Louis Libby, M.D., pulmonologist and medical director of the Sleep Disorders Center at Providence Portland Medical Center, answers questions on the topics below:
| Q: How can the “spring forward” time change in March affect us? |
A: When we switch to Daylight Saving Time in March, we lose an hour of sleep. The effects can be significant. Reliable data show that there are more car accidents on the Monday following the weekend of the time change. Our productivity goes down, as well. We’re all in a bit of a fog because of that lost hour of sleep.
What this really tells us is that we’re on the edge in terms of the amount of sleep we get in general. Adults should get eight to nine hours of sleep each night, but the average adult gets only seven to seven and a half hours. As a society we are burning the candle at both ends all the time, so just one lost hour of sleep can put some of us over that edge.
| Q: What can I do to reduce the effects of the time change? |
A: Here are some tips:
1. Get up 15 - 20 minutes earlier than usual on Friday and Saturday to start adjusting gradually to the coming change.
2. Get up at your usual time on Sunday – do not allow yourself to sleep in! If you sleep in, you will just delay the adjustment and risk insomnia on Sunday night.
3. Make sure you start thinking in Daylight Saving Time on Sunday. Adjust all your clocks and watches on Saturday night and do not fall into the trap of thinking about what time it was before the time change.
With a little preparation and smart sleep habits, you should be able to steer clear of trouble – and accidents – on Monday!
| Q: Is it possible to make up for sleep hours lost during the week by sleeping in on the weekends? |
A: Sleep can’t be fully made up until you get back into a regular pattern. One of the problems with trying to catch up on lost sleep hours is that it disrupts your natural sleep clock, which requires roughly 16 hours of wakefulness before you’re ready to fall asleep again.
After a night of getting only six hours of sleep, many people try to catch up by sleeping until 9 or 10 a.m. the next day. But when they try to fall asleep the next night at 10 p.m., their sleep clock won’t let them, because they haven’t yet been awake for 16 yours. They may not be able to fall asleep that night until 1 a.m., and if they have to get up early the next day, the whole pattern starts again.
It’s best to try to establish some regularity in your sleep schedule, so that every night you go to bed at a reasonable time, get a good amount of sleep and wake up at roughly the same time each morning. Varying that schedule by an hour or an hour and half isn’t a big deal for people who aren’t having sleep problems. But trying to make up three lost hours of sleep on a Saturday morning is going to be tough on anyone’s sleep clock.
| Q: What are some of the characteristics and results of sleep deprivation? |
A: Sleep deprivation is pervasive in our society. Most of us are living on an hour less sleep than we need every night. Sleep deprivation affects our physical, mental and emotional health. We get grumpy, irritable, tired and nonproductive. We’re more prone to biting the heads off our coworkers.
Sleepy drivers have more car accidents, and sleepy people are more prone to the effects of alcohol. The combination of sleepiness and a little alcohol, even within the legal limits, can be deadly when you get behind the wheel.
| Q: How does stress affect sleep? And how does lost sleep affect our performance under stress? |
A: When you are under stress – worrying about an upcoming presentation or a nerve-wracking problem, for example – you wake up more at night. If that happens one night every week or two, its probably not a problem. In general, you can perform just fine after one less-than-ideal night of sleep.
In fact, I tell my three teenagers not to worry about getting a good night’s sleep the night before a big test – worry about the two or three nights before that. If you sleep well for a couple of nights, and then don’t sleep quite so well the night before the test, you’ll still do fine. But if you have three or four days in a row of bad sleep prior to a test or presentation, your performance will suffer.
| Q: What tips can you offer to make it easier to fall asleep? |
A: It should take you about five to 15 minutes to fall asleep, once you turn off the lights and try to fall asleep. If it takes more than half an hour, something is probably wrong - either you’re trying to go to bed too early, or you did something that inhibited your ability to go to sleep, or there’s something bugging you.
