We all have trouble sleeping sometimes. But what if you sleep so poorly that you experience problems during the day? Does it help to gain more insight into your sleep via a watch or ring, or is it better to leave that alone? Co-founder of Slaapstraat, general practitioner Bart van Pinxteren, tells you everything you wanted to know about sleep, gadgets and the future of sleep therapy.
Until seven years ago, GP Bart van Pinxteren felt empty-handed when a patient with sleeping problems came for a consultation. “I didn’t know what I could offer, except the advice not to drink coffee in the evening, not to eat too late and to turn off the screens on time,” he says honestly. His approach changed radically when he started studying sleep problems for a project at the health center (with the aim of reducing the use of sleeping pills). “The insight that insomnia is not a complaint, but a condition, opened my eyes. When I found out that there are incredibly good ways to diagnose and treat, I was completely surprised. More general practitioners should have knowledge of this, I thought. That’s how it started Sleeping Street.”
Sleep Street is a care program; the GP and his colleague Stephanie van Emmerik have now trained more than 50 general practices to effectively diagnose and treat sleep problems. Time to ask Bart all about sleeping problems and how to tackle them.
Let’s start with the basics. When does poor sleep really become a sleep problem?
“Poor sleep becomes a problem if it leads to disruptions in daily functioning. If you experience problems during the day, such as fatigue, concentration problems or irritability due to lack of sleep, it is time to pay attention to your sleep patterns. The guideline that we use as general practitioners provides a very concrete guideline when it comes to insomnia: a person must experience problems falling asleep or staying asleep three nights a week for at least three weeks (and in the international guideline for three months). and therefore function worse during the day.”
1 in 10 Dutch people have sleeping problems. How do these sleep problems arise, what makes people susceptible?
“Sleep problems often arise from stressors, such as illness, pain, menopause, grief or, for example, the arrival of a baby. People adjust their behavior to compensate for poor sleep or to avoid having to lie awake for too long. For example, watching television until late, staying in bed longer in the morning, reading for a long time or drinking alcohol. When the original trigger disappears – the baby continues to sleep, the menopause is over, the period of stress is over – then the compensatory behavior sometimes persists. This can lead to chronic insomnia.”
So it is actually a disease that can arise from our own behavior?
“Exactly, many diseases naturally arise from behavior. But it is important to recognize insomnia as a formal condition that can be treated with behavioral therapy. There is a specific form of cognitive behavioral therapy for insomnia (CGTi), which has been shown by research to be the most effective treatment for insomnia. Unfortunately, it is currently not reimbursed by health insurers, who consider it a lifestyle problem.”
Bart is lobbying insurers to reimburse it, but if that happens, the question is: who should provide that therapy? Psychologists are overcrowded. That is partly why it is so essential to look at innovations when it comes to diagnosing and treating sleep problems, Van Pinxteren sees.
Is there already a tool that can replace the psychologist in this?
“I see many opportunities for i-Sleep for behavioral therapy for insomnia, which was developed by the Vrije Universiteit in collaboration with the University of Amsterdam. This online tool automates part of the behavioral treatment, allowing patients to work independently. In terms of content, it is really well put together and its effectiveness has now been demonstrated in research.”
You have a passion for innovations when it comes to diagnosing and treating sleep problems.
What gadgets have you experimented with?
“A nice device is the Night Owl for sleep apnea. That’s a kind of licorice that you stick on your finger when you go to sleep. The sleep data arrives directly on my computer. After three nights we usually have enough data to see whether someone has sleep apnea or not. I think this is a great device, it is small and therefore not disturbing. People can simply sleep in their own bed and do not have to go to a sleep center (which can give a distorted picture, because they sleep more restlessly there anyway). And that is partly why it can save healthcare a lot of money if you can discover or rule out sleep apnea in this way. But the problem is, and I say it with pain in my heart, unfortunately this device will no longer be available because the company has been taken over and the Dutch market is temporarily put on pause.”
What is your position on the use of technological gadgets for sleep by people at home,
like Garmin for tracking sleep scores?
“I have to be honest: when I first started looking into sleep problems, I really hoped that nice gadgets could help people. I have such a ring myself that I can use to track my sleep. But now I would say: don’t do it. Sleeping should remain something natural and you should not want to force sleep. The watches do not measure well enough whether you are really sleeping, because they cannot measure your brain waves. The problem is that this can give them the wrong picture with their scores. For example, maybe you lie very still when you are awake, then the watch can measure that you are still asleep and show a good sleep score. A watch also does not measure sleep apnea. If you experience sleeping problems, see your doctor. The core of the treatment lies in a good diagnosis and behavioral approach, not in technological gadgets.”
Finally, what tips do you have for people who want to sleep better?
“A good night’s sleep starts during the day. Not until 11 o’clock at night. By this I mean: make sure you get enough rest and exercise during the day. And it’s always good to practice sleep hygiene. Maintaining regular sleep times, creating a comfortable sleep environment and avoiding stimulating activities before bedtime can help. But if these measures do not lead to improvement, it is time to consult a professional. But also put yourself into perspective: we can usually tolerate a period of poor sleep.”
Sleep disorders at a glance
It is important to be able to distinguish between different sleep disorders. Because each type of sleep disorder requires a specific approach. For example, insomnia can be effectively treated with cognitive behavioral therapy, while sleep apnea requires other interventions such as the use of a CPAP machine. A good diagnosis lays the foundation for targeted and successful treatment, says Bart.
Poor sleepers at a glance:
Some common sleep disorders, according to Bart, are:
Less common examples include:
Want to know more about sleep care? Also take a look at the Sleep Coalition website.
2024-01-25 06:29:19
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