Proper sleep is paramount to well-being, but achieving it isn’t always easy. Stress, improper diet, lack of exercise, caffeine, prescription medications and even too much sleep are among the culprits interfering with optimal rest.
Sleep experts study various symptoms, from snoring to sleep paralysis, morning headaches to drowsy driving and dry mouth to choking. They help patients achieve what Fariha Abbasi-Feinberg, M.D., uses as a motto for her practice: “Sleep well to live well.”
The Medical Director of Sleep Medicine at Fort Myers-based Millennium Physician Group, Abbasi-Feinberg has more than 30 years of experience as a sleep medicine specialist and neurologist. She relocated to Southwest Florida in 2019 after 20 years of practice in North Carolina.
“Many factors contribute to poor sleep, including stress, social media, constant access to entertainment, excessive light and noise and a busy schedule,” says Abbasi-Feinberg, a national speaker on sleep disorders and member of the board of directors for the American Academy of Sleep Medicine. “With so many demands, it can be difficult to prioritize sleep. People need to recognize that sleep isn’t just ‘down time.’ It is a crucial period for learning, regeneration, healing and recovery.”
David Clarke, M.D., is president of the Portland, Oregon-based Association for Treatment of Neuroplastic Symptoms, a nonprofit dedicated to ending the chronic pain epidemic. He believes there is a connection between adverse childhood trauma that causes stress (which continues into adulthood) and sleep issues.
“There is evidence we are living in a more stressful world for a variety of reasons these days,” says Clarke. “There can be so many distractions. One of the common impacts of stress among my young patients is that they become the kind of people who are trying to fix everything, trying to solve everyone’s problems and make everything better for those who are close to them. They are just going nonstop trying to achieve that, and the result of that can be a stress level that interferes with sleep and a lot of other stuff, and all of that can lead to pain and illness.”
Like other sleep experts, Clarke recommends various practices to improve quality sleep — from maintaining a consistent sleep schedule to avoiding heavy meals, caffeine and nicotine close to bedtime. Commonsense guidelines include optimizing a preferred sleep environment by keeping the space cool, dark and quiet. Regular exercise is as important as practicing techniques such as deep breathing, meditation and mindfulness.
A recent study in National Health Statistics Reports, an online publication of the U.S. Centers for Disease Control and Prevention, associated the increased amount of prescription medications among older adults with sleeping issues. The national public health organization in Atlanta reported 88.6% of adults over age 50 took a prescription medication in the previous 12 months. Among adults age 65 and older, 54% take at least four medications, according to a poll conducted by the Kaiser Family Foundation, the independent nonprofit health policy organization headquartered in San Francisco.
Brienne Miner, geriatrics and sleep medicine specialist at Yale Medicine and assistant professor of medicine at Yale School of Medicine, describes sleep issues among adults age 50 and older as “more frequent arousals from sleep,” according to a recent article in AARP The Magazine. The predicament results in increased lighter stages of sleep, and less deep sleep and less rapid eye movement sleep.
Asthma medications, decongestants and blood pressure medicines can interfere with sleep, reports the American Association of Retired Persons. The Mayo Clinic details other health problems that interfere with proper sleep, including acid reflux, arthritis, chronic pain, dementia, diabetes and Parkinson’s disease.
Patients’ physicians can determine if adjusting dosages, changing medications or changing consumption times of medications can improve sleep. But common recommendations include eating a well-balanced snack before bedtime and raising pillow positions. Having a proper snack prevents blood sugar level issues for diabetics; having a more elevated head position while sleeping helps alleviate acid reflux problems.
“Many prescription medications can affect sleep,” says Abbasi-Feinberg. “For instance, certain decongestants can cause insomnia, many blood pressure medications can cause strange dreams and trouble sleeping and many medications used for depression can affect sleep.
“It is always important to review the possible effects of medications on your sleep and discuss options with your physician to adjust the timing of medications, or even consider changing your medications. I often feel like a detective and review all medications and supplements my patients take to better advise them.”
