Sleeping through the Storm Steps to a better night’s sleep

Jill Verchota-Luce, MPH, RDN, LD, IFNCP Health Management Consultant

May 2020 Overview • How much sleep are Americans getting? • Sleep-health connection • Lifestyle factors that impact sleep • Sleep disorder treatment options • Tools you can use

Marsh & McLennan Agency LLC So what’s the problem? The decline of the quality of sleep over the years and why it matters

2 How much sleep are we getting?

The amount of sleep Americans get each night has decreased since 1942.

Source: Jones, J. (2013, Dec. 9). In U.S., 40% Get Less Than Recommended Amount of Sleep. Retrieved from http://news.gallup.com/poll/166553/less- Marsh & McLennan Agency LLC recommended-amount-sleep.aspx How much sleep have we lost?

On average, we’ve lost over an hour of sleep each night!

Average # hours of sleep: 40% of Americans get less 1942 = 7.9 than the recommended 2013 = 6.8 amount of sleep.

Source: Jones, J. (2013, Dec. 9). In U.S., 40% Get Less Than Recommended Amount of Sleep. Retrieved from http://news.gallup.com/poll/166553/less- Marsh & McLennan Agency LLC recommended-amount-sleep.aspx Prescription Sleep Aid Use Sleep Aid Use Increase with Age % >20 years old who used a sleep aid in the past 30 days 8% Over 9 million 7% Americans 6% over the age 5% of 20 years old 4% use sleep Age 3% aids! 2% 1% 0% All 20-39 40-49 50-59 60-69 70-79 80+

Chong, Y, Fryar, CD, Gu, Q. (2013, Dec.). Prescription Sleep Aid Use Among Adults: United States, 2005–2010. Retrieved online from https://www.cdc.gov/nchs/products/databriefs/db127.htm Marsh & McLennan Agency LLC https://www.fox9.com/news/prescriptions-for-anti-anxiety-meds-spike-amid-coronavirus-outbreak-new-report-finds The Sleep-Health Connection

What happens to your body when you sleep? • Both mind AND body are affected • Memory and learning are consolidated • Supports mood regulation • Physical repair of the body

• Heart rate and breathing slow down 6 • Blood pressure lowers • Hunger hormones are regulated Darley, Dr. C. (2014). Sleep – putting in place the missing foundation for your patient. Retrieved from American Academy of Nutrition and Dietetics Dietitians Marsh & McLennan Agency LLC in Functional and Integrative Medicine Practice Group portal. The Sleep-Health Connection

• Lowers cognitive • Increased BMI and risk for functioning: memory, obesity judgement, planning, creativity • Increased risk for type 2 • Lower optimism and self- diabetes and cardiovascular esteem disease • Impacts energy/motivation, • Increased risk for cancer mood and mental health (anxiety) • Makes us age faster • Serious safety risk when driving or operating machinery

Marsh & McLennan Agency LLC Multiple sources – see last slide How much sleep do I actually need? Adults ages 18-60 years old should get at least 7 hours of sleep each night. • Varies by individual • Try out an activity to determine how much sleep your body needs!!

Marsh & McLennan Agency LLC American Academy of Sleep Medicine. (2017). Healthy sleep habits. Retrieved from http://www.sleepeducation.org/essentials-in-sleep/healthy-sleep-habits Celebrity sleep schedules

Ben Franklin Ellen DeGeneres Bill Gates

10 pm – 5 am 11 pm – 7 am 12 am – 7 am (7 hours) (8 hours) (7 hours)

Sleep Patterns of 21 Winners. 2017. Retrieved from: Marsh & McLennan Agency LLC http://www.homearena.co.uk/kc/tips/sleep-patterns-of-21-winners/ What you do during the daytime matters: Simple activities during the day to optimize sleep at night

10 Wake-up call • Wake up at the same time everyday • Open up your shades • Drink a glass of water right away in the morning • Eat a nutrient-packed breakfast – Protein 11 – Healthy Fats – Carbohydrates

Marsh & McLennan Agency LLC Breus, M. (2017, Sept 26). The Welcoa Institute. The Impact of Sleep on Workplace Productivity. Retrieved online from: https://institute.welcoa.org/courses/impact-of-sleep Design your day to enhance sleep at night

• Take a break • Stay active daily • Get outside midday • Talk to someone

12

American Sleep Association. (2017). Sleep hygiene tips – research and treatments. Retrieved from https://www.sleepassociation.org/patients-general- public/insomnia/sleep-hygiene-tips/ Marsh & McLennan Agency LLC Mayo Clinic Staff. (2017). Exercise and stress: Get moving to manage stress. Retrieved from: https://www.mayoclinic.org/healthy-lifestyle/stress- management/in-depth/exercise-and-stress/art-20044469?pg=1 Socialize • Did you know that people who socialize with others throughout their day are more likely to have a good nights sleep? • Social isolation can be harmful to your health • Take action

