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Got sleep? How to get your snooze back 

Dr. Meredith Maxwell on the effects of sleeplessness

If you think you're the only one not getting enough sleep at night, think again. And if you think it's not a big deal, definitely think again.

 A 2016 study of the effects of sleep loss on the United States' economy by the RAND Corporation (a public policy research group) found that the U.S. loses over 1.2 million working days a year due to employee absenteeism related to sleep deprivation. Sleeplessness costs the country $411 billion a year. It increases mortality risk by 13 percent.

Clean your routine for good sleep hygiene:

Remove distractions from your bed — including pets and kids.

Don't watch the clock if you can't sleep. Get out of bed and move to another room to do something calming until you feel drowsy again.

Earplugs help if you're a light sleeper. Try different types (wax, rubber, foam, etc.) to determine which works for you.

Soothing scents (such as lavender) can help create a restful sleep environment.

Maxwell advocates quitting smoking, especially before bed ­— nicotine is a stimulant.


Dr. Meredith Maxwell, a primary care physician at Touro Infirmary, often hears patients complain of tiredness. It's common, but she stresses the need for downtime and proper rest. She says most adults need between seven and eight hours of sleep a night.

 "Some people can run quite effectively on six hours, but only one-third of adults sleep at least six hours," she says.

 The effects of sleeplessness increase in severity the longer the problem continues. Short-term effects are irritability, depression and strain on the immune system.

 "Long-term sleep deprivation — three or more nights per week for three months or more — can cause PTSD (post-traumatic stress disorder), neurologic disorders or even restless leg syndrome," she says. "It's really important that people who have sleep problems do something about it."

 A common medical intervention is prescription sleep medication, which has its own risks. Many are addictive, and there is some science, such as a 2012 study published in the National Institutes of Health's National Library of Medicine, that suggests sedated sleep is on par with poor sleep.

 Sleeplessness isn't always linked to a sleep disorder. The inability to disconnect from work is a common cause. Many adults feel pressure to always be reachable, prompting them to check emails and texts constantly, even when it's time for bed.

 "People have problems shutting down at the end of the day," Maxwell says. "In the long run, you're making yourself less successful. You could be your most productive self if you can shut down for a while and get good rest and [are] more effective the next day."

 Maxwell urges consulting a physician before trying remedies for sleeplessness to rule out any medical conditions that may require professional care.


Maxwell says the simplest remedy is good "sleep hygiene": Clean up your daily sleep routine. Consistency is key — have the same sleep time and wake time (even on weekends), the same sleep aids (supplements, ear plugs, sleep mask). Establish a regimen that tells your body it's time for bed and usually restful sleep will follow.

 You also can change mattresses and pillows or try different sheet thread counts or a cooling gel pad, but Maxwell says there's no substitute for being physically tired at night.

 "I think exercise is the best remedy, but people have to be motivated to do it," Maxwell says.

 She also suggests putting daily problems into a time slot to keep them from creeping into your sleep routine.

 "Set aside a 'worry time,' so you don't deal with anxieties at bedtime," she says.

 Maxwell warns against doing too much before bed. This includes eating, drinking alcohol and exercising. The sweet spot is two hours before bedtime, but 30 minutes will work in a pinch. Turn off electronics, take a warm bath and lower the thermostat (Maxwell says 60 to 67 degrees is optimal) to let the body wind down.

 "Sleep is attainable. You just have to put in the work. It's lots of trial and error. ... It takes 30 days to make a habit, so get started on some good ones."


An illuminated sleep mask may restore the sleep cycle. The lenses give off a red light to simulate sunset, letting your body know it's bedtime (and to increase melatonin production); as day approaches the light slowly turns blue to simulate sunrise. Blue light suppresses melatonin production in the body and increases alertness. That's why too much "screen time" (watching TV or using a smartphone or a tablet) before bed can increase sleeplessness.

 Programmable home lighting systems work the same way. There are white lightbulbs that emit blue light in the morning hours to stimulate the body and bulbs that produce warm spectrum light to induce drowsiness, often with the tap of a finger on an app.

 Maxwell isn't sure that any color or amount of light induces sleepiness (she urges patients to avoid light at bedtime), but she has observed that daylight-mimicking bulbs help people perk up in the morning.


Personal monitoring devices (such as wearable trackers and sensor pads that are placed under the bedsheets) are becoming popular. Many monitors offer steps to improve sleep habits when they detect a disruptive pattern or an environmental factor (poor air quality, for example) that may trigger sleeplessness. Maxwell says the accuracy of the sleep data they provide is not yet known. For some, Maxwell included, they can increase anxiety about potential sleep problems.


Supplements like melatonin and valerian root offer a natural remedy, although effectiveness depends on the cause of sleeplessness. These supplements work to reset the body's internal "clock" by regulating natural melatonin, which usually is elevated at night to keep the body in sleep mode, and slowly decreases as the sun rises. Circadian (sleep/wake) rhythms can be disturbed by things like nighttime overexposure to light (especially the blue light emitted by electronic devices), travel and diet. If restlessness isn't caused by one of these factors, these supplements may not work. They also may interfere with other medications and can build up in the body, causing long-term effects.


Noise-canceling or white noise machines or apps, classical music and even the whirring of a fan all have the same function: They're distracting techniques that drown out intrusive noises and replace them with sounds that are easier on the ears. Maxwell says pleasanter sounds can distract people from replaying the day over in their heads and from anticipating the next day at bedtime, reducing anxiety.


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