Canceled Clients (4762)

Additional Info

• Segment Number 2
• Audio File northshore/1438nh2b.mp3
• Doctors Lovitz, Lori
• Featured Speaker Lori Lovitz, DO
• Guest Bio Lori Lovitz Board certified neurologist specializing in sleep medicine (pediatric and adult).
  
  Learn more about Lori Lovitz
• Transcription Melanie Cole (Host): The cure for sleep difficulties can often be found in your daily routine. Your sleep schedule, bedtime habits and day-to-day lifestyle choices can make an enormous difference to the quality of your nightly rest. And here to give us best tips is Dr. Laurie Lovitz. She’s a board-certified neurologist specializing in sleep medicine at NorthShore University Health System. Welcome to the show, Dr. Lovitz. So tell us. There’s a big sleep disorder problem in this country. People have stress and electronics and all these things keeping us awake at night. What do you tell people as your first, most important bit of information in getting a good night’s sleep?
  
  Dr. Laurie Lovitz (Guest): Well, thank you for having me, number one. And secondly, yes, I do believe that with the change of technology and people have being their phones present and their computers present at all times, I always tell people that you have to respect your sleep. You have to make sure that you are allowing yourself to get a good 7 to 8 hours per night of sleep, number one. And number two, that it’s at regular bedtimes and wake times. And then number three, you want to make sure that your bedroom environment is going to be set up for the best possible sleep that you can get. So this means trying to remove all of those items from your bedroom. A lot of these phones have alerts, they have sounds, they have lights. The lights might turn on every time you get a new email, and these can be very disruptive to your sleep, not only during your sleep, but also when you are trying to fall asleep. They often serve as a constant reminder to what you have to do next day or what you should have done earlier during the day. So it’s constantly playing with your brain and keeping your brain awake while you should be trying to relax and fall asleep. So I think that that's the crux of what people should be aiming for, just trying to get rid of all of these alerting devices while you’re trying to fall asleep.
  
  Melanie: So it’s important that we get 7 to 8 hours to really be our best the next day. So, start from the beginning of the night. We don't use electronics for, what, an hour at least before bedtime? And what should be our room -- do you feel like a cooler environment, a hotter environment, darker? What should we be doing to get our bedtime ready?
  
  Dr. Lovitz: Absolutely. So yes, I always tell people to start winding down about two hours before they want to fall asleep. So this means getting rid of those stimulating activities, trying to turn off the TV and shutting all the work programs, brushing their teeth, getting their pajamas ready, getting their clothes ready for the next day. So I would think a good two hours of winding down is important. And this also means no exercise during that time, no dinner during that time. And then, when they get their bedroom environment to be optimal for sleep, this is something called sleep hygiene. And so the optimal sleep hygiene would be a completely dark room, a completely quiet room, and yes, cool temperature tends to be better for more efficient sleep during the night. And of course you want to make sure that you have covers, that you can keep yourself warm if you need to be warm. But having a cooler room versus a warmer room tends to be better.
  
  Melanie: What about white noise? With babies, that's how you can sometimes get them to sleep. And I know people I know have to have a fan in the room when they go to sleep so that that constant, little bit of white noise -- what do you think of that?
  
  Dr. Lovitz: I think that’s fine. It’s actually worse for many, many of my patients and babies as well. The reason why that works is because with the white noise, you’re basically cancelling out any of these other external noises that can be enough to stimulate an awakening. Some people are more hyper-alert than others. And so, if there’s a honking horn outside on the street or if there’s a phone alert in the next room, sometimes people can wake up from those noises. So having a white noise machine or some sort of a continuous noise can be enough to drown out those other noises and help people sleep better.
  
  Melanie: So now, what about regulating our sleep and wake cycle, natural melatonin versus taking a supplement? What do you think of people who have these kind of not correct sleep and wake cycles? How do they get on to that cycle?
  
  Dr. Lovitz: So melatonin can be very useful for people who do have disruptions in their sleep cycle, and let me just back up by saying that, naturally, we do have an inherent sleep cycle rhythm. Sometimes they could be disrupted, either in the situation where, later on, in someone's life because as we get older we are less likely to have a strong circadian rhythm. But also sometimes, people can disrupt their sleep cycle because they’re travelling back and forth often, they have got jetlag, they’ve got shift work disorder. So there’s a lot of other reasons why a circadian rhythm can be altered. So, if this is the case, then, yes, there are things that we can do with treatment either by use of melatonin. If you were to take melatonin earlier in the evening, let's say about five hours before your intended bedtime, it will make it easier for you to fall asleep during that intended bedtime. And then other factors that can help with circadian rhythm—actually, even a stronger factor—is light exposure. So if you are waking up at the intended time that you want to wake up, you want to be sure that you’re exposing yourself to light so that you can maintain that wakefulness during the day. So during the day, you want to expose yourself to light, and during the night, when you’re trying to sleep, you don't want to expose yourself to light. So, these are all things that are going to enhance the circadian rhythms that you would like to have.
  
