Bedroom Talk: Healthy Sleep, Healthy Living. Rachel E. Salas, MD

Transcription

1 Bedroom Talk: Healthy Sleep, Healthy Living Rachel E. Salas, MD Assistant Professor, Neurology and Medicine 2014

2 Disclosure I have no financial relationships with a commercial entity that is relevant to the content of this presentation. I will not reference unlabeled or unapproved uses of drugs or other products.

3 Objectives By the end of this talk, you will be able to: Recognize when to seek evaluation for a potential sleep disorder Recognize the importance of sleep

4 You Snooze X You Lose

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6 Who has time for sleep?

7 The Sleep Drive is Strong Micro sleep Local sleep

8 X Good sleep room X Sleep is a priority X Stress minimized X Medical treatment X Adequate Sleep Good sleep practices X X Diagnosed sleep disorder

9 Effects of Poor Sleep scapegoating decreased libido risky behavior decreased pain tolerance reduced performance forgetful mood issues decreased attention/concentration decreased vigilance/reaction time look older weight gain

10 Chronic Insufficient Sleep Insomnia Circadian Sleep Wake Disorder Sleep Apnea Restless Legs Syndrome

11 Sleep talking Sleep groaning Sleep texting Sleep eating Sleep shopping Narcolepsy Idiopathic hypersomnia Bruxism Sleep inertia

12 Take longer than 30 mins to get to sleep? Mood issues/disorders Reduced QOL Poorer Health Cardiovascular risk Absenteeism Sleepiness Memory and concentration issues Headaches

13 Treatment

14 man postmenopausal smoke asthma diabetes hypertension heart disease heart arrhythmia family history snore overweight small chin large tongue short, thick neck neurological disorder small airway

15 Sleep Apnea

16 GERD/Reflux Hypertension Arrhythmias Diabetes Hypercoagulability Atherosclerosis Obesity Erectile Dysfunction Congestive Heart Failure Pulmonary Hypertension Accidents Changes in Mood Memory and Concentration Problems Insomnia

17 Sleep Apnea: Treatment Conservative Therapy -weight loss -positional therapy Dental Appliance Surgical Intervention CPAP

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19 RLS Diagnostic Criteria uncomfortable sensations in legs motor restlessness (urge to move) at rest, with activity at night/evening Excluded mimics

20 Treatment Anti-epileptic medications Dopaminergic agents Opioids Iron RLS Benzodiazepines

21 Deep Breaths

22 Cyberchondria and/or Cybertherapy 65% 8 in 10

23 Rubber bands around legs Bar of ivory soap Listen to radio Chiropractor Orgasm Pickle juice French s mustard Salt water bath Vibrating massager Vicks vapor rub on feet Avoid MSG Wearing socks to bed Having a dog sleep by your feet Dry skin brushing Do figure-eights Dead-arm yourself Treatments L-cartinitine Horse chestnut Vitamin E Tumeric Gatorade Marijuana Tonic water No fortified orange juice Drink Water Menthol gel Peppermint tea Eat a stalk or two of raw celery Stop eating all dairy products Heavy blanket Stand barefoot on concrete floor for 5 min before going to bed Urine on the legs

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25 Seek Medical Evaluation..

26 Now let s talk about how we can make a difference

27 Burning the candle at both ends 24/7 we work after we work we don t take time for sleep optimization

28 Common sleep behaviors Variable bed times Plugged in Stress/anxiety Not sleeping enough Light activation Late meals Limited exercise Negativity Failure to see sleep as important

29 You re not sleeping tonight I m thinking about lots of random stuff all night long Behavioral Treatments Unplug Happy Thoughts

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31 What Do You Wear to bed?

32 The Bed Buddy

33 Should I have a Sleep Buddy Pros Security Humans are social Cold intolerant Sleep witness Cons Noise Movement Hot intolerant Sleep witness

34 The Sleep Environment is important!

35 Environmental Sleep Disorder NOISE LIGHT TEMPERATURE

36 Light is Bad for Sleep

37 Karl Sluis Noise is Bad for Sleep

38 Hospitals are not conducive to Sleep

39 Pts baseline sleep history and patterns is essential for optimizing sleep quality in the ICU The ICU team should be aware that the commonly prescribed medications for the ICU may affect sleep Noise is the most common environmental sleep disrupter in the ICU Light, diagnostic tests, and pt staff interactions also interfere with pt sleep quality in the ICU Implementing behavioral protocols in the ICU may reduce a pt s sleep disturbance, morbidity, and mortality while increasing their overall satisfaction Salas and Gamaldo 2008

40 Changing Perceptions

41 If we can change the sleep perceptions in the hospital, can we do it at home? First things First

42 The JH Sleep Environment Survey

43 We Are Going Live

44 In the mean time

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46 Sleep Etiquette On average, men s pillows have 2X as much bacteria as women s After 2 yrs of use, 1/3 of a pillow s weight is made up of dead skin cells, dead dust mites, and droppings A mattress can double in weight after 10 yrs

47 Change your sheets

48 Feng Shui the bedroom 1. Reposition your bed 2. Clear clutter and clean 3. Encourage equality/balance 4. Use appropriate colors 5. Depersonalize

49 My Secrets

50 What Americans Think it is Important for Sleep Comfortable mattress Comfortable pillows Comfortable feel of sheets and bedding Cool room temperature Fresh air, free of allergens Dark room Quiet room Clean bedroom Sheets with a fresh scent A relaxing bath or shower just before bed Get a new GREAT mattress every 10 years Replace pillows every year Get an air filter No nightlights; Yes flashlights White noise device Cotton earlier

51 Be consistent Sleep. Improve sleep practices

52 Snooze Well! Rachel E. Salas, M.D. Assistant Professor of Neurology and Medicine Director, Medical Student Education in Neurology Assistant Medical Director, JH Center for Sleep Clinic Phone: 1800 WE SLEEP