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Although there are still many things we do not understand about sleep, it is well known that there are numerous health concerns that can result from inadequate sleep (Hackley & Kriebs, 2017). Both short-term and long-term consequences can result from sleep disturbances. Short-term consequences of inadequate sleep include: increased stress response, headaches, abdominal pain, mood disorders, fatigue, and decreased cognitive performance (Medic, Wille, & Hemels, 2017). Women with sleep issues during perimenopause and menopause are likely to suffer sleep disturbances for an extended period of time due to hot flashes, night sweats, and other factors (Hackley & Kriebs, 2017). These extended episodes of poor sleep may increase the risk of developing long-term consequences. One long term consequence of inadequate sleep is cardiovascular disease (Medic et al., 2017). Long-term sleep issues are associated with hypertension, higher cholesterol levels, increased atherosclerosis risk, and increased risk of myocardial infarction (Medic et al., 2017). Metabolic issues are also associated with long-term sleep disturbances (Medic et al., 2017). Sleep loss is known to affect energy metabolism, which can ultimately impair insulin sensitivity and increase food intake (Medic et al., 2017). These factors are known to contribute to type 2 diabetes and obesity (Medic et al., 2017). A third health concern of long-term sleep disturbance is the development of different types of cancers (Medic et al., 2017). Melatonin, an important hormone involved in the circadian rhythm and in sleep, has numerous important properties including DNA repair, inhibition of tumor growth, and scavenging free radicals (Medic et al., 2017). During clinic visits, it is always important to take the time to revisit healthy bedtime habits. It is always my goal to avoid medication unless absolutely necessary. Sometimes by revisiting healthy routines or discussing nonpharmacological interventions, patients can see great improvement in their sleep. Some basic sleep hygiene interventions include: having a consistent bed time; choosing relaxing activities before bed; avoiding alcohol, coffee, tea, or other stimulants 4 to 6 hours before bed; avoiding smoking before bed; avoiding heavy meals or spicy foods before bed; increasing daytime physical activity; and creating a comfortable sleeping environment (Santos et al., 2018). Patient should be encouraged to read or journal before bed instead of using electronic devices (Santos et al., 2018). Cognitive behavioral therapy has also been proven effective for treating insomnia (Santos et al., 2018).

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