Sleep Dr – Dr Scott

If you are like me and approximately 65 million Americans that suffer from insomnia (difficultly falling sleep, difficulty staying asleep throughout the night or waking up too early in the morning), then you’ll want to read this interview with my sleep doctor, Dr Rebecca Scott. I was introduced to Dr Scott after undergoing a sleep study at NYU. I’ve been seeing Dr Scott for approximately six months and for the first time in years I’m making progress with falling asleep, waking up refreshed, being more energized throughout the day, and just overall feeling better.

What Kind of doctor are you? What do you do exactly? What is your title:

My degree is in clinical health psychology and my area of practice has always been sleep disorders medicine.  I’m board-certified in sleep disorders medicine by the American Academy of Sleep Medicine and hold certifications in behavioral sleep medicine, nutrition coaching and Functional Medicine Health Coaching.

I evaluate and treat patients who are struggling with any variety of sleep difficulties, ranging from difficulties falling and/or staying sleep, restlessness in sleep, unusual behaviors in sleep, snoring, sleep apnea and daytime sleepiness, tiredness and fatigue.

At NYU, my official title is Research Assistant Professor of Neurology, NYU School of Medicine

How common are sleep issues in woman?

Very common—especially all forms of insomnia and daytime tiredness

Do women snore like men?

They certainly can.  Before menopause, women are less likely than men to have any clinically significant sleep disordered breathing; however, after menopause, due to the decrease in estrogen, the incidence of sleep disruptive snoring and apnea tends to be similar between men and woman.

What is OSA?

Obstructive sleep apnea occurs when the muscles in the airway relax and temporarily block the airway, resulting in a drop in blood oxygen level.   After several seconds, breathing resumes with a snort or gasp causing a brief disruption in sleep.  Many people with sleep apnea are unaware of these awakenings and are more aware of the consequences of sleep apnea (daytime sleepiness, tiredness, difficulties with focus/concentration, low energy, low mood, difficulties with weight management).  It’s often a bed-partner that notices (and is frightened by) the loud and unusual breathing sounds.

What are common causes of sleep problems?

This is a tough one to answer because the answer varies depending on the sleep problem.   Is there a particular sleep problem you’re most interested in?

What are good sleep habits?

The following guidelines can help us sleep our best and feel most alert.
– 10-15 minutes of sunlight exposure within the first 2 hours of waking up
-Regular exercise
-Healthy diet consisting of lean proteins, vegetables, healthy fats and low-glycemic carbohydrates
-drinking plenty of water across the day (most of us don’t drink enough water)
-maintaining a fairly consistent bedtime and wake time during the work/school week
-turn off all electronic devices (other than an actual TV) the hour before you go to bed
-relax and enjoy the hour before bed (watch TV, read, spend time with family/friends-do whatever relaxation means to you as long as it does not involve devices such as computers, ipads, phone, etc).
-comfortable bedroom environment (cool, dark and quiet)
-limit caffeine to morning/early afternoon

What is the # of hours sleep one should get?

Sleep need varies from person to person but, in general, the average adult needs about 7-7.5 hours of sleep for optimal health and functioning.  Although there are exceptions, less than 6 hours for too many nights can have negative health effects; however, trying to get more sleep than one needs can results in poor quality sleep and insomnia.

What is the impact of the cell phone on sleep?

A couple of hours before our usual bedtime, our brain starts to prepare us for sleep by releasing melatonin, a hormone that regulates sleep and wakefulness.  If we are exposed to light that is too bright or from devices (such as cell phones, ipads, computers) that give off light in the blue wavelength frequency during the hour before bed, melatonin gets suppressed and the signal to the brain that prepares for sleep gets disrupted.  The result is that it can take longer to fall asleep, sleep quality can be lighter and it can be more difficult to awaken.

Should the TV be on when trying to go to sleep?

Ideally, no, and all TV watching would take place outside the bedroom; however, in some cases (and this is really on a case by case basis) watching TV while falling asleep can be fine.  I would, however, recommend that the TV be set to a timer.  Otherwise, if the TV is on the entire night, changes in volume with commercials and other programming can disrupt sleep.

At what point does someone make an appointment to see someone like you? What is the first step?

Honestly, an appointment can be made at any time if someone feels they are not sleeping well, has concerns about their sleep, doesn’t feel rested or is struggling with daytime sleepiness/fatigue or difficulties with focus/concentration.   Sometimes patients schedule an appointment because they recognize how important sleep is to their health and quality of life and they want to be sure they are doing everything they can to ensure healthy sleep.   If someone is interested in scheduling an appointment, the best way is to call the sleep center directly and ask to schedule an initial consultation.  At that time, we’d be able to take their insurance information, determine if a referral is needed and schedule the session.

What are your thoughts on NyQuil, Tylenol PM, Melatonin, essential oils, Ambien?

I think medications or supplements can be very useful tools when managing insomnia as long as they are taken/prescribed in the context of behavioral strategies that encourage healthy sleep and decrease the need for medication.   Medications alone will never resolve insomnia.   Therefore, before any prescription medication is started, or if someone finds they are relying on a supplement/OTC more than just occasionally, it is best to consult with a sleep specialist who will evaluate the problem, address all the factors that are contributing to the problem and then offer solutions that are best tailored to the individual.

Is Ambien Addictive?

Although anything can be psychologically addictive, physiologically Ambien is not “addictive” in the way that most people think of addiction.  It is more that one can develop a dependence on the medication if they take it for an extended period of time.   I often see patients who have taken Ambien or similar medications for long periods of time and then try to skip a night.   What then happens is they can have a very normal withdrawal reaction of difficulty sleeping; this experience just reinforces the belief that they “need” medication to sleep or are “addicted” to sleeping pills when that is often not the case.  What we would want to do is slowly taper the medication in a way that would minimize or eliminate any withdrawal reaction and often we can do so successfully when we incorporate healthy sleepy habits.