Update on the Sleep Clinic & Recommendations

Well I guess it's time I give an update on the results from my sleep study. This follow-up appointment was so much different than any follow-up I've been to before. I went in there and the nurse practitioner went through my different sleep cycles and brain waves and limb movements... which all looked like the picture you see on the left. Those lines signify all the different hook-ups I talked about in the previous post.

So it ended up that out of the 8.4 hours they were doing the study (from lights off until lights on), I slept 4.8 hours of it. I only recall waking up for 1 prolonged period of time and that is where I was laying there thinking about how best to let the tech know I wanted to get up to pee. In the summary part of this long report they gave me, it says that I waked up 13 times/hr throughout the night, which obviously disrupts my sleep (normal is less than 5). They also wrote down here that my REM sleep is slightly low (that's why I don't have a lot of good dreams!), I have mild snoring when laying on my back (knew that...), and that I have rare bursts of periodic limb movements (about 3/hr). Very interesting... right? So, it says here I have chronic insomnia which pretty much just means that I don't have apnea or narcolepsy, or some reason like that that I can't sleep...

After she went through all that stuff with me, she started talking about different options I could choose to help with my sleep. This is the different part... I'm used to a doctor just writing me a prescription and calling it a day, but she gave me a whole bunch of things I can choose from, and kinda left it at that. I like this approach, because some people... like myself want to try to fix things without prescription drugs, and some people don't. Here are the options given to me, and if you have sleeping issues too, you should definitely try them.

-Cognitive Behavioral Therapy

-Light Therapy with a SunBox light box (http://www.sunbox.com)

-Melatonin (found at a health food store or a drugstore)

-Neurontin (prescription used for epilepsy, pain disorders, restless legs syndrome, and insomnia)

-Rozerem (prescription - has more drug interactions and side effects than neurontin, so they try neurontin first...)

-They also said that for chronic insomnia, they don't recommend Ambien or Lunesta because you gain tolerance to them and they're only used for the short term.

I decided to start with Melatonin because it seemed like the easiest for me. On the bottle, it says to take 30 minutes before you go to sleep, but the nurse practitioner told me to take it around the time the sun goes down (but since that's anywhere between 5pm and 9pm around here, she usually tells people around 7pm). Honestly, I have no idea if I'm still waking up those 13times/hr, but I feel like I've been sleeping a lot better so far on it. I've actually slept through the night a couple times in the past week or so, and that never happens to me. It definitely makes you feel sleepy after you've taken it, so if you want to go out on the weekend or something, I would delay the dose. Anyway, I'm pretty happy with it right now, and kind of feel like my body is trying to make up for the 10 years of sleep loss. I'm hoping the melatonin will be enough and I won't have to take a prescription drug.... but we'll see :). Let me know how any of the options work out for you if you try them!

Why Sleep is Important to Your Health... and My Experience at a Sleep Clinic

Ok, so obviously there's a crazy picture of me with a bunch of wires hooked up to the right from when I recently went to a sleep clinic and got a Polysomnogram, but I'll get back to that...

Getting the right amount of sleep is a lot more important than most people may think. Some problems associated with chronic untreated sleep disorders are: high blood pressure, heart attack, stroke, obesity, depression, etc. One study even found that reduced sleep time has a greater mortality risk than smoking, high blood pressure, and heart disease. Given all of these problems from sleep deprivation, hopefully my description of my experience going to a sleep clinic will result in some people trying it out and getting the treatment they need.

Back to my story... for the past 5-10 years, I've had issues sleeping compared to other people around me. On an average night, I'll go to bed around 11pm, get up at 2am, be up for about 1.5hrs, go back to bed, and be up by 6am. About 5 days/month in a row, it's worse, and I'm up about 3 times for an hour each time and finally get pissed off around 5am and just get up for the day. I've tried the whole laying in bed and trying to go back to sleep thing but that always leads to less sleep. I'm also extremely tired by about 4pm (which sucks when meetings go until 5:30...), and have a hard time driving more than an hour without almost falling asleep (which I actually did once when I was 18... flipped my car a couple times, and almost died). So finally my doctor referred me to a sleep clinic... I called and set up an appointment.

For my initial appointment, I had to fill out a bunch of papers about my sleeping patterns and just talked to a doctor for half an hour... not too exciting. I set up the appointment for my overnight assessment to get a Polysomnogram (I had no idea what was going to go on at this point... I don't really ask questions). I showed up to the sleep place around 6:30pm, which kind of looked like a cross between a hotel and a doctor's office. One of the techs on duty gave me a tour and there are about 6 separate bedrooms with patients occupying all of them, a couple bathrooms with towels, shampoo, showers, and also a snack / breakfast area with fruit, oatmeal, cereal, and a bunch of other free stuff. I got sent to my private room with a queen sized memory foam mattress and a flat panel TV... pretty sweet. This is also when I noticed the security camera that would be staring at me all night on the ceiling, and also some other medical equipment I figured would probably be hooked up to me later.

After a while, the tech came in after I was in my jammies and told me he was going to start putting the electrodes on me. He explained everything, put some wires on my legs, chest, and face with some sticky patches, along with 2 stretchy bands around my waist and chest. At this point, he was going to start placing electrodes on my head that are used to measure what sleep state you're in. He had to measure my head, mark it with a red grease pencil where each electrode would be placed. It felt like there was a million, but I think it was probably about 20. Each location needed to be cleaned with a q-tip with some stuff on it, and sometimes it felt like he was rubbing pretty hard, but I think that was needed for the electrodes to work correctly. The electrodes were put on with what he called model airplane glue (yeah, don't think your hair is going to look pretty after this... ). This whole process took about an hour, but when they're monitoring all of your brain activity, your breathing, your leg movements, etc, I guess it takes a while to prep for that :). I went back to my room to watch the Bachelor, of course.

