[Music] [Music] they're the ones who raise the bar the ones dedicated to providing care in the most demanding of circumstances the ones that understand the healing benefits of kindness and compassion they're the people of sarah bush lincoln and they set the bar high sarah bush lincoln trusted compassionate care right here close to home for over 50 years horizon health has been keeping you and your family healthy and although some things have changed horizon health's commitment to meet the ever-changing needs of our community has remained the same horizon health 50 years strong carl is redefining health care around you innovating new solutions and offering all levels of care when and where you need it investing in technology and research to optimize health care carl with health alliance is always at the forefront to help you thrive thank you for joining us for this episode of being well i'm your host lacey spence and on today's episode uh we hope it won't put you to sleep but we hope it'll cause you to get some better sleep we are joined by sarah bush's registered sleep technologist rodney wildman welcome to the show thank you i guess i should say welcome back it's been a bit since we talked to sleep it's been a couple years yes so today as we're talking sleep um first off how do you know if you're getting enough sleep the best indicator is if you feel refreshed whenever you first get up in the morning do you feel like you need to go back to bed or do you feel like hey i don't feel too bad you know of course you're going to take a few minutes to actually get up and get moving but if you feel like you need to go back to bed you're probably not getting the right amount of sleep or not good quality sleep and sleep is so integral to i mean everything we do again why do we need to have that good sleep the good sleep is going to help with your overall health and it's going to help you with your memory your learning and just being a not so grouchy because sometimes if we don't sleep well just like any adult we're going to be grouchy and nobody wants to be grouchy so good night's sleep is really good for your health especially and for different age groups are there certain amounts of sleep that we should be getting oh yeah my girls are 13 and 10 and i tell them you still need at least nine hours of sleep every night so yeah they still have a bedtime they want to stay up late but no and as adults we should get about seven to nine hours and then the younger kids you know they need tend to need more and so what if i'm a person who that seven to nine i always end up feeling kind of groggy but i know some folks who get shorter than seven and they say oh i just need a couple hours i just need you know five five good hours right yeah there's lots of people that just they can function really really well on six hours of sleep and there again if you feel like like you're refreshed after maybe six hours of sleep if that is that if that's what works for you hey that's what works for you you know that's just what the experts tell us seven to nine hours of sleep so that can be an indicator that even if you're not sleeping as long you're having a better quality sleep correct yeah yep so again i guess this kind of leads into that so it's all sleep the same now about about 75 of our sleep is what we call non-rem sleep that's where we're not dreaming we're either in stage one sleep stage two sleep or what we call our deeper sleepers which is our delta sleep and then our rem sleep it's about 25 minutes or 25 of our normal sleep and that's where we're dreaming and that's what restores our brain and stuff like that and the stage three sleep that's what restores our body and everything and so we don't wake up with the aches and pains and stuff like that but unfortunately as we get older we tend to lose that stage three sleep the slower delta sleep like whenever your kids are little and you pick them up off the couch and they don't remember how they got to their bed they're in that stage three sleep you can just pick them you can go in there and lift their arm up and lay it back down they won't even know what happened i love watching the videos of that where the parents are just getting away with so much because those kids are out oh they are yes they are they're repairing everything they tore up during the day in their little body of theirs so if you were to watch somebody as they were going to sleep or maybe i guess what's happening on the inside in the brain what uh what kind of time frame does it look like as people are falling asleep how long does it take them to go through those stages okay so it should take you anywhere between 10 and 20 minutes to actually fall asleep and then the sleep cycles you should go through your sleep cycle every 90 minutes so you're going through your stage one stage two stage three and then you hit your rem sleep about every 90 minutes you should be dreaming but like i said as we get older we lose a delta sleep so we tend to dream more as adults than what we did when we were younger as children interesting and so um who is most at risk for poor sleep shift workers they get i'm we're not made to be up all night we're intended to be sleeping at nighttime so shift workers people that that travel a lot further jobs jet lag is a big one you know stress at work stress at home um so there's lots of different sleep stealers caffeine alcohol so there's lots of different stuff that can rob you of good quality sleep what about blue light exposure i feel like that's something that's kind of been brought up more recently with everyone being in their phones or on the tablets on the laptops watching the tv right all the time and the best thing to do is shut any electronics off like an hour or so before you intend to go to sleep so an hour before bedtime get a book because that white light is what's going to keep your brain activated and it's going to hey i'm still awake i'm still awake i'm still awake that's why i say no electronics in the bedrooms you know keep the tvs out of there phones you know if you're going to have a an alarm clock clock watchers turn it around that way you don't see it yeah you're going to use your alarm and everything if you have your phone in there turn it over to where it doesn't