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Getting a Good Night's Sleep
Dr. Lisa Kransdorf shares why quality sleep is so important and her best advice for getting a better night's sleep.
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Learn more about Lisa N. Kransdorf, MD, MPH
Lisa N. Kransdorf, MD, MPH
Lisa N. Kransdorf, MD, MPH is a primary care physician who practices in Santa Clarita. She is board certified in internal medicine and pediatrics, and sees patients of all ages. Her interests include women’s health, adolescent health and medical education. She promotes a collaborative and team-based approach when working with patients.Learn more about Lisa N. Kransdorf, MD, MPH
Transcription:
Getting a Good Night's Sleep
Melanie Cole (Melanie): Getting a good night sleep is so important in maintaining over all health. There are several things that you can do to promote good sleep, and ultimately get better quality sleep. My guest today is Dr. Lisa Kransdorf. She’s a primary care physician and a member of the medical staff at Henry Mayo Newhall Hospital. Dr. Kransdorf, what is the health burden and even the economic impact of sleep disorders?
Lisa N. Kransdorf, MD, MPH (Guest): Hi Melanie. So, we, in the U.S, treat sleep as a luxury, but really it should be a priority in preventing a host of chronic medical conditions. I think you mentioned to me before that there are safety concerns for lack of sleep related to drowsy driving. Certainly, from a medical standpoint, we have associated poor sleep—or habitually less than six hours per night is usually the number that is quoted—as being associated with increased risk of obesity, increase in medical conditions like diabetes, high blood pressure, and heart disease. All of which lead to a shortened life expectancy.
Melanie: What’s the recommended amount of sleep that people should get every night? I know it depends on your age doctor, but generally.
Dr. Kransdorf: Sure. So there have been studies that have tried to look at this. It does seem that patients who sleep habitually less than six hours or more than nine hours have poorer health. So that old adage of about eight hours of sleep is actually true and has some science behind it.
Melanie: Hm. That’s so interesting. So, we mentioned some of the health conditions that can result from poor sleep habits. Obesity seems to be one that’s being talked about a lot. There’s a link now with studies that are combining obesity with sleep apnea or insomnia or just poor sleep quality, yes?
Dr. Kransdorf: Correct. It seems that poor sleep… so with sleep apnea and those conditions, we’re looking at maybe hours of sleep that seem like they should be normal but achieving really poor-quality sleep. Or in those who have trouble sleeping or because of other things, they're not sleeping enough. When you obtain too little sleep, it upsets the balance of the hormones that control our stress and our appetite. This seems to promote increased fat storage, it seems to increase eating in situations that you otherwise would not be doing these things.
Melanie: So then let’s talk about sleep hygiene, which is really a burgeoning field in itself Dr. Kransdorf. Let’s start with what you should do before you get ready for bed every night, and what you want people not to do as far as behaviors and lifestyles, things that interfere with our sleep.
Dr. Kransdorf: So, with regards to things that you should do, so we should sleep only feel like we are sleepy to do so. To force yourself to go into bed before you are so often leads to frustration. We should sleep as much as we need do and not more than that. Lingering in bed can actually make things worse. You want to keep a regular sleep schedule, especially the awakening. Sometimes the time you go to bed is difficult to control, but it seems that keeping a regular wakeup time the next day is very important.
Regular exercise does seem to help though. So, for some patients, it seems that doing so at least four hours before they go to bed is best. You do want to make your bedroom environment conducive to sleep. It should be dark, it should be sleep. We do want you to deal with your worries and your stressors before you go to bed and not take them to bed with you.
What we don’t want you to do is to go to bed hungry. We don’t want you to use light emitting screens before bed time. So that is cellphones, tablets, laptops, TV. Those are all things that will stimulate your brain to disrupt your circadian rhythm. We want you to avoid alcohol near bed time and avoid smoking near bed time as well.
Melanie: So, I'm going to back up for just a minute and start with anxiety and stress. You are a primary care physician. You must see this a lot. How, especially us women Dr. Kransdorf in this day and time, how can we turn our minds off and fall asleep? What do you recommend to do to stop our minds from spinning and our heads from thinking of all the millions of things on our list that we have to do so we can relax and fall asleep?
Dr. Kransdorf: Great. So, I find that for my patients who have a lot of stress or anxiety that is disrupting their sleep, it tends to come in two forms. I have my patients who are so tired they can fall asleep, but then they wake up say two or three hours later and are up because of their thoughts and worries. Then I have my group that cannot fall asleep initially at all. It’s that sleep onset that is delayed because of their stress and anxiety.
