https://www.ajmc.com/peer-exchange/insomnia-elderly-patients/practical-steps-for-better-sleep
Practical Steps for Better Sleep




Peter L. Salgo, MD: In the little time we have left, I’m going to do some personal consulting with you guys because what I hear on television, on my phone, on radio, on my computer, is that these devices are a curse for people trying to get a good night’s sleep. And it’s the color of the screen, or it’s the time you have the screen. Don’t use your phone in bed. Good luck with that. I don’t know anybody who doesn’t take his phone or her phone to bed.

Karl Doghramji, MD: Right.

Peter L. Salgo, MD: You know? That’s your bed partner. Have you seen this multiplying and exploding and destroying sleep?

Karl Doghramji, MD: It’s interesting that people in general are gravitating toward these devices as a way to understand their sleep and to objectify their sleep. Patients come to me and they say, “You know, look at this, it said how many times I’m waking up, the deep sleep,” and so on. And I ask them: “Well, how do you feel about your sleep?” They say, “I don’t like my sleep.” Well, why do you want to look at this? They say, “Well, this is more objective, I want this.” So it gives them something to follow. I think that there’s some advantage to these things because they’ve increased patients’ sense of awareness of their sleep. They’ve helped them pay more attention to their sleep. So in that regard, I think they’re positive. What you’re referring to is the light coming into the eye, and its effect.

Peter L. Salgo, MD: Yes.

Karl Doghramji, MD: And that can be mitigated easily. The blue lights can actually be disruptive of sleep—the blue light that’s emitted by these devices. So glasses that filter blue light may help that.

Peter L. Salgo, MD: They have a sleep mode.

Karl Doghramji, MD: Yes, that could be very helpful.

Peter L. Salgo, MD: Does that work? Does it help?

Karl Doghramji, MD: It seems to, yes.

Peter L. Salgo, MD: When I was younger—God, that sounds ancient—we didn’t use phones at night. We had a light which, because it was incandescent, was typically red or pink on a page with black and white type. And I can remember, oh, ages of waking up with a book on my chest; it didn’t seem to affect my sleep at all.

Sanford H. Auerbach, MD: There are 2 talking points: 1 is the blue light. One of the keys of sleeping is, which Karl mentioned, that there’s a timing system that goes on here—there’s a certain sleep need that occurs as you stay up all day, and then finally you accumulate that sleep debt. Assuming there’s no other disorder, there’s the ability to relax. If you’re there, you’re watching TV and a cell phone is in your hand, and you’re texting, you’re probably not relaxing. You’re probably not leaving the day behind you. You’re not separating yourself from all the stresses of your day, you’re taking them right into bed with you.

Peter L. Salgo, MD: This could be a headline I would miss; my gosh, I need my phone at night!

Sanford H. Auerbach, MD: You got it. And years ago, when you had that incandescent lamp, you weren’t worried about those headlines at night.

Peter L. Salgo, MD: I realize I couldn’t worry because it wasn’t there. My parents never let me have a TV in the bedroom, and I don’t to this day let my kids either, but they bring their phones.

Karl Doghramji, MD: This is an art and not a science. In some patients’ cases, they need that telephone, or they need that PDA [personal digital assistant] or whatever it is to get their minds off of what’s been happening during the day, which has been bothersome to them. So sometimes it can be beneficial, sometimes it can be harmful. I think it’s a matter of judgment.

Sanford H. Auerbach, MD: People always say you shouldn’t read in bed. But my perspective is for some people, some people like me, if I read in bed, I would read a few sentences, and pow. Others, they’ll take a book, get into bed, and they’ll stay up all night until they finish reading the book.

Peter L. Salgo, MD: I’ll finish the book.

Sanford H. Auerbach, MD: So obviously, one person should read, the other one shouldn’t. There’s no simple answer.
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