Selected Podcast
Why Can't I Sleep
The important health benefits of getting sleep and what happens when you don't get the required amount. Sleep is imperative to our physical and psychological well-being. In this podcast, Dr. Ahmad will talk about what occurs during the sleep cycle, why it's important to nearly every aspect of one's health, and why we can't seem to get a good night's rest. He will address the consequences of not sleeping soundly consistently and where to go for help if you can't get the required amount of rest each night.
Featuring:
Masood Ahmad, MD
Masood Ahmad, MD is Medical Director of UPMC Pulmonary Medicine and Rehab / Medical Director of Respiratory Medical School. Transcription:
Bill Klaproth: So, let me ask you a question. Are you having trouble sleeping, tossing and turning all night long? Do you feel like you been hit by a truck when you wake up? Maybe you're suffering from sleep deprivation. Maybe your sleep habits or sleep hygiene as they call it need to be improved. Well, let's find out what Dr. Masood Ahmad, Medical Director of UPMC Pulmonary Medicine and Rehab and the Medical Director of the Respiratory Medical School.
This is Healthier You, the podcast from UPMC in Central Pennsylvania. I'm Bill Klaproth. Dr Ahmad, thank you so much for your time. This is such an important topic because we all need sleep and probably many of us aren't getting enough sleep. So let's first talk about the process of sleep itself. Can you let us in on that? What is the process of sleep?
Dr. Masood Ahmad: Thank you very much for inviting me. The process of sleep is automatic. We don't have force ourselves to sleep. It's an automatic process. For example, when we wake up in the morning, let's say 7:00, that's the time for our sleep drive starts. So the moment we wake up, our sleep drive processes starts, which is called process S, that's the sleep drive process. And as a day goes on, that sleep drive actually continue to increase. And then when the evening time comes, our wake drive actually decreases. The same time, the moment when we wake up our sleep drive decreases. and the wake drive increases So if there is a large difference between the sleep drive and wake drive, that's a whole distance that drives our sleep. For example, if you wake up at 7:00 and, by 7:00 PM, your sleep drive will be at the peak-- towards the peak, I should say, not highest peak, but it's still going towards the peak and our wake drive is going down. So when our sleep-wake drive is down and the sleep drive is highest, that's the moment when we get the very strong urge to fall asleep. That's the automatic process. We don't have to think about that. We don't have to do something to put ourselves to sleep. This is an automatic process.
Of course, we need to do our things. The lights should be off when it's time go to the bed. There should be no noise, lights should be off and we should be in the bed. So if the environment is right for sleep, that should be the time for us to sleep.
Bill Klaproth: And then what are the different stages of sleep?
Dr. Masood Ahmad: When we sleep, we start very low stage, stage I sleep. That lasts there for 10 to 15 minutes. Then, go to the stage II sleep, which is literally deeper. And as we go into the stage II, our metabolism actually starts going down, blood pressure starts going down. And our interaction with the environment actually is down. We are less responsive to the environment as we go into the stage II, then the stage three comes in where we are more deep into the sleep stage and our blood pressure continues to go down, metabolism is down and we are going into the deep sleep stages. And then the final stages, the REM sleep comes when we dream. So then the cycle starts again. That's the process of sleep.
Bill Klaproth: And then the benefits of sleep, you just mentioned a few of them, lower blood pressure being very important. What are the impactful benefits of sleep?
Dr. Masood Ahmad: There are too many. Believe me, there are too many benefit effects of sleep. Not only this heart rate and blood pressure and our metabolism. But there is a lot of papers showing that good sleep is also very good for your immunity, for your memory. Basically, this is the rejuvination for your whole body. You improve your memory. You improve your wear and tear of the whole day during your sleep.
They have shown that the people who are chronically sleep deprived, their inflammatory markers are higher, just like the septic patients. They have done the studies. For example, sleep apnea patients, they did the bronchoscopy where we put a scope into the lungs and get the secretions from the lungs. And those people who had sleep apnea, meaning that they were wakingup a lot during nighttime because of the apnea, those people have the same inflammatory markers that we see in the septic patients.
Bill Klaproth: Wow.
