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Sleep Answers from Sleep Expert Charlene Gamaldo

Charlene Gamaldo, M.D., of Johns Hopkins Center for Sleep at Johns Hopkins Howard County Medical Center discusses the importance of establishing sleep routines when it's time to see a sleep specialist and more.

I have a hard time going to sleep during the week, but I sleep a lot during the weekend. What can I do to get a more restful sleep throughout the week?

Everyone should get 7 to 8 hours of sleep per night to feel rested; otherwise you will feel tired throughout the week. Often, people will try to catch up on sleep over the weekend to repay the "sleep debt" we accumulate over the week. While this can help, one weekend of increased sleep is not enough to repay [it].

One of the keys to good sleep is establishing a routine—make sure you have a wind-down schedule before going to bed. There are many potential treatment options for sleep issues, so ask your doctor and if needed, ask for a referral to see a sleep medicine physician.

What is the best way to get back into an acceptable sleep pattern?

Here are some of the recommendations I have for getting into a better sleep routine:

  • Consider exercising no closer than 3 to 4 hours before bedtime
  • Have a wind-down routine of 30 to 60 minutes before you go to bed
  • Go to bed at a regular time each night
  • Wake up at a regular time every morning
  • Avoid naps later than 4 p.m.
  • Avoid alcohol close to bedtime
  • Avoid caffeine after 12 p.m.
  • Avoid hot baths or showers within an hour of bedtime

I get at least 7 to 8 hours of sleep each night, but I wake up exhausted and overwhelming daytime sleepiness. Is it possible to be getting enough sleep but never reach REM sleep?

If you are getting 7 to 8 hours of sleep and still feel sleepy, you should discuss this with your physician or consider seeing a sleep specialist. Although the sleep medicine community recommends 7 to 8 hours of sleep per night, some individuals may need more on a regular basis to wake up feeling rested.

There are other sleep disorders that can cause sleepiness despite 7 to 8 hours of sleep, including sleep apnea, narcolepsy and a delayed sleep phase. A good medical history and a sleep test may be needed to help further.

I often wake up throughout the night and have trouble falling back asleep. Is there a simple explanation for this?

Interruptions during the night are a common problem reported by many patients with sleep problems. Reviewing your sleep history and sleep habits with a sleep provider along with conducting the appropriate diagnostic tests like a sleep study is the first step to gaining better insight on what may be getting between you and a good night’s sleep.

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