Sleep

Ways to Improve Sleep

By R. Ryan Patel DO, FAPA OSU-CCS Psychiatrist

About 30% of adults experience insomnia (1), which can be thought of as daytime impairment caused by frequent difficulties falling or staying asleep or poor quality sleep (1).

College students with sleep disorders are more likely to experience academic failure (defined as GPA less than 2) compared to college students without sleep disorders (2).

Individuals with insomnia are more likely to suffer from depression, anxiety, alcohol, and drug abuse (3 ).

What are some ways of improving sleep?

The American Academy of Sleep Medicine suggests the following ways to improve sleep (4):

  • Keep a consistent sleep schedule.
  • Get up at the same time every day, even on weekends or during vacations.
  • Plan to get at least 7 hours of sleep.
  • Don’t go to bed unless you are sleepy.
  • If you don’t fall asleep after 20 minutes, get out of bed.
  • Establish a relaxing bedtime routine.
  • Use your bed only for sleep and sex.
  • Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
  • Limit exposure to bright light in the evenings.
  • Turn off electronic devices at least 30 minutes before bedtime.
  • Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
  • Exercise regularly and maintain a healthy diet.
  • Avoid consuming caffeine in the late afternoon or evening.
  • Avoid consuming alcohol, nicotine, other drugs.
  • Reduce your fluid intake before bedtime.

Anything else?

  • For some, the effects of sleep deprivation can start by missing as little as 30 minutes or more of your usual sleep time.
  • Some people may need to eliminate caffeine or alcohol completely, gradually.
  • If you have to use electronics in the evenings, consider BLUEBLOCKERS.
  • Young adults should plan on 8 to 9 hours of sleep per night.
  • Avoidance of things that interfere with sleep: screen time (consider using a bluelight filter or nightmode). Avoid large meals/snacks at bedtime.
  • Practice Relaxation skills such as progressive muscle relaxation, meditation, deep breathing, guided imagery.
  • Positive visualization: visualize positive past or future events.
  • Consider keeping a notebook to jot down things on your mind at bedtime.
  • Avoid naps when possible, sleep more at night instead, and if you take naps, keep them brief (under 20 minutes) to avoid nighttime sleep disruption.
  • If you have had limited or no benefit from these strategies, professional treatment may be needed (see resource link below).

For more resources: Go to our mental health support options page: https://ccs.osu.edu/mental-health-support-options/

By R. Ryan Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Roth T. (2007). Insomnia: definition, prevalence, etiology, and consequences. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 3(5 Suppl), S7–S10.
  2. Gaultney JF. The prevalence of sleep disorders in college students: Impact on academic performance.  J Am Coll Health.  Sep-Oct 2010; 59 (2): 91-97.
  3. Breslau N et.al. Biol Psychiatry. 1996, 39: 411-418.
  4. http://sleepeducation.org/essentials-in-sleep/healthy-sleep-habits

Poor sleep and poor grades might go together

College students might stay up late or have an erratic sleep schedule for a variety of reasons.

A recent study looked at the impact of sleep pattern on grades.

Who was studied? (1,2)

  • 61 undergraduate students at Harvard college
  • They were asked to keep a sleep diary for 30 days.

What did the investigators find? (1,2)

Compared to peers, students reporting irregular patterns of sleep and wakefulness had:

  • Lower grade point averages.
  • Delays in the times people went to bed and woke up compared to more normal sleep/wake times.
  • Upto 3 hour delay in melatonin (sleep related hormone) release compared to students with regularly scheduled sleep and wakefulness pattern.

What are some caveats?

  • Poor sleep can impact almost every aspect of health and many parts of brain functioning, including learning, remembering, mood, energy level, decision making, etc.
  • This is a small study and does not prove cause-and-effect (2).
  • Students with erratic sleep schedules ended up sleeping the same number of hours as those with a regular sleep schedule. (1,2).
  • Study participants might have an erratic sleep schedule for a variety of reasons.

What are some ways of improving sleep?

The American Academy of Sleep Medicine suggests the following ways to improve sleep (3):

  • Keep a consistent sleep schedule.
  • Get up at the same time every day, even on weekends or during vacations.
  • Plan to get at least 7 hours of sleep.
  • Don’t go to bed unless you are sleepy.
  • If you don’t fall asleep after 20 minutes, get out of bed.
  • Establish a relaxing bedtime routine.
  • Use your bed only for sleep and sex.
  • Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
  • Limit exposure to bright light in the evenings.
  • Turn off electronic devices at least 30 minutes before bedtime.
  • Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
  • Exercise regularly and maintain a healthy diet.
  • Avoid consuming caffeine in the late afternoon or evening.
  • Avoid consuming alcohol before bedtime.
  • Reduce your fluid intake before bedtime.

Anything else?

  • Some people may need to eliminate caffeine or alcohol completely.
  • If you have to use electronics in the evenings, consider BLUEBLOCKERS.

Consider seeking professional help:

OSU Counseling and Consultation Service

OSU Wilce Student health center

https://ccs.osu.edu/self-help/sleep/

How is your sleep? How are your grades?

