CDC Study Examines Social Patterns Among Healthy Sleepers

Featuring Carol Ash, D.O.
Director of Sleep Medicine
Meridian Health

Inadequate sleep has been linked to conditions that include obesity, high blood pressure, diabetes, heart disease, stroke, anxiety, and depression.

Now, with an increasing number of Americans stressing more and sleeping less, the need has never been greater for us to challenge traditional answers to an age-old question: What is really keeping us up at night?

According to a recent CDC report, 35% of U.S. adults are getting less than the essential seven hours of sleep, and 12% of Americans are sleeping less than five hours per day. The report includes a demographic breakdown of healthy sleepers in each of the 50 states — revealing patterns which beg further questions about the nation’s sleep epidemic.

These trends hint at deeper, social connections to this potentially life threatening health condition, and they are a further reminder that the difficulties that Americans struggle with during the day don’t simply disappear when the lights go out.

Key points from the CDC’s findings include:
· Lack of sleep is more prevalent in urban, densely populated areas
· Married and unmarried couples get more sleep than people who are divorced, widowed or separated
· People with a college education get more sleep
· The unemployed have the lowest average of healthy sleepers (51%)

“Look at the trends, and then ask yourself ‘Why?’ What’s the connection?” says Carol Ash, D.O. “When we’re fighting to make ends meet — whether it’s due to unemployment, poverty or problems with a spouse — it plagues our mental, physical and emotional health. People need stability, and when we’re struggling with economic and/or social turmoil, the stress, anxiety and depression can be overpowering, even when the lights go out.”

Dr. Ash believes the solution lies in a push toward education and an emphasis on every day, healthy minded practices. She credits groundbreaking research initiated in 1965 involving nearly 7,000 residents of Alameda County, California, which concluded that sleep was one of seven health habits, a.k.a. the "Alameda 7," revealed to be key determinants of good health and, ultimately, a longer life.

“The key is education on the importance of simple, everyday lifestyle adjustments, empowerment from the knowledge that, yes, you are in control,” Ash says.

Simple behaviors proven to have a positive impact on sleep include:
· Eat healthier
· Exercise. 30 minutes a day is optimum, but starting at even less is still a start.
· Mindfulness and/or breathing exercises
· Maintain a consistent bedtime and wake up time

Read the full CDC report here for more information.

Don't Let Holiday Stress Keep You Awake at Night

With Thanksgiving less than a day away, and just a month until Christmas, we're once again reminded how quickly "the most wonderful time of the year" can also become the most stressful.

Family. Finances. A tree in your house. Holiday stressors can feel immense when they all seem to hit at once, and in today's society, it's almost commonplace to simply "give in" to our anxieties keeping us awake at night.

According to a recent article in the New York Times,  Why Sleep Matters, nearly a quarter of Americans don't get enough shut-eye because they're too busy “concentrating on things."

 As commonplace as it may seem, however, losing sleep to stress is unhealthy and counterproductive.

"Lack of sleep can contribute to numerous health issues, including higher prevalence of chronic pain, high blood pressure, obesity, Type 2 diabetes, heart disease and premature aging," says Carol Ash, D.O., Director of Sleep Medicine for Meridian Health.

In addition to restoring the immune system, sleep is vital to the energy and focus necessary to handling the life's most stressful situations head on. To break the stress-insomnia-stress cycle and get to sleep when your mind is in overdrive, Dr. Ash recommends a few different techniques.

"Find a cause. Studies show volunteering and pro bono work helps create external focus and connects us to others," Dr. Ash says. "These types of commitments help people find purpose and meaning in life, which can help eliminate racing thoughts at night."

"For a more immediate solution, try deep breaths," she adds. "Mindful breathing helps you relax and clear your mind prior to bedtime."

Decoding Your Dreams

Carol Ash, D.O., director of Sleep Medicine for Meridian Health, recently stopped by the Fox & Friends studio to discuss the meaning behind some of our most common dream-time scenarios, including being chased, being cheated on by a partner, and more.

