Sleep Bytes & Blog

Help. I've fallen and I can't wake up. You know the feeling - You're in the middle of a dream or maybe just falling asleep when you feel yourself falling, and then suddenly you jerk awake. If this has happened to you, you are not alone. Around 70% of people report these types of occasional jerks. This phenomenon is called a hypnic jerk, or sometimes a sleep start. And while not necessarily dangerous, they can be fairly alarming. Now, the exact cause of a hypnotic jerk is not well understood, but there are a couple of theories. Number one is that it has to do with your brain's response to dream content, such as actually feeling like you're falling. Or two, it could be a type of misfiring event in your brain that occurs when your body fully relaxes as you drift off to sleep. Now, there are certain risk factors that can increase your chances of having a hypnotic jerk, and these include things like excessive caffeine or caffeine too close to bedtime, increased alcohol use, increased stress, or even sleep deprivation. These are all things that can interfere with the transition from waking to sleep. So, if this happens enough to disrupt your sleep regularly, then I recommend keeping a journal of the events. Something simple like putting an X on a calendar on the nights that your hypnotic jerks occurred. You can then start to connect the dots with other things that are going on, such as alcohol use or worsening stress. Now, if you snore loudly or find yourself gasping for breath as you jerk awake, talk to your doctor about being evaluated for sleep apnea, a more serious sleep disorder. But if you just occasionally experience this phenomenon, well, you're not. Your brain just hiccupped. And now you can rest easy. Thanks for being here. See you next time.

What’s involved in a sleep study? Are you at risk for sleep apnea? If so, the next step is to get a sleep study. There is really no way around it…because, you want to know! A sleep study is done while you are sleeping and measures your breathing (airflow and effort to breathe) and oxygen levels. There are two types of sleep studies: Spend the night in a sleep lab (polysomnogram) Home apnea test Think of them like megapixels in a digital camera, the overnight, in-lab polysomnogram is like a 10 megapixel camera that provides extensive, detailed data about your sleep, like sleep stages and leg movements, and it can pick up even subtle sleep apnea. The home apnea test (sometimes referred to as HAT or HSAT) is like using a 2 megapixel camera – you can see enough to diagnose most sleep apnea, but other details aren’t captured, and sometimes mild sleep apnea is missed. The home apnea test is usually more convenient for people and costs significantly less money. And because of this, some insurance companies require a home apnea test before paying for an in-lab sleep study. Home apnea tests are a great way to start your journey of improving your sleep. There are two important things to remember about a home apnea test. It underestimates the degree of sleep apnea. Your AHI (apnea-hypopnea index) will be lower than an in-lab sleep study If a home apnea test is negative for sleep apnea and you have symptoms suggestive of sleep apnea (like snoring, daytime sleepiness, or non-refreshing sleep – to name just a few), then I recommend an in-lab sleep study. A home apnea test can miss sleep apnea up to 20% of the time! And don’t forget, you can talk to just about any medical provider about ordering a sleep study. If they can’t order one for you, they can refer you to someone who can. Why? Because better sleep changes everything. Good luck on your journey.

Sleep: Are you getting too little or too much? Hi there. Kimberly MD, here with the first in a new series of weekly quick tips that will help you start improving your sleep today. I'm glad you're here. So you've probably heard me talk about all the problems associated with insufficient sleep, including effects on your memory, your concentration, even your mood. But did you know that getting too much sleep has also been associated with memory problems? So a recent study published in the journal Nature Aging studied almost 5000 adults from the UK. The participants were asked about their sleep duration and were asked to perform a number of cognitive tasks over time. Interestingly, the researchers found that both insufficient and excessive sleep were both associated with impaired performance on these tests. And these findings were most pronounced in people over age 50. They identified that 7 hours per night was the optimal amount of sleep for best cognitive performance, but also for the best mental health. In fact, people experienced more symptoms of anxiety and depression and worse overall well-being if they reported sleeping for longer or shorter than 7 hours per night. So, a few things to note on this study 94% of the subjects were of white European descent. So these findings may not apply to everyone. And they aren't able to say that getting too little or too much sleep causes problems with thinking or mood, just that those that reported 7 hours of sleep performed the best and reported the best mental health. So what does this study mean to me Well, it's more evidence that our sleep is tied to our memory, mood and overall well-being. And in this study, once we reach 7 hours of sleep nightly, more doesn't exactly mean better. So that being said, each of us has a unique requirement for the amount of sleep that is right for you. And that is usually the one where you can wake up on your own, feel refreshed, and function well during the day. So, thanks for being here. I'll see you in the next video.

Navigating Medications with Contradictory Side Effects Hey sleep warriors! Dealing with medication side effects that include both sleepiness and insomnia can be tricky, but there are a few strategies you can try to help you figure out how a medication may affect you as an individual. If the dosage timing is flexible, the following three tips can help you determine how a medication impacts your sleep and wakefulness. Of course, these are generalizations, and you will want to first consult with your healthcare provider or pharmacist to understand the medication’s effects, both on its own and in combination with any other medications you are taking. For once-daily medication, start by taking it in the morning on a non-workday. This approach allows you to minimize your responsibilities if you become drowsy. On the other hand, if you take the medication first at night and it disrupts your sleep, you may lose a night’s rest and the following day. It’s generally best to avoid making any other lifestyle or medication changes at the same time. This helps ensure that any changes in your energy or drowsiness levels are a direct result of the new medication, rather than other factors. Keeping a sleep diary can be helpful in tracking how the medication affects you. Try taking the medication in the morning for one week, and then in the evening on a different week, and record how well you slept and how alert you felt during the day. I hope these tips help you navigate the next time you experience this seemingly contradictory scenario. Thanks for being here. I’ll see you next week.

