Rest Up and Stress-Proof Your Holiday Schedule

Marygrace Zetkulic, M.D.
Hackensack University Medical Center

Thanksgiving is behind us, and with just over a month until Christmas, the "most wonderful" (and "most nerve racking")  time of year is in full swing. 

Family. Finances. A tree in your house.

Our holiday to-do list can feel immense when it seems to hit us all at once, and it's commonplace to simply accept our anxieties keeping us awake at night. 

As routine 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. In addition to restoring the immune system, adequate sleep  is central to maintaining energy and focus, which are essential for keeping a cool head when confronting holiday stress.

In this time of giving, make sure to give yourself what you need to keep from feeling overwhelmed and stay well rested into the new year.

Here are some tips from Marygrace Zetkulic, M.D., director of Medical Education in the Department of Medicine at Hackensack University Medical Center, to cope with and avoid holiday stress:

• Discuss plans in advance. If you can’t be with one branch of the family for the holidays, breaking the news early can prevent hurt feelings. If you have a child returning from college, don’t focus entirely on his or her visit. This can help prevent the January letdown.
• Don’t feel you have to perform every holiday activity. Give yourself permission to let some things slide, like that seven-step holiday recipe. Feeling hassled by housework? Ask a friend to help you bake or decorate, then return the favor.
• Don’t budge on your budget. Small, thoughtful gifts can bring great delights and prevent post-holiday financial woes.
• Don’t do all your heavy lifting at the mall. Try to move your body every day. Give yourself the gift of a yoga class or exercise video.
• Have a strategy for handling family get-togethers. For example, plan your polite-but-firm response to that nosy relative with the knack for asking uncomfortable questions.
• Find a volunteer opportunity or reach out to a relative or neighbor who needs assistance.

“Even if only for a few hours, volunteering can take the focus off your own holiday tasks and remind you how good it feels to help others,” adds Dr. Zetkulic.

Feeling Sleepy? Here are 4 Tips for a Sound Night's Sleep

Adrian Pristas, M.D.
Corporate Medical Sleep Director
Hackensack Meridian Health

When your daily routine involves waking up early, putting in a full day at work, running errands, cooking dinner and tucking everyone in to sleep before finally hitting the pillow yourself, feeling fatigued seems unavoidable.

While a busy schedule may be a given, being exhausted shouldn’t be. You’ve probably heard the analogy about how you have to take care of yourself first before you can most effectively take care of anyone else. But how can you do that when you have so much going on? One word: sleep.

GETTING THOSE QUALITY Z’S
“Not getting consistent or enough sleep can affect your daytime functioning, including your ability to deal with unexpected, changing situations and distractions,” says Adrian Pristas, M.D., Corporate Medical Sleep Director, Hackensack Meridian Health. “It also impacts your capacity to evaluate risks. You want all of that in tip-top working order, which means you need restful sleep. These four small tips can have a big impact on making that happen.”

■ Keep your room like a cave. You want it to be quiet, dark and cool — somewhere between 60 to 67 degrees Fahrenheit is optimal for most people. Stay away from alarm clocks that give off a sleep-disrupting light.

■ Develop a sleep routine. Go to sleep and wake up at the same time every day. Yes, even on the weekends. That can be difficult, but it will help keep your internal body clock on schedule.

■ Set a sleep mood. Having a bedtime ritual can signal your brain and body that it’s time to unwind. Maybe it’s drinking a cup of herbal tea, practicing a breathing exercise or putting a hot water bottle at your feet, which dilates your blood vessels and pushes your body toward an optimal temperature.

■ Limit caffeine consumption. Caffeine even six hours before bedtime was found to significantly hurt sleep in a recent study. Similarly, alcohol is a stimulant; it’s recommended that women have no more than one drink a day, and not too late in the evening.

