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Dr. Ruckshanda Majid, a pulmonary disease critical care and sleep medicine doctor, poses for a portrait Monday, May 16, 2022, at a sleep disorders clinic at Memorial Hermann Hospital in Houston.

Dr. Patni Puneet, pulmonary, critical care, sleep medicine physician at Kelsey-Seybold

Dr. Randall Wright, neurologist at Houston Methodist

Dr. Ruckshanda Majid, a pulmonary disease critical care and sleep medicine doctor, poses for a portrait Monday, May 16, 2022, at a sleep disorders clinic at Memorial Hermann Hospital in Houston.

Dr. Ruckshanda Majid, a pulmonary disease critical care and sleep medicine doctor, poses for a portrait Monday, May 16, 2022, at a sleep disorders clinic at Memorial Hermann Hospital in Houston.

Dr. Ruckshanda Majid, a pulmonary disease critical care and sleep medicine doctor, poses for a portrait Monday, May 16, 2022, at a sleep disorders clinic at Memorial Hermann Hospital in Houston.

When it comes to staying healthy, those hours spent with eyes shut are just as important as our time awake, says Dr. Ruckshanda Majid, co-medical director of the Memorial Hermann Sleep Center.

“We spend a third of our lives asleep,” she says. “We need to focus on our own sleep health.”

Majid also serves as associate professor of pulmonology and sleep medicine at McGovern Medical School at UTHealth Houston.

People can get so focused on career and the hustle of daily living that quality sleep can get lost in the mix.

“Unfortunately, I don’t think people understand how important sleep is,” she says.

In fact, Dr. Randall Wright, neurologist at Houston Methodist, said a lack of sleep can lead to memory loss and contribute to dementia.

“I look at four categories of health — how we eat, how we move, how we sleep and how we interact socially,” he says. “If any of those four are off, we won’t be healthy.”

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And lack of sleep, Wright adds, can negatively impact the other quadrants. For instance, without rest, exercise becomes a challenge. Not sleeping can also affect mood.

Healthy eating can also become an obstacle. Appetite regulating hormones — leptin and ghrelin — are both influenced by sleep.

“If we don’t sleep, it affects everything else,” Wright says. “We tend to think of sleep as a luxury. It’s really a necessity.”

Dr. Puneet Patni, a pulmonary, critical care, sleep medicine physician at Kelsey-Seybold, says that the amount of sleep needed is not set in stone.

“Some people get fixated on getting eight hours of sleep,” he says. “And people can be over-stressed about it.”

The National Sleep Foundation recommends seven to nine hours for adults, while seniors over 65 need slightly less, between seven and eight hours.

Some individuals require more — and others, less, Patni says. Still, the average range does not vary more than a couple of hours.

“It’s kind of a bell curve, but it’s fairly narrow,” he says.

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Age can be a factor in how many hours are needed on the pillow. For instance, newborns sleep constantly, Patni points out.

The American Academy of Sleep Medicine states that children ages 6 through 12 should average between nine and 12 hours, while teenagers, ages 13 to 18, should get eight to 10 hours.

While it might seem like teens are sleeping more, Patni says that their schedules actually tend to shift at that age — and they may stay awake later.

One thing is for certain, however. Getting the right amount of rest is essential.

“You clearly can’t do without it,” Patni says. “Sleep definitely affects everything.”

Catching the right amount of Z’s can be difficult for a number of reasons.

“There’s a huge percentage of the population that are sleep deprived,” Patni says. “Those are the people who are burning the candle at both ends.”

He has patients who know they need more sleep, but with the demands of their careers and families find it increasingly difficult to carve out eight hours in bed.

Then, there are people who have the time but simply struggle to nod off or stay asleep — or both. This common sleep disorder is known as insomnia.

“A lot of people’s main complaint is ‘I can’t sleep,’” Patni says.

While having a few sleepless nights here and there is common, problems arise when it becomes chronic or affects daytime function, including workplace issues, trouble concentrating and mood disturbances.

The underlying causes can range from poor sleep habits to lack of exercise, as well as anxiety and depression.

“And that’s really important to recognize,” Patni says. “You want to address the underlying cause.”

He adds that disturbed sleep can begin during a time of grief — say a lost job, death of a loved one or divorce — and then perpetuate afterward.

