Illustration by Angelina Aragon

Zzzzz Expectations

Written by Lauren Loftus Category: Valley News Issue: April 2018
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Subpar sleep is affecting more and more people. But it doesn’t have to be this way.

Sleeping is a lot like breathing. It’s a physiological necessity. But when you stop being able to do it properly, it affects everything else in your life. And it seems more and more of us are having trouble taking deep breaths.

Sleep deprivation is such a problem that the Centers for Disease Control and Prevention called insufficient sleep a public health epidemic last summer, estimating upward of 70 million Americans suffer from one of more than 100 types of sleep disorders. But bad sleep isn’t new, says neurologist Dr. Joyce Lee Iannotti, medical director of the Banner University Medical Center Phoenix Sleep Center. “All of us have had insomnia at some point,” she says. It’s just that more research linking sleep disorders to other issues like cardiac arrest and stroke means “primary care physicians are screening for it more.”

Plus, Lee Iannotti says, “things like sleep apnea have always been underdiagnosed.” Obstructive sleep apnea is the most common form, defined by the Mayo Clinic as occurring when the muscles in the back of your throat relax so much that the airway narrows or closes, lowering the level of oxygen in your blood. Essentially, you’re suffocating youself, so your brain wakes you up dozens of times each night to breathe. Once thought to primarily affect obese males, studies in the last few years have concluded that obstructive sleep apnea can occur in anyone of any size. The common denominator? Snoring.

Flagstaff radio producer David Zorn was diagnosed with sleep apnea in early 2017. “I have [always] been a snorer... but I wasn’t aware of any issues,” he says. Finally giving in to his wife’s demands, he had a sleep test done, and doctors “found that I stopped breathing over 60 times an hour.” Luckily, sleep apnea is easily treatable with a CPAP (Continuous Positive Airway Pressure) machine worn while sleeping. “Now I have more energy for longer,” Zorn says.

Dr. Ruchir Patel, founder of The Insomnia and Sleep Institute of Arizona, says another large issue facing sleepless patients in the U.S. and Arizona – where nearly 33 percent of adults reported getting less than the recommended seven hours of sleep in 2014 – is over-prescribing sleep-aid medicines. Few if any primary care doctors receive much training in sleep medicine, so prescription sleep aids are too often used as a first solution. “Studies say long-term use of prescriptions could lead to increased risk of dementia,” he says, pointing to a series of international studies in the last three years that found people who used benzodiazepines or zolpidem (sedatives like Restoril and Ambien, respectively) to sleep for more than a few months had an increased risk of dementia and Alzheimer’s disease, particularly in elderly patients. Then there’s risk of addiction.

“The most commonly prescribed [sleep aid] is Ambien,” Patel says, which “was designed not to be addictive, but there’s still a huge psychological addiction at play. You’re convinced if you don’t have ‘my little white pill,’ [you] can’t sleep.” Patel says while meds can be beneficial in the short term for acute insomnia, patients should also undergo cognitive behavioral therapy, CBT, to address what’s blocking their path to dreamland.

Dr. Jenna Gress Smith, a Phoenix clinical psychologist specializing in CBT for insomnia, says “I’ve been astounded by the number of physicians who don’t know that prescriptions are no longer the first or best treatment for insomnia.” Instead of prescribing pills, Gress Smith says doctors should be encouraging patients to “talk to someone to see what’s underlying as to why you can’t sleep.” In her practice, that means talk therapy for anxiety or depression (which can lead to insomnia), charting sleep nightly, stimulus control and improving sleep hygiene (see sidebar). A little brain digging, she says, is all it takes to put bad sleep, and the resulting health issues, to bed.

SLEEP A-Z
Sleep hygiene is a collection of habits to promote high-quality sleep on a regular basis. A few tips on improving your sleep hygiene, from the American Sleep Association:

Sleep A-Z

photos courtesy Adobe Stock Images