Magnavita, N. And Garbarino, O & S. (2017, Nov 6). Int. J. Environ. Res. Public Health. Sleep, health and wellness at Marsh & McLennan Agency LLC work: a scoping review. 14(11), 1347. Retrieved online from http://www.mdpi.com/1660-4601/14/11/1347/htm Dietary sleep disruptors • Caffeine – Sensitivity varies by individual – Quit at noon (or earlier)! • Alcohol – Limit to 1-2 drinks per day – Avoid drinking within 3 hours of bedtime

• Too much “sleepy tea” 14 • Midnight snacks & not eating enough

Division of Sleep Medicine at Harvard Medical School. (2007, Dec. 18). 12 simple tips to improve Marsh & McLennan Agency LLC your sleep. Retrieved from http://healthysleep.med.harvard.edu/healthy/getting/overcoming/tips Caffeine content of common foods and beverages: Common foods and beverages Portion Size Amount of Caffeine Starbucks coffee, blonde roast 10 oz. 237.5 mg Folgers ground coffee, house blend 12 oz 60-80 mg Brewed green tea 8 oz. 29 mg Gold Peak unsweetened tea 9.5 oz. 11.5 mg Pepsi Zero Sugar 10 oz. 57.5 mg Diet Coke 12 oz. 46 mg Mountain Dew – diet or regular 12 oz. 54 mg Barq’s root beer 10 oz. 19 mg Rockstar & Red Bull energy drinks 8 oz. 80 mg Center for Science in the 5-hour energy 2 oz. 200 mg Public Interest. (n.d.). Caffeine chart. Retrieved Hershey’s milk chocolate kisses 9 pieces 9 mg from https://cspinet.org/eating- healthy/ingredients-of- Gums, chews, peanut butter, granola, ice cream varies 11-150 mg concern/caffeine-chart Marsh & McLennan Agency LLC How to reduce caffeine intake Day 1: Today, have your usual amount of coffee Days 2-5: Blend your regular coffee with 50% decaf. Drink that for the next four days. Day 6: Have 25% regular coffee, 75% decaf for one day OR switch to green tea. Day 7: Start drinking pure decaf or herbal (not green) teas.

Lipman, F. (2013, May 10). How to quite caffeine in 1 week (painlessly!). Retrieved from Marsh & McLennan Agency LLC https://www.mindbodygreen.com/0-9165/how-to-quit-caffeine-in-one-week-painlessly.html Support for Sleep Disorders • Sleep medicine • CBTI (Cognitive Behavioral Therapy for Insomnia) • Go! To Sleep program by Cleveland Clinic • American Academy of Sleep Medicine – sleepeducation.org • American Alliance for Healthy Sleep – www.sleepallies.org • Sleep Foundation – sleepfoundation.org

Marsh & McLennan Agency LLC https://www.mayoclinic.org/departments-centers/sleep-medicine/sections/overview/ovc-20407454 Beyond counting sheep: Things you can do in the evening to prepare your body for sleep

Marsh & McLennan Agency LLC Develop an evening routine • Limit exposure to bright lights

• Dim lights in your home

• Avoid screens 30 minutes to 2 hours before bed

• Use a blue light filter for your phone or tablet at night (Ex. Twilight, F.Lux, Lumen) • Choose relaxing activities before bed

• Yoga Nidra • Epsom salt bath American Academy of Sleep Medicine. (2017). Healthy sleep habits. Retrieved from http://www.sleepeducation.org/essentials-in-sleep/healthy-sleep-habits Marsh & McLennan Agency LLC https://www.sleep.org/articles/can-yoga-help-sleep-better/ Set the mood for a good night sleep Create a bedroom environment that supports sleep: • Dark • Quiet • Cool – 60-68 degrees F & well ventilated • Comfortable mattress • Free of pets, clocks, TVs, computers and smart phones

American Academy of Sleep Medicine. (2017). Healthy sleep habits. Retrieved from Marsh & McLennan Agency LLC http://www.sleepeducation.org/essentials-in-sleep/healthy-sleep-habits Getting into a healthy bedtime routine • Brain dump on paper • Mindfulness or breathing exercise • Be consistent and go to bed and rise each day – Choose a bedtime that allows you to get at least 7 hours of sleep – Don’t go to bed unless you’re sleepy • Get up after 20 minutes if you can’t fall asleep

