Dr. Oz Wants to Tuck You In

In addition to being a frequent guest on The Oprah Winfrey Show, Dr. Mehmet Oz is the vice chair and a professor of surgery at Columbia University as well as medical director of the Integrated Medicine Center and director of the Heart Institute at New York Presbyterian/Columbia Medical Center. He has written four New York Times bestsellers, and next month his new book,You: Being Beautiful, arrives in bookstores. In the first of two parts, Oz talks about sleeping problems and how to overcome them.

As a country, how well are we sleeping?
Fifty percent of people don’t sleep well.

Are sleep problems a special challenge for doctors to treat?
Common problems are poorly treated. The reason for that is because we [doctors] learn about them so early in our training. So we figure, “I know how to treat insomnia. Give them Ambien.” Or whatever pill you’re going to give that day. That becomes what your norm is. So whenever someone asks you about a sleeping problem or high blood pressure or diabetes or any common problems, you’re sort of embarrassed about asking advice because you learned about them when you were an intern.

How can we improve that 50 percent number?
Things like a cool room, loose-fitting clothing [and] dimming the lights about a half hour before you go to bed to let melatonin levels naturally increase in your brain. There’s an art form to going to sleep right that most folks ignore.

Has sleeping well always been a problem?
Our ancestors had no choice but to do these things because the sun went down. The lights were going to be dark no matter what they did. So their melatonin levels would go up and they’d get tired.  

Does medication help?
There are pills that work. Melatonin is primarily effective for people who have jet-lag problems. [It] does not work nearly as well for people with baseline insomnia. There are some very good sleeping pills but I would only use them from 30 to 60 days at a time and then move away from them.

How do you determine what sort of medication works best for a particular patient?
If your problem is you can’t get to sleep, or once you’re asleep, you’re fine, I give you a very short-acting sleeping pill. There’s no point if your problem is you wake up early. Then don’t take it [the pill] before you go to sleep. You can take it in the middle of the night when you’re up. If your problem is you’re up and down all night long, you would take something like Ambien.

What else can be done?
I tell people if they have chronic issues that are keeping them up—whether it’s restless legs, pain or sleep apnea—address those. They’re not just minor inconveniences.  If you’re not sleeping, you’re losing your best opportunity to make growth hormone.

And if all else fails?
If despite all those, you don’t get to where you want to be, you need to see a sleep expert. A sleep expert will do a sleep study. That generally is very effective [in] figuring out what kind of sleep problem you’re having. Do you fall asleep and wake up early? Do you not fall asleep? Those kinds of discussions are very important to have.