light up if you get a notification for whatever reason you know because the white light is what's going to get you but the blue light glasses and stuff like that they help decrease it the white light and everything but i still wouldn't try to avoid any of that light an hour so before bedtime and then just to make sure i'm understanding so then you will have a better sleep if you also turn off the tv like once you're correct okay yeah because everybody said well i always sleep with the tv on we hear that a lot in a sleep lab my husband's one of them yes and it's not necessarily the sound because sound can drown out the ambient noises of anything else environmental sounds around you know like fire engines police officers in their cars and stuff like that or just noises outside the home but sound machines will drown them out but it's the light of the changing of the scenes and stuff like that throughout the tv shows that's what activates your brains because you can close your eyes and you can still see light through your eyelids so that's what activates your brain it's like nope i'm not going to sleep just yet so you won't be getting you won't be falling into your stages of sleep properly because they could definitely arouse you out your sleep and are there any other methods i guess would it be kind of like a oh the sleep mask are those a good route for some people to take maybe oh yeah yeah sleep masks are really good yeah ear plugs sleep mask ear plugs yeah you just don't want to sleep through that alarm the next day that's when you get into trouble yes you will and so i think you kind of hit some of the sleep steelers but do you mind running back through those just a little bit okay um caffeine don't drink caffeine i try to cut out my caffeine before lunch i try not to have anything caffeinated after noon really yeah that helps me with my sleep and nicotine they all they're all stimulant they're both stimulants um exercise try to exercise earlier in the day and definitely try not to exercise anywhere three hours before your bedtime so if you're going to bed at 10 try to get your exercising in before 6 pm i would almost think that's kind of counterintuitive i would think like oh man if i work out um i will be tuckering myself out so what causes you to kind of stay up after a workout your heart rate will still be increased okay and your body temperatures still be increased so you want to keep them because as we get um our circadian rhythm it tells us our our body temperature is going to start going down somewhere probably around 9 p.m between 9 and 11 p.m our body temperatures tend to go down so that's why we start to get tired and everything so what about folks who nap so i know some people it's it's kind of a blessing other people are like oh no i'm not the napping type because then i won't sleep do you have any sort of recommendations for that if you're going to take a nap there's nothing wrong with it but don't let it go longer than 20 minutes 30 minutes at the very most because once you start doing that then you're going to start getting into the deeper stages of sleep you start getting into a deeper stage of sleep it's going to be harder for you to fall asleep that night so a 20 minute nap there's nothing wrong with that now you told us earlier it takes like 15 to 20 minutes to get to sleep right so do i need to a lot like 30 to 40 minutes so i have time to get to sleep have that little bit of a nap and then wake up or is it just 20 minutes total 20 minutes total is all i would do because you're going to be resting you know you may not actually fall asleep in them 20 minutes but 20 minutes of lying down and resting yeah and if you doze off your doze off yeah but i wouldn't sleep more than 20 minutes i definitely wouldn't sleep more than 20 minutes don't make it an all-day affair which i know is kind of guilty after you're wrapping up the chores on a sunday maybe yeah like a two hour nap that's not a nap that's a sleep because you went through all your sleep cycle so yeah so i know a lot of people maybe kind of joke about snoring being like oh they're out they were snoring is snoring normal is it a good thing bad thing indifferent snoring is common okay it's definitely not normal because i haven't heard anybody yet that's a weight that snores because our body has control of our airway so it's nice and open and the snoring is all them soft tissues starting to collapse your airway starting to collapse that's where all the vibrations come from that's where all the racket comes from when people are snoring so it's common but it's not normal um it sounds if my i mean my airways are closing is that a bad thing then that doesn't sound very good no no it's definitely a bad thing that's where snoring is the first sign that maybe you're having some sort of sleeping disorder that may lead to sleep apnea because that's your airway starting to block off so no it's definitely not a good thing can we talk about sleep apnea works i feel like it's something that people talk about and i just kind of picture like the the stereotypical sitcom and they've got the sleep mask and that's about all i know about it well the apnea is of course apnea means sensation of breathing so that's where your airway is completely blocked off you're not moving any air i mean you can see the people that have sleep apnea their chest and stomach are moving and everything but there's no air being moved past here it's just it's kind of and then when they get that airway open their body gets controlled the airway they make all the racket and everything the big gasps and snorts and stuff like that yeah so now it's definitely not a good thing is it something that t people typically find out that they have on their own like they've realized that they're waking up gasping or is it typically maybe a spouse who notices their symptoms right it could be both because people wake up and they may wake up in a panic because they feel like they're short of breath they're like i just had a something happening they not exactly they can't explain what happened but they're waking up and they're short of breath and they're almost panting trying to get their breath and everything that was probably because their airway is blocked off for who knows how