Sleep Archive

There are many things about hospital routines that make it difficult for patients to sleep well. If you find yourself hospitalized, there are things you can do to improve the chances that you will get a better night’s sleep.

Many people now wear smartwatches and other wrist-based devices, and use them to collect and track information about their sleep. But the algorithms that govern how the devices work are opaque, and there is no data comparing them to devices that sleep researchers use.

A sleep shortfall can be hard on your heart. Make sure you're getting enough quality snooze time.

Maybe you stay up past midnight watching TV or checking your smartphone while lounging in bed. Or perhaps you snuggle under the covers and close your eyes at a decent hour, but then toss and turn, unable to fall asleep. Whatever the reason, the results are familiar to many people — feeling unrefreshed and maybe even a bit cranky when you wake up the next morning. According to the CDC, about one in three adults doesn't get enough sleep.

"Some people have trouble falling asleep. But others choose to stay awake and end up chronically sleep deprived," says Dr. Sogol Javaheri, a sleep specialist at Harvard-affiliated Brigham and Women's Hospital. When you don't sleep enough, feeling tired and bleary-eyed is only part of the problem. People who consistently get less than six hours of sleep nightly face a higher risk of heart disease as well as other, often co-occurring conditions such as diabetes and obesity. The exact mechanisms aren't fully understood, but disruptions in blood pressure and blood sugar regulation likely play a role. Insufficient sleep also appears to raise stress hormone levels and inflammation, which also strain the heart.

Over the past decade, research has revealed that the majority of patients treated for cancer experience difficulties with memory, attention, concentration, and thinking. There are several lifestyle actions that can help improve these symptoms, as well as certain medications.

Using a CPAP machine is beneficial for people with obstructive sleep apnea, but if the machine isn’t kept clean it could lead to an illness. There are sanitizing systems available, but cleaning the parts by hand is just as effective.

It may be as simple as adjusting the dose, avoiding alcohol, or taking the drug at a different time of day.

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One of the most commonly reported side effects of some medications is drowsiness. "Many people report tiredness or fatigue as a side effect from their medicines. However, there are things you can do to minimize the feelings of daytime sleepiness," says Laura Carr, a pharmacist at Harvard-affiliated Massachusetts General Hospital.

Typical offenders

Common culprits that cause sleepiness include antidepressants; antihistamines, found in sleep aids or medicines that treat allergies; anti-emetics, which are used to control nausea and vomiting; antipsychotics and anticonvulsants, which can be used to treat seizures or depression; drugs to treat high blood pressure, including alpha blockers and beta blockers; benzodiazepines and other sedatives, which are commonly used for anxiety or insomnia; drugs for Parkinson's disease; muscle relaxants; and opioids and other prescription pain medications. Many over-the-counter medicines may also make you drowsy, such as remedies for insomnia, allergies, nausea, vomiting, or diarrhea.

Bacteria and mold can accumulate in various parts of the device. But regular equipment cleaning reduces risks.

Continuous positive airway pressure (CPAP) can be hard to get used to. The mask may feel bulky, or it may feel strange to have air blowing in as you try to breathe. That keeps many people from using a treatment that may, in fact, be a lifesaver (see "What is CPAP?").

People also can be put off because they've heard that a dirty CPAP machine can make you sick. Is that true? "Yes, if you don't clean the machine regularly," says Dr. Lawrence Epstein, a sleep expert at Harvard-affiliated Brigham and Women's Hospital.

Ask the doctors

Q. I often wake up with a sore neck in the morning. What can I do to prevent this?

A. Poor sleep habits can cause neck pain or make it worse. Simple changes can make it less likely that you will wake up in pain in the morning.

Trying to make up for not getting enough sleep during the week by sleeping longer on weekends has been found to have negative effects such as weight gain, expending less energy, and increased calorie intake during evenings.

The FDA has issued its most serious category of warning about three sleep medications due to reports of injuries related to their use. Aside from next-day drowsiness, these medications can cause sleep behaviors that may be dangerous.