So what do they all mean? Watch Dr. Carol Ash on Fox & Friends below and find out! Be sure to visit MeridianHealth.com/Sleep to learn more about the Meridian Centers for Sleep Medicine.

Test Your Sleep IQ

A healthy night's sleep — we all know we need it, but not all of us get it. When we're under pressure and time is of the essence, it's the first thing we're willing to sacrifice to get the job done. 

Few of us would think twice about burning the midnight oil for the sake of productivity. But at what cost?

How much does a healthy night's sleep really matter? Take the quiz below and find out!

1. Rapid eye movement (REM) is the deepest stage of sleep, when most dreaming occurs. On average, how frequently does REM occur throughout the night? a.)  4 times
   b.)  3 times
   c.)  2 times
   d.)  1 time

Take the rest of the quiz here!

Join Us in Freehold for a "Mall Walk" and Wellness Discussion Featuring Dr. Carol Ash!

Join us Wednesday, July 22 at Freehold Raceway Mall  for a relaxing morning mall walk, followed by a special discussion with Meridian's own authority on sleep health, Carol Ash, D.O.

Dr. Ash will talk about how making small, gradual adjustments to sleep and lifestyle habits can dramatically improve your long-term health. 

Register by calling  1-800-560-9990.  More information is available here.

For expert sleep advice, here's Dr. Ash on FOX News discussing some of the long-term effects lack of sleep can have on the overall health of adults and teenagers.

Dr. Carol Ash on "CBS This Morning" discussing the effects of sleep issues on "brain drain"

For Tom Brady, the perfect 'night out' is a night in

When a Super Bowl MVP and star NFL quarterback has a night to himself, you might imagine him spending it out on the town, partying till dawn, and indulging in a few of the all star "perks" of being a celebrity baller.

(Photo by Stephan Savoia/Associated Press)

“I’m not doing anything like that. That time has come and gone in my life. I did a lot of charger work last night - sleeping," said Patriots QB Tom Brady during an interview on WEEI's "Dennis and Callahan Show."

"This is my first time away from my kids in a while, so I finally get some decent sleep," he added.

While teammates Rob Gronkowski, Jonas Gray, and Shane Vereen were attending a recent Clippers game, Brady had no qualms admitting his ideal "night out" is often a night in - catching up on some much needed sleep, according to Jordi Lippe of Yahoo Health.

Dr. Carol Ash on Fox's Shepard Smith Show discussing long-term affects of sleep loss

Inadequate Sleep Detrimental to Teens' Physical and Mental Health

This year the American Academy of Pediatrics came out in support of delaying the start of the school day for older students to allow teenagers to get more sleep.

As reported in the Asbury Park Press, New Jersey State Senator Richard Codey supports the recommendation, announcing a bill last week that would direct the state Department of Education to study the benefits of delaying school start times.

“Studies are showing that our current school start time is flipped the wrong way,” Codey said. “Middle and high school start times are too early, and elementary and pre-k classes are too late.”

Lack of sleep is detrimental to mental health, making adolescents more prone to automobile crashes and hindering their academic and athletic performance, according to Dr. Carol Ash, director of sleep medicine at Meridian Health.

The physiology of teenagers makes it difficult for them to fall asleep quickly, she adds. Teenagers naturally require more time than adults to "wind down" before falling asleep, and distractions such as cell phones and television only exacerbate the problem.

Dr. Carol Ash on "CBS This Morning," Do Our Kids Need More Sleep?

Deciphering the Enigma of Your Slumber's Multiverse

We've all had those types of dreams. Whether funny, creepy or just plain bizarre, they're the dreams we can't seem to shake, at least until we get an answer to "What did that mean??"

On FOX News' "While You Were Sleeping" segment, Dr. Carol Ash took on that very question and offered insight into the body's slumber responses and how to go about "decoding the mysteries of your mind and unlocking the meaning from your dreams."

"You have to remember that the brain is taking in all the old information and new information and processing it in new patterns to help you come up with solutions to the problems of the day," Ash says. "Dreaming allows you to work through all those negative emotions and solve them in a safe environment, your bedroom."