If you find there’s something bugging you night after night after night, take 10 minutes after dinner to make a list of the things that are bothering you. Then write down what you’re going to do tomorrow to help take care of those things. That way, they not longer need to concern you when you get into bed.
People who have trouble falling asleep also need to be conscious of establishing and sticking with a bedtime routine.
Taking a hot shower or bath is one of the best things you can do before going to bed because the drop in body temperature that follows will promote sleep.
A lot of people ask whether reading in bed promotes sleep. In many cases, it doesn’t. Typically we recommend that people who have trouble getting to sleep reserve the bed for only two things: sleep and sex. Trying to do anything else in bed may increase alertness or raise your frustration level. Watching the news at 10:15, for example, can be awful! Reading books can be pleasant but also may stimulate your brain. Similarly, talking with your partner may raise interpersonal issues that get your emotions churning.
On the other hand, if reading in bed for 10 minutes before turning off the light works for you, then there's no reason to stop doing that. If watching the news is part of your routine and it doesn’t bother you, then go for it. If you do have trouble falling asleep at night, however, take a look at some of these habits that may be causing problems.
| Q: How common is snoring, and how does it affect sleep? |
A: About half of men snore, and around 25 to 35 percent of women snore. Many of us are intermittent or light snorers. I’m one of them, according to my wife! I don’t believe it, but she says I snore if I’m on my back.
The effects of light, continuous snoring are often insignificant. But more serious snoring can cause problems, especially if you have loud, stop-and-start snoring. This pattern interrupts your sleep, and it can have a number of sleep-depriving effects, including daytime sleepiness, lost productivity and more car accidents.
In addition, if you snore loudly, stop for 10 to 20 seconds, and then resume the loud snoring, you’re at very high risk for a condition called sleep apnea, in which breathing patterns during sleep are seriously disrupted.
Between four and 10 percent of middle-aged men have this condition, and about half as many middle-aged women have it.
| Q: What is the cause of sleep apnea, and how is it treated? |
A: Sleep apnea is caused when muscles at the back of your throat relax, narrowing or closing your airways and preventing breathing. Your brain quickly senses lost oxygen and sends a signal for you to wake up and resume breathing. People with sleep apnea usually awaken for only a few moments before falling back to sleep and resuming the pattern.
Sleep apnea treatments are aimed at keeping the airways open. For many people, that is accomplished through weight loss.
About 70 to 80 percent of people with sleep apnea have a weight problem. Reducing excess fat around the neck can improve problems with a narrowed airway.
Another treatment involves a special mask that is worm over the nose to deliver enough air pressure to keep the airways open. There are also mouthpieces available that help keep the throat open. And in some cases, surgery to remove tissue or to fix structural abnormalities in the nose or throat can resolve the problem.
Nose strips may help you breathe when you’re congested, but they’re not an effective treatment for sleep apnea. If you think you might have sleep apnea, see your doctor for evaluation and treatment.
| Q: How would I know if I have a sleep disorder? |
A: The most obvious sign of a sleep disorder is daytime sleepiness that isn’t corrected by regularly getting eight hours or more of sleep at night. The other major sign is if a partner tells you that you snore loudly and stop breathing repeatedly during the night. If either of these signs applies to you, contact your doctor.
| Q: What happens during a sleep study at the Sleep Disorders Center at Providence? |
A: The Sleep Disorders Center at Providence Portland Medical Center has been operating since 1985. We currently see and study more than 140 patients a month in the sleep center. These patients sleep at the center all night while we observe their sleep and their breathing. The vast majority of problems we observe are due to sleep apnea, although we also occasionally see patients who have sleep disorders due to leg movement problems or brainwave problems.
It’s a comfortable place for patients. They have a private room with a nice bed and a television. Our observations help us to start them on the right treatments, and many people are much improved within a few weeks of their sleep study.
In the future, computer technology will probably advance to the point where we don’t need sleep centers like ours. We may continue to study a few patients in a sleep center setting, but many patients will be observed with a tiny computerized monitor that they can wear at home.
Updated February 2008
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