How Is Your Sleep?

By Dr. Jessica Cho, MD

Has anyone asked you recently, how is your sleep? The pandemic has led us to pay closer attention to our sleep, whether our sleep has improved or become worse, and how it affects our day to day life. Sleep Health is a combination of a healthy routine creating regular habits for our sleep in addition to addressing Sleep Disorders.

It’s exactly like our overall health, by creating healthy habits around diet and exercise but also addressing our underlying medical problems. Sleep Health is much more than just that one night of sleep. With the pandemic, we’re now spending all of our time in bed.

We’re working, studying, eating, watching Netflix, and catching up with our friends on Zoom. But it’s not just Gen-Z or Millennials facing disrupted sleep. Many Baby Boomers and Health Care Professionals’ quality of sleep has been poor. Ideally, our bed should only be used for sleep and sex since our brain is good at making associations. Now, this might sound counterintuitive, but if it’s taking longer than 15 minutes to fall asleep, then you should get out of bed until you’re feeling sleepy again and then get back to bed.

Well known among sleep professionals is that chronic insomnia that lasts longer than 3 months is best addressed first by Cognitive Behavioral Therapy for Insomnia (CBT-I) and not by medication. But, it is unfortunately less known to the public and even other non-sleep doctors. It’s much more than just sleep hygiene. It’s to take a look and assess our sleep with a sleep journal, figure out how much sleep our body needs, and only spend that time in bed all while creating healthy habits and attitudes about sleep.

I also want to preface that insomnia might be related to other sleep disorders such as Obstructive Sleep Apnea which often presents itself as insomnia in women. So, it’s very important to be assessed by sleep doctors first. For those of us who want to optimize our sleep before it gets bad, I do have some recommendations.

Use technology to work for you and not against your sleep. Generally, we want to avoid light exposure from our phones, TV, and computers about an hour before bed. Apps to help with breathing exercises before bed can help you get better rest. Especially for students, you might also have noticed that your sleep is better with the pandemic because your circadian clock is delayed and have that extra hour for sleeping instead of driving to school.

In preparation for returning to early school time, try light exposure about 30 minutes after waking up for about for about half an hour. If sunlight is limited, then try using a lightbox > 10,000 lux instead. This can help can shift your circadian clock earlier to make those early rises less painful.

Avoiding late evening naps in front of the TV can prevent fragmented sleep at night. Trying to take a short nap earlier in the afternoon instead of the evening can ease this fragmented sleep at night if you’re feeling a bit tired. Also, keeping consistent wake up times on the weekends can help you to maintain your schedule for waking up during the weekdays.

A note to Healthcare Professionals, it can be tough to be sleep deprived, and I feel your pain. To optimize your naps for work, consider naps that are either 30 minutes or 90 minutes to avoid sleep inertia or that groggy feeling trying to wake up from your nap. And, to the optimistic soon to be jet-setters, websites and apps are available to help you schedule your light exposure and low dose melatonin before your departure to ease the adjustment of your circadian clock.

Finally, to my physician colleagues, let’s continue our advocacy to treat sleep as a pillar of health in addition to Sleep Disorders. Hopefully, this will be helpful to continuing on our Sleep Health journey!

“I am a Sleep Medicine fellow physician in Los Angeles, California with a background in Internal Medicine having completed my residency at NYU Langone. I've also earned my M.D. from the University of Illinois at Chicago and have experience shaping policy by working with state and national medical societies. I am passionate about advocating for better Sleep Health as one of the pillars of health through advocacy, wellness, technology, and education in an accessible way.”

According to Merriam-Webster Dictionary, the word “Circadian” is a compound of the two latin words “circa” meaning “about” and “dies” meaning “day”. The word “Circadian” first appeared in the Merriam-Webster Dictionary during the 1960’s.