By Dr. Joel Bennett, Consultant to Designed Wellness
(Note. This is a follow-up to Part 1 on “A New Era in Healthy Sleep”)
Self-Assessment, Stress, and Consultation: Early Intervention
For a growing number of adults and children, even the healthy habits discussed in Part 1 may not be sufficient. According to the Centers for Disease Control, sleep is increasingly recognized as important to public health, with sleep insufficiency linked to motor vehicle crashes, industrial disasters, and medical and other occupational errors. In particular, estimated prevalence rates of sleep apnea have increased substantially over the last two decades, most likely due to the obesity epidemic. It is now estimated that 26 percent of adults between the ages of 30 and 70 years have sleep apnea.
Hence, it is also important to monitor yourself. In my interview with sleep expert Jessica Davenport (see Part 1), she emphasized knowing “what is my normal?” Track your drowsiness during the day or changes in sleep quality. In college, Jessica was known as “The Queen of Naps” because — or so she thought — her hard studying at night and ordinary school stressors required pillow time during the day. Today, ten years later, her friends call her “The Narcolepsy Whisperer” because she’s assisted several friends and family members get the proper sleep disorder diagnosis. It took Jessica over 10 years to get the proper diagnosis for her sleep problems. This was partly due to a general lack of scientific information available to the public. In addition, Jessica now believes that routine self-assessment can be critical to making sure one gets the support (and/or early intervention) needed.
Here are important tips to know about early intervention.
- Self-Assessment Tools. Hundreds of sleep health measures exist (see 2014 review here). There are several online subjective surveys that can help you keep track of your “normal.” This includes the most commonly used Epworth Sleepiness Scale, which is available from Division of Sleep Medicine at Harvard Medical School. I am also a big fan of tracking how well you unwind after work and daily recovery of energy. My colleagues and I have studied healthy unwinding after work and there is also the “Recovery Experience Questionnaire.” See inset for sample items. A new scale called “R U SATED?” is also shown in the insert below. There are also mobile applications to track sleep, reviewed by Men’s Fitness magazine in 2014.
- Stress and Anxiety Management. Many sleep issues occur because we stay awake worrying about problems from the day or are anxious about upcoming events. There are also key life transitions (pregnancy, moving, new job, marriage) that require more psychic energy to manage. It is possible that a sleep disorder could be triggered by trauma, job stress, the accumulation of stressors or untreated anxiety problems. All this means is that (1) insufficient sleep may NOT be the root cause of one’s problems, (2) healthy coping skills can often help with sleep, and (3) we may need to seek help from a professional.
- Seeking Help. It may be time to seek help from a psychological counselor or wellness coach if diet, exercise, stress, or anxiety are behind your sleep problems. They may help you get on the right track. If not, consider a professional sleep doctor. Not many primary care doctors have been trained in sleep medicine. If they prescribe sleep medication that only masks your core problem, you would not get the proper type of help. To find the right professional for you, here are some resources:
- A Note About Supplements. Research suggests that between 5% and 10% of the U.S. Population use some type of herbal supplement to help with their sleep problems. This includes valerian, melatonin, echinacea, ginseng, and ginko biloba. Other studies shows adults using chamomile and kava to help with sleep. A 2006 review of 16 studies suggest valerian might improve sleep quality without producing side effects. However, we still do not know how effective these supplements are because of poor manufacturing or labeling on products and lack of proper clinical studies.