We already know that getting enough sleep supports our immune system, memory, and mental health. Getting enough sleep promotes healthy weight and blood sugar levels. Now add another benefit: Sleep is an essential ingredient for heart health, according to guidelines updated this summer by the American Heart Association.
The AHA has updated its previous guidelines, Life’s Essential 7, which outlines the seven most important behaviors and health factors for optimal heart and brain health. For years, this list has included things like nicotine exposure, blood pressure, blood sugar, and weight. Beginning this year, the AHA updated the list of Life’s Essential 8, which includes a new health behavior: sleep duration.
“Adequate sleep promotes healing, improves brain function, and reduces the risk of chronic disease,” the AHA states in its new guidelines.
Guideline after guideline and study after study continue to reinforce the importance of sleep for health and well-being. Along with clean air, clean water and nutritious food, sleep is a pillar of good health. Take away any of them, and good health is impossible.
Why, then, has it taken us so long to recognize the importance of sleep? Why have we relegated a good night’s sleep as a luxury and not an essential ingredient of life – essential, as the AHA has written, to the very beating of the heart and functioning of the brain? And, knowing this, how should our healthcare system deal with the subject of sleep?
I have researched sleep for over 40 years, seeing the challenges of conveying the importance of sleep to the public, even though I have witnessed the dramatic health improvements that people experience when they improve quality and duration of sleep. Here are five important tips for healthcare systems and providers to educate patients about the importance of sleep:
Step 1: Adopt positive public health messages
Public health messaging plays a difficult role: Too often, public health workers can sound like the Ministry of No Fun. We tell people what not to do; we urge them to avoid the things they love (too much food, alcohol, tobacco, etc. is bad for you) while promising long-term gain.
With sleep, however, we have a much more positive story to tell. Sleep offers a return the next day. The rewards are immediate and the quality of our days depends a lot on the quality of our nights. The long-term effects are also evident – from heart to brain to mental health – and we can get there one good night and one good day at a time.
Step 2: Integrate sleep into the clinical examination process
For heart health, we see a cardiologist. For brain health, a neurologist. Our bodies, however, are not so well partitioned. Sleep – and the lack thereof – affects almost every aspect of our body and mind. Conversely, sleep – and enough – can improve nearly every aspect of our body and mind.
Sleep patterns should be included as part of the clinical review process. Specialists and primary care providers should ask patients how long they sleep the same way they measure blood pressure and other vital signs. In addition to asking patients about their days – about their eating and exercise habits – we should also ask them about their nights.
Step 3: Connect people to the tools that support healthy sleep
Even if a provider’s specialty lies beyond sleep medicine, they should have resources to guide patients toward evidence-based techniques for improving sleep. Allowing patients to feel a sense of control over their sleep health.
People want and value resources to help them sleep. Guide patients to evidence-based methods that can improve their sleep quality. This can include healthy sleep habits and sleep hygiene, such as a consistent bedtime, keeping phones in a different room, and a quiet sleep environment. This can include educating patients on the success of cognitive behavioral therapy (CBT) in improving sleep quality and duration, whether through in-person therapy or digitally, such as via a digital or evidence-based therapeutic application.
It’s important to offer ways to improve sleep quality without medication or supplements, because people who are currently taking medication for other conditions are naturally hesitant to add another one – and some of these sleeping pills can have side effects. side effects that compromise the health benefits of the extra sleep. while supplements lack effectiveness.
Step 4: Recognize healthy sleep as a matter of health care equity
While some people have poor sleep quality due to bad habits, many people have poor sleep quality due to issues of socio-economic inequality. Just as many people don’t have equal access to quality health care or healthy food, so many people don’t have access to enough sleep: they can work night shifts and hold multiple jobs; they may have babysitting duties that require round-the-clock responsibilities or live in a noisy environment.
Talk to patients about how their lives interfere with sleep quality and work with them to find resources or methods that might help. Ask about their sleep, then listen carefully. The discussion that follows should be non-blaming and solution-oriented.
Step 5: Reinforce the concept of sleep as a fundamental element of good health
For too long, sleep has been an afterthought for both patients and providers. When we’re short on time and need a corner to cut, the corner we cut is often sleep. Amid providers’ limited time with patients, it’s understandable that there’s little time to have a meaningful conversation about sleep, if any. Yet, it is essential to remind patients that adequate sleep is essential for good health. They don’t need to feel guilty for not having enough, nor to brag about how little they need. An open conversation between providers and patients about sleep, as well as evidence-based methods that can improve sleep patterns, are too crucial to remain a corner that providers are cutting. The Five Principles of Good Sleep Health is a free resource you can share to help your patients get started.