Marsh & McLennan Agency LLC American Academy of Sleep Medicine. (2017). Healthy sleep habits. Retrieved from http://www.sleepeducation.org/essentials-in-sleep/healthy-sleep-habits Simple body scan exercise

https://www.csh.umn.edu/sites/csh.um Marsh & McLennan Agency LLC n.edu/files/body-scan-exercise.pdf Try out a sleep diary Purpose: To identify trends in your lifestyle and sleep patterns unique to your body. Things to track for 1-2 weeks: 1. Time you go to bed 2. Time you go to sleep 3. Time you wake up 4. Time you get out of bed

5. Naps 23 6. Physical activity 7. Alcohol 9. Caffeine Marsh & McLennan Agency LLC American Academy of Sleep Medicine. (n.d.). Sleep diary. Retrieved from http://yoursleep.aasmnet.org/pdf/sleepdiary.pdf What are 1 or 2 ways you can improve your sleep?

Marsh & McLennan Agency LLC Take-Aways

1. Sleep impacts the function of both body and mind 2. How you spend your day and evening has an impact on your sleep

• Light exposure and activity during day

• Relaxation and dim light at night 3. There are many simple, free lifestyle hacks you can use to help improve your sleep and that of your family! 4. Professional support is available if you struggle with a sleep disorder

Marsh & McLennan Agency LLC Sources

Klein, S. (2016, Jn. 6). 10 fascinating things that happen while you’re sleeping. Retrieved from https://www.prevention.com/health/what-happens-during-sleep Darley, Dr. C. (2014). Sleep – putting in place the missing foundation for your patient. Retrieved from American Academy of Nutrition and Dietetics Dietitians in Functional and Integrative Medicine Practice Group portal. CDC. (2013, July 1). Sleep and chronic disease. Retrieved from https://www.cdc.gov/sleep/about_sleep/chronic_disease.html Taheri, S. (2006, July 17). The link between short sleep duration and obesity Arch Dis Child 2006;91:881-884. Retrieved from https://www.researchgate.net/publication/6738879_The_link_between_short_sleep_duration_and_obesity_We_should_recommend_more_sleep_to_prevent_obesity Magnavita, N. And Garbarino, O & S. (2017, Nov 6). Int. J. Environ. Res. Public Health. Sleep, health and wellness at work: a scoping review. 14(11), 1347. Retrieved online from http://www.mdpi.com/1660-4601/14/11/1347/htm Breus, M. (2017, Sept. 26). The impact of sleep on workplace productivity. Retrieved from The Welcoa Institute online platform. American Department of Transportation. (n.d.). Drowsy driving: drive awake. Retrieved from https://www.trafficsafetymarketing.gov/get-materials/drowsy- driving/drive-awake Division of Sleep Medicine at Harvard Medical School. (2007, Dec. 18). 12 simple tips to improve your sleep. Retrieved from http://healthysleep.med.harvard.edu/healthy/getting/overcoming/tips American Sleep Association. (2017). Sleep hygiene tips – research and treatments. Retrieved from https://www.sleepassociation.org/patients-general- public/insomnia/sleep-hygiene-tips/ Jones, J. (2013, Dec. 9). In U.S., 40% Get Less Than Recommended Amount of Sleep. Retrieved from http://news.gallup.com/poll/166553/less-recommended-amount- sleep.aspx Chong, Y, Fryar, CD, Gu, Q. (2013, Dec.). Prescription Sleep Aid Use Among Adults: United States, 2005–2010. Retrieved online from https://www.cdc.gov/nchs/products/databriefs/db127.htm Center for Science in the Public Interest. (n.d.). Caffeine chart. Retrieved from https://cspinet.org/eating-healthy/ingredients-of-concern/caffeine-chart Lipman, F. (2013, May 10). How to quite caffeine in 1 week (painlessly!). Retrieved from https://www.mindbodygreen.com/0-9165/how-to-quit-caffeine-in-one-week- painlessly.html American Academy of Sleep Medicine. (n.d.). Sleep diary. Retrieved from http://yoursleep.aasmnet.org/pdf/sleepdiary.pdf American Academy of Sleep Medicine. (2017). Healthy sleep habits. Retrieved from http://www.sleepeducation.org/essentials-in-sleep/healthy-sleep-habits Breus, M. (2017, Sept 26). The Welcoa Institute. The Impact of Sleep on Workplace Productivity. Retrieved online from: https://institute.welcoa.org/courses/impact- of-sleep/ Mayo Clinic Staff. (2017). Exercise and stress: Get moving to manage stress. Retrieved from: https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469?pg=1

Marsh & McLennan Agency LLC MarshMMA.com

Marsh & McLennan Agency LLC