Watch the full segment below to hear Dr. Ash's interpretation of dream scenarios such as losing control of a vehicle, being chased, being lost and having your teeth fall out (which is more common than you think.)

Can't sleep? The answer may be all around you.

Sleep deprivation can be a symptom of numerous health issues, but it's important to remember that the causes of our sleep disruptions aren't always internal.

According to Dr. Carol Ash, the following external factors can affect our sleeping patterns:

• Room temperature
• Jet lag
• Variations in schedule
• Snoring

 Watch Dr. Ash's Weather Channel appearance to learn more about the effects our environment can have on our sleep habits.

Harness Your Dreams Through the Power of Lucid Dreaming

The ability to control your dreams may sound like a fantasy, but it's a power that actually lies within all of us, according to Dr. Carol Ash, Director of Sleep Medicine at Meridian Health.

"If you can recognize you are in a dream, you can control the content of your dream," says Dr. Ash, in a July 7 article published in the Asbury Park Press.

According to Dr. Ash, mastering the process of lucid dreaming is all about repetition and technique. She recommends establishing specific habits and visual patterns throughout your day (such as looking at yourself in the mirror while reading) to help bring neurological functions utilized during daytime hours into your dream world.

"The more you do it, the more you will recognize it in a dream," she says.

Dr. Ash helps answers the question, "Why am I so tired?"

It's a question we've all asked ourselves: "Why am I so tired?"

On a visit to TODAY earlier this year, Dr. Carol Ash and Julie Bain, Health Director for Ladies Home Journal, offered tips to help provide answers to that question.

Both Ash and Bain agreed that mental fatigue and stress can be one of the biggest causes of daytime sleepiness.

"Stress is a good thing; it helps us overcome challenges," Ash said. "But sustained stress can lead to anxiety and depression."

These types of stress can keep you awake at night - and exhausted during the day.

Ash advises, when stress and anxiety are keeping you up, write it down, and then confide with someone you trust during the day.

Watch the full TODAY segment below.

'Slumber Smoothie' Recipe

Multiple food options that can help with sleep. Foods rich in calcium and magnesium, serotonin, zinc, tryptophan and antioxidants are just a few that have been suggested as great choices. 

I have become a fan of the "NutriBullet" for creating the following "Slumber Smoothies:"

1 cup of vanilla almond milk
1 tsp of honey
1 cup of spinach or apricots.

Blend it all up and enjoy!

(You can use warmed almond milk for extra effect. You can also substitute soy milk, which can add tryptophan.)

-- Dr. Carol Ash

Healthy Sleep Habits Can Optimize Your Child’s School Performance

Carol Ash, M.D.
Director of Sleep Medicine
Meridian Health

For many parents summer means relaxing and letting go of rules. Our kids have spent summer hanging out enjoying time with friends and family, staying up late and sleeping in. The days are getting shorter, and the end of summer is here which means parents and kids will need to prepare for the transition back to school.

In a recent Proctor and Gamble and ORC International Survey 93 percent of moms said they face challenges preparing for back to school. Nearly half (47 percent) of the moms surveyed said the “biggest pain point” was getting kids back to a regimented sleep pattern and a set schedule.

Getting kids back on schedule and out the door to school and activities is not just a “big pain point” for moms.

Inadequate or poor quality sleep will affect a child’s development, and has been linked to emotional instability, poor school performance, and serious health issues such as childhood obesity, diabetes, and missed school days from infections.  It has been linked to risky behaviors such as drowsy driving, alcohol and tobacco abuse. 

According to the National Sleep Foundation (NSF) two-thirds of American children age 10 and younger have sleep problems.  They noted 60 percent of children under the age of 18 complained of being tired during the day, and 15 percent fell asleep at school.

Despite increasing awareness of the importance of sleep, and the prevalence of the problem, shopping for new school supplies and preseason sports still gets the most attention.

Most sleep problems are treatable, and for many all that is required is adopting good bedtime habits.  A Back to School Sleep (BTS) sleep check list would make the transition easier and get our kids off to a good start. 