The best we can do for those either as you or falling asleep or when you awaken is try to not lay in bed for more than 20 minutes. We do want to have people get out of bed so that you're not associating the tossing and turning and the frustration. Many patients will find guided meditation to be extremely helpful. This can be done with the help of a lot of apps that are out there that will help. Some patients like to do it on their own without voices speaking to them. Some people like to do it with white noise in the background. The idea is to do deep breathing exercises and to clear their head.
Some patients really benefit from journaling. Being able to write out their thoughts and concerns for their day. I tell my patients, if you have a to-do list that you're running through in your head of things that you did not do that day or things you need to do the next day, put it out on paper. It keeps these thoughts from circling around in your head.
Rituals such as a hot bath, some chamomile tea, those are all things that are very beneficial. For those who have kids, we know that we put our children through a whole routine to go to bed time. Then we jump into bed ourselves without any similar routine. Really giving ourselves that winddown 30 minutes to an hour before we go to bed can be very beneficial.
Melanie: You mentioned white light and electronics. In this day and age, we all feel like we need to be, especially our teenagers who have a circadian rhythm issue as they're growing anyways. Everybody feels that they need to answer their email right away or get to that text or check Facebook, whatever it is. So, what do you want us to do? People don’t want to take their electronics out of their room, but it really does help get a better night sleep. Yes?
Dr. Kransdorf: Correct. I had to start in my own home too. My husband and I had to agree that the world will not end if we don’t answer that email immediately. The technology itself has tried. Many phones and tablets will have a setting to make the screen not as bright. They sell glasses that are supposed to block that blue light. It’s not clear if those things really work at all. You don’t have to turn off your phone necessarily if you have an urgent phone call or urgent text that you do want to receive, but it is a matter of telling ourselves, “I’m going to put down my phone 30 minutes before I go to bed. I'm not going to scroll through my Facebook.”
The phone doesn’t have to be next to the bed. It can be over on a different shelf perhaps that’s right next to the night stand where you will be stimulated awake if you do receive any texts overnight. There are sleep mode as well. I think it is a bit of a personal commitment to tell yourself that we didn’t have these devices five to ten years ago and we did okay. We can do okay for one night without them.
Melanie: A really big question people have quite often is to nap or not to nap.
Dr. Kransdorf: Yes. So, if somebody is tired, napping is allowed 20 minutes or less. That’s my answer.
Melanie: Wow. 20 minutes or less. Okay, but they say that that really is the perfect nap. I think that even corporations are even seeing this and realizing that people do their best in the day if they're allowed to take that short 20-minute nap. So, what about things like lifestyle like weight loss or you mentioned smoking. Speak about some of those things that we can do that can help contribute to our good sleep.
Dr. Kransdorf: So, we do know that exercise, especially for those who use exercise to help them manage their stress and their anxiety can be very beneficial. The trick is to not, as you can manage it, get those adrenaline levels up close to when you want to go to bed. So, if you're somebody who wants to be in bed by ten o’clock then it doesn’t make a lot of sense to exercise at 8:00 p.m. Four hours seems to be the window of time that you want to finish your exercise before going to bed. For all the benefits of exercise that allow us to reduce our cortisol levels, which are our stress hormone level, definitely those who don’t sleep well I encourage exercise. Just timing it in a way that makes sense for your desired bed time.
Smoking is a trickier one. It depends a little bit on why the person is smoking. Of course, I have to say we shouldn’t smoke at all and there are numerous reasons for that. From a sleep stand point, if it is a stimulating habit… Many patients will say, “I smoke to relax,” but to be honest, it is sometimes a way that somebody is coping with their stress in an indirect way instead of addressing their stress head on. I would then advocate my patients to figure out why they're smoking. Is it out of habit? Is it out of boredom? Or is it out of stress? If they can address that underlying issue, they can usually correct that issue and that will help their sleep overall.
Melanie: It’s great information. So, Dr. Kransdorf, wrap it up for us what you would like people to know and what you would like them to think about when they or someone is maybe not getting the best night’s sleep. And whether they should do see their primary care provider or a sleep specialist. Have a sleep study to see why they're not getting that great night sleep. But more importantly, the things that they can do, sleep hygiene as we stated in the beginning, to really get that best night sleep.
Dr. Kransdorf: So, I would say in summary, we need to treat sleep as a priority for us. It is tied into so many of our health benefits as well as detrimental health behaviors. If we can make it a priority for ourselves, it would help our overall life expectancy and our quality of life as well. Everybody feels better when they have had enough sleep. I think we all work hard all day and then deserve at home for that self-care and to be kind to ourselves and allow us that wind down period that we need to achieve good sleep hygiene and a achieve a good night sleep. I think we would all benefit from a little bit of relaxation techniques, a little bit of meditation. Maybe putting that phone down before we go to sleep.
