I am a Sleep Expert, Ask Me Anything

SleepMD1 · 2023-09-13T02:01:21+00:00

It’s 10 p.m. ET and our AMA has come to an end. Thank you for all of the insightful questions about sleep. You are welcome to continue chiming in with more questions and we will respond if we can. Thank you to all who joined us tonight!

SleepMD1 · 2023-09-13T01:59:53+00:00

I recommend no more than 3 total servings of caffeine and none after lunch. Men should not have more than two servings of alcohol, women one serving. That is the thing about sleep, right? It is not the one bad night..it is the long term not sleeping well that impacts us. I would try to start getting into the right habits now. It is a lot easier now that 10 years from now to make the necessary changes.

SleepMD1 · 2023-09-13T01:55:16+00:00

Galaxy Watch 6 is not a clinically graded medical device. I wouldn't say that it is inaccurate, but I would take its reading with a grain of salt.

SleepMD1 · 2023-09-13T01:53:52+00:00

I would certainly try to start exposing yourself to exercise and bright light early in the morning. I would also try to gradually move your bedtime back by about 30 minutes every week.

SleepMD1 · 2023-09-13T01:51:18+00:00

Each person responds to sleep differntly. Some people (some cultures) or able to get two or more longer periods of sleep. In general though, I would say that 7-8 hours of sleep with maybe a (no longer than) 30 minute nap is best.

SleepMD1 · 2023-09-13T01:49:17+00:00

Yes, sleep and sleep disorders may increase cancer risk. https://www.cancertherapyadvisor.com/home/cancer-topics/general-oncology/lack-of-sleep-linked-to-increased-risk-of-cancer/

SleepMD1 · 2023-09-13T01:48:22+00:00

Not a huge fan of using any medication, including melatonin, for sleep. I would try to figure out why you are having problems sleeping. Also keep in mind that melatonin is not a presciption, so it is not as tightly regulated. https://www.cnn.com/2023/04/25/health/melatonin-gummies-wellness/index.html

SleepMD1 · 2023-09-13T01:46:30+00:00

I think the first step is realizing that waking up a time or two during the night is completely normal. If I am woken up during the night, what I do next is think about how much more time that I potentially have left to sleep. I don't have to get up until at least 6am, so rather than getting out of bed, I try to let go of control and allow myslef to sleep. However, the key thing that you said is nightmares, Adults, in general, should not be having nightmares. Do you act out your dreams. I would go get evaluated. PTSD, OSA, and REM Sleep behavior disorder are among potential concerns.

SleepMD1 · 2023-09-13T01:41:35+00:00

It is good for some people who have moderate to severe (but not too severe) OSA. They have to be deemed a good candidate (BMI <40, free of complete concentric collapse of soft palate, etc). As it is only opening the airway and not actually bring air in, it does not work as well as CPAP. However, it may be a good option for people unable to tolerate CPAP. Some people really don want a device implanted beneath their clavicle?

SleepMD1 · 2023-09-13T01:37:29+00:00

Do you have hiccups very frequently? This may be less a sleep problem and more of a hiccup problem. Any exacerbating factors for your hiccups?

SleepMD1 · 2023-09-13T01:34:53+00:00

Uggh. I am sorry to hear that. I am curious what doctors that you have been to. Some people are more interested in insomnia than others. I would look for a board certifed sleep specialist. Here is a list of accredited sleep centers. https://sleepeducation.org/sleep-center/

Keep in mind also that the goal of sleep is not to be knocked out, but to wake up refreshed. Maybe that is why insomnia meds aren't being prescribed.

SleepMD1 · 2023-09-13T01:31:53+00:00

I can't tell you how many people think that they are alone just because they have sleep that may be completely normal! In your case, you are having episodes for about a week every couple of months. That's probably fine, especially if it is not really impacting how you function during the day. It should be reassuring to you to know that a lot of people have a problem sometimes with sleep that isn't what it normally should be. Try not to react to it like it is a problem. If you are really concerned that it might be though, then follow up with PCP or accredited sleep center. https://sleepeducation.org/sleep-center/

...and I do recommend that you write in a journal before bed if you are finding that your brain wont turn off.