BTS Sleep check list

1. Get the right amount. The NSF recommends:

• 11-13 hours of sleep for preschoolers age 3-5
• 10-11 hours of sleep for 5 to 12 year olds
• 9 hours or more for teens

2. Start the shift early. Prior to school start sleep experts recommend gradually getting back to a school year sleep schedule by moving bedtime up 15 minutes a night.

3. Don’t let them sleep in. For those that didn’t start this early, you should now focus on maintaining the same wake-up time on weekends. This will help set your child’s internal clock. Eventually it will make getting them to bed at night easier.

4. A 20 min nap will help until the transition is complete. Most kids older than five no longer need to nap. A 20-minute nap after school can help during the transition if bedtime is a struggle.

5. Make sure the room is quiet, dark, cool, and uncluttered. Bold colors and flashy décor might be a great fashion statement but you want a serene sanctuary.

6. Remove all electronics from the room. NSF found children who get more sleep are more likely to read as part of their bedtime routine.

7. Sleep training books are great for younger kids. 
"Getting Your Toddler to Go to Sleep and Stay in Bed," by Jill Spivack and Jennifer Waldburger, Sleepy Pl

8. Try a sleep gadget. Even for kids intrusive thoughts and worries about the day may can keep them up at night.

Gadgets such as "Deep Sleep" will teach them mediation and help them learn how to unwind and relax. Deep Sleep with Andrew Johnson is available for iPhone, iPod touch, and iPad on the iTunes App Store.

Finding the Perfect Sleep Position

Featuring Carol Ash, M.D.
Director of Sleep Medicine
Meridian Health, Riverview Medical Center

A need so basic it is often overlooked, a healthy night's sleep (or lack thereof) is pivotal to a host of health-related issues.

Addressing topics ranging from itchy skin and alopecia to more serious conditions like sleep apnea and SIDS, Dr. Carol Ash is Momtourage's go-to expert for all your sleep-health inquiries. Read on for answers to some of Dr. Ash's most commonly asked sleep questions:

Finding the Perfect Sleep Position
We rarely think of our sleep position as an early clue to hidden heath problems, and doctors don't often ask. Certain sleep position can optimize your health, and paying attention to your sleep position can be an important indicator of hidden health dangers.

Side Sleepers
57% of us start on our side, but we usually will not stay there for long, as side sleeping can put pressure on your hips or shoulders. Side sleeping can be a sign of seasonal allergies, upper respiratory infections or acid reflux.

Snorers can benefit from side sleeping, and people with muscle or skeletal injuries may also favor side sleeping. The left side is also best for pregnancy, as it improves blood flow to the uterus.

Sleeping on an Incline
I have been surprised over the years how many people sleep on an incline because "it is more comfortable."  Not infrequent is to find a patient sleeping in a recliner at night.  (A physician) wouldn't know this if they didn't ask.

Most think of this position as a method to relieve acid reflux, but it can also be an early sign of heart problems, severe sleep apnea or neuromuscular problems that result in swallowing problems or aspiration. A patient with these conditions would prefer this position and might not even know why.

As a sleep doctor, I know it is important to ask about sleep positioning as a clue to your heath.

Back sleepers sometimes will sleep with their arm over their head. This position helps to expand the rib cage and facilitates a deep breath at night.  Patients tell me it helps them feel more relaxed and helps some with snoring or respiratory problems.

Sleeping with a Pony Tail
We normally change our sleep position many times at night.  Rolling over and landing on an uncomfortable pony tail can be a source of sleep disruption if you have to keep waking up to reposition.

When we first go to bed at night circadian or biological rhythms create a drive for sleep that helps us slip into slumber.  We do not have the same drive with subsequent awakenings, and it  can be harder to drift back to sleep.

Setting the stage at night to make sure we are comfortable and avoid disruptions might be all that is necessary to avoid a sleepless night. This includes eliminating the pony tail.

An additional concern with a bed-time pony tail is traction alopecia, which is loss of hair due to chronically wearing your hair in a tightly pulled style. Tight headgear and hairstyles such as pony tails have all been known to be culprits.

