use it in 90 degree heat — in which case you probably wouldn’t be using any blanket at all anyways.
I am thinking of buying one for my wife to see if it helps her sleep better.
Take care of your sleep hygiene.
Your ability to compensate from poor sleep gets worse as you get older.
Small changes can have big results.
Don’t drive tired/sleepy.
Sleep apnea is more common than we think.
If you need a sleep aid, please be evaluated by a sleep doc first.
Weighted blankets are interesting – and seem to help some people. I’m considering buying one for my wife.
Agree? Disagree? Questions, Comments and Suggestions are welcome.
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