by Rick Mitchell, M.D.

“In peace I will lie down and sleep, for you alone, Lord make me dwell in safety.” Psalm 4:8

It is, perhaps, a case of “Physician, heal thyself” that leads me to write about the subject of sleep, and in the space I have I won’t be able to do it exhaustively (pun intended), but I’ll take a shot at it. If I fumble over my words or ramble a bit, those are symptoms of sleep deprivation, and I ask you to forgive me.  I was up too late last night doing some cleaning (but those dishes don’t do themselves, you know?), and I fear I may not be my usual eloquent self. As you see, I’ve already needed to resort to puns which shows you that on a cleverness scale of “Wearing Furs” to “The Creation of Forced Air Heating Systems”, I’m at “Hey Guys, What Do You Suppose Is At The Bottom Of The Crack In This Glacier?”

As a doctor, I view overall health as a three-legged stool. One leg is nutrition, the second is exercise, and the third is sleep. With some obvious exceptions, most diseases are either the direct result of a problem in these three areas, or else these three areas are significant contributors to disease. Contributions from nutrition and exercise are pretty easy for most people to understand and buy into. For example, people with diabetes or high blood pressure are told to be careful with the sugar or salt in their diet. We tell people with heart issues that they need to exercise regularly. However, I think that most of the patients I tell, “You need to get some more sleep!” discount the advice. “Some more sleep would be nice, but I don’t really need it to be healthy – I’ll just be a little tired, that’s all.”

But poor sleep is a big public health issue! According to the CDC, “35.3% of adults reported <7 hours of sleep during a typical 24-hour period, 48.0% reported snoring, 37.9% reported unintentionally falling asleep during the day at least once in the preceding month, and 4.7% reported nodding off or falling asleep while driving at least once in the preceding month…The National Department of Transportation estimates drowsy driving to be responsible for 1,550 fatalities and 40,000 nonfatal injuries annually in the United States.”

We know that when people are sleep deprived, their concentration suffers, they have a hard time making new memories, and it can make it difficult to access information they already know. I often see patients who are worried that they may be at the beginning of Alzheimer’s dementia because they walk into a room and forget what they were looking for, or can’t remember words to express their ideas, and what is often happening is that they aren’t getting enough sleep. Poor sleep contributes to worsening anxiety, depression, and pain from all sources. About $4500 per minute is lost in the United States to fatigue related work absences. 7 million doctor visits per year are attended to discuss fatigue.

Then there are sleep disorders themselves.  An estimated 10% of Americans suffer from obstructive sleep apnea. 6-7% of people suffer from insomnia. Restless leg syndrome is thought to affect up to 10% of people at any given time. There are a whole host of other sleep disorders known to medical science.

All this sleep difficulty comes despite a hefty price tag. In addition to lost wages from fatigue as noted above, a 2012 article in The Financial Times suggested that money spent to the “sleep market” which includes over the counter sleep aids, sleep testing, specialized sleep products and things like that runs about 32 billion dollars annually!

So what do we do about this?  For starters, you can practice good sleep hygiene measures. These include avoiding drinking alcohol near bedtime (which gives poor quality sleep), keeping a consistent bedtime and wake up time even on the weekends, saving the bedroom for sleep alone (and moving that TV out of the bedroom), and not staying in bed if you’re tossing and turning. Getting some early morning exercise, especially outdoors, can help reset your sleep cycle in a healthy way. Avoiding caffeine and other stimulants after noon can help keep you from having to fight to get to sleep. And giving yourself a few minutes at bedtime to pray is a good idea for a bunch of reasons!

Finally, take your sleep seriously! If you find yourself unable to get a consistent 7-8 hours of refreshing sleep each night, this is important enough to bring to the attention of your usual health care provider. Don’t let anything get in the way of your sleep. Don’t worry, those dishes will wait!