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SOUND ASLEEPNo More

America’s Chronic Fatigue and the Fight for Rest

Health Today DisorDereD sleeping

By Katy Mena

We’ve all been there, lying in bed, staring at the clock as it ticks closer and closer to our wake-up call…

We know that rest is critical to our health and success for the day ahead, but for some of us, we just can’t get enough sleep. In fact, as a result of my own personal chronic insomnia, I am writing this article at my kitchen table at 3:30 a.m. Go figure.

According to the Center for Disease Control (CDC), somewhere between 50 and 70 million adults in the United States have problems falling and stay-ing asleep. The reasons vary, stem-ming from hectic work schedules to sleep apnea to being technologically available 24/7. Americans today are suffering from insomnia and chronic fatigue more than ever before.

How Insomnia is Hurting Us In a May 2013 article entitled “In-

sufficient Sleep is a Public Health Epidemic,” the CDC describes the increasing sleeplessness that faces many in our nation and how it is associated with an array of hazards that affects every area of life. The ar-ticle describes how lack of rest can

lead to the development of chronic disease such as hypertension, diabe-tes, depression, and obesity.

But the consequences are cer-tainly not confined to illness. Sleep deprivation also affects an individ-ual’s ability to contribute to their personal and professional life. Whether fighting to stay awake be-hind the wheel or engaged during an important meeting, a sleepless person simply is not living life as fully as they could. According to a recent article in U.S. News & World Report, adults who do not sleep enough are more likely to interact negatively with others and less likely to retain information.

“People just don’t realize how im-portant sleep is and what the health consequences are of not getting a good night’s sleep on a regular ba-sis,” says Carl Hunt, M.D., direc-tor of the National Center on Sleep Disorders Research at the National Institutes of Health, in a recent inter-view with WebMD. “Sleep is just as important for overall health as diet and exercise.”

“ The amount of sleep a person needs depends

on their age. Children need more sleep than adults. Most adults need 7-8 hours of sleep per night. However, a few individuals may feel rested with only 6 hours of sleep but some may need up to 9 hours. You can tell that you are getting enough sleep if you feel refreshed throughout the day. If you are sleepy even after getting an adequate number of above sleep hours, this may be a sign of an underlying sleep disorder, and you should seek medical attention.”

Naseer A. Humayun, M.D., FCCP, FAASM, Board-Certified Sleep Specialist, Pulmonary & Sleep Medicine Sleep Disorders Center

How Much to Sleep

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How Much We Really NeedSo how much sleep should you be get-

ting every night? And is it possible to “make up” for lost sleep by sleeping in until noon on the weekends?

Unfortunately, the answer to the sec-ond question is no. A recent Harvard Magazine article entitled “Lost Sleep is Hard to Find” details the brain’s inabil-ity to wipe the slate clean and recharge completely. “The brain literally keeps track of how long we’ve been asleep and awake—for weeks,” says Harvard Med-ical School (HMS) neurology instructor Daniel A. Cohen, M.D.

As far as how much we need, the Na-tional Sleep Foundation says there is no “magic number” when it comes to the amount of rest that all human beings need on a nightly basis. Somewhere between 7 to 9 hours is generally a safe bet. But the specific amount necessary for each indi-vidual can be dependent on a variety of factors, including age, weight, and per-sonal biology. For example, adolescents

usually need a minimum of 9 hours of sleep each night, based on their circadian rhythms. In contrast, youths between the ages of 3 and 5 years old should clock 11 to 13 hours nightly, while 12-year-olds need about 10 to 11 hours each evening.

To properly care for their children, most parents sacrifice the recommended 7 to 9 hours they should sleep every night. Whether they are staying up late to care for their children or working all hours to earn family income, many adults skimp on their personal rest. And the same can be said for single adults who are under professional pressure or who simply can-not turn off the TV or computer in time to get the appropriate amount of rest.

As a consequence of this sleep depriva-tion, many adults tend to compensate for lack of rest with too much food, thus gain-ing weight and perpetuating a vicious cycle of obesity, sleep apnea, hypertension or even diabetes.

Sleep challenges continue as we age and require more rest to recover from dai-ly activities or certain diseases. However,

many people age 65 and older tend to di-vide their daily sleep between nighttime rest and a daytime nap, which illustrates just how varied the need of sleep is across different age groups.

Top Sleep Disturbances Now the question becomes, how do we

maximize our ability to achieve a routine of restful sleep? First, we must identify the primary factors that can be a barrier to all of us. According to Harvard Medical School, the main causes of sleep depriva-tion are:

• exposure to light in the late evening

• professional responsibilities that re-quire late shift work or frequent trav-el across time zones

• medical conditions that cause pain or anxiety

• common chemicals such as alcohol, antihistamines, caffeine and nicotine

• a poor sleep environment (light, noise, temperature, etc.)

Health Today DisorDereD sleeping

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From time to time, most men experi-ence occasional episodes of erectile

dysfunction (ED). It’s a common prob-lem that affects 18 million men in the United States every year—and their sig-nificant others.

But evidence is mounting that the inability to obtain or maintain an erec-tion is often a warning signal linking ED with other more serious conditions such as cardiovascular disease and diabetes. It can also contribute to self-esteem issues, anxiety, a depressed mood, and tension within a relationship.