Hair loss will certainly sabotage any beauty sleep efforts.

Bedding and Clothing
We should consider the comfort of our mattress and pillow, and we also want to make sure we have put some thought into the right clothing or pajamas, as they  should be comfortable and not scratchy or tight fitting.

Uncomfortable clothing can be a source of sleep disruption if you have to keep making adjustments throughout the night. You also do not want to wear clothing that will cause you to overheat.

Traditional images of sleep attire might include a night cap to keep us warm and cozy. The optimum temperature for sleep is actually quite cool, with the range being  65-75 degrees Fahrenheit. Sleep caps therefore might actually sabotage your sleep if they cause you to get overheated.

Light sleepers may find they are better sleeping with nothing at all.

How Sleep (or Lack of) Can Affect Appearance

Carol Ash, M.D.
Director of Sleep Medicine
Meridian Health, Riverview Medical Center

Sleeping Beauty had it right, as studies show lack of sleep can have an effect on our appearance in many ways.

Lack of sleep can stress many organ systems including skin, which is the largest organ in the human body. Sleep is important for maintaining the structure and integrity of collagen, which is your skin's main component and important for protection and elasticity.  Collagen formation can be affected by changes in the immune response.

Studies show sleep plays a role in restoring the immune system. Changes in immune response can injure blood vessels vital to the health of your skin.

Sleep deprivation causes oxidative stress, which is a known cause of accelerated aging. Sleep deprivation can cause breaks in the protective function of the skin barrier and mucous membranes. The end result is accelerated aging of your skin and wrinkles.

Your skin can also be affected by sleeping positions. The supine position is believed to be best, as it offset the effects of gravity. Positions that put continuous pressure on thinner facial skin can compromise blood flow and pull on delicate facial tissue aging your skin.

The best sleep position is on your back, as it also provides the best positioning for spine alignment and minimizing muscle aches and pains.

Side sleeping would be best for those with nasal congestion and allergies, or even simple snoring. The side position will help to keep your airway open and your sleep will be more restful.

Most people never think about the detergent in their sleepwear, but any material that touches your skin can cause harm. Ionic detergents are particularly harsh and are widely found in many body-care products and household detergents.

The most common ionic detergents are sodium lauryl sulfate, (SLS). The good news is there are several “green detergents” on the market that are SLS free.

Eye masks can be  an essential for healthy sleep.  For some, even a small amount of light can block the melatonin response and cause sleep onset difficulty.

Facial creams and lotions are a great way to add moisture. Those formulas with antioxidants and anti-wrinkle agents such as retinol have been shown to boost the overnight repair function of sleep. Once again, avoid detergents, shampoos and other cleansers with SLS.

Sleep Tips to Reduce SIDS Risk

Carol Ash, M.D.
Director of Sleep Medicine
Meridian Health, Riverview Medical Center

Since the start of the “Back to Sleep” campaign, there has been a reduction in SIDS deaths by 50%.

SIDS however still remains the leading cause of death among infants.

With the success of the “Back to Sleep” campaign, other risks have become important factors, with bed sharing causing 38% of deaths and sleeping in adult beds alone causing another 45%.

Bed sharing with a parent who is a smoker or who uses drugs and alcohol has been known to increase the risk of SIDS.

For exhausted moms keeping the baby in the same bed to make breast feeding easier seems like a simple solution.

Research shows that there can be a fivefold increase in the risk of SIDS associated with bed-sharing in breast fed babies who were under three months old, had non-smoking parents and when  the mother had not used drugs or alcohol. Adult bedding and mattresses are softer and can cause suffocation of an infant.
 
So while the “back to sleep campaign has proved to be a success, it is still important to make sure all new moms understand the multiple risk and take steps to keep their baby safe.

Tips to reduce SIDS risk:

•Always put your baby to sleep on their backs
•Invest in a comfortable bed side rocker to breast feed babies at night
•Never put your baby to bed in your bed or a sofa.  Infant mattresses are firmer
•Avoid alcohol 3 hours prior to bedtime
•For the sake of your baby, don't smoke or take drugs