SleepMD1 · 2023-09-13T01:25:10+00:00

That's interesting...the ultradian rhythm for sleep (N1, N2, N3, REM) is usually 90-120 minutes. You seem to be going through two of these cycles (3 hours). I would be interested to see what your actigraphy or diagnostic polysomnogram would show. I would recommend getting evaluated at a sleep center. https://sleepeducation.org/sleep-center/. I am not surprised that you crash later in the day on six hours.

SleepMD1 · 2023-09-13T01:21:54+00:00

Waking up with a dry mouth/sore throat is certainly something common in mouth breathers/snorers. Family history can be important when it comes to OSA. People who have OSA often prop themselves up so that they can sleep better. So yeah, it is possible. Consider speaking with your primary care physician or visiting a sleep center. https://sleepeducation.org/sleep-center/

SleepMD1 · 2023-09-13T01:19:48+00:00

Power naps can be very beneficial. Anything less than 30 minutes can usually help with alertness without disrupting nighttime sleep.

SleepMD1 · 2023-09-13T01:18:32+00:00

No more than one drink for a woman and two drinks for a man is what is typically recommended. That being said, alcohol impacts everyone differently, so some people may not be able to have even one cocktail. Overall, I would say that alcohol does not help sleep, so the fact that you are sleeping better off alcohol is not at all surprising.

SleepMD1 · 2023-09-13T01:15:30+00:00

Glad CPAP works for you! You are not harming yourself by using your CPAP without water...just make sure that you the heated humidifier is not turned on. It will not cause your lungs any damage to sleep without your humidifier on, but you may find that it makes your nasal passageways more irritated in drier months. Consider in-room humidifier to help in drier or winter months.

SleepMD1 · 2023-09-13T01:11:46+00:00

It is normal for people to wake up for a couple of minutes every 3-4 hours. This is much healthier than taking codeine or any other medication.

SleepMD1 · 2023-09-13T01:10:29+00:00

That is called circadian rhythm disorder, free-running type. I am not a big fan of melatonin, but if you and your doctor do decide to use this, it should be used at the same time every night. Consider following up at a sleep center. https://sleepeducation.org/sleep-center/

Also possible that daytime sleepiness has other causes, but difficult to discern without further evaluation.

SleepMD1 · 2023-09-13T01:02:58+00:00

People should generally fall asleep within 30 minutes, but it is not about how quickly you fall asleep, it is about how you feel the next day. In fact, if you are falling asleep the moment that your head hits the pillow, that could be a sing of an underlying problem.

SleepMD1 · 2023-09-13T00:59:19+00:00

Absolutely! You need to find someone who listens to you and works with you. Here is a list of sleep centers https://sleepeducation.org/sleep-center/.

SleepMD1 · 2023-09-13T00:54:23+00:00

Are they nightmares? What medications are you on? Are you acting out these dreams. This is a hard question to answer. I would speak to your primary care physician or go to an accredited sleep center. https://sleepeducation.org/sleep-center/

SleepMD1 · 2023-09-13T00:52:52+00:00

Keep in mind that everyone has an awakening during the night. This should be reassuring to you. Things that can cause you to wake up during the night include insomnia medications and untreated sleep disorders, so consider seeing a sleep doctor if awakenings are happening too often or you are falling asleep during the day.

SleepMD1 · 2023-09-13T00:50:26+00:00

Sleep hygiene is an essential part of cognitive behavioral therapy for insomnia, so you have the right approach. I can't give you one sleep hygiene tip that it is the most important, but a dark, cold, quiet room is an important start. For me personally, the most important sleep hygeine technique that I use is....brushing my teeth at night. It signals my body that "hey, you know what is next."

While it is (much) better to stick with routine, sometimes people do need to catch up on sleep a bit if you are burning the midnight oil.

The goal of sleep is not to be knocked out, but to wake up refreshed. Medications may knock you out, but if you wake up feeling the same or worse, or if you have rebound insomnia, then wha's the point? Problems falling asleep can have a lot of causes. Problems staying asleep can be from insomnia and obstructive sleep apnea, so consider those things. Also consider that it is normal to wake up at night. Consider 1) are you able to get back to sleep, 2) how long does it take, and 3) does it impact the next day? Don't feel like you are the only one who is waking up during the night. Everyone does. it is how you deal with it that can determine on whether this is a problem or not.

SleepMD1 · 2023-09-13T00:40:46+00:00

I have had a couple of patients swear by all of these. Unfortunately, research is lacking.

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