SomnoSeal Giveaway Hey Sleep Warriors!  This week, I am on my way home from my overseas work in Saipan, in the Northern Marianas Islands. I started a small practice there when my husband and I, and our two small kids, moved there to do underserved work in 2007. When we came home a little over a year later, there was no one to replace me, so I have been returning annually to see patients and doing other work remotely throughout the year. Each year, I bring a senior neurology resident from OHSU with me. This gives the resident a Global Health experience and allows us to see more patients. This year, I brought Audrey Oliger, MD, and she did a fantastic job! As the only neurologist and sleep doctor for the island of 50,000, it was a busy trip! It’s interesting how the sleep patients I care for over there have many of the same sleep issues as people on the US Mainland. They also suffer from dry mouth and I had a great time this year introducing them to the SomnoSeal.  Next week, Kenny and I will be offering our monthly FREE Workshop and LIVE Q&A that will be all about dry mouth and what you can do about it. I’ll be demonstrating how to use the SomnoSeal and we will have a giveaway for a FREE SomnoSeal Starter Kit! And don’t worry if you can’t join us LIVE, just be sure to sign up and we will email you the REPLAY link.  And if you can’t wait to see the SomnoSeal in action, today I have a very special guest who is demonstrating how she uses it. Take it away, Mom! Thanks for being here. I hope to see many of you at the Workshop!

How do I know if I have sleep apnea?    While millions of people have undiagnosed sleep apnea, there are many who don’t have sleep apnea. So how do you know which group you fall into?  If you are a healthy person who feels they sleep well and you function well during the day, chances are you don’t have sleep apnea and you can stop reading here.  However, if you fall into the category of being tired or functioning poorly during the day, or wake up wishing you could go back to sleep (even after sleeping 7 or more hours), then read on.  Primary symptoms of sleep apnea include: non-refreshing or restless sleep daytime fatigue daytime sleepiness irritability problems concentrating depressed mood poor judgment poor memory it can even cause weight gain through affecting appetite hormones. Yikes.  While many of the symptoms of sleep apnea can also be caused by other things, treating any underlying sleep apnea is guaranteed to help. The most common reason people today are sleepy during the day is that they aren’t getting enough sleep at night. We live in a 24/7 culture, and one that values productivity and achievement over physical and mental wellbeing. Sleep is undervalued so the first thing to do is get adequate sleep at night. This is 7-8 hours for most adults.  If you are getting enough sleep at night yet still feel sleepy during the daytime, then you are at risk of something disrupting the sleep you are getting, such that the quality of your sleep is not ideal. This is where sleep apnea comes in. Most people aren’t aware of the repetitive brief arousals to breathe at night, but these disruptions prevent us from getting into and staying in the deeper stages of sleep that we need to feel restored and function our best during the day.  How do I know if I have sleep apnea? The first place to start is to talk to your doctor about a sleep study. Most sleep studies for adults are now done in the home and involve being hooked up to fewer wires than in the past. Home sleep studies are much less expensive and more readily available. Word of caution: while these home tests are particularly good at identifying moderate to severe sleep apnea, they often miss mild sleep apnea, so if you have symptoms and your home test is negative, I recommend going into the sleep lab for more detailed monitoring. Sleep Apnea Curious? Take the Quiz

How Much Should I Care About Screen Time At Bedtime? There you are, tucked into bed, your phone in one hand and a book in the other. Which one should you choose? The phone is so tempting. Scrolling through news, social media, or playing games feels like a great way to relax before bed. But if you’ve ever been on your device at bedtime, waiting to get sleepy, you know that sleep doesn’t always come. In fact, you’ve probably been surprised to suddenly realize you’ve been scrolling for an hour or more! It’s remarkably easy to “zone out” on a device. But there is reason for concern.   Blue Light 101 Electronic devices like televisions, phones, and tablets emit blue light – a significant portion of visible light that has a short wavelength and high energy. Sunlight is our biggest source of natural blue light and is responsible for boosting alertness, improving memory and brain functioning, and elevating our mood. BUT, blue light inhibits melatonin, our natural, internal sleep hormone that is released when it gets dark outside and signals that it’s time to get some shut-eye. When it’s time to wind down for sleep, spending time with devices that mimic sunlight blocks melatonin -- and the signal that it's time for sleep.   Blue Light Blockers Research is limited on the effectiveness of blue light blocking options like “night mode” on smartphones and blue light blocking glasses. What we know is that even on "night mode", there is enough blue light to inhibit melatonin, our natural, internal sleep hormone. When we hop on a device right before bed, melatonin is blocked and you’re less likely to get a signal that your body is ready for sleep. If you must be on a screen at night, I recommend night mode AND wearing blue-blocking glasses for the final 2 hours before bed, with no screens at all for 30 minutes before bed.     Winding Up or Down Blue light aside, the media we consume on a device can also stimulate our brains into thinking it’s time to be awake and alert. Whether watching a show that increases your anxiety, playing a video game that requires focus, or getting “riled up” by eye-catching headlines; media is designed to get you going, not calm you down. The National Sleep Foundation recommends that you should stop using electronic devices, like your cellphone, at least 30 minutes before bedtime. If you want more sleep and better quality sleep, the choices you make at bedtime are key!   What To Do Relaxation is key. Instead of picking up your phone, consider a relaxing wind-down routine that is more likely to help you feel sleepy naturally. Sticking to the same set of activities before bed every night can help your brain more quickly recognize it’s time for sleep. Here are a few things to try: Read a book with dim light Listen to music or an audiobook Stretch Deep breathing exercises Meditation or journaling Hopefully, by regularly doing one or more of these activities before bed, you’ll be impressed with how quickly you fall asleep and how much better you feel the next day. Give it a try!