Dr. Masood Ahmad: Sleep is good for immunity. Sleep is good for your heart health, your brain health, for your memory, for your metabolism. There's a lot of benefits
Bill Klaproth: Your whole body. We just need it. Our body needs to recharge every night when we sleep.
Dr. Masood Ahmad: Yup.
Bill Klaproth: So then what are the general causes of why so many Americans aren't getting quality sleep?
Dr. Masood Ahmad: Some of the medical factors, some of the medications, some of our behavioral factors. The way our lifestyle is, we are too busy. And then the shift work, some people are changing shifts all the time. They are manipulating their own circadian rhythm for their sleep, which is not very helpful for them.
Other behavioral factors like too much caffeine during daytime, alcohol before bedtime. Nicotine also disrupts our sleep. Some medications also affect their sleep, like depression medications, not all the depression medications are helpful for sleep. Actually, some of the depression medications like serotonin re-uptake inhibitors, they are known to cause insomnia. Some of the blood pressure medications are known to cause insomnia.
Then the medical conditions, if somebody has asthma, if they have asthma attack at nighttime that can disrupt their sleep. Any heart failure patients, diabetic patients, because they have to wake up to pee. Or if we have a snack right before bedtime, that can cause acid reflux. And, if you drink and snack before bedtime, then we have to wake up to pee.
So there are a lot of behavioral factors, medical factors, medication factors. And then, watching TV right before bedtime, surfing on the net is also not good for sleep. Lack of exercise, also major factor. Obesity is also a major factor. Then the sleep apnea I mentioned before, sleep apnea can cause insomnia too. Then restless legs, during the sleep restless legs, there is a condition called periodic limb movement disorder. Their body jerks a lot at nighttime, and that disrupts their sleep. Their brain wakes up with those moments.
Bill Klaproth: Wow. There's a lot going on there. That's for sure.
Dr. Masood Ahmad: A lot, yeah.
Bill Klaproth: So with all of these many causes of the lack of sleep, as you just told us, tell us then, what is the problem? What is the effects of sleep deprivation?
Dr. Masood Ahmad: Yes. So there was a study I think that was published in JAMA. I think that was in 2009 or 2010. They looked at thousands of people, very simple study. They looked at the people who slept less than seven hours versus people who slept more than seven hours. And the main finding of that study was the people sleep less, they are having more cardiac problems than the people who are sleeping at least six hours. So sleep deprivation is known to cause cardiac problems. It's known to cause neuro problems. It's known to cause obesity.
Bill Klaproth: So sleep really, really is important. So then, Dr. Ahmad, help us out here because we need your help. What can we do to get a better night's sleep? I know you've mentioned a few. You know, don't check your computer, don't eat before bed, those kinds of things. But what can we do to get a better night's sleep?
Dr. Masood Ahmad: So that's a very good question. First, behavioral things, as I mentioned before, like regular exercise, not watching TV, surfing on the internet, fixed bedtime and wake up time. Be consistent with your bedtime and wake up time. Not having any snacks right before bedtime. Those are the behavioral things.
Then you have to look at the other factors like, as I mentioned before, the medications or the medical history. So those should be optimized. Then if somebody has those things optimized, then the sleep specialist can also look at what other factors could be contributing, whether somebody has underlying sleep apnea that's causing the insomnia and poor quality of sleep. And the restless legs, because restless legs, not only during daytime, they can have it at nighttime, too. Those are called periodic limb movements.. Those are the things only sleep specialists can figure out. Any doctor can, but sleep specialists, they are specialists on these disorders.
So, if you have any issue, talk to someone who knows these things, who can figure it out and where it can be helped. Whether you have sleep apnea, we have very good treatment for sleep apnea, or restless legs, we have good medications. Periodic limb movements, we have good medications to treat. And there are some factors, not only the medication, some other things that we can do whether some other medications causing these things. Some people have low iron levels, that can cause restless legs.
The people who knows these things, I think they can better help you. If you have problems, my recommendation is talk to someone, talk to a sleep specialist, talk to your primary care physician and get help because sleep is so important.
