‘Fall Back’ to Better Sleep Health Every Night

The effect of ending “daylight saving time” really hits home as darkness comes earlier, restricting outdoor activities. And in the morning, the time shift literally comes to light with an earlier sunrise.

On Sunday morning, “fall back” became official at 2 a.m., and everyone got that extra hour of sleep. For those with sleep disorders, that one-hour shift serves as yet another disruption to an ongoing health issue.

Not getting enough sleep has short-term effects on alertness and cognitive function. But over a long period of time, sleep deprivation can lead to significant health issues.

“Many times, you have to really hone in with a patient and ask what time they’re going to bed during the weekdays and during the weekends, how much sleep they’re getting, and ask questions about their quality of sleep,” explains Harneet Walia, M.D., director of sleep medicine and continuous improvement at Miami Cardiac & Vascular Institute. “So, essentially the symptoms to recognize include daytime sleepiness, fatigue, impaired concentration, not able to work well, and so forth.

In a recent Baptist HealthTalk podcast on sleep health, Dr. Walia was joined by Rachel Rohaidy, M.D., psychiatrist and medical director with the Recovery Village at Baptist Health South Florida. Host Jonathan Fialkow, M.D., preventative cardiologist and lipidologist at Miami Cardiac & Vascular Institute, lead the questioning.

Here are excerpts from the podcast:

How can nutrition and exercise improve sleep habits?

Dr. Walia:
“First thing we talk about is maintaining a very good sleep hygiene. And a big part of it is diet and exercise. So, we often tell folks not to have a heavy meal too close to the bedtime, and avoid alcohol close to the bedtime. Because it can disrupt your sleep at the later part of the night. Avoid caffeine after lunch hours because it has long half-life and can disrupt the sleep.

“And exercise is also helpful in promoting good sleep. There are studies to show that folks who exercise, and particularly do aerobic exercise, are able to fall asleep quickly, and have a better sleep quality. We do discourage them from exercising close to bedtime because that can disrupt sleep. But diet and exercise can play a good role.”

Can you elaborate on the link between stress and sleep?

Dr. Rohaidy:
“We do know that increased stress, increased worry, can cause sleep deprivation, right? It’s difficult for us nowadays to unplug ourselves from the world and say:  ‘We’re going to get sleep now. So, it’s really important to have those conversations with everyone. You need to pencil in sleep. We’ve got everything else regulated. We’ve got our phones hooked up to everything. Why not just put a little alarm and say: Okay, time to start winding down and go to sleep and unplug from that busy world. We do know that there is definitely a direct link between the amount of stress and stimulation that you get and sleep deprivation.”

What is first-line treatment for sleep disorders?

Dr. Walia:
“I would go to the root cause of the issue. Why are they not able to sleep? So, there are reasons why folks are not able to sleep. It’s either the stress or they may have underlying sleep disorder, such as sleep apnea, restless leg syndrome. They may have pure insomnia, which is difficulty sleeping or falling asleep, maintaining sleep, waking up early in the morning — despite getting the right opportunity to sleep.

“The first-line treatment is often not medications. It’s often what we call it, cognitive behavioral therapy for insomnia. Which is focused on restructuring those negative emotions or cognitive emotions that are linked with sleep. So, that’s a first line treatment. We generally do not recommend taking over-the-counter medications. They may stay in the body for a long time. They may promote grogginess and in turn, maybe actually perpetuate trouble sleeping.”

What are specific things that a person could do to ensure a better quality and quantity of sleep?

Dr. Rohaidy:

“You can go online and find 20 different things that you can do to improve sleep hygiene. But what it actually means is just having a better sleep routine, right? So just cleaning up that sleep. About half an hour before bed, start shutting things down. Put your phone away and relax. And you’re kind of telling your body: All right, it’s time to rest. Keep a schedule of sleep. So, you know, life happens, right? And a lot of us can’t necessarily always go to bed at 9:02 at night or whatever. Keep a schedule as close as possible. And make sure that you’re going to bed around the same time, even on weekends. So, you’re getting up around the same time as well.”