“You can get into a cycle where you are spending time in bed but not sleeping,” Patni says.

Bringing activities into bed, including a meal or a laptop, can prevent restful sleep.

Fighting insomnia often starts with creating healthy sleep habits, like eliminating noise and light, Wright says.

For instance, while any light can prevent a good night’s sleep, blue light, emitted from ever-present phone and tablet screens, is the most disruptive. “That light wakes us up,” Wright says.

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He adds that scrolling through social media before bed can result in heightened anxiety, another sleep inhibitor.

Binge-watching shows can even disturb a normal sleep routine. Wright suggests reserving 35 to 45 minutes before bedtime to wind down. “Do the same pattern every night,” he says.

That can include lowering the lights, turning off the TV, silencing the phone, reading a book, listening to relaxing music and cooling the room.

Patients’ perceptions of how much they are sleeping can be off.

“People with insomnia or restless sleep often feel like they didn’t sleep at all,” Patni says. “And sometimes there’s the perception that if they are tossing and turning, they literally did not sleep.”

That’s usually not the case. For some patients, an underlying disorder can prevent them from feeling rested, even if they’ve been in bed for hours.

That’s when a sleep study can help — where technicians observe a patient’s sleep patterns throughout the night. Patni’s patients are seen for full sleep observation and analysis when needed at the Kelsey-Seybold Sleep Center.

Patients could have periodic limb movements disorder, which affects 4 to 11 percent of the population, according to the Sleep Foundation. Individuals with the condition suffer jerking or twitching of their limbs during sleep, which disturbs their rest, even if they do not wake up.

Sleep apnea — a disorder when breathing stops and starts during sleep — is the most common disorder Patni sees at his clinic.

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If symptoms are present for sleep disorders, patients should seek help from their doctors. For example, those with sleep apnea might wake up with a headache or acid reflux. They might snore loudly and find themselves gasping for air or choking in the night. And those with restless leg syndrome might experience deep pain in their limbs.

Sleep disorders often go undiagnosed, Majid says. She sends patients to the Memorial Hermann Sleep Centers as a critical step to help.

One disorder she treats often is narcolepsy, which is characterized by an overwhelming drowsiness during the day.

“These individuals are often labeled as lazy or nonproductive,” Majid says. “Through no fault of their own, they can’t stay awake. And often, no one believes them.”

She added that it can sometimes take a decade before diagnosis. Then once patients are treated, they have a whole new lease on life.

“Take symptoms of sleepiness during the day seriously,” Majid says. “Maybe there’s something more to your symptoms.”

One common misdiagnosis she sees is insomnia for what actually is a circadian rhythm sleep disorder.

In these patients, their inner clock is simply different than others. They struggle to go to sleep at night and feel more awake and productive in later hours.

She has methods to help patients adjust their circadian rhythms, while others accept having a different schedule and adjust their hours accordingly. “Chronotype” is the current buzzword to describe this phenomenon, Wright says. It’s the natural inclination to sleep during certain hours.

The four chronotypes include people who are night owls and morning larks.

Majid often asks to speak to the bed partners of her patients to learn more about their sleep habits. That person can often help her pinpoint an area of concern. Once the disorder is identified, it can be a game changer in the patient’s overall health.

Majid, Patni and Wright all rely on cognitive behavioral therapy for treatment, which involves developing healthier habits, as well as changing negative thoughts and behaviors.

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Often, an in-depth interview is the best way to start. Patni asks how the patient sleeps, what they do at night and how they feel during the day. Do they nap? Exercise? Drink alcohol? How much caffeine is part of their routine?

“It involves getting a basic framework,” Patni says.

There is a role for medications for some people, he added, as long as they understand concerns and take precautions. Individuals 65 and older have a higher risk with pharmaceuticals.

For insomnia, Majid says that some have success with melatonin pills, while the verdict is still out as to whether any science supports its use. She avoids prescribing medications like Ambien for long-term treatment of insomnia. “I feel like it is a Band-Aid,” she says.

And Majid would rather look deeper to help resolve underlying causes.

“It just takes a little more time with each patient,” she says.

Lindsay Peyton is a Houston-based writer.

Lindsay Peyton is ReNew Houston's Transformation columnist.