When it comes to sleep, you toss and turn or you can’t fall asleep at all. There are only so many sheep you can count. Or maybe you find yourself waking up several times a night (even without a poke in the side because of your snoring). 

March is National Sleep Awareness Month which focuses on an opportunity for you to take a look at your own sleep habits and make improvements in the quality and quantity of your nightly rest. 

How Sleep Works

Sleep is a complex process and still part of proven science and intriguing mystery. Multiple parts of your brain are involved in producing hormones and helpful chemicals that regulate your rest and wakefulness. There are four main stages of the sleep cycle based on what’s called REM (rapid eye movement). The first three stages are non-REM sleep in which your brain and body slows and your muscles relax. During stage three deep sleep, your body repairs itself and builds tissue, muscle and bone. The fourth stage is REM sleep that allows your brain to process information, dream and store memories. 

Normal sleep involves each sleep cycle lasting about 90 minutes with four or five sleep cycles repeated per night. For years the tried-and-true number of hours of sleep needed for healthy adults was considered eight hours. Sleep experts and medical professionals are now realizing there is more of a range of six to eight hours. As their bodies grow and develop, teens, children and infants require the most sleep, with some newborns needing up to 17 hours a day. In my observations, senior adults may need more sleep because they suffer from the worst sleep. As you age, your brain doesn’t really sleep as efficiently. Older adults also face more health difficulties that interrupt their rest. 

Common Sleep Problems

Your physical, emotional and mental health are interwoven in how well you sleep. As a think Internal Medicine physician, I see a wide range of patients with varying degrees of sleep deprivation. Common sleep disorders include insomnia, obstructive sleep apnea and restless leg syndrome. The most prevalent sleep disorder is insomnia, the inability to fall asleep and stay asleep.

Other health conditions such as pain, menopause, enlarged prostate and respiratory ailments including asthma also affect sleep patterns. People with uncontrolled heart failure, diabetes and other chronic illnesses also experience a lack of restful sleep. 

Effects of Sleep Deficiency

Sleep deficiency means you don’t sleep enough, you don’t sleep well, you sleep at the wrong time of day (narcolepsy) or you have a sleep disorder that causes poor-quality sleep. Reports show that about one-third of Americans are not getting sufficient sleep every day. The National Institutes of Health states, “an estimated 50 to 70 million Americans have chronic, or ongoing, sleep disorders.” 

A lack of sleep contributes to mood disorders and mental health struggles, decreased focus and concentration, loss of productivity, injuries and even an increased risk of death. People also tend to gain weight with sleep deprivation because they tend to crave calorie-rich food and they opt for eating more unhealthy comfort foods when they are overtired. 

Not getting sufficient sleep is also linked to more long-lasting health problems including depression, high blood pressure, diabetes, kidney disease, heart disease and stroke. It is a myth that people can cope well with little sleep for great lengths of time and experience no negative effects.

How to Improve Sleep 

Our sleep is affected because our lives are too busy and too stressful. Screen time and social media habits tend to bleed into our evenings. We cause our circadian rhythms, part of our body’s internal clock, to get off balance when we stay up late some nights and sleep in other mornings. Most people actually train themselves to be bad sleepers. So most sleep can be corrected through regimenting your lifestyle. 

The following are steps to improve your sleep habits:

• Stay with a routine for when you go to bed and wake up every day. On the weekends limit your extra sleep to only about an hour more. 
• Reserve the hour before bed for quiet. Avoid bright artificial light from TV and computer screens. Turn off the loud music and skip intense exercise late in the day. 
• Stay away from large or heavy meals within a few hours of bedtime. A light snack can be okay, but don’t load up too much. 
• Avoid drinking alcohol close to bedtime. Alcohol can make you feel drowsy, but it interferes with the architecture of your sleep overall. 
• Consider the effect nicotine and caffeine (caffeinated sodas, coffee, tea and chocolate) have on your body. Nicotine and caffeine are both stimulants that can impair sleep quality. Some people are not affected by caffeine later in the day, so beware of your individual response. 
• Stay physically active every day. When possible, get outside and move around during the day so your body gains the benefits of exercise.