long probably more than 20 seconds or so and then they're waking up and gasping and or it could be a bed partner that noticed hey my husband my wife you know they're i can tell that they're not breathing and then they kick and jerk and then they wake themselves up and everything yeah and it's usually that's how the physicians usually find out somebody has sleep apnea is from a spouse and so after they've been uh they tell their doctor that they've had this go on what are the next steps i guess to start getting treatment um go talk to your doctor about it and let them know what is going on keep like a two-week diary of what's been going on if you suspect something is going on with your sleep keep a two-week diary of it and take that information into your provider and talk to them about it that way they can make an educated decision on what actually needs to be done and then what they will probably do is schedule for either a in lab study or at home study and for those who maybe haven't had to have either can you walk us through what an in-house study looks like or one that's at home sure sure okay so if you come to stay with us sarah bush overnight all right we're gonna greet you we're gonna send you a bunch of paperwork have it filled out and everything and then um what we will do we'll look through the paperwork see if we have any questions and then the technician that works that night will put about 28 different wires on you that night to monitor your brain waves your breathing um your eye movements your see if you're clenching your jaw grinding your teeth put a storm microphone on you will watch your heart rate and heart rhythm we'll watch whether you're breathing from your chest or from your stomach and we'll put a couple leaves on each of your legs that way we can see if you're moving your legs at night so it's quite it's it's quite involved it really is and the home test all it consists of is a pulse ox that goes on your finger one belt around your chest and a cannula that goes into your nose that way we can tell if you're breathing or snoring do patients typically have a hard time i mean relaxing with all of that uh the wires on they do but it's it's dark in the in the sleep lab and it's cool and it's quiet so you will fall asleep i think i've had four people in 15 years stay awake all night that's a pretty good record though yeah that's not too shabby and so after someone is diagnosed with sleep apnea how do you know if they need you know the type of breathing machine or are there other actions they can take to um is it like lifestyle changes so that they don't have to wear the mask at night or it could be a little bit of both okay the biggest um probably the best thing to do is come back in have your cpap titration study and we'll set your um pressure at whatever what what your optimal pressure is what keeps your airway open what keeps you from having the respiratory events what keeps you from snoring that's where we will stop with the air that's being put through this the cpap mask itself um sometimes it is just a weight issue with people but most of the time it's what we get from our parents or make up of them so i mean the anatomy they gave us is what we got so sometimes it's not a weight issue it is definitely a cpap or you can have surgeries done to remove your uvula tonsils add noise whatever else you got in there they can also remove any kind of fatty tissue and everything in there do the surgeries always work not always i mean it just depends on how much scar tissue develops back after the surgery and for milder cases there's oral appliances that can work go to a dentist that makes the oral appliances and what they do is they lock your teeth together and pull your jaw forward just a little bit and then work for very mild cases of the sleep apnea correct and then um is it also your dentist you would need to see if you are like clenching or grinding your teeth right yep yep because they could probably give you a mouth guard to help protect your teeth and everything so that way you don't flatten them out and how important is it to keep that cpap equipment clean oh that's very important very important you should wipe it down every every morning after you get done with it wipe it down with a mild detergent and water they have cpap wipes at some dme companies and they have the other cleaning machines that sanitize your cpap machines and your hoses and the mask and everything but you still need to wipe all the oils and stuff off of the mask that makes contact with your skin got to keep them clean so after i guess kind of on the flip side instead of being asleep and your airways having issues um the flip side not being able to get to sleep what is insomnia insomnia is just that not being i mean we'll get to sleep yep or you may wake up and just you may doze off pretty quick you know pretty normal and everything but you wake up for whatever reason you know and you're not able to get back to sleep you're just laying there awake laying there awake you know and you made those off then you wake up again and then you may wake up early every day you know so i mean yeah insomnia is just just not being able to get a good night's sleep and that right there would be something you would discuss with your provider and then they can proceed with the treatment that they are more educated on than what i am especially a sleep doctor they can actually help you out a lot more and this might be a little bit out in left field but i have to ask if you have um like a dream or it feels like you're falling and you wake up real quick is something happening to your body in that moment do you know you mean like when you're first dozing off yeah and you kind of just all of a sudden it's just like the bed is out from underneath you is there something that's happening that's one of my favorite words it's called a hypnagogic jerk one more time hypnagogic jerk okay that's what it's called like when like when we were all in school you know we'd be sitting there dozing off or whatever you know like and then you jerk and you're looking around make sure nobody seen you you know that's what that is it just you're just dozing off and then you realize oh i gotta wake up it's just a hypnagogic jerk and it's normal it's