WHAT’S WRONG WITH BEING A LITTLE TIRED?
About a third of Americans don’t get enough sleep (at least seven hours per night), and the number has only been growing over the past 20 years. There’s no doubt that pressure to be a do-it-all mom exists, but make sure doing it all involves getting your 40 winks. Sleep deprivation can lead to an increased risk for:

■ Cardiovascular disease
■ Some cancers, such as breast and colorectal cancer
■ Car accidents
■ Work-related injuries

Dr. Pristas advises, “If you’re struggling with sleep, see your doctor, who might refer you to a sleep specialist. Everyone deserves a night of sweet dreams.”

Did You Know?
About one-third of the population has trouble sleeping. To find a location where you can seek treatment from our board-certified sleep medicine physicians, visit HackensackMeridianHealth.org/Sleep.

Is Your Child Getting Enough Sleep?

What your kids do during the night has a huge impact on their daily lives.

Sleep plays a key role in mental, physical and emotional health, from infancy through teen years.

Now, experts at the American Academy of Sleep Medicine have reviewed the research and arrived at a target slumber number for each age group.

Healthy Rest Offers Many Rewards

New guidelines published in the Journal of Clinical Sleep Medicine advise the following daily sleep totals:

• 4 to 12 months: 12 to 16 hours
  
• 1 to 2 years: 11 to 14 hours
  
• 3 to 5 years: 10 to 13 hours
  
• 6 to 12 years: 9 to 12 hours
  
• 13 to 18 years: 8 to 10 hours
  

“The right amount of sleep helps kids learn well, behave and feel happy,” says Lewis Milrod, M.D., director of Pediatric Sleep Medicine and a neurologist at K. Hovnanian Children’s Hospital.

“Adequate rest also wards off health problems like high blood pressure, extra weight and heart issues.”

It's normal for kids to resist  bedtime. Help ease them into a healthy sleep routine by remembering the following guidelines.

• Modeling: Kids learn by watching you. Show them you value sleep and they’ll start to understand its importance.
• Routines: “Keep sleep, waking, naps and play around the same time every day,” advises Dr. Milrod. “And develop soothing night time rituals, such as reading.”
  
• Screen-Free Time: Ban phones, TVs and tablets from kids’ bedrooms.

"Make it a rule to shut them down at least 30 minutes before bedtime," Dr. Milrod says.

This Father’s Day, Give Dad a Gift He Can Really Use: A Nap

Manisha Parulekar, M.D.
Hackensack University Medical Center

Please, no more ties or gold-toe socks. And save the power tools for Christmas.
This Father’s Day, give Dad a gift he can really use: A nap.

Napping has often been written off as a guilty pleasure, but a new study suggests that an afternoon nap may be a brain booster for those 65 and older.

The study of nearly 3,000 adults aged 65 and older found that those who had taken an hour nap after lunch showed improved memory, clearer thinking and increased cognitive performance than those who did not nap or took a shorter or longer nap.

The people who napped for an hour after lunch performed better on the brain function tests than those who didn't nap at all, and those who slept for an hour also outperformed the people who slept for less than an hour or more than an hour, the findings showed.

Study participants who either didn't nap, or took short naps or very long naps had declines in their mental abilities that were up to six times greater than those who slept for an hour in the afternoon.

“This study shows that a nap after lunch may be part of a healthy lifestyle for older adults, whereas naps at other times of the day might affect night time sleep,” says Manisha Parulekar, M.D., of Hackensack University Medical Center.

So for adults, it all comes down to the question of, to nap or not to nap? Still unsure which is the right choice for you? Read more here!

Fighting Fatigue

We all have them now and then, those days when it seems like we’re dragging a tractor behind us - from the moment we step out the door.

While healthy lifestyle choices such as daily exercise and proper nutrition are still the most effective tools for combating daytime fatigue, finding yourself continually tired through the day could also be a compelling case for sleep apnea – a potentially life-threatening disorder characterized by interrupted breathing patterns during sleep.

Sam Bebawy, M.D., Bayshore Community Hospital, who specializes in pulmonary disease and sleep medicine, recommends that anyone struggling with daytime sleepiness, excessive snoring and/or unexplained tiredness talk to their doctor about scheduling a sleep study. This non-invasive, overnight exam utilizes electrodes to monitor key elements of sleep impacted by sleep apnea, including sleep stages, breathing rate, snoring and sleep disturbances.

