Neal K. Maru, MD, joined Dr. Pascal Ngongmon in the Mary Washington Sleep Medicine Practice in October. Dr. Maru completed a sleep medicine fellowship at George Washington University, and was drawn to the practice because of the power sleep has to improve our health and quality of life. As our December expert, Dr. Maru shares tips on building healthy sleep habits, and where to seek help when the 40 winks just aren’t coming.

 

Q: What role does sleep play in our overall health?

Dr. Maru: Sleep affects us from head to toe. Adequate sleep plays a role in cardiovascular health, brain health, our immune system’s ability to fight off infections, as well as our overall quality of life. When we don’t get adequate sleep, it can exacerbate mood disorders, chronic pain and other problems. Without adequate sleep, not only are we not going to feel rested, but we are also more prone to having accidents. When accidents happen, people get hurt. I want to try to avoid that.

 

Q: How much sleep is enough?

Dr. Maru: Teenagers and adolescents generally need between nine and 10 hours of sleep, and most adults need between seven and nine hours. That’s on a bell curve, so we have to understand that some people will be able to get by with less than these averages, and some individuals will need more. Every individual is different, but when I tell adults how to build schedules that support healthy sleep habits, I tell them to make sure they block off at least eight hours that are dedicated to sleep.

But quantity is really only one part of getting adequate sleep. We also have to look at the quality of sleep you are getting.

 

Q: How do we know whether we are getting sufficient quality in our sleep?

Dr. Maru: I immediately think of quality of sleep as an issue if someone is getting what should be enough sleep by the numbers, but they are still experiencing some of the consequences of not getting good sleep. So if they are feeling tired, falling asleep or dozing during the day, needing to use caffeine to stay awake, having trouble focusing or concentrating, and it looks like they should be getting enough hours of sleep based on their schedule, I will usually suspect an issue with sleep quality.

When we sleep, we go through cycles of light sleep, deep sleep and what we call REM (rapid eye movement) sleep. Each stage of sleep plays a different role in helping our bodies and minds restore themselves, grow and stay healthy. Some of the wearable devices on the market today try to estimate how much of each stage of sleep we are getting. It’s important to remember that these estimates are based on a built-in algorithm and can’t be 100% accurate. If we really want to diagnose a problem with sleep quality, we may do a sleep study, where we monitor the patient’s sleep to determine whether something abnormal is happening during sleep to prevent them from getting into that deep, restorative sleep.

 

Q: What if my sleep problems are caused by an issue related to another medical specialty?

Dr. Maru: One of the things I love about sleep medicine is the team approach we take to patient care. At Mary Washington Sleep Medicine, we will work with your primary care physician, cardiologist, neuropsychologist, ENT, dentist and other related specialists and healthcare providers to help you get the sleep you need.

 

Q: Should parents be concerned when teenagers stay awake late into the night?

Dr. Maru: A lot of teenagers and even young adults into their 20s have a natural circadian shift where their brains are wired at that point in their life to fall asleep later and wake up later. They are going to have trouble falling asleep and waking up earlier. Some school systems across the country have delayed start times for high school students to accommodate that need for teens and help them get better sleep and be able to function at a higher level. In general, you want to make sure your teen practices good sleep hygiene. This means they need to put away the electronics close to bedtime, limit caffeine later in the day, and keep a regular sleep schedule. If you are doing those things, getting an adequate amount of sleep and feeling rested, it may not matter exactly when the sleep happens, as long as the teen is getting adequate sleep at the same time each day. The problem is, school and work schedules often conflict with these natural circadian rhythms and can leave teens and young adults fighting against their own biology.

 

Q: What are good habits we should all follow for healthy sleep?

Dr. Maru: It’s all about practicing good sleep hygiene, and that means:

• Keep a regular schedule that allows for eight hours or more for sleep each night.
• Don’t consume too much caffeine during the day, especially after noon.
• Avoid alcohol close to bedtime.
• Don’t exercise too close to bedtime.
• Put away the electronics and turn screens off at a set time each night that is well before your bedtime. If you need a distraction to get you to sleep, a book is much better than a lighted screen.

In addition, there are all kinds of resources online. Two websites I recommend people consult are:

• The National Sleep Foundation: https://www.thensf.org/
• The American Academy of Sleep Medicine’s Sleep Education website: http://sleepeducation.org/

 

Q: What is the first step I should take if I am worried about my sleep or a loved one’s sleep habits?

Dr. Maru: If you are having trouble with sleep and are unsure where to begin, call our office at 540-741-7846. Our staff can help you determine whether you need a referral from a primary care physician and can help arrange how to get you in for a consultation.

 

For more information, visit practices.mwhc.com.