normal yeah nothing that causes it nope and i think there's a few other sleep conditions that are handled in your office narcolepsy narcolepsy yes we test for narcolepsy so if you suspect that you have narcolepsy which is the ability to just not an ability i guess it's just you fall asleep for whatever you're doing it don't matter where you're at what you're doing you just fall right asleep okay so we can test for that you will come in for an overnight study then the following day you'll have a series of five different naps they'll be each of them will be two hours apart and if you start dreaming in any of them naps that's a positive sign for narcolepsy interesting oh it's it's very interesting it's it's very uncommon we don't get a lot of patients that test for it but we get maybe three or four a year three or four years and so if i'm somebody who is diagnosed with this what is what can be done is there anything that can be done for me there's um lots of different i shouldn't say lots of different treatments because i don't know lots of different treatments but light therapy can be one of them and i think they do that up at northwestern university i'm not real up on what the treatment is for it but a lot of times just pharmacological stuff the medicines that the doctors will prescribe for them fair enough and i feel like i hear a lot about rls the restless leg syndrome what does that kind of look like right the restless legs is sometimes it gets confused with periodic limb movements so your restless legs is what's going to keep you awake at night so when you feel like you have this urge to move your legs when you're just relaxing in your chair or on the couch and you're sitting there watching tv and you feel like you just got to move your legs or if you're lying in bed and you just got to get up and walk because your legs are tingling and you just got to move them that's what restless legs is now periodic limb movements that's whenever you're actually moving either your feet or your arms so it's your limbs so it's periodic limb movement so they move while you're sleeping which they shouldn't be doing that no and i think we hit it a little bit earlier the shift worker disorder talking about shift workers what's the best uh course of action for them since that's i mean it's definitely part of their lifestyle to not be matching the regular sleep cycle right the best thing is just like on with anybody else try to keep the same sleep time same goal at bedtime and same awake time as anybody else try to keep that as regularly as you can that's going to be the hugest that's going to be the biggest benefit for you it really is because your body will kind of uh map out that rhythm and get into it it will do its best yes yes and so if i ha am somebody who's having issues with sleep do i start with my primary doctor and then move to something like your office or here at sarah bush the primary physicians they will send an order to us in in the sleep lab and we'll take care of it that way you don't need to go to a sleep doctor the primary care physicians will write the order and then go to the insurance and then see what happens from from the insurance point and so how long have you been where you're at i've been at sarah bush it'll be 15 years this september well congrats is it all for uh sleep technology correct right so what uh in your 15 years have you noticed the technology changing the the way people are study changing what did you notice in those last 15 years they've added a few more wires over the years but the biggest changes are the masks which they've they're really more patient um they're better for the patients now because the old mask you know they would cover your whole face and have pieces that go on your forehead now we have new minimal contact masks that do the same thing so they don't go any higher than the tip of your nose and you can breathe out through your nose or your mouth with either one whereas the old full face mask they still cover your whole face so the the mask they've come a long way the technology with them they're really improving a lot and i feel like that would help with getting more accurate results for the patients maybe they can sleep a little easier since not as much of their faces go right and then they're more compliant after they leave us in the sleep lab and then they continue with their cpap therapy throughout the years excellent in our last couple minutes here is there anything else that you would like to share with the viewers at home that might be helpful to getting better sleep or to not uh not wait to see if you have problems with your sleep now just keep that sleep diary and for for two weeks if you think you're having a sleep issue keep that sleep diary for two weeks and talk to your physician about it and and uh if they think that you're having an issue to where we can help you out in the at sarah bush we'll be happy to help you and if you do have problems with your cpap masks as long as you've had your study done sarah bush we have a mass fitting that is no charge to you all you do is just make an appointment and me or one of the other daytime people will help you with a different mask very convenient it's all on site yes all right well if you'd like to see see rodney wildman you can find him at sarah bush and thank you for coming on our show today thank you and we hope you uh sleep well and join us for our next episode of being well carl is redefining health care around you innovating new solutions and offering all levels of care when and where you need it investing in technology and research to optimize healthcare carl with health alliance is always at the forefront to help you thrive for over 50 years horizon health has been keeping you and your family healthy and although some things have changed horizon health's commitment to meet the ever-changing needs of our community has remained the same horizon health 50 years strong they're the ones who raise the bar the ones dedicated to providing care in the most demanding of circumstances the ones that understand the healing benefits of kindness and compassion they're the people of sarah bush lincoln and they set the bar high sarah bush lincoln trusted compassionate care right here close to home [Music] you