 “Sleep apnea that is not treated can increase the risk for cardiovascular disease, especially heart attack and stroke,” Dr. Bebawy says. “Not only are you making the patient feel good by treating it, you are preventing a serious condition from setting in or getting worse.”

Read more about sleep apnea, Dr. Bebawy, and one patient's sleep study experience in the May/June edition of Hackensack Meridian HealthViews.

Health Experts: A shut-eye starved child is nothing to sleep on

A good night's sleep is as important to your child as a hearty breakfast. Without enough shut-eye, children are more likely to struggle with their school studies, do poorly on the playing field, and suffer depression.

According to the National Sleep Foundation (NSF), children are getting less than the recommended amount of sleep over a 24-hour period. This can make it tough for your child to solve problems and memorize lessons, which can lower grades and self-esteem.

Sleep-starved kids are also more easily frustrated and fidgety. A child's sleep trouble affects the whole family. Parents who are up coaxing a child to bed are robbed of their own valuable sleep.

The best cure is a consistent bedtime schedule. Stick to a bedtime that permits this amount of nightly sleep:

• 11 to 13 hours for a 3- to 5-year-old child. Preschoolers often have difficulty falling asleep and staying asleep. Children this age also are more likely to have nightmares and sleep terrors, and to sleepwalk.
  
• 10 to 11 hours for a school-aged child. Schoolchildren spend time with TV, computers, and the Internet, all of which can erode time for sleep. This age group also may be drinking caffeinated beverages that can affect the ease of falling asleep at night. Watching TV just before bedtime may make it more difficult to fall asleep and may create resistance or anxiety about bedtime. Too little sleep can lead to mood swings, and behavioral and cognitive problems.
  

If the current bedtime for your child is too late, move it 15 minutes earlier each night, until you reach the desired bedtime. Tuck resisters back into their own beds, promptly and repeatedly, until they get the message that you expect them to get to sleep on their own.

Sound Advice for Sound Sleep

• Unplug : Turn off TVs, computers, and cell phones. Better yet, keep such things out of the bedroom, which should be a stimulation-free zone.
  
• Wind down: Start the transition to sleep with dimmed lights and a warm bath; end with reading a book. Avoid watching TV just before bedtime.
  
• Decaffeinate: Drinking any caffeine during the day can affect sound sleep. Caffeine is found not just in coffee and cola, but also in tea and chocolate.
  
• Decompress: Overbooked kids who rush from band practice to dance class to dinner to homework may be too keyed up at bedtime to unwind. Experts recommend one activity per season.
  
• Get help: If, despite these measures, your child still resists bedtime, has nighttime awakenings, or snores, talk with your doctor.

The sleep experts at Hackensack Meridian Health K. Hovnanian Children's Hospital can help determine if your child has a sleep disorder, or another type of neurological condition. Hackensack Meridian Health K. Hovnanian Children’s Hospital offers the region's first pediatric sleep program, backed by research and dedication from our physicians and nurses. Learn more here.

Adrian Pristas, M.D. talks with Two River Times about sleep apnea severity and treatment

According to the National Sleep Foundation, some 18 million Americans now struggle with sleep apnea - a serious, potentially life-threatening condition that has been linked to heart attack, stroke, high blood pressure, blood clots and diabetes.

Two River Times recently spoke with Adrian Pristas, M.D., Medical Director of Sleep Medicine for Hackensack Meridian Health, to help convey both the severity of sleep apnea and the scope of treatment options available to patients.

“Sleep apnea is a relatively common disorder of breathing that occurs during sleep where the posterior air way collapses during certain stages of sleep and causes a cessation of breathing for at least 10 seconds or more,” says Dr. Pristas in the Two River Times piece, "A Snorer's Alarming Affliction: Sleep Apnea."

Read the complete Two River Times piece featuring Adrian Adrian Pristas, M.D., Medical Director of Sleep Medicine for Hackensack Meridian Health, here.