sleep questions answered by a doctor
Healthy Living

Advice from a Sleep Medicine Specialist

Aug 2 2018

Dr. Sanjiv Patel speaks about sleep awareness on 700WLW’s Mercy Health Medical Minute podcast.

Prior to the recording session, Dr. Patel sat in a swivel chair and waited for radio personality Mike McConnell’s arrival with the chief producer, an Integrated Media Solutions provider and a Mercy Health marketing representative in the iHeartRadio soundboard room.

“How do you think dolphins sleep at night?” he asked the small group.

The Integrated Media Solutions provider asked if dolphins float on the ocean surface, and a smile crept on Dr. Patels’ face when another guessed that dolphins mildly beach themselves in shallow waters.

“These are fantastic and common responses. As you know, dolphins are mammals that need air to live,” said Dr. Patel. “They do not have a physical resting time, and their brains are divided into two regions. One remains active and carries out the body’s functions while the other ‘sleeps.’ They continuously switch roles so that dolphins are always alert.”

“You thought that was interesting? Wait until you hear my thoughts about human sleep!” Dr. Patel concluded.

Read more of Dr. Patel’s sleep insights in the following Mercy Health Medical Minute interview.

Mike McConnell: Why do some people sleep well, while others wake up four-to-five times a night and have difficulty falling back asleep?

Dr. Patel: There is a whole midrib of disorders. Many of the issues with sleep are self-imposed; for instance, someone may drink caffeine after dinner and does not make sleep a priority. Sleep is fundamental to all living organisms, and researchers trace sleep down to bacteria. Single cell organisms have some form of rest, so this indicates that sleep is important to every animal on this planet. I tell patients this all the time: You spend a third of your life sleeping, but you often spend little time thinking about it.

Mike McConnell: How do we know when we hit just the right amount of sleep? I’m a good sleeper. I may have people come up to me and say, “You sleep TOO much.” When do you know you’ve slept well?

Dr. Patel: I have quite a few patients tell me they can fall asleep anytime and anywhere. That’s not normal. When someone feels rested during the day, they slept seven or eight hours the night before. There are periods of time when we operate a little slower after lunch, and that’s a natural dip in our circadian rhythms. When you can get through the day without sleepiness or difficulty concentrating, you received a good amount of sleep. Quality sleep is the important key for receiving the right amount, and many people have a hard time measuring it. That’s where sleep medicine specialists play a role.

Mike McConnell: This is a little off topic, but I recently read a book called “Before There was Light.” It claims that people once slept twice at night. They fell asleep a little after dark, woke up around midnight, stay awake for one hour and go back to sleep again. That was the normal human cycle until we invented electrical lights that allow us to extend our evenings and sleep for a full eight hours. Does this mess with people to a certain degree?

Dr. Patel: Sleep studies from Mammoth Caves suggest that people stick to sleeping eight hours, but each night they progressively sleep an hour later when there isn’t a sense of time from natural light or clocks. Our intrinsic circadian rhythms are about 24 hours in a day. The only thing that resets us to 24 hours is sunlight, but our bodies intrinsically operate on a 25-hour cycle. There are also evolutional questions about two-phasic sleep versus one-phasic sleep, and what I can say from my experience is that patients still sleep seven hours when they’re placed in dark rooms.

Mike McConnell: Sleep medicine involves what from A-Z?

Dr. Patel: Sleep medicine specialists look at all aspects of your sleep. The most common sleep disruptions include sleep apnea, insomnia and narcolepsy. In pediatrics, we most commonly treat sleep walking, nightmares and night terrors. There is a disorder we call parasomnia, where people unconsciously yell, scream and act out their dreams. We also treat movement disorders, such as restless leg syndrome, which involves periodic movements when you kick in your sleep. By far, the number one most common disorder we treat is sleep apnea.

Mike McConnell: What are some ways to improve your sleep?

Dr. Patel: I recommend three ways to improve the quality of sleep:

  • Stay physically active: It helps consolidate and improve our circadian rhythms.
  • Never exercise too late: In some ways, these 24-hour gyms are nice because they give you a resource for exercise, but exercise raises your body temperature, which in turn raises your brain temperature and alerts your organs to stay awake. We tell people to cease exercise five hours before bedtime.
  • Reduce caffeine intake: I have patients tell me they can drink a full bottle of Dr. Pepper and fall right into a sound slumber, but sleep medicine researchers know caffeine affects the sleep rhythms even if the patients do easily fall asleep. Bottom line, you don’t receive a quality sleep because the stages of sleep accelerate much faster than normal. Caffeine is also a diuretic, which makes you wake up needing to use the restroom.

Mike McConnell: Do Americans have more sleep problems than other countries?

Dr. Patel: The American Sleep Academy has a phone survey they conduct every two years, and we are one of the most sleep deprived countries. Other countries often recognize the need for an afternoon siesta – a break for naps. In other European countries, they tend to wake up later and they eat later, which helps their bodies fall into a more natural sleep circadian. The United States always has a “get up and go,” “move, move, move,” 24/7 culture, which affects how people perform. In the sleep surveys, we know more than 50 percent of Americans complain about some sort of sleep disorder or disturbance.

Mike McConnell: If someone comes up to you and says, “I’m just a very light sleeper. I wake up four times a night and turn on the TV or flip open my iPad.” Are these device lights bad for your sleep?

Dr. Patel: Light tells us when it is day and night, so the worst thing you can do is stimulate your brain by opening a device and having the light enter your eyes and receptors. When you wake up at an irregular hour, you typically pick a stimulating activity. Instead, try these things when you can’t fall asleep:

  • Listen to light music
  • Read from regular, paper-bound books (NO e-readers)
  • Refrain from using indirect light (While blue waves seem to activate our eye cells the most, all forms of light trigger wakefulness.)

Mike McConnell: What about adults? Have you ever had a 35-year-old with restless leg syndrome or whatever else? Is there a drug you usually give them?

Dr. Patel: We examine the patients first and review their medications. For instance, restless leg syndrome can be a side effect for certain medications treating something else. Even over-the-counter medications, nicotine and caffeine trigger restless leg syndrome. We start analyzing what the patients consume each day and what drugs they use. From there, we work through the situation. We may need to conduct additional work or medical research. If medication is appropriate, we provide a prescription.

Do you have tips for setting up the perfect sleep environment? Let us know in the comments section.

Tune into the Mercy Health Medical Minute on 700WLW AM at 7:45 a.m. Monday-Friday. Each week, Mercy Health experts share their medical interests and insights. 

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Patti Hian

I recently fell and broke my back in 2 places had kypho plasty. I’ve been home recovering and have time to read all these email you may normally don’t have time for. I think there is much valuable information provided. Needed the info on sleeping. Thank you
August 02nd, 2018 | 10:49pm

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