The tech said he would come back in around 10:30pm and I should have brushed my teeth and anything else I needed to do because I will be hooked up all night. Although, if I needed anything, like to go to the bathroom, I could just ask him if he could unhook me....since he would be listening to and staring at me all night through another camera thing next to the bed. Awesome, he's going to listen to me snoring with my mouth open all night... He hooked the thing up that I have in my hand in the picture to a machine, and taped a tube onto my face with one part going into my nose and the other part going into my mouth.

At this point, I asked him... how am I going to sleep with all this stuff! He responded with "everyone says that, but everyone end up sleeping...". So it took me about an hour to fall asleep because I always sleep on my stomach and couldn't, but I did fall asleep with all that stuff on, and you kind of forget about most of it after a while. I woke up around 2am, the normal time, stared off into space, and after about 45 min decided that I do need to get up, but felt awkward being like... helloooo, are you there? So I just stared at the camera thing until the guy asked me if I needed anything...haha. He came in and unhooked me, and I walked around for a while, ate a couple bites of a granola bar, and went back into the room. I really wanted to go to my own house at this point, but he made me try to go back to bed to finish the study.

I ended up sleeping until about 5am and he came in at 6am to unhook me and take all the stuff off. It only took about 10 minutes to get everything off and now I had globs of glue in my hair... sexy for work. He gave me a couple bottles of this oil stuff that was supposed to help get it all out, so I worked that into my hair for about 15 minutes in the shower, and got most of it out and went to work. I told everyone not to pay attention to any globs of glue that may be falling off my head that day. By the next wash it was all out.

So that was how everything went, and I have my follow up appointment this Thursday, so I'm really excited to see if there's anything wrong with me, or if I'm just crazy :). All in all, I think it will all be worth it. They really try as hard as they can to make you feel comfortable given the situation with the bed, TV, and free continental breakfast, but obviously it's not going to be like your own home. In the long run, it's only 1 night, and it could change your life. The doctor told me almost all sleep disorders can be treated...so hey, why not. At least you know what to expect now...

For a lot more info on sleeping, go to WebMD... they have a huge section on it.

NuVal - Overall Nutritional Quality Index (ONQI)

So there's this thing called NuVal that is a pretty complex nutritional scoring system which has started to trickle into supermarkets and seems like it's aimed to be available at every supermarket in the country, eventually. The NuVal system was created by a team of independent nutrition, public health, and medical experts and scores food on a 1-100 scale (100 being healthiest) to try and help people learn how to eat healthier. This score will be located directly on the shelf tag to be easily viewable.

Considering the fact that currently, 34% of Americans are obese, and that number is expected to hit 43% by 2018, I honestly think that something like this is very much needed right now to help people to make healthy choices at the grocery store. Most people don't go through the stores analyzing everything located on a food label before they purchase it, and a lot of people don't know everything they'd be looking for even if they had the time to compare every single label. It's a good quick way to see the relative healthiness of what you're picking up and putting into your cart.

Anyway, some science behind the whole NuVal thing... Their scoring system looks at more than 30 different nutrients and nutrition factors to make it a very comprehensive rating system. I'm sure their whole algorithm is really complicated, but essentially, nutrients with favorable effects of health are placed in the numerator (higher value = higher score), and nutrients with unfavorable effects on health are placed in the denominator (higher value = lower score). If you want to get a quick idea of the numerator and denominator nutrients, just look at the image I've attached... I think it makes it very easy to understand.

In addition to these good and bad nutrients, the NuVal system also takes into account other key factors that measure the quality and density of nutrients and the strength of their effect on your body (i.e. trans fat). Since trans fat is very much associated with heart disease, foods with trans fat get a weighting coefficient which is aimed at lowering the overall score. Other things that factor into the score: fat quality, protein quality, glycemic load, energy density, etc.

On their website, you can find a store near you that has already implemented the NuVal scoring, check out the scores of your favorite foods, look at their trading up tips (kind of like an eat this, not that type thing), and read a whole lot more of background on it than what I gave you. I was reading up online about this (off of their site), and there was one discussion I saw where someone was complaining about how yogurt with fake sure had a higher score than yogurt with real sugar, and the Dr. who was the lead on this NuVal score thing wrote a very detailed response. He started off by saying that he doesn't like eating things with fake sugar, and how you should think of this rating system as you would a GPS... if you don't know where you're going, it will guide you, but if you do know where you're going, you're obviously going to make those choices by yourself. Then he went into the science about it and how it has not been proven that fake sugars harm you, so foods don't get penalized for containing it. So I guess the main point of why I shared that story is that NuVal scoring only takes into account things that have been scientifically proven, so just keep that in mind, and use the number as a guide in your healthy lifestyle.

Oh, also, they have A LOT more foods to rate. On their website they say they've rated about 100,000, but they don't list very many at all.... so I think it's going to be a very gradual thing.

Foods scoring 100: blueberries, broccoli, green beans, and Hodgson Mill unprocessed wheat bran...and the only food on their website right now with a score of 1: Glutino pretzel twists gluten free. See...obviously they don't have everything on here yet, I mean where are the Reeses Peanut butter cups??

NuVal website