Motivate your patients to move 150 minutes a week, seek good sleep hygiene

LAS VEGAS — The message was clear from two experts: primary care physicians should increase their role in the reduction of cardiometabolic risk through thoughtful discussions with patients about ways to mitigate risk such as good sleep practices and an active lifestyle.

Timothy S. Harlan, MD, outlined key aspects to good sleep hygiene here at the Cardiometabolic Risk Summit.

Harlan suggested physicians use the STOP-Bang questionnaire to assess sleep apnea risk.

“In most patients and with most insurance carriers, you can bypass that clinic visit with the sleep specialist and go right to the sleep study,” Harlan said about the STOP-Bang questionnaire.

He also uses the Epworth Sleepiness Scale to measure a patient’s daytime sleepiness level.

On sleep hygiene, Harlan said that light pollution, specifically as it relates to blue light spectrum from smart phones, is a problem. He said patients should downregulate the use of devices in the evening and some smart phones now have a nighttime setting that removes all the blue light spectrum from the screen. There also options for PCs that function in a similar way.

Other things to advise patients about: sleep in a cold room; don’t eat late; take the alarm clock out of the equation; don’t nap late; avoid caffeine later in the day; and consider the use of melatonin, he said.

Healio Internal Medicine recently reported from Annual Meeting of the North American Menopause Society that sleep duration and quality contribute to CVD risk.

“Short or poor sleep was associated with markers of elevated CV risk,” Rebecca C. Thurston, PhD, professor of psychiatry and director of the Women’s Biobehavioral Health Laboratory at the University of Pittsburgh told Healio. “Sleep may not only be a quality-of-life issue, but also a physical health issue. We need to understand whether improving women’s sleep at midlife improves their CV health.”

W. Clay Jackson, MD, DIPTH, and Cheryl L. Lambing, MD, FAAFP, shared their tips to increase a patient’s activity level.

“I write on a piece of paper. 1. 5. 0. I want you to be active, off of your behind, doing something. 1. 5. 0. A week. You can do 2 ½ hours on Saturday and be sore and curse my name or you can do 22 minutes a day if you want to; you can do 30 minutes five times a week. I do not blank care. I just want you to do 150,” Jackson said.

“When people are feeling overwhelmed with all these things that we are going to throw at them in a 15-minute visit I think exercise should not be looked at as a barrier,” Lambing, said. “One of the strategies I like to use in my clinic is I tell [the patient to] ‘move your body through space for 30 minutes a day and in any way that creates joy for you’ and will increase your heart rate.” – by Joan-Marie Stiglich

Disclosures: The sources reported no relevant disclosures.

References:

Harlan T, et al. Presented at: Cardiometabolic Risk Summit Fall Pre-Conference; Oct. 14, 2016; Las Vegas.