When You Need Medical Help for Your Sleep

If you’re dealing with sleep disruptions consistently, I recommend making an appointment with your think healthcare provider. We can do a full assessment to determine the root cause of your sleep problems. 

Insomnia is the most common sleep disorder and most cases are caused by lifestyle, particularly extra stress and anxiety in a person’s life. To help, we recommend following better sleep hygiene (see the steps above) and learning better emotional and mental health exercises to eliminate the worry and stress triggers. We also refer patients to our Behavioral Health team if certain mental health conditions are blocking nightly rest.

Sometimes, we will prescribe medications for insomnia, but none of them actually help your sleep structure. They just kind of make you drowsy so you can sleep. I dissuade the use of certain over-the-counter medications like Benadryl^® because there’s information that the diphenhydramine drug leads to dementia. 

Research shows that on average a sleep aid only gains you 20 minutes of extra sleep a night. We have to weigh that out with the side effects of taking a sleep medication. It is also pertinent to tell your medical provider about all prescriptions and medications you are taking so we can ensure the medicines are interacting well together and not causing your sleep issue. 

If we determine that you have an underlying health condition such as sleep apnea, we may refer you to a sleep specialist for further evaluation. But first, losing some weight often helps correct obstructive sleep apnea. Be encouraged that most sleep disorders are treatable. All of us at think Whole Person Healthcare want you well rested and safely enjoying your life again. Come see us and let’s get you catching that beauty rest and more. 

NEED MEDICAL CARE? CONSIDER THINK YOUR GO-TO FOR BETTER HEALTH

Think Whole Person Healthcare is dedicated to keeping you healthy through preventative care and treatment for a wide range of medical conditions. From sleep issues to persistent back pain, our physicians, advanced practice providers and specialists are committed to you and your family’s lifelong health and well-being. 

Our walk-in clinic treats anyone, even those who are not a think patient or do not have a primary care provider currently. To learn more about our comprehensive healthcare services, visit our Services page online and choose your own think medical professionals by visiting our Meet Your Doctor page. 

We help you stay healthy. Give us a call at 402.506.9000. 

Nearly half of all adult Americans have high blood pressure. That’s approximately 116 million people. Hypertension is a very treatable disease and yet takes the lives of more than 500,000 people–each year!

What is Hypertension and its effect on your body?

Hypertension is the medical term for high blood pressure. A healthy adult’s blood pressure will have a systolic blood pressure up to 120 mmHg and diastolic blood pressure of lower than 80 mmHg. There are two diagnostic stages:

1. Stage One is classified with a systolic blood pressure of 130-139 mmHg and a diastolic blood pressure range of 80-89 mmHg.
2. Stage Two is over 140 mmHg systolic and over 90 mmHg for diastolic.

How to read your blood pressure.

There are two numbers that make up your blood pressure reading.

Systolic Blood Pressure is the pressure exerted when the heart pumps blood into the arteries. Systolic pressure is the top number of the fraction systolic/diastolic.

Diastolic Blood Pressure is the pressure in the arteries when the heart rests between beats. Diastolic blood pressure is the bottom portion of the blood pressure fraction.

Over time, untreated Hypertension can affect the body in significant ways. 

Arteries are flexible and can expand and contract as needed. Over time, the pressure of blood flowing through your arteries can damage the cells lining your arteries. The damaged cells will cause your arteries to be less flexible and constrict blood flow. The constant pressure of blood running through weakened arteries may cause aneurysms—an aneurysm forms when the weakened arterial wall bulges. The Aorta is a common location for aneurysms to form. 

Aneurysms can go unnoticed; however, they can be life-threatening when they rupture. Your heart has to work overtime when a patient has high blood pressure. Hypertension can lead to coronary artery disease, enlarged left ventricle-the part of the heart that pumps blood to the body, or even heart failure (heart attacks).

