Prioritizing Quality Sleep for Overall Health

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JOHN WHYTE
Welcome, everyone. I'm Dr. John Whyte. I'm the Chief Medical Officer at WebMD. Sleep plays an important role of our overall health. If you're not getting enough sleep and quality sleep, you're putting yourself at risk for increased rates of cancer, increased rates of heart disease, yet so many of us don't think of sleep as a priority or if we are having trouble sleeping, we think we'll get around to it later.

But my guest today is going to talk about how important it is to get good sleep. What should you do if your snoring? Is it more serious than just annoying your partner? And what are some of the myths around quality of sleep?

I am delighted to be joined by my good friend Dr. Azizi Seixas. He's the Interim Chair of the Department of Informatics and Health Data Science at the University of Miami Miller School of Medicine. It is great to see you. Thanks for joining me.

AZIZI SEIXAS
Thank you so much, Dr. Whyte. Thanks for having me again.

JOHN WHYTE
I want to start off by talking about a survey we conducted at webmd.com. We had over 2,000 respondents. And I wasn't surprised by the fact that 27% of people reported quality of sleep over the past six months is either fair or very poor.

But what I was surprised by is that people are struggling to fall asleep and stay asleep. On average, respondents spent 5.75 hours sleeping but 7.6 hours in their bed. Does this surprise you, Dr. Seixas?

AZIZI SEIXAS
Unfortunately, it doesn't. The reason why is because we know that we do have a sleep crisis at its epic proportion. When you look at certain sleep disorders like insomnia, many of the symptoms that you just described, difficulty falling asleep, difficulty maintaining and staying asleep, and the third one that many people have a hard time really understanding is when you wake up earlier, let's say waking up at 3 AM, and you do so involuntarily. And you're unable to go back to sleep. And so those are three critical symptoms of insomnia.

JOHN WHYTE
And we forget that because we often focus on just falling asleep. But maintaining sleep and not getting up too early are important. I'm glad you mentioned that. Now it's interesting that there are some age and sex differences.

So our survey showed that people between the ages of 25 to 34 as well as women had more sleep challenges and more sleep problems than men, as well as older people. Because sometimes we think as you get older, sleep is more problematic. But what we're seeing in our survey that it really was mostly people 25 to 34.

AZIZI SEIXAS
Dr. Whyte, I'm happy that your survey was able to bear out something that we've been seeing for quite some time that the sleep difficulties that we see here in the United States and dare I say globally doesn't just affect one particular demographic group, that it actually impacts people of different age groups. And in many ways, it affects both men and women as well.

JOHN WHYTE
I got to ask you-- and I was excited to talk to you today about this. But it's also about priorities. And I wasn't surprised by 25 to 34 because that's when you're starting your family, your early on your work career. Sleep doesn't seem like a priority. We've got other more important things to do.

So how do we help people think through the importance of sleep, especially when you're talking about priorities? You think you're going to bank some extra sleep over the weekend by sleeping more. We all know that's not true.

But as you know, I referenced at the beginning we're seeing the relationship to heart disease, cancer. Could be an underlying sign of thyroid disease when you're having poor sleep. So how do you have that conversation or what do you recommend in terms of helping people understand that poor sleep can be an indicator of poor health and that you need to make it a bigger priority in your life now not over the weekend or sometime later?

AZIZI SEIXAS
We believe that we cannot provide a one-size-fits-all communication strategy. So here's what we do for younger folks. We know that they are in the prime of their lives. And as a result, they want to ensure that they are at their peak performance. So, instead, we position sleep as what we call your superpower.

And so we use this slogan. What we say is that sleep is an investment. And we oftentimes say start your day with sleep. Let me break that down. What does that mean? It means, therefore, when we talk to our younger demographic-- and let's say they have a very tough day ahead of them the next day or they have a great presentation that they must perform at peak-- what we tell them is that lots of evidence have shown that when you get a good night's rest that your cognition, your ability to memorize the way in which you can articulate is far superior than if you hadn't gotten adequate sleep.

And so when we make sleep your superpower, we found that younger individuals are more likely to see the importance of sleep. What we say is that during your midlife, this is when certain diseases like heart issues and diabetes typically rear their heads unfortunately. And what we do is that we lay out all of these different models. And we use testimonials showing where people who don't get enough sleep are at significant greater risk for heart disease, diabetes, cancer, and the like. And that's how we actually address individuals midlife.

