Welcome to the Caribbean College of Family Physicians Blog!
We are delighted to introduce our new blog, a dedicated platform for healthcare practitioners across the Caribbean and beyond. This blog will serve as a resource for sharing knowledge, insights, and the latest updates in family medicine and primary care.
Each month, we will feature medical articles authored by experts in various fields, tailored to the needs of family physicians, allied health professionals, and other healthcare providers. Our goal is to support your continuous learning journey, provide practical guidance, and keep you informed of new developments in medicine that impact patient care.
This month, we are excited to explore the critical topic of Sleep through articles submitted by Dr. Colin Alert. These pieces will delve into the importance of sleep in overall health, the impact of sleep disorders, and strategies for improving sleep hygiene in patients. We hope these insights will enhance your practice and empower you to better address this vital aspect of your patients' well-being.
We encourage you to engage with our content, share your thoughts, and contribute to the ongoing dialogue as we strive to empower our healthcare community. Whether you are looking to stay updated on clinical practices, explore new research, or simply connect with fellow practitioners, this blog is your space.
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Sleep and Health.
Dr. C.V. Alert, MB BS, DM. FCCFP.
Family
Physician.
“Sleep
awaits those of us who dare to dream”.
Sleep
medicine is a relatively new specialty in medicine, with literally just a
couple of medical practitioners here trained in this new area. However, what
happens (or doesn’t happen) when you sleep one night has a significant effect
on what happens (or doesn’t happen) next day when one is awake, or tries to
stay awake. During sleep, your
body is working to support healthy brain function and maintain your physical
health. The way you feel while you are awake depends in part on what happens
while you were sleeping. Not
getting enough quality sleep regularly raises the risk of many diseases and
disorders.
In children and teens, sleep also helps support growth and
development. Getting inadequate sleep over time can raise the risk of chronic
health problems. It can also affect how well you think, react, work, learn, and
get along with others.
Sleep affects
various aspects of your overall health, from your mood to your immune system.
When you don’t get enough sleep, you experience sleep deprivation. Signs of
sleep deprivation can include:
- Difficulty concentrating
during the day
- Excessive daytime sleepiness
- Forgetfulness or poor memory
Tips for a “Good
Night’s Sleep”.
·
Get more sleep- ideally aim for 7-9
hours every night.
·
The bed and bedroom should be cool,
quiet, dark and comfortable.
·
A consistent sleep schedule is
important, with regular bedtime and waking (except when the Olympics are on
television all through the night).
·
The 3,2,1 rule: No physical activity
for 3 hours before bedtime, no heavy meals for 2 hours before bedtime, and no
electronics, including television, video, telephone, smartphone or radio 1 hour
before bedtime. On the other hand, people who include regular physical activity
into their daily routines tend to be better sleepers.
·
The bed should be reserved for only
two activities that start with the letter ‘S’: sleep and sex. It is hoped that
sickness, which also starts with an ‘S’,
does not keep you in bed too long.
·
A cool bath, and a warm drink, may
help you relax before bedtime. However,
drinks containing caffeine or theophylline (coffee, tea and ‘black’ soft
drinks), and alcohol, should be avoided.
·
If you sleep in the day, even a brief
nap, this may affect your ability to fall asleep at night. Avoid taking naps
close to your bedtime.
·
(Easier to say than to do but) Avoid
taking your daytime problems to bed with you.
Stress can be a major destroyer of sleep patterns.
Over time, chronic
sleep deprivation is linked to health conditions like diabetes, depression,
obesity, dementia and cardiovascular diseases. Some of these diseases are
associated with fatal outcomes so literally ‘not getting proper sleep can kill
you’. In these situations, the physician has to treat both the actual condition
and the underlying sleep deprivation for optimal management. One night of poor
sleep can affect you the next day. Many poor nights of sleep can affect you for
a lifetime.
Sleep Disorders.
Dr. C.V. Alert, MB BS, DM. FCCFP., Family Physician.
Patient: Someone recommended a sleeping tablet, and I
have been sleeping ‘like a baby’.
Doctor:
Really? How many have you taken?
Patient: Well,
I am not actually taking them. I give them to my wife!
While most
doctors have probably been faced by some patients, and explanations (or
conspiracy theories) about the reasons for poor sleep, there are actually a
variety of ‘medical’ sleep disorders. Sleep
disorders are a group of conditions that affect the ability to sleep well on a
regular basis. Sleep disorders can be caused by a health problem or by too much
stress. Some people occasionally experience sleeping problems due to hectic
schedules, loud neighborhoods or other influences. However, when these issues
begin to occur on a regular basis and interfere with daily life, they may
indicate a sleep disorder.
Depending on
the type of sleep disorder, people may have a difficult time falling asleep and
may feel extremely tired throughout the day. The lack of quality
sleep can have a negative impact on energy, mood, concentration, ability
to work or play, and overall health.
It’s important
to receive a diagnosis and treatment right away if you suspect you might have a
sleep disorder. When left untreated, the negative effects of sleep disorders
can lead to further adverse health consequences. They can also affect your
performance at work, cause strain in relationships, and impair your ability to
perform daily activities.