Melanie: That’s great information and so important for people to hear because they just don’t really even realize the importance of a good quality night sleep. Thank you so much Dr. Kransdorf for being with us today. You're listening to It’s Your Health radio with Henry Mayo Newhall Hospital. For more information, please visit henrymayo.com. That’s henrymayo.com. This is Melanie Cole. Thanks so much for tuning in.
Getting a Good Night's Sleep
Melanie Cole (Melanie): Getting a good night sleep is so important in maintaining over all health. There are several things that you can do to promote good sleep, and ultimately get better quality sleep. My guest today is Dr. Lisa Kransdorf. She’s a primary care physician and a member of the medical staff at Henry Mayo Newhall Hospital. Dr. Kransdorf, what is the health burden and even the economic impact of sleep disorders?
Lisa N. Kransdorf, MD, MPH (Guest): Hi Melanie. So, we, in the U.S, treat sleep as a luxury, but really it should be a priority in preventing a host of chronic medical conditions. I think you mentioned to me before that there are safety concerns for lack of sleep related to drowsy driving. Certainly, from a medical standpoint, we have associated poor sleep—or habitually less than six hours per night is usually the number that is quoted—as being associated with increased risk of obesity, increase in medical conditions like diabetes, high blood pressure, and heart disease. All of which lead to a shortened life expectancy.
Melanie: What’s the recommended amount of sleep that people should get every night? I know it depends on your age doctor, but generally.
Dr. Kransdorf: Sure. So there have been studies that have tried to look at this. It does seem that patients who sleep habitually less than six hours or more than nine hours have poorer health. So that old adage of about eight hours of sleep is actually true and has some science behind it.
Melanie: Hm. That’s so interesting. So, we mentioned some of the health conditions that can result from poor sleep habits. Obesity seems to be one that’s being talked about a lot. There’s a link now with studies that are combining obesity with sleep apnea or insomnia or just poor sleep quality, yes?
Dr. Kransdorf: Correct. It seems that poor sleep… so with sleep apnea and those conditions, we’re looking at maybe hours of sleep that seem like they should be normal but achieving really poor-quality sleep. Or in those who have trouble sleeping or because of other things, they're not sleeping enough. When you obtain too little sleep, it upsets the balance of the hormones that control our stress and our appetite. This seems to promote increased fat storage, it seems to increase eating in situations that you otherwise would not be doing these things.
Melanie: So then let’s talk about sleep hygiene, which is really a burgeoning field in itself Dr. Kransdorf. Let’s start with what you should do before you get ready for bed every night, and what you want people not to do as far as behaviors and lifestyles, things that interfere with our sleep.
Dr. Kransdorf: So, with regards to things that you should do, so we should sleep only feel like we are sleepy to do so. To force yourself to go into bed before you are so often leads to frustration. We should sleep as much as we need do and not more than that. Lingering in bed can actually make things worse. You want to keep a regular sleep schedule, especially the awakening. Sometimes the time you go to bed is difficult to control, but it seems that keeping a regular wakeup time the next day is very important.
Regular exercise does seem to help though. So, for some patients, it seems that doing so at least four hours before they go to bed is best. You do want to make your bedroom environment conducive to sleep. It should be dark, it should be sleep. We do want you to deal with your worries and your stressors before you go to bed and not take them to bed with you.
What we don’t want you to do is to go to bed hungry. We don’t want you to use light emitting screens before bed time. So that is cellphones, tablets, laptops, TV. Those are all things that will stimulate your brain to disrupt your circadian rhythm. We want you to avoid alcohol near bed time and avoid smoking near bed time as well.
Melanie: So, I'm going to back up for just a minute and start with anxiety and stress. You are a primary care physician. You must see this a lot. How, especially us women Dr. Kransdorf in this day and time, how can we turn our minds off and fall asleep? What do you recommend to do to stop our minds from spinning and our heads from thinking of all the millions of things on our list that we have to do so we can relax and fall asleep?
Dr. Kransdorf: Great. So, I find that for my patients who have a lot of stress or anxiety that is disrupting their sleep, it tends to come in two forms. I have my patients who are so tired they can fall asleep, but then they wake up say two or three hours later and are up because of their thoughts and worries. Then I have my group that cannot fall asleep initially at all. It’s that sleep onset that is delayed because of their stress and anxiety.
The best we can do for those either as you or falling asleep or when you awaken is try to not lay in bed for more than 20 minutes. We do want to have people get out of bed so that you're not associating the tossing and turning and the frustration. Many patients will find guided meditation to be extremely helpful. This can be done with the help of a lot of apps that are out there that will help. Some patients like to do it on their own without voices speaking to them. Some people like to do it with white noise in the background. The idea is to do deep breathing exercises and to clear their head.