  Melanie: Dr. Lovitz, what about lifestyle and lifestyle behaviors? People drink, they think that, "Oh, the alcohol is going to make me fall asleep much faster." But it doesn't necessarily help get a good night’s sleep, does it?
  
  Dr. Lovitz: Well, right, that's correct. So, when someone drinks alcohol, it might help them fall asleep in the beginning of the night more easily because it makes them drowsy. However, when that alcohol wears off and you get that caloric burst after the alcohol wears off of their system, oftentimes, what people will get will be an awakening in the middle of the night where they actually feel like it's time to get up, like, it's their usual wake time. And so, once they eliminate or significantly reduce their alcohol intake, they can actually have more consolidated sleep.
  
  Melanie: Now, what about stress and anxiety? Because we lay there awake at night thinking of bills and all of the millions of things that we have to the next day. How do we get that out of our heads, Dr Lovitz, so that we can fall asleep?
  
  Dr. Lovitz: One of the strategies that I like to use with my patients with regard to the stress and the planning, all the things that flood your head when you’re trying to sleep is something called Scheduled Worry Time. And this is really simply when you make an appointment with yourself earlier on in the day—and this should be a time more than two hours before the time you want to fall asleep. It could be at 10 a.m. It could be at 7 p.m., whatever time is your time that you have a full hour where you don't have to do anything else. And I tell them to just sit down there with a piece of paper and just write down all those things that tend to flood into their heads when they’re trying to go to sleep at night. This could be things like conversations that they’ve had, things that have bothered them, people that they have to speak with, plans for the next day, plans for the future, all the things that tend to flood their head when they’re supposed to be falling asleep. And once they sat there for an hour and just let it all out, get it all out onto paper, when it comes time for them to fall asleep later on in the evening, they can just tell themselves, "That's okay. I’ve already done that. I have already given myself that hour." And it makes it a lot easier for them to fall asleep. And if per chance there is something that comes into their heads when they’re trying to fall asleep, all they have to do is tell themselves, "I could do this again tomorrow the same time." So if you do this every single day consistently, if your time is at 10 a.m. and you do it every day at 10 a.m., it makes it easier for you to plan things and get all of that stress out during that scheduled worry time because it becomes a habit now. And then when they go to sleep at night, all they have tell themselves is, "Nope. It's okay. I already did it." So it makes it a lot easier for people to fall asleep over time.
  
  Melanie: Dr. Lovitz, how do we know when someone's sleep issues are severe enough that they need to come see a doctor? And why should people come to NorthShore University Health System for their sleep issues?
  
  Dr. Lovitz: What I would tell patients is that if they have tried all of these circadian rhythm enhancements and improve their sleep hygiene and got rid of the stress, that they still have short sleep or, more importantly, disrupted sleep, like they’re waking up multiple times during the night and they don't know why. That would be a good time to have a professional evaluation. Because what we could do is we can actually do a sleep study and find out are these awakenings coming from snoring disorders or sleep breathing disorders, or are they coming from limb movement disorders? So, we can find out these things by doing a formal evaluation. The great thing about NorthShore University Health System is that we’ve got four different hospitals—Skokie, Highland Park, Evanston, and Glenbrook—and we’ve got six specialists in all of hospitals as well as up in Guerney and we can take a multidisciplinary approach and address any of these complications. We also have two sleep labs involved in these four hospitals. So we can definitely accommodate all of the patients up in this area. What's also great is that we’re doing some great research studies in collecting clinical information in the hopes of learning more about either the genetics behind certain disorders such as Restless Leg Syndrome, as well as what treatments are the most effective and tolerated in the long run for these patients. So a lot of exciting things to come in our system.
  
  Melanie: Thank you so much, Dr. Laurie Lovitz. You're listening to NorthShore Health and Wellness. For more information you can go to NorthShore.org. That is NorthShore.org. This is Melanie Cole. Thanks so much for listening.
• Hosts Melanie Cole MS