What if I can't sleep?

Quality sleep should be a priority. But what can you do when sleep eludes you?

Sleep framework:

1. Understand the importance of quality sleep
2. Make quality sleep a priority in your life
3. Diagnose and treat sleep disorders

Why it matters:
Sometimes sleep is elusive, even if you are attempting to make sleep a priority in your life. As we age, sleep duration decreases and the time we spend awake during the night (so called "wake after sleep onset") increases, decreasing the efficiency of sleep.

But sometimes sleep disorders are present that require specific diagnosis and treatment to help you get the sleep you need.

Sleep disorders:

Do I have sleep apnea?
Sleep apnea (obstructive sleep apnea, OSA) is a condition that occurs when, during sleep, the airway relaxes to the point that airflow is blocked or partially blocked, leading to reduced oxygen in the blood and disrupted sleep. Potential consequences of sleep apnea include daytime sleepiness, fatigue, irritability, and depressed mood. People with sleep apnea have an increased risk of high blood pressure, heart disease, diabetes and prediabetes, low testosterone (men), and stroke.

• The cardinal symptoms of sleep apnea are loud snoring and witnessed apnea (pauses in breathing during sleep). One screening tool for sleep apnea is called the STOP-Bang questionnaire. (If you score intermediate or high-risk, please talk with Sarah or me at your next visit.)
   
• Treatment of sleep apnea can improve your blood sugar metabolism (see image below) in addition to improving your energy and helping with weight loss.

Do I have restless legs syndrome?
Restless legs syndrome (RLS) is a neurological sleep disorder characterized by an uncomfortable sensation in the legs that give you an overwhelming urge to move your legs. The symptoms are usually worse at night, and resolve momentarily when the legs are moved. RLS can cause disrupted sleep, both for you and potentially for your bed partner :)

Ask yourself these 4 questions:

• Do you have difficulty falling asleep because you of an urge to move your legs?
• Do you wake up at night because you feel like your legs are on fire?
• Do you feel an itching in your legs when you lie down to go to sleep?
• Do your legs seem to feel better when you walk, stretch or make other movements?

If you answered yes to any of these questions, you may have RLS. Let's discuss when you come to clinic. Remember, treating conditions that disrupt your sleep can improve your energy, help you lose weight, and reduce your blood sugar.

Do I have insomnia?
You probably don't need a questionnaire to answer this one. Insomnia is thought to affect about 70 million people in the US, and can include both problems falling asleep and problems staying asleep. Many conditions and medications can cause insomnia, and the preferred and most effective therapy is not medication, but rather something called CBT-I (cognitive behavioral therapy for insomnia).

Sleep Resources:

• Colorado Sleep Institute. Sleep disorders information.
• Quality Sleep Checklist
• Why We Sleep. Book by Dr. Matthew Walker.

Have a super week,

Dr. Topher Fox

P.S. If you missed any previous emails, the content is posted weekly here

P.P.S. Below are the pictures from my exam room wall which we are exploring for this email series.