The symptoms
associated with sleep disorders differ depending on the type and severity of the
sleeping disorder. However, general symptoms of sleep disorders include: Difficulty
falling or staying asleep; strong urge to take naps during the day or daytime
fatigue; unusual breathing patterns; unusual movement or other experiences
while asleep; depression, irritability or anxiety; or impaired performance at
work or school.
There are
different types of sleep disorders, including insomnia, sleep apnea, restless
legs syndrome, parasomnias and narcolepsy.
Insomnia.
Insomnia refers to
the inability to fall asleep or to remain asleep. It can be caused by jet
lag, stress and anxiety, hormones, or digestive problems. It may also be a
symptom of another condition. Insomnia can be problematic for your overall
health and quality of life, potentially causing issues like depression; or difficulty
concentrating at work or school; irritability.
Unfortunately,
insomnia seems to be very common (although official figures are not available).
Sleep apnea.
Sleep apnea is
characterized by interrupted breathing during sleep. This is a serious
condition that causes the body to take in less oxygen. It can also cause you to
wake up during the night.
Parasomnias.
Parasomnias are a
class of sleep disorders that cause abnormal movements and behaviors during
sleep. They include sleep walking; groaning; nightmares; bed wetting; teeth
grinding or jaw clenching.
Restless leg syndrome.
Restless legs
syndrome (RLS) is an overwhelming need to move the legs. This urge is sometimes
accompanied by a tingling sensation in the legs. While these symptoms can occur
during the day, they are most prevalent at night. RLS is often associated with other
health conditions, including attention deficit hyperactivity disorder (ADHD)
and Parkinson’s disease, but the exact cause isn’t known.
Narcolepsy.
Narcolepsy is
characterized by “sleep attacks” that occur while awake. This means that you
will suddenly feel extremely tired and fall asleep without warning. The
disorder can also cause sleep paralysis, which may make you physically
unable to move right after waking up. Although narcolepsy may occur on its own,
it is also associated with certain neurological disorders, such as multiple
sclerosis.
In some cases, sleep disorders develop as a result of an
underlying health problem. Some of these conditions include:
1.
Allergies
and respiratory problems.
Allergies,
colds, and upper respiratory infections can make it challenging to breathe at
night.
2.
Frequent
urination.
Frequent
urination may disrupt your sleep by causing you to wake up during the night. In
our population, elderly men with large prostates and slightly younger women
with uterine fibroids fall into these categories. Diseases like diabetes and heart
failure, among others, are often associated with frequent urination, especially
at night.
3. Chronic
pain.
Constant pain can make it difficult to fall
asleep. It might even wake you up after you fall asleep. Some of the most
common causes of chronic pain include conditions such as arthritis, severe
headaches and low back pain.
4. Stress
and anxiety.
Stress and anxiety often have a negative impact on
sleep quality. It can be difficult to fall asleep or to stay asleep.
Nightmares, sleep talking, or sleepwalking may also disrupt sleep.
Nowadays, advances in medical technology, as well
as advances in the new specialty of sleep medicine, has allowed improved
diagnostic and treatment options for sleep disorders.
Lifestyle
adjustments can help treat sleep disorders, especially when they’re done along
with medical treatments. Such adjustments may include: Including more
vegetables and fish into your diet; reducing sugar intake; reducing stress and
anxiety by exercising and stretching; creating and sticking to a regular
sleeping schedule; drinking less water before bedtime; and limiting your
caffeine intake, especially in the late afternoon or evening. Decreasing
tobacco and alcohol use; eating small low carbohydrate meals before bedtime; maintaining
a healthy weight based on your doctor’s recommendations; going to bed and
waking up at the same time every day can also significantly improve your sleep
quality. While you might be tempted to sleep in on the weekends, this can make
it more difficult to wake up and fall asleep during the workweek.
Medical
treatment for sleep disturbances might include any of the following:
sleeping pills;
melatonin supplements; allergy or cold medication; medications for any
underlying health issues; breathing device or surgery (usually for sleep apnea),
a dental guard (usually for teeth grinding).
If you suspect
you have insomnia, sleep apnea, or another sleep disorder, talk with your family
doctor. Many sleep disorders can be managed through lifestyle changes and
pharmacotherapy. Your doctor may advise you to change your sleep environment or
habits, practice meditation or other relaxation strategies, prescribe medications,
or suggest you have a sleep study, known as a polysomnogram, to further
evaluate the cause of your sleep disturbance.
About our Contributor
About
Founder & Director, The Wellness Clinic, Bridgetown, Barbados.
Former Researcher, Chronic Disease Research Centre(CDRC), Barbados.
Team Physician for Team Barbados at Commonwealth Games 2006;Junior Commonwealth Games 2008; 1st Youth Olympics 2010; Pam Am Games, Central American and Caribbean Games.
Member, National Anti-Doping Commission (NADC) 2000 to 2010
Member, and former President, Barbados Sports Medicine Association (BSMA) 1987 to present
Specialties: Family Medicine
Sports Medicine
Linne Thompson HyattAdministratorCaribbean College of Family Physicians Secretariat19a Windsor Avenue, Kingston 5, JAMAICATel: 876. 946-0954 or 876-517-6636/876-386-1443 Fax: 876.946-0954https://www.caribgp.org
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