A few nights of tossing and turning probably won’t destroy your mental and physical health. But persistent sleeplessness can signal a real, diagnosable sleep condition. Which can lead to other health concerns. Last week, we talked about how life circumstances like night shift work and having a baby can affect your sleep, and asked you to make a list of all your sleep concerns. (Check back on Week 2 here.)
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In Week 3, we’ll… - Explore common sleep disorders.
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Talk about when to see a doc (your sleep diary from Week 1 and sleep problems list from Week 2 can be useful here).
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Dig into the relationship between mental health and sleep.
- And start to put a couple of things we’ve spoken about into practice.
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Roughly the number of American adults affected by sleep disorders, with marginalized groups and those without health insurance most at risk. And sleep disorders are not something to snooze on. Lack of sleep has been associated with physical health problems down the line, including heart disease, depression, diabetes, and certain cancers, as well as mental health issues. Anxiety and depression can contribute to poorer sleep, while not enough sleep can make depression and anxiety worse.
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“There are certainly bidirectional relationships between sleep difficulties and mental health concerns, and they fuel one another,” says sleep researcher Rebecca Robbins, an instructor in medicine at Harvard Medical School and associate scientist at the Brigham and Women’s Hospital. “In a perfect world, we would screen for both chronic sleep difficulties and mental health then treat both sleep difficulties and mental health concurrently.” |
The most commonly diagnosed sleep disorders are… |
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The one where you have difficulty falling or staying asleep. Insomnia’s considered chronic when it occurs for at least three nights a week for three months or more. The disorder is caused by a lot of different things, which is why it’s important to bring it up with your health care provider so they can figure out the best treatments for you (more on that below). |
The one where snoring isn't just an annoying sound — but a sign of a bigger problem. This disorder makes your breathing stop and restart for short periods throughout the night — and it can occur hundreds of times in one sleep sesh. Not only does it prevent you from getting enough oxygen, but it also lowers sleep quality, making it harder to stay awake during the day. There are two types: - Obstructive: When the throat muscles relax too much during sleep, blocking the upper airway.
- Central: When the brain fails to send signals to the muscles that control breathing.
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Sleep difficulties and mental health concerns...they fuel one another. |
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Sleep difficulties and mental health concerns...they fuel one another. |
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The one marked by sudden, unexpected bouts of deep sleep and major sleepiness during the day. It’s thought to be caused by the absence of a brain chemical called hypocretin. People living with narcolepsy might fall asleep anywhere, anytime, without warning. And might also experience loss of muscle tone and hallucinations. |
🦵 Restless legs syndrome…
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The one with the, yes, restless legs. It’s characterized by an uncontrollable urge to move your legs — usually because of a sensation in the limb (think: throbbing, itchiness, achiness). It happens more often at night and can worsen with age — as well as temporarily during pregnancy. |
The one that can involve night terrors. This is an umbrella term for a whole list of unusual sleep disorders that can occur before and during sleep. It includes sleepwalking, nightmare disorder, and bed-wetting.
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Experiencing sleep issues night in and night out over several weeks, coupled with fighting to maintain alertness during the day could be signs you need professional help, says Robbins. And the same goes if you’re consistently sleeping more than nine hours and still waking up feeling tired. Here are two routes you can take: |
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1. Talk to your primary care provider…
Sleep is often overlooked as a health concern — in part because traditional medical school only offers about 25 minutes of sleep medicine education for those who don’t plan to specialize, says Robbins. There are also low rates of screening for sleep disorders among primary care providers, so make sure to speak up. You should discuss what you wrote down in your sleep diary from Week 1 and the list of sleep issues from Week 2.
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2. Visit a sleep specialist…
You can get this referral from your PCP or do your own research on accredited sleep disorder specialists near you. Robbins recommends this site for finding one. At a sleep center, you may undergo a sleep study, aka a polysomnogram. This procedure involves a doctor watching while you sleep (in a non-creepy way) to monitor your brain waves, muscular activity, heart rate, breathing, and eye and leg movements. The study is meant to both diagnose and help devise a treatment plan. And it’s typically covered by Medicare. If you have private insurance, the amount covered will depend on your state and your specific coverage plan. Costs can range from $1,000 to $7,000 depending on the type of study and your state.
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Rebecca Robbins, PhD, author of “Sleep for Success,” is an instructor in medicine at Harvard Medical School and an associate scientist at the Brigham and Women’s Hospital where her research focuses on sleep and circadian rhythms. |
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Rebecca Robbins, PhD, author of “Sleep for Success,” is an instructor in medicine at Harvard Medical School and an associate scientist at the Brigham and Women’s Hospital where her research focuses on sleep and circadian rhythms. |
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Your treatment plan depends on your unique set of symptoms and will likely involve a combination of medical and lifestyle fixes (we’ll go over the latter next week). |
Medical treatments may include: -
Prescription sleep meds like Ambien
- Supplements like melatonin
- Meds for any underlying health issues
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Devices like a CPAP machine (which helps treat sleep apnea)
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Thing to Know
When it comes to melatonin, there’s a time and a place. The sleep aid is generally safe and can be helpful in small doses for people experiencing jet lag or insomnia, Robbins said in March during our SkimmU Well course about sleep. But think of it as a short-term solution. And talk to your doc about the right treatment plan for your particular case.
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😴 Keep it consistent
Last week, we asked you to make a list of all your sleep issues. This week, let’s try out two baseline strategies for better sleep. - Try to go to bed and wake up at the exact same time every day for the full week.
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Put your phone in another room an hour or two before bed and don’t touch it again until you’re up the next day.
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Breaking up with your phone at night can help you break up with bad habits (like doomscrolling) that contribute to insomnia and mental health struggles. And consistency will help regulate your circadian rhythm, the all-important sleep-wake cycle we outlined in Week 1. |
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WHAT'S HAPPENING IN WEEK 4 |
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We’ll talk about tools, gadgets, and habits for better sleep. Night, night for now. |
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Skimm’d by Avery Carpenter Forrey, Anthony Rivas, Margaret Wheeler Johnson, Karell Roxas, and Hannah Parker |
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