Some new research shows that death may come sooner if you don’t sleep. The Washington Post reported research studies from multiple universities. Look here for the article:

In the screen-lit bustle of modern life, sleep is expendable. There are television shows to binge-watch, work emails to answer, homework to finish, social media posts to scroll through. We’ll catch up on shut-eye later, so the thinking goes — right after we click down one last digital rabbit hole.

Brain research, which has pushed back hard against this nonchalant attitude, is now expanding rapidly, reaching beyond the laboratory and delving into exactly how sleep works in disease and in normal cognitive functions such as memory. The growing consensus is that casual disregard for sleep is wrongheaded — even downright dangerous.

Everything from poor school performance to potentially early dementia and Alzheimer’s. What I find in all of this is the need for good sleep hygiene. Most people have a poor sleep regimen. Nursie poo does too. We have a nice bed, but there is a TV in the room that is usually on when we get in bed and then we use the sleep timer. Often, we are asleep when the TV cuts off, which is bad. One or both of us is on our phone in a normal, daytime mode making sure that no one is wrong on the internet because if they are, we must correct them, which is also bad. We eat before bed, again, bad. Our sleep time varies with no regular pre-bed prep, even worse, but sometimes can’t be helped.

So, what is the correct way to go to bed? Bedtime is when you enter the bedroom. You should spend time before doing by that taking care of anything before sleep. This includes personal hygiene, toilet time, checking locks, or anything else. No food or drink, usually 1-2 hours prior to bed. Once in the bedroom, you should be prepared to sleep. Electronics should be put away at the door, and the TV or even a radio should not be playing. While this seems strict and not in alignment with how one normally gets ready for bed, that’s how it should look. The CDC recommends between 6-8 hours of sleep a night, which all of us have some difficulty doing at times.

Let’s talk about insomnia too. Insomnia comes in two forms. The first is trouble falling asleep or the fancy term, sleep initiation. Typically, this comes from two problems. One of these problems is poor sleep hygiene. You have too much going on when you walk into the bedroom. You must get up and take care of unfinished business, or you have other distractions once you are in bed. Believe it or not, the first prescription I give the patient who has trouble initiating sleep is to run through their bedtime routine with them and educate them on what may or may not help him fall asleep. Why don’t I just run to drugs? Quite simple, you know how Nursie poo feels about drugs. I always like to try something less invasive first. If you’re having trouble falling asleep, my first advise to is to keep a diary. Have a list, almost like a checklist, of things you do or need to do before you go to bed. This will help you organize your sleep plan and allow you to go to bed with your mind relatively free of things that need to be done in the house. The second part of the sleep diary is what happens that keeps you from falling asleep. This is usually something like a wolf howling outside your window or cats doing the nasty in the alley or missionaries ringing the doorbell. Anyway, it’s all different for every person, but must be identified.

Now, if you are truly having trouble initiating sleep after you performed sleep hygiene, we can see if it is something that can be fixed by behavior modification, or if we actually need to prescribe you medication. I always start low and try something easy like Benadryl. The reason I do this is I want to give my patient the least amount of medication to induce sleep (It works well for me, at Master’s advice). Many, heavier sleep medications such as Ambien, Lunesta, and trazodone can leave you feeling hung over in the morning if not prescribed at an effective dose (Also, some side effects may include racist tweets, just like Roseanne). By starting slow, we’ll leave out that hangover because we know everyone hates hangovers and there is nothing like trying to get going when you feel that way. Once we step through medications and find one that works right for you, we still like to find if this is working. So, we like to keep that sleep diary for another four weeks. This combines sleep hygiene with medication and hopefully fixes the problem.

The other type of insomnia is mid sleep insomnia. Mid-sleep insomnia can occur for a lot of reasons. The most common of these reasons are intrusive nightmares, sleep apnea, and distracting behavior. Once again, we asked these patients to keep a sleep diary. However, we take a little bit of a different tactic here. If it is intrusive nightmares, we ask them to document how many they have a night and whether they can reinitiate sleep afterward. If they can reinitiate sleep, there may be nothing we can do for them except to refer them for cognitive behavioral therapy to assist in dealing with intrusive dreams. Distracting behavior is something we usually can control. The last his sleep apnea.

Nursie poo has sleep apnea. Sleep apnea occurs, usually mechanically, from the soft palate blocking the airway. Your first hint of sleep apnea is persistent snoring. However, your spouse or someone in the room listening to you sleep may hear you stop breathing, choke, and then wake up briefly only go back to sleep and repeat this over and over. A good indication that you have sleep apnea is even though you’ve had a full night’s sleep, you end up feeling like you need a nap in the middle of the afternoon. This is not being older or lazy, but that your body did not recover like it should when sleeping. In these situations, when we find out that the patient is a snorer and stops breathing in their sleep, or takes frequent daytime naps, we order what’s called a sleep study. These have become less and less invasive, and now some are even being done at home. The machine measures the oxygen saturation of your blood as well as your respiration and brain activity. This whole process gives you a score. The higher that number, the worse your sleep apnea is. If the number is sufficiently high, a CPAP may be recommended. This device blows positive air pressure through your nose to keep your soft palate open, which allows you to breathe without obstruction.

Okay, I’m going to lay this out here right now. There are a lot of funky ass devices out there that claim to help with sleep apnea. There are also surgical procedures that are sometimes recommended for sleep apnea. None of these have proven more effective than the CPAP. I wear one, and trust me, they take a little getting used to. You can do it, and in those situations, I will sometimes recommend a mild sleep aid to assist you in falling asleep. The most important part of the CPAP is keeping the mask on as much as possible. If your number on the sleep study shows that your oxygen saturation drops while you sleep, it may be necessary to provide you supplemental oxygen. Most sleep patients do not need this, however, when it is necessary, it is prescribed.

So, I’m pretty sure you are tired of sleep (I still slay myself). I think if you take time with your sleep hygiene, you will find that you get better sleep and will feel better.