Sleep: A Precious Commodity

Sleep: A Precious Commodity

Did you wake up this morning refreshed and ready to tackle your to-do list with focus and energy? Or did you lean on coffee, caffeinated tea, or energy drinks to jump-start your day because you slept poorly or not enough? This article will cover the importance of enough restful sleep, as well as potential barriers and solutions that may benefit you and your patients.

The Importance of Enough Restful Sleep

Sleep is a precious commodity for individuals of all ages. Getting enough sleep supports good health—including your heart. While the recommended number of hours of sleep is highest for infants, even adults are recommended to get 7-9 hours of sleep.

It is well known, however, that, like many health recommendations, not everyone meets these goals. The Centers for Disease Control and Prevention (CDC) estimates that 1 in 3 people in the US are living with sleep deprivation.[i] This not only causes drowsiness or grogginess (never a good thing when trying to learn, take a test, care for patients, problem-solve, or operate a car or other machinery) but may also lead to chronic diseases and conditions.

In 2023, the American Heart Association released Life’s Essential 8™, which included updated key measures for cardiovascular health and added the dimension of sleep.[ii]  

Poor sleep may put you at risk for:2

  • Cardiovascular disease and stroke
  • Dementia; cognitive decline
  • Depression
  • Hypertension
  • Elevated blood sugar
  • High cholesterol
  • Obesity

During sleep, our bodies work to support our physical health and brain function.[iii],[iv],[v]

  1. Breathing, heart rate, and blood pressure naturally decrease and then return to normal during different parts of the sleep cycle. When the parasympathetic nervous system takes over, your heart doesn’t have to work as hard as when you are awake.
  2. Muscles gradually relax, and the total energy expenditure of the body drops.
  3. Your body removes toxins from the brain while you sleep and helps prepare your brain to learn, remember, and create. REM sleep is thought to enable critical cognitive abilities, including memory consolidation.
  4. Many other body parts, including blood vessels and the immune system, use sleep for repair.
  5. Hormone levels vary during the day and night, including the production of melatonin, growth hormone, cortisol, and appetite-related hormones leptin and ghrelin.
  6. Your metabolism is impacted by the amount and quality of sleep you get.

Why Sleep Can Be Elusive

Anyone who has lain awake at night and/or tried unsuccessfully to return to restful sleep knows how frustrating it is to know that you are supposed to be asleep, but you can’t seem to get there.

Sleep is not just elusive for health care professionals, parents of young children, shift workers, those facing physical or mental health issues, or people who are trying to fit 26 hours of activity into a 24-hour day. Sleep deprivation can plague any of us at any time, such as in times of stress, physical or emotional pain, or when we are feeling overwhelmed.

For some individuals, prescription or over-the-counter medications may be causing disruptive sleep—including diuretics that cause nocturia. Other medications that may lead to sleep interference include decongestants, SSRIs (selective serotonin reuptake inhibitors), stimulants, corticosteroids, beta-blockers, and others.

Sleep-Supporting Habits: Sleep Hygiene

We know that it is important to get enough high-quality sleep. “Sleep hygiene” is the term used to describe good sleep habits. These actions set the stage for our minds and bodies to transition successfully from wakefulness into sleep—which in today’s connected world often takes a concerted effort to achieve.

A commitment to getting enough sleep is often the first step towards a healthier sleep regimen.

  • Use a regular sleep schedule—even on the weekends. Go to sleep and get up at the same time every day.
  • Exercise regularly. Exercise earlier rather than later in the day.
  • Avoid alcohol, nicotine, caffeine, or a big meal for a few hours before bed.
  • Plan for ‘wind down’ time 30-60 minutes before going to bed.
    • Tune out from electronics
    • Keep electronics out of the bedroom
  • Keep your sleeping area cool, dark, and quiet.
  • Keep pets out of the bedroom if they bother you at night.

Clinical Takeaways

Ensuring a full night of restful sleep will help patients function better during the day and will help reduce the risk of cardiovascular and other health problems.

Consider the following clinical actions:

  • Ask about a patient’s sleep habits and patterns at every visit
    • If there is an issue, is it acute—due to a stressful situation related to work or family—or more chronic, which may be related to medications or other health issues?
    • Is the patient relying on sleep aids such as melatonin to acquire a good night’s sleep?
  • At each visit, review the patient’s list of medications and supplements
    • Are there new or existing medications or supplements that may be responsible for sleep patterns that are less than optimum?
    • Consider possible side effects and dosing regimens that may be impacting sleep.
  • Discuss the use of alcohol, nicotine, and other drugs, which may impact sleep cycles and quality.
  • Consider sleep apnea in those who snore loudly or feel tired even after a full night’s sleep.[vi]

Resources

  • Patient Handout: Sleep, Blessed Sleep – The Importance of Adequate for Your Health, found in the Heart Healthy ToolboxPodcast: Sleep Apnea and AFib
  • CE Course: Identification and Management of Sleep Apnea to Reduce CVD Risk
  • Article: Sleep and Cardiovascular Health

References

[i] Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Do You Get Enough Sleep? 2021. Accessed April 24, 2024.

[ii] American Heart Association. Life’s Essential 8.™ 2024. Accessed April 24, 2024.

[iii] National Heart, Lung, and Blood Institute. Why is Sleep Important? 2022. Accessed April 25, 2024.

[iv] National Institutes of Health. Good Sleep for Good Health. April 2021. . Accessed April 25, 2024.

[v] Jung, C. M., Melanson, E. L., Frydendall, E. J., Perreault, L., Eckel, R. H., & Wright, K. P. (2011). Energy expenditure during sleep, sleep deprivation and sleep following sleep deprivation in adult humans. The Journal of physiology, 589(Pt 1), 235–244.

[vi] Mayo Clinic. Sleep Apnea. April 6, 2023. Accessed April 25, 2024.

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