Bill Klaproth: So how do we know when it's time to see a doctor? How do we know if we're not getting enough rest? Obviously, if you're tired throughout the day, but what are the signs of sleep deprivation?
Dr. Masood Ahmad: Sleep deprivation affects daytime fatigue, tiredness, sleepiness. Some people got microsleep attacks. Just for a couple of seconds, they just fall asleep, which could be very dangerous for them. Just imagine you get a three-second microsleep attack and you are driving at the speed of 60, in those three minutes, you will be 250 feet ahead. So anything can happen. That's not good.
These are the symptoms for chronic sleep deprivation, not having energy during daytime, sleepiness during daytime, judgment issues, cognitive issues, memory issues. if somebody has those issues, I think that's the time to talk to someone.
Bill Klaproth: Okay, very good. That makes sense. So speaking of going to talk to someone, where should someone go to seek an evaluation or help?
Dr. Masood Ahmad: Any sleep specialist can actually help you figure out what is the problem and take the necessary steps.
Bill Klaproth: So look for your sleep specialist. You can also call UPMC at (717) 735-0336 or you can visit UPMC.com/centralpasleep for more help. So this has really been interesting, Dr. Ahmad. Thank you so much for your time. Once again, just to go over those great tips that you gave us. Make sure you're getting enough exercise. Make sure you have a consistent bedtime that always helps. No snacks before bedtime. Shut off all of your electronics. As you said, don't be surfing the web while you're laying in bed, that certainly doesn't help. And if you're on any medications, make sure you're optimizing those medications. Those are the first things you should start with, right? To try to improve your quality of sleep.
Dr. Masood Ahmad: Absolutely.
Bill Klaproth: And when we talk about sleep hygiene, that's kind of what we're talking about, right? Doing those right things before bedtime, to make sure that you're trying to get the most restful sleep possible when we talk about sleep hygiene, that's what you mean?
Dr. Masood Ahmad: Yes. Those are the primary steps.
Bill Klaproth: Excellent. Well, thank you so much for your time. This has really been interesting and we need more sleep. We need restful sleep. So thank you for talking to us about this today. It's really, really important. Dr. Ahmad, thank you again.
Dr. Masood Ahmad: Thank you very much.
Bill Klaproth: And that's Dr. Masood Ahmad. And for more information, as we just said, call (717) 735-0336 or visit UPMC.com/centralpasleep. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Healthier You, a podcast from UPMC. I'm Bill Klaproth. Thanks for listening,
Bill Klaproth: So, let me ask you a question. Are you having trouble sleeping, tossing and turning all night long? Do you feel like you been hit by a truck when you wake up? Maybe you're suffering from sleep deprivation. Maybe your sleep habits or sleep hygiene as they call it need to be improved. Well, let's find out what Dr. Masood Ahmad, Medical Director of UPMC Pulmonary Medicine and Rehab and the Medical Director of the Respiratory Medical School.
This is Healthier You, the podcast from UPMC in Central Pennsylvania. I'm Bill Klaproth. Dr Ahmad, thank you so much for your time. This is such an important topic because we all need sleep and probably many of us aren't getting enough sleep. So let's first talk about the process of sleep itself. Can you let us in on that? What is the process of sleep?
Dr. Masood Ahmad: Thank you very much for inviting me. The process of sleep is automatic. We don't have force ourselves to sleep. It's an automatic process. For example, when we wake up in the morning, let's say 7:00, that's the time for our sleep drive starts. So the moment we wake up, our sleep drive processes starts, which is called process S, that's the sleep drive process. And as a day goes on, that sleep drive actually continue to increase. And then when the evening time comes, our wake drive actually decreases. The same time, the moment when we wake up our sleep drive decreases. and the wake drive increases So if there is a large difference between the sleep drive and wake drive, that's a whole distance that drives our sleep. For example, if you wake up at 7:00 and, by 7:00 PM, your sleep drive will be at the peak-- towards the peak, I should say, not highest peak, but it's still going towards the peak and our wake drive is going down. So when our sleep-wake drive is down and the sleep drive is highest, that's the moment when we get the very strong urge to fall asleep. That's the automatic process. We don't have to think about that. We don't have to do something to put ourselves to sleep. This is an automatic process.