And for older adults, we know that they want to spend time with their younger ones, particularly grandkids and the like. And they want to preserve a sense of vitality. So we coach the story along the lines of this is how you're able to spend time and to feel vital again and energetic to spend time with your friends, family, and the like.

JOHN WHYTE
Let's go over some things about sleep as well as ways to improve sleep because people want to know. But I want to start off with that there is some confusion about what's normal. How long should it take to fall asleep once you get into that bed?

AZIZI SEIXAS
We said 15 minutes. I think 15 minutes is on average. And, obviously, with averages, plus or minus. Many people feel as if, well, if you hit the sack and you fall asleep, it means that, yes, you're a good sleeper. It actually means that you're sleep deprived.

And so when you take time to fall asleep, then you're preparing your body to actually go through the different stages of sleep. So 15 minutes or so is adequate time for you to fall asleep. My concern is that if people spend longer in bed that they can actually start to develop what we call forms of insomnia whereby you start to associate the bed with not falling asleep. And you will toss and turn, and people will get frustrated with their inability to fall asleep.

So what we typically tell people is that if you're having problems falling asleep, read a book under very dim lighting, no LED or blue lighting. And maybe you can also listen to some audiobooks that will allow you to fall asleep as well. And that's what we tell people. If those don't work, we tell them get out of the bed, change the scenery, and restart your routine to fall asleep again.

JOHN WHYTE
What's the right temperature?

AZIZI SEIXAS
67 degrees or so. You don't want it to be too hot or too cold.

JOHN WHYTE
67--

AZIZI SEIXAS
Yeah, 67, 68 degrees. Yes.

JOHN WHYTE
Colder is better.
AZIZI SEIXAS
Colder is better. It's a happy medium. it's a thin line.

JOHN WHYTE
What about a humidifier?

AZIZI SEIXAS
I actually think a humidifier works. So when you look at the entire sleep environment, here are the factors that we know can significantly impact someone's sleep, temperature, humidity, noise, and light. There are some others as well and air quality as well.

In our own work and in our own studies, we actually measure all of those parameters in people's rooms to provide the most ideal sleep environment, so ensuring that your room is dark enough. It doesn't have too much lighting because that can activate you in a way that will cause you not to fall asleep. Noise-- you want to ensure that you block out all external noise because that could also create a stimulus that will cause you to be aroused or you could cause you to not fall asleep.

JOHN WHYTE
What about a white noise machine?

AZIZI SEIXAS
So that's a tricky one. There's some mounting evidence. So many people believe that white noise can work. What we have seen in our own work as well as others is that white noise is important. But you probably want to put the source of the white noise outside of the room because what white noise does it blocks outside noise from coming in.

JOHN WHYTE
What about a weighted blanket?

AZIZI SEIXAS
Weighted blankets can work as well depending on what the source of your sleep problems are because weighted blankets gives you this sense of comfort as well as it can add a certain degree of weight and warmth that can allow someone to feel fully at ease and comfortable to fall asleep.

JOHN WHYTE
I want to turn to snoring because sometimes people will come in and say, well, I can't sleep because my partner is snoring or they themselves may be snoring. I'm not making this up. I saw a patient the other day and, she said she was snoring. And she wanted to be evaluated.

And I said, well, how do you know you were snoring? And she said her watch told her. So she had an app that actually recorded her snoring. And she showed it to me. And I was glad that she did because sometimes we think snoring is just a nuisance. But we're also learning more about the health implications of snoring, aren't we?

AZIZI SEIXAS
That's a great question. While not all snoring can be bad, but it's really is an ominous sign that portends a potential health condition called sleep apnea. And particularly the sleep apnea is a sleep breathing disorder that can cause partial or full blockage of air flow when someone is asleep.

And if someone goes through this repeatedly over time that their body lacks the sufficient oxygen to maintain all the necessary physical and physiological activities. And if your body is starved of oxygen that there is a reflex in your body that essentially kicks you awake. And this can happen over, and over, and over.

JOHN WHYTE
Really what we're trying to talk about today is that having trouble sleeping, either falling asleep or maintaining sleep, is something that you want to talk to your doctor about. That having snoring is not just an inconvenience. That's something that you may want to talk to your doctor about. These can be harbinger signs of more serious conditions as well. And all too often, we've dismissed them.

AZIZI SEIXAS
Absolutely, I agree with you. And your listeners and your audience need to take this into serious consideration.

JOHN WHYTE
Well, Dr. Seixas, I want to thank you for taking time today. It is always good to speak with you.

AZIZI SEIXAS
My pleasure and honor. Thanks for having me. [MUSIC PLAYING]