By R. Ryan Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. https://consumer.healthday.com/sleep-disorder-information-33/misc-sleep-problems-news-626/poor-sleep-habits-61-poor-grades-723563.html
  2. Phillips AJK, Clerx WM, O’Brien CS, et al. Irregular sleep/wake patterns are associated with poorer academic performance and delayed circadian and sleep/wake timing. Scientific Reports. 2017;7:3216. doi:10.1038/s41598-017-03171-4.
  3. http://www.sleepeducation.org/essentials-in-sleep/healthy-sleep-habits

 

Could Vitamin D boost your Mood and Energy?

By R. Ryan Patel DO, FAPA OSU-CCS Psychiatrist
Many students may be aware of Vitamin D and with decreasing sunlight, many might not be getting enough vitamin D.
• Initially thought of as a vitamin, it is now believed that it works more like a hormone and has many functions throughout the body.
• Inadequate vitamin D has been implicated in fibromyalgia (1), sleep (2,3), athletic performance (4), energy levels (5) as well as bone disease (7).
• A recent study had discussed findings regarding vitamin d and depression.

What did this study involve?
• 40 patients between 18 and 65 y of age with Major Depressive disorder.
• Randomly assigned to get either a single capsule of 50 kIU vitamin D per week (n = 20) or placebo (n = 20) for 8 weeks.
• This was a randomized, double-blind, placebo-controlled clinical trial.

What did the authors analyze?
• Fasting blood samples before and after.
• The primary [Beck Depression Inventory (BDI), which examines depressive symptoms].
• Secondary outcomes such as glucose homeostasis variables, lipid profiles, hs-CRP, and biomarkers of oxidative stress.
What did the study show?
• After 8 weeks of treatment with vitamin D, depression scores improved in the patients receiving vitamin D supplementation.
• The improvement was also related to improvement in vitamin d levels.
How can I get vitamin D tested?
• There is a blood test for vitamin D, which can be ordered by your prescriber.

Can I get vitamin D from food?
According to the National Institute of Health (NIH) (7),
• “Very few foods naturally have vitamin D. Fortified foods provide most of the vitamin D in American diets.
• Fatty fish such as salmon, tuna, and mackerel are among the best sources.
• Beef liver, cheese, and egg yolks provide small amounts.
• Mushrooms provide some vitamin D. In some mushrooms that are newly available in stores, the vitamin D content is being boosted by exposing these mushrooms to ultraviolet light.
• Almost all of the U.S. milk supply is fortified with 400 IU of vitamin D per quart. But foods made from milk, like cheese and ice cream, are usually not fortified.
• Vitamin D is added to many breakfast cereals and to some brands of orange juice, yogurt, margarine, and soy beverages; check the labels.”

Is too much Vitamin D harmful?
Too much vitamin D can be harmful.

According to the NIH (7):
“Signs of toxicity include nausea, vomiting, poor appetite, constipation, weakness, and weight loss. And by raising blood levels of calcium, too much vitamin D can cause confusion, disorientation, and problems with heart rhythm. Excess vitamin D can also damage the kidneys.”

What is the main cause of too much Vitamin D?

• Vitamin D toxicity almost always occurs from overuse of supplements (7).
• Excessive sun exposure doesn’t cause vitamin D poisoning because the body limits the amount of this vitamin it produces (7).

What are some caveats?

• To avoid the risk of harm, taking Vitamin D supplements should be done under the supervision of your prescriber/doctor.
• This is the 1st study showing benefits on depression with high dose weekly Vitamin D supplementation.
• Further studies are needed.
• Some previous studies showed mixed results though under-dosing and other factors may have been involved (6).
• Vitamin D has shown benefits in some studies and in clinical experience in psychiatry for select patients.
• Benefits on vitamin D may extend beyond mood.
• Treatment with vitamin D with supplement or prescription may NOT be suitable for everyone, but it may be worth discussing with your prescriber.

Is your mood, energy level, etc impacted by low vitamin D? Could replacement benefit you? Check with your health care provider if treatment is appropriate for you.
What are some resources regarding Vitamin D?

• https://ods.od.nih.gov/factsheets/VitaminD-Consumer/
• Counseling and Consultation Service
• Wilce Student health center

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.
References

1. Jesus CA, Feder D, Peres MF. The role of Vitamin D in pathophysiology and treatment of fibromyalgia. Curr Pain Headache Rep. 2013 Aug;17(8):355.
2. Bertisch SM, et al. 25-Hydroxyvitamin D Concentration and Sleep Duration and Continuity: Multi-Ethnic Study of Atherosclerosis. Sleep. 2015 Aug 1;38(8):1305-11
3. McCarty DE, et al. The link between vitamin D metabolism and sleep medicine. Sleep Med Rev. 2014 Aug;18(4):311-9. Epub 2013 Sep 26.
4. B Hamilton. Vitamin D and Human Skeletal Muscle. Scand J Med Sci Sports. 2010 Apr; 20(2): 182–190.
5. Al–Dujaili E, Revuelta Iniesta R. http://www.eurekalert.org/pub_releases/2015-11/sfe-vdp102915.php Preliminary study presented Fall 2015 at the Society for Endocrinology Annual Conference in Edinburgh.
6. Sepehrmanesh Z, et al. Vitamin D Supplementation Affects the Beck Depression Inventory, Insulin Resistance, and Biomarkers of Oxidative Stress in Patients with Major Depressive Disorder: A Randomized, Controlled Clinical Trial. J Nutr. 2015 Nov 25. pii: jn218883. [Epub ahead of print].
7. https://ods.od.nih.gov/factsheets/VitaminD-Consumer/