“But I have promises to keep, and miles to go before I sleep, and miles to go before I sleep.” Robert Frost
A relative of mine, Stewart, (not his real name) was driving home from LA, and fell asleep at the wheel. Stewart was 18 years old at the time, and on winter break from college. He drove to LA in the morning, and then, after spending the day there, drove home that night. Although he knew he was drowsy, he made the decision to drive home. The last thing he remembered was listening to a 49er Monday night football game before he dozed off without warning. His new 1996 Toyota Corolla was totaled when the car crashed into a barrier on the side of the highway as he was going at least 65 mph. The front of the car ended up at the windshield.
The National Highway Traffic Safety Administration estimates that drowsy driving results in 1550 deaths, 71,000 injuries, and 100,000 accidents each year. Younger drivers, age 16-24, are almost twice as likely to be involved in a drowsy driving crash compared to drivers age 40-59. Stewart was not unusual in that 55% of drivers who report falling asleep did so while driving on a high speed divided highway.
Often we take our need for sleep for granted, but getting sufficient sleep is as vital to our health as getting enough exercise and eating properly. In more immediate terms, lack of sleep can impair judgment, affect mood, decrease the ability to retain information, and increase the risk of accidents. In the long run, lack of sleep can lead to increased risk for obesity, diabetes, and heart problems. For example, if a person with high blood pressure has a single night of poor sleep, this can lead to high blood pressure throughout the following day- which, if it persists on a daily basis, can adversely affect the heart. Likewise, a single night of poor sleep can make a person irritable the next day, and chronic lack of sleep has been correlated with depression and anxiety.
According to the National Sleep Foundation, here are some healthy sleep tips which should become habits:
- Stick to the same bedtime and wake up time even on weekends.
- Practice a relaxing bedtime ritual.
- Avoid naps, especially in the afternoon.
- Exercise daily, but not at the expense of your sleep!
- Create a comfortable sleep environment. Room temperature should be between 60-67 degrees, free from noise, and free from any light.
- Sleep on a comfortable mattress and use comfortable pillows.
- Manage your circadian rhythms by avoiding bright light in the evening and seeking sunlight in the morning.
- Avoid alcohol, tobacco, and heavy meals in the evening. Also, try to avoid caffeine late in the day. (In my patients whom I treat for chronic insomnia, I recommend eliminating caffeine entirely.)
- Spend the last hour before bedtime doing a calming activity such as reading. If you are having trouble sleeping, avoid electronics such as laptops before bedtime or during the middle of the night.
- If you can’t sleep, go into another room and do something relaxing until you feel tired. The common adage is to use your bed only for sleep or sex.
Stewart survived the car crash and ended up only with a bloody nose when the air bag deployed and punched him in his face. He had a friend in the front passenger seat who survived despite not wearing a seat belt because his airbag kept him from flying through the windshield. Stewart was ticketed by Highway Patrol for trying to pass someone on the right side of the highway where there was no actual lane. The officer had not realized that Stewart had simply fallen asleep. What did Stewart learn from this experience? “Rest before driving, switch off drivers, and take your time.”
Don’t let poor sleep affect your health or lead to serious injury. Getting enough sleep should be a priority in your life, not an afterthought as you try to accomplish everything else you want to do. Unlike Robert Frost, reject the attitude of “miles to go” before you sleep.
For more information about sleep and health, go to the National Sleep Foundation.
Jerry Saliman, MD is a volunteer internist at Samaritan House Medical Clinic in San Mateo. He retired from Kaiser South San Francisco after working there more than 30 years. While at Kaiser SSF, Dr. Saliman was also Chief of Patient Education. He received the 2012 “Lifetime Achievement Award” given by the Kaiser SSF Medical Staff.
Editing acknowledgement: Ellen Saliman
Neither the PJCC or our guest columnists provide medical advice, diagnosis, or treatment. Please make your health care decisions in partnership with your health care provider.