Of course, we need to do our things. The lights should be off when it's time go to the bed. There should be no noise, lights should be off and we should be in the bed. So if the environment is right for sleep, that should be the time for us to sleep.
Bill Klaproth: And then what are the different stages of sleep?
Dr. Masood Ahmad: When we sleep, we start very low stage, stage I sleep. That lasts there for 10 to 15 minutes. Then, go to the stage II sleep, which is literally deeper. And as we go into the stage II, our metabolism actually starts going down, blood pressure starts going down. And our interaction with the environment actually is down. We are less responsive to the environment as we go into the stage II, then the stage three comes in where we are more deep into the sleep stage and our blood pressure continues to go down, metabolism is down and we are going into the deep sleep stages. And then the final stages, the REM sleep comes when we dream. So then the cycle starts again. That's the process of sleep.
Bill Klaproth: And then the benefits of sleep, you just mentioned a few of them, lower blood pressure being very important. What are the impactful benefits of sleep?
Dr. Masood Ahmad: There are too many. Believe me, there are too many benefit effects of sleep. Not only this heart rate and blood pressure and our metabolism. But there is a lot of papers showing that good sleep is also very good for your immunity, for your memory. Basically, this is the rejuvination for your whole body. You improve your memory. You improve your wear and tear of the whole day during your sleep.
They have shown that the people who are chronically sleep deprived, their inflammatory markers are higher, just like the septic patients. They have done the studies. For example, sleep apnea patients, they did the bronchoscopy where we put a scope into the lungs and get the secretions from the lungs. And those people who had sleep apnea, meaning that they were wakingup a lot during nighttime because of the apnea, those people have the same inflammatory markers that we see in the septic patients.
Bill Klaproth: Wow.
Dr. Masood Ahmad: Sleep is good for immunity. Sleep is good for your heart health, your brain health, for your memory, for your metabolism. There's a lot of benefits
Bill Klaproth: Your whole body. We just need it. Our body needs to recharge every night when we sleep.
Dr. Masood Ahmad: Yup.
Bill Klaproth: So then what are the general causes of why so many Americans aren't getting quality sleep?
Dr. Masood Ahmad: Some of the medical factors, some of the medications, some of our behavioral factors. The way our lifestyle is, we are too busy. And then the shift work, some people are changing shifts all the time. They are manipulating their own circadian rhythm for their sleep, which is not very helpful for them.
Other behavioral factors like too much caffeine during daytime, alcohol before bedtime. Nicotine also disrupts our sleep. Some medications also affect their sleep, like depression medications, not all the depression medications are helpful for sleep. Actually, some of the depression medications like serotonin re-uptake inhibitors, they are known to cause insomnia. Some of the blood pressure medications are known to cause insomnia.
Then the medical conditions, if somebody has asthma, if they have asthma attack at nighttime that can disrupt their sleep. Any heart failure patients, diabetic patients, because they have to wake up to pee. Or if we have a snack right before bedtime, that can cause acid reflux. And, if you drink and snack before bedtime, then we have to wake up to pee.
So there are a lot of behavioral factors, medical factors, medication factors. And then, watching TV right before bedtime, surfing on the net is also not good for sleep. Lack of exercise, also major factor. Obesity is also a major factor. Then the sleep apnea I mentioned before, sleep apnea can cause insomnia too. Then restless legs, during the sleep restless legs, there is a condition called periodic limb movement disorder. Their body jerks a lot at nighttime, and that disrupts their sleep. Their brain wakes up with those moments.
Bill Klaproth: Wow. There's a lot going on there. That's for sure.
Dr. Masood Ahmad: A lot, yeah.
Bill Klaproth: So with all of these many causes of the lack of sleep, as you just told us, tell us then, what is the problem? What is the effects of sleep deprivation?
Dr. Masood Ahmad: Yes. So there was a study I think that was published in JAMA. I think that was in 2009 or 2010. They looked at thousands of people, very simple study. They looked at the people who slept less than seven hours versus people who slept more than seven hours. And the main finding of that study was the people sleep less, they are having more cardiac problems than the people who are sleeping at least six hours. So sleep deprivation is known to cause cardiac problems. It's known to cause neuro problems. It's known to cause obesity.
