Patients tend to have many questions about sleep. I’ve noticed that some questions are asked more frequently than others, and that many deal with sleep myths. My hope is by discussing these questions, I can provide answers that the rest of you can then share with your patients.
The number one question patients ask in the sleep clinic is how many hours of sleep they should get each night. The answer really depends on how the patient feels when waking. The average is seven to eight hours per night. However, there are people called short sleepers, who feel rested after just five to six hours. Consequently, there are also long sleepers, who prefer 10 to 12 hours of sleep per night.
If a patient is fatigued, ask how many hours they sleep per night. With the average American sleeping only 6.9 hours per night, it’s no surprise that fatigue is a common complaint. When awakened by an alarm, many people will feel a little groggy. This is normal. If, however, they are still groggy after 30 minutes, or are experiencing fatigue or hypersomnia during the day, consider a sleep disorder.
Another sleep myth is that staying in bed longer will result in more sleep. This is not necessarily the case. What is more important is sleep quality, not sleep quantity. Patients need to keep a regular schedule every day. Sleeping in can interrupt their circadian rhythms and can actually hurt their sleep. Too much sleep can be as bad as too little.
Patients also tend to get concerned if they wake up during the night. They may feel that this negatively impacts their sleep. In truth, we all have brief awakenings during the night. Most of us fall right back to sleep and don’t even remember waking up.
Some patients remember waking. They often look at the clock and can tell you what time of the night they are waking. This behavior can establish a pattern. Think of clock watching when a patient says, “I am waking every morning at three o’clock!” Knowing the exact time is evidence that they are looking. Have them cover the clock or turn it around, so they can’t look at it.
Talk to your patients about sleep as often as you can. You will be amazed at some of the sleep myths they believe. If you can educate them about the true nature of sleep, it will often “cure” their problem.
Many of us believe strongly that our day will be miserable if we do not sleep well the night before. We have a very strong attachment to sleep, due in a large part because we spend a third of our life in bed. However, that fear of not getting enough sleep can also increase anxiety, which in turn can make sleep even harder to obtain.
Encourage your patients to think positive thoughts about sleep. For example, if a patient did not sleep well one night, reinforce that they will sleep even better the next night. Simply establishing positive expectations can be helpful.
As I’ve discussed in previous blogs, keeping a sleep journal can be very helpful to you and the patient. Using this record makes it easier to point out to the patient where they may have unrealistic perceptions of their sleep. Often with sleep journals patients will notice before they even talk to you that their sleep may be better than they originally thought.
Of course, always be mindful that there may actually be a sleep disorder present that needs to be addressed, in which case a referral to a sleep provider would then be warranted.
Sharon M. O’Brien, MPAS, PA-C, works at Presbyterian Sleep Health in Charlotte, N.C. Her main interest is helping patients understand the importance of sleep hygiene and the impact of sleep on health.