In one study, 65 percent of men who experienced a heart attack had erectile dysfunction and no history of heart dis-ease. Additionally, research has shown about three years after the first signs of ED men may experience their first heart attack.

Because the penile arteries are much smaller than arteries of the heart, evi-dence of cardiovascular disease may be displayed first as ED symptoms, long be-fore other symptoms occur. As research continues to demonstrate the link be-tween ED symptoms and cardiovascu-lar disease, any man with ED should see

a doctor to be screened for heart disease—and hopefully avert more serious cardio-vascular issues.

ED is also a common complication of diabetes. Up to an estimated 85 percent of men with diabetes may experience ED. High blood sugar can permanently damage the nerves and blood vessels responsible for erections. Also, poor blood sugar control can inhibit the release of a chemical known as nitric oxide. Low levels of nitric oxide can limit the blood flow to the penis that is re-quired to achieve or maintain an erection.

The good news is many treatment op-tions are available for successfully treating ED, even if the condition is caused by dia-betes or heart disease. Recent advances and treatment methods have changed the way this condition is treated. Some treatment op-tions offer a temporary solution, while oth-ers, including a minimally invasive proce-dure, can provide a permanent way to re-solve the problem. Options may include oral medications, injection therapy, vacuum-as-sisted devices, or a penile implant.

Men experiencing ED should seek treat-ment from a urologist who can determine the cause and conduct appropriate screen-ings to rule out heart disease. Urologists are doctors that specialize in the diagnosis and treatment of ED. It’s important to have a candid discussion with your urologist to determine the best course of treatment to help regain and optimize your health, well-being, and intimacy in your life.

Anand Shridharani, M.D., urologist with Academic Urologists at Erlanger, specializes in men’s reproductive and sexual health. He re-ceived advanced surgical training through a clin-ical fellowship in Andrology (male reproductive medicine and surgery) and Sexual Dysfunction at the Medical College of Wisconsin. His major clinical interests include ED, Peyronie’s disease, penile prostheses, male reproductive health and vasectomy reversal. For more information or to schedule an appointment, contact Academic Urologists at Erlanger, Erlanger Medical Mall offices at 423-778-5910, or Erlanger East offic-es at 423-778-8478.

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65 percent of men who experienced a heart attack had erectile dysfunction and no history of heart disease.

32 | Available on HealthScopeMag.com Available on HealthScopeMag.com | 33

To make matters more complicated, not all sleep disorders are created equal. The U.S. National Library of Medicine has reported that there are more than 100 different sleeping and waking disorders, including:

• insomnia – difficulty falling asleep or

staying asleep

• sleep apnea – difficulty breathing dur-

ing sleep

• restless leg syndrome – an urge to

move your legs, accompanied by tin-

gly, creeping sensations

• narcolepsy – overwhelming daytime drowsiness and sudden attacks of sleep

Developing Good Sleep Hygiene The good news is that there are steps we

can take to gain better control of our sleep patterns. The Mayo Clinic has pinpointed a list of tips that are proven to help our bodies adapt! To get better rest, here’s what to do:

Set yourself a schedule. Try to go to bed and get up at consistent times every day of the week—Saturdays and holidays included!

Be mindful of what you’ve had to eat or drink. Make sure you’re comfortable with what you’ve had to eat in the hours leading up to bed, and don’t be hungry or full when you hit the sack. Also, avoid alcohol or nicotine for a few hours before bed.

Have a bedtime ritual. Set yourself a routine that will signal to your brain that it’s almost time for bed. Take a bath, read a book, or wind down with relax-ing music.

Be comfy. Make sure your bedroom is dark, cool, and quiet. Add white noise creators if necessary, such as a box fan or a sound machine. Additionally, have a comfy mattress and pillows that you can snuggle into.

Nap sparingly. If you rest during the day, try to keep your naps between 10 and 30 minutes sometime during the mid-after-noon.

Exercise. If physical activity is part of your lifestyle, you are likely to get better rest when it’s time to head for bed.

Set aside your stress. It may be easier said than done, but as bedtime approaches, it is important to file your worries away for the next day. In your daily life, find ways to keep stress at bay by staying organized and prioritizing.

Many of us have heard these sugges-tions for getting better rest, but daily life and our adherence to our habits tend to make us ignore what is good for us when it comes to sleep. If this is you, keep in mind that there are consequences of not getting enough rest!

If you are having chronic problems getting enough rest, there are many resources that can offer help. For more information, visit www.sleepeducation.com. There are solutions! Learn what works for you and go get some rest. Your life is waiting!

Make sure your bedroom is dark, cool, and quiet.

Health Today DisorDereD sleeping

WelcomesKatie vonWerssowetz Gooden, M.D.

Specialist in Family Medicine

Galen East Internal Medicine and Pediatrics1651 Gunbarrel Road, Suite 302 Chattanooga, TN 37421

(423) 899-2904 • www.galenmedical.com

PULMONARY & SLEEP MEDICINE SLEEP DISORDERS CENTER

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NASEER A. HUMAYUN, MD, FCCP, FAASMDiplomate, American Board of Sleep Medicine

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