Bill Klaproth: So sleep really, really is important. So then, Dr. Ahmad, help us out here because we need your help. What can we do to get a better night's sleep? I know you've mentioned a few. You know, don't check your computer, don't eat before bed, those kinds of things. But what can we do to get a better night's sleep?
Dr. Masood Ahmad: So that's a very good question. First, behavioral things, as I mentioned before, like regular exercise, not watching TV, surfing on the internet, fixed bedtime and wake up time. Be consistent with your bedtime and wake up time. Not having any snacks right before bedtime. Those are the behavioral things.
Then you have to look at the other factors like, as I mentioned before, the medications or the medical history. So those should be optimized. Then if somebody has those things optimized, then the sleep specialist can also look at what other factors could be contributing, whether somebody has underlying sleep apnea that's causing the insomnia and poor quality of sleep. And the restless legs, because restless legs, not only during daytime, they can have it at nighttime, too. Those are called periodic limb movements.. Those are the things only sleep specialists can figure out. Any doctor can, but sleep specialists, they are specialists on these disorders.
So, if you have any issue, talk to someone who knows these things, who can figure it out and where it can be helped. Whether you have sleep apnea, we have very good treatment for sleep apnea, or restless legs, we have good medications. Periodic limb movements, we have good medications to treat. And there are some factors, not only the medication, some other things that we can do whether some other medications causing these things. Some people have low iron levels, that can cause restless legs.
The people who knows these things, I think they can better help you. If you have problems, my recommendation is talk to someone, talk to a sleep specialist, talk to your primary care physician and get help because sleep is so important.
Bill Klaproth: So how do we know when it's time to see a doctor? How do we know if we're not getting enough rest? Obviously, if you're tired throughout the day, but what are the signs of sleep deprivation?
Dr. Masood Ahmad: Sleep deprivation affects daytime fatigue, tiredness, sleepiness. Some people got microsleep attacks. Just for a couple of seconds, they just fall asleep, which could be very dangerous for them. Just imagine you get a three-second microsleep attack and you are driving at the speed of 60, in those three minutes, you will be 250 feet ahead. So anything can happen. That's not good.
These are the symptoms for chronic sleep deprivation, not having energy during daytime, sleepiness during daytime, judgment issues, cognitive issues, memory issues. if somebody has those issues, I think that's the time to talk to someone.
Bill Klaproth: Okay, very good. That makes sense. So speaking of going to talk to someone, where should someone go to seek an evaluation or help?
Dr. Masood Ahmad: Any sleep specialist can actually help you figure out what is the problem and take the necessary steps.
Bill Klaproth: So look for your sleep specialist. You can also call UPMC at (717) 735-0336 or you can visit UPMC.com/centralpasleep for more help. So this has really been interesting, Dr. Ahmad. Thank you so much for your time. Once again, just to go over those great tips that you gave us. Make sure you're getting enough exercise. Make sure you have a consistent bedtime that always helps. No snacks before bedtime. Shut off all of your electronics. As you said, don't be surfing the web while you're laying in bed, that certainly doesn't help. And if you're on any medications, make sure you're optimizing those medications. Those are the first things you should start with, right? To try to improve your quality of sleep.
Dr. Masood Ahmad: Absolutely.
Bill Klaproth: And when we talk about sleep hygiene, that's kind of what we're talking about, right? Doing those right things before bedtime, to make sure that you're trying to get the most restful sleep possible when we talk about sleep hygiene, that's what you mean?
Dr. Masood Ahmad: Yes. Those are the primary steps.
Bill Klaproth: Excellent. Well, thank you so much for your time. This has really been interesting and we need more sleep. We need restful sleep. So thank you for talking to us about this today. It's really, really important. Dr. Ahmad, thank you again.
Dr. Masood Ahmad: Thank you very much.
Bill Klaproth: And that's Dr. Masood Ahmad. And for more information, as we just said, call (717) 735-0336 or visit UPMC.com/centralpasleep. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Healthier You, a podcast from UPMC. I'm Bill Klaproth. Thanks for listening,