As we creep closer, day by day, to the Spring Equinox, the dark days of midwinter come to a close. And hopefully our sleep-wake cycles start to equilibrate. In the darker months, it’s normal to feel a little lower energy than usual. Many of us crave carbs and want to sleep more, like hibernating bears. The opposite tends to happen in the bright days of summer – we may feel energized and excited and need a little less sleep than we do in winter. Slight seasonal variation in our sleep-wake cycles is normal (albeit hard to manage when our work and family schedules don’t also shift seasonally). But for people with insomnia or other sleep disorders, seasonal changes can be really challenging. March 12-18 is sleep awareness month, so as medical director, I want to shine a light on this important topic.
Those of us who work with AWARE clients know how important sleep is. We encourage our clients to get good, consistent sleep every night. And when our clients’ sleep gets disrupted, it can be a warning sign of difficulties to come or the result of other medical or psychological underlying problems. Our providers spend a lot of time asking our clients, “how are you sleeping recently,” and for good reason. Sleep can be an important clue, hinting at other issues to be addressed (maybe with behavioral interventions, medications or even a trip to the sleep medicine clinic).
Sleep medications are very popular – a lot of people suffer from sleep disturbances. We use quite a few of these medications for our clients, when needed. But even more important than using medications to treat sleep is identifying what is causing the sleep issues. Depending on the underlying cause, the treatments can be different. And some of our “sleep medications” (even the over-the-counter ones advertised as “safe” or “natural”) can actually make sleep worse if used inappropriately. So rather than jumping to pharmaceuticals right away, it’s important to explore the sleep issues a little more – whether we’re talking about your client or even yourself or family member when you go to see your own doctor.
The first step of addressing sleep issues is to empower yourself to make it a priority. This means making time for sleep and keeping track of sleep at home (or with your client) and then speaking up about it being an issue when you see the provider. Sleep is super important so don’t forget to mention it if it’s an issue for you or your client!
The second step is asking some more questions. When I’m assessing a patient for sleep disturbances, I ask the following questions:
Generally speaking, how has your sleep been recently?
How has your energy level been in the daytime? Well-rested? Tired? Does it fluctuate during the day or with activities?
Do you drink caffeine, and if so, when and how much?
What is your usual bedtime routine? What time? How do you “wind down?”
Do you consume any alcohol or other substances to help “calm down” before bedtime?
Do you use screens in the evening? If so, what kinds, what time and for how long? What kind of content do you consume in the evening (the news, horror movies, etc.)?
When you lie down, how long does it take to fall asleep?
Do you wake up in the night? Why? How often? How long does it take to fall back to sleep?
Do you snore? If you say no… what does your partner say? They might have a different story!
Do you experience any discomfort while trying to sleep (pain, restlessness, tingling, shortness of breath, cough…)?
How many hours of sleep do you get most nights?
Do you take daytime naps?
And that’s just a start. Once we know more about your sleep, we can try to identify the problems and come up with a solution. Besides good old-fashioned insomnia, many people suffer from sleep apnea and don’t even know it! Restless leg syndrome is also common. Menstrual cycles, pregnancy and menopause can also cause sleep changes. And even aging leads to changes in what we call “sleep architecture” (the duration and type of sleep cycles a person has each night). Most of these problems can be fixed! And usually without medications. So this is your friendly reminder to take care of yourself, your loved ones, and your clients – take sleep issues seriously, and speak up!
Sleep Awareness Week - American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) (entnet.org)