Ask the 'Sleep Doctor'

01/23/2012
By Karen Angelo

Sleep deprivation does a lot more than just make people groggy. It increases the risk of obesity, cardiovascular diseases, inflammatory diseases, mood disorders and cancer, says Prof. Geoffry Phillips McEnany of Nursing. The worse part, he adds, is that doctors, nurse practitioners and patients are not discussing sleep issues as a possible underlying problem to medical conditions.

We asked Phillips McEnany – co-author of a new book “Sleep Disorders and Sleep Promotion in Nursing Practice” that was recently recognized as a Book of the Year by the American Journal of Nursing – about the link between sleep and disease, what people can do to get a good night’s rest and how to be more informed patients.

 

Why is getting a good night’s sleep important to good health? 

Inadequate sleep increases the risk for the onset of a number of serious illnesses. We know that there’s a direct link between not enough sleep and obesity. In turn, obesity can lead to diabetes and hypertension. Unfortunately, what typically happens during a doctor’s appointment is that the symptoms of high blood pressure and diabetes are discussed, drugs are dispensed and a lot of money is spent. The problem is that we are often not addressing the root of the problem – the condition is treated but the sleep disorder related to it is not.

 

What should we discuss with our primary care doctors and nurse practitioners when experiencing health or sleep problems?

I recommend that people raise the issue of sleep with their primary care provider, whether that person is a nurse practitioner or a physician. If a sleep medication is offered for a sleep complaint, then ask for a broader sleep assessment. The important question is “What’s the cause of my sleep problem?” If obesity is a clinical issue, then discuss snoring and daytime sleepiness, which is the best indicator of poor or inadequate sleep. Bring sleep into the light of day in any clinical visit.

What are some tips to help people get a good night sleep?

  • Provide adequate time for the need for sleep to be satisfied. For example, if you are an eight-hour sleeper, sleeping six hours will not be adequate.
  • Avoid alcohol. It may help to fall asleep but it causes a lot of brief awakenings and this impairs daytime alertness.
  • Minimize caffeine. Intake of caffeine that stops at 3 p.m. can still impact sleep because caffeine takes hours to clear the body.
  • Have a regular bedtime and a regular wake time.
  • Provide some ‘down time’ before bed.
  • Do not use the bedroom for anything but sleep or sex. Reading, laptops, watching TV or eating are not things that help with sleep quality. We lose the association between the bedroom and sleep.
  • Avoid exercise within three hours of bedtime as it causes disturbances in sleep quality. On the other hand, exercise in the morning helps with sleep quality.
In addition to writing a book about sleep disorders, you also developed a new sleep certificate program for health professionals. Why is this necessary?

Many health professionals do not know about sleep and its relationship to health and disease. Surveys of medical and nursing school education reveal that on average, nurses and physicians receive only three hours of training on sleep in their entire educations. The result is that sleep-related causes of disease are being missed. 

Diabetes is reaching epidemic proportions in the U.S. today but clinicians may not be aware of the direct relationship between sleep disorders and diabetes. How many times will a clinician prescribe an antihypertensive medication for someone with high blood pressure without asking about something as simple as snoring, a cardinal sign of sleep apnea? My goal is to help healthcare providers better understand, diagnose and treat sleep-related health problems and related diseases.

 

How did you get interested in researching the importance of sleep?

It started over 30 years ago in my clinical practice with people who had been diagnosed with psychiatric diseases. Every one of them had problems sleeping and while the explanations at the time came more from a psychological perspective, I knew that there had to be more to it. It’s impossible to separate the physical from the psychological and we’re learning how powerful that connection is in relation to sleep in health and disease.

Read selected chapters from the book “Sleep Disorders and Sleep Promotion in Nursing Practice,” published by Springer Publishing Company.

The online graduate certificate in “Sleep and Sleep Disorders” offered through UMass Lowell’s Division of Online and Continuing is one of the first programs of its kind in the United States.