High blood pressure can also damage your vision. Over time, the tiny blood vessels in your eyes can be overstressed and impede blood flow to your eyes. Retinopathy is common among patients with Hypertension.

Hypertension is one of the leading causes of kidney failure. Damaged blood vessels impede kidney function and ultimately cause kidney failure, needing dialysis, or a kidney transplant.

Brain functions are also affected by high blood pressure. Strokes and Transient ischemic attacks (TIA, or sometimes called ministrokes) are common among people with Hypertension. When the blood flow to the brain is compromised, patients may also experience dementia and other cognitive impairments.

What are common symptoms of Hypertension?

One of the biggest challenges of identifying Hypertension is recognizing the symptoms. One-third of those diagnosed with Hypertension didn’t know they had high blood pressure. 

Stage one hypertension usually goes undetected unless your Primary Care Physician sees you. 

Stage two hypertension or more severe Hypertension may present some symptoms such as:

• Headaches
• Vision issues
• Difficulty breathing
• Pounding in your chest, neck, or ears
• Nosebleeds
• Chest pain
• Irregular heartbeat
• Dizziness, nervousness, sweating
• Trouble sleeping
• Facial flushing

What causes Hypertension?

The exact causes of high blood pressure are not known. However, studies have shown that several variables can contribute to Hypertension. These risk factors can include but aren’t limited to:

• Genetics – You may have a family history of Hypertension.
• Age – Your blood pressure can increase with age.
• Race – People of African heritage may develop Hypertension faster than Caucasian folk.
• Diet – Too much sodium or too little potassium can contribute to Hypertension. Alcohol consumption can lead to Hypertension.
• Stress – High levels of stress can increase blood pressure. 
• Tobacco – Smoking and chewing tobacco are directly linked to Hypertension.
• Sedentary – Not getting enough exercise can contribute to Hypertension.
• Obesity – Studies link obesity with a higher occurrence of Hypertension.
• Other diseases – Diabetes, sleep apnea, and some kidney diseases can increase your chance of developing Hypertension.

What can I do to avoid Hypertension?

The best way to avoid getting high blood pressure is to see your Primary Care physician regularly and follow their advice. Hypertension can be managed when diagnosed early. Some common changes patients can make to help avoid high blood pressure are:

• Health Maintenance – See your Primary Care physician at least annually.
• Diet – Change your diet to include more vegetables and less red meat, and fried foods. Reduce your sodium (salt) intake. Cut back on the amount of alcohol you consume.
• Exercise – Even taking a walk in the evening is better than sitting on the sofa. Exercise combined with diet can greatly improve the odds of not having health issues in the future.
• Relaxation – Meditation, yoga, or changing stress-inducing situations in your life can help mitigate the risk of high blood pressure.

Some common treatments for Hypertension.

Physicians will want to try the least invasive treatment program, which starts with lifestyle changes before medication intervention in the case of Hypertension. General treatment approaches for both stages of Hypertension begin with lifestyle changes like weight reduction, dietary changes, limiting alcohol and sodium, exercise, and stress reduction. Your doctor may prescribe medication if lifestyle changes are ineffective.

There are a variety of medications available to treat high blood pressure. Each one works a little differently and comes with unique side effects. Your doctor can work with your Clinical Pharmacist to prescribe the best medication for your specific case. It’s important when taking new medications to follow the prescribed dosage and instructions. Feedback on how the medication works and any side effects can help your doctor adjust your medication program. Some medications work better when taken at certain times of the day, so be sure to take your medication at the time your doctor prescribes.

Treating Hypertension is most effective when treatment includes both lifestyle and medication therapies. When properly treated patients can live symptom-free, productive lives.

I think I have high blood pressure. What should I do?

As with any medical concerns, you should schedule an appointment with your Primary Care physician who can examine you for high blood pressure. You may be asked to provide routine blood pressure checks in order to establish a baseline. Your doctor and care team will work with you to create a treatment plan to address your health issues. The important thing to remember is that hypertension is not something to ignore.

Don’t have a Primary Care provider? Visit our Find your doctor page and schedule an appointment for your medical exam today!