Some patients really benefit from journaling. Being able to write out their thoughts and concerns for their day. I tell my patients, if you have a to-do list that you're running through in your head of things that you did not do that day or things you need to do the next day, put it out on paper. It keeps these thoughts from circling around in your head.
Rituals such as a hot bath, some chamomile tea, those are all things that are very beneficial. For those who have kids, we know that we put our children through a whole routine to go to bed time. Then we jump into bed ourselves without any similar routine. Really giving ourselves that winddown 30 minutes to an hour before we go to bed can be very beneficial.
Melanie: You mentioned white light and electronics. In this day and age, we all feel like we need to be, especially our teenagers who have a circadian rhythm issue as they're growing anyways. Everybody feels that they need to answer their email right away or get to that text or check Facebook, whatever it is. So, what do you want us to do? People don’t want to take their electronics out of their room, but it really does help get a better night sleep. Yes?
Dr. Kransdorf: Correct. I had to start in my own home too. My husband and I had to agree that the world will not end if we don’t answer that email immediately. The technology itself has tried. Many phones and tablets will have a setting to make the screen not as bright. They sell glasses that are supposed to block that blue light. It’s not clear if those things really work at all. You don’t have to turn off your phone necessarily if you have an urgent phone call or urgent text that you do want to receive, but it is a matter of telling ourselves, “I’m going to put down my phone 30 minutes before I go to bed. I'm not going to scroll through my Facebook.”
The phone doesn’t have to be next to the bed. It can be over on a different shelf perhaps that’s right next to the night stand where you will be stimulated awake if you do receive any texts overnight. There are sleep mode as well. I think it is a bit of a personal commitment to tell yourself that we didn’t have these devices five to ten years ago and we did okay. We can do okay for one night without them.
Melanie: A really big question people have quite often is to nap or not to nap.
Dr. Kransdorf: Yes. So, if somebody is tired, napping is allowed 20 minutes or less. That’s my answer.
Melanie: Wow. 20 minutes or less. Okay, but they say that that really is the perfect nap. I think that even corporations are even seeing this and realizing that people do their best in the day if they're allowed to take that short 20-minute nap. So, what about things like lifestyle like weight loss or you mentioned smoking. Speak about some of those things that we can do that can help contribute to our good sleep.
Dr. Kransdorf: So, we do know that exercise, especially for those who use exercise to help them manage their stress and their anxiety can be very beneficial. The trick is to not, as you can manage it, get those adrenaline levels up close to when you want to go to bed. So, if you're somebody who wants to be in bed by ten o’clock then it doesn’t make a lot of sense to exercise at 8:00 p.m. Four hours seems to be the window of time that you want to finish your exercise before going to bed. For all the benefits of exercise that allow us to reduce our cortisol levels, which are our stress hormone level, definitely those who don’t sleep well I encourage exercise. Just timing it in a way that makes sense for your desired bed time.
Smoking is a trickier one. It depends a little bit on why the person is smoking. Of course, I have to say we shouldn’t smoke at all and there are numerous reasons for that. From a sleep stand point, if it is a stimulating habit… Many patients will say, “I smoke to relax,” but to be honest, it is sometimes a way that somebody is coping with their stress in an indirect way instead of addressing their stress head on. I would then advocate my patients to figure out why they're smoking. Is it out of habit? Is it out of boredom? Or is it out of stress? If they can address that underlying issue, they can usually correct that issue and that will help their sleep overall.
Melanie: It’s great information. So, Dr. Kransdorf, wrap it up for us what you would like people to know and what you would like them to think about when they or someone is maybe not getting the best night’s sleep. And whether they should do see their primary care provider or a sleep specialist. Have a sleep study to see why they're not getting that great night sleep. But more importantly, the things that they can do, sleep hygiene as we stated in the beginning, to really get that best night sleep.
Dr. Kransdorf: So, I would say in summary, we need to treat sleep as a priority for us. It is tied into so many of our health benefits as well as detrimental health behaviors. If we can make it a priority for ourselves, it would help our overall life expectancy and our quality of life as well. Everybody feels better when they have had enough sleep. I think we all work hard all day and then deserve at home for that self-care and to be kind to ourselves and allow us that wind down period that we need to achieve good sleep hygiene and a achieve a good night sleep. I think we would all benefit from a little bit of relaxation techniques, a little bit of meditation. Maybe putting that phone down before we go to sleep.
Melanie: That’s great information and so important for people to hear because they just don’t really even realize the importance of a good quality night sleep. Thank you so much Dr. Kransdorf for being with us today. You're listening to It’s Your Health radio with Henry Mayo Newhall Hospital. For more information, please visit henrymayo.com. That’s henrymayo.com. This is Melanie Cole. Thanks so much for tuning in.