7 Ways Summer Can Wreck Your Sleep

Summer can wreck your sleep in ways you may not expect: hotter nights and longer daylight to travel, jet lag, alcohol, caffeine and changes in your daily routine can all play a role. 

In this episode of Baptist HealthTalk, sleep medicine physician Dr. Edward Mezerhane explains how these seasonal disruptions can interfere with your body’s natural sleep cycle and leave you feeling exhausted even after a full night in bed. He also clears up common melatonin myths, including why taking more does not necessarily it'll work better, and why timing matters. 

You’ll learn practical ways to cool your bedroom, protect your sleep schedule and recognize when poor sleep may signal an underlying sleep disorder. Listen now to discover seven ways summer can wreck your sleep and what you can do to wake up feeling restored.

Host:
Anthony Gonzalez, M.D.
Chief of Surgery, Baptist Health Baptist Hospital
Medical Director of Bariatric Surgery, Baptist Health

Guest:
Edward Mezerhane, M.D.
Sleep Medicine Physician

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The Science Behind Sleep and its Connection to our Health

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Transcript

SPEAKER_02 0:00

We can negate the fact that, well, summer months are the summer months, and you know, after that, right? Some of these difficulties may go away. But if you see persistent issues with, I never wake up restored, I never wake up refreshed, I didn't get a full battery charge. I feel beat up. I feel worse when I wake up in the morning than when I went to bed after having supposedly slept six, seven, eight hours, right? Um, that's a sign that maybe something's going on.

SPEAKER_00 0:22

Welcome to Baptist Health Talk, a podcast on all things healthcare powered by Baptist Health South Florida, your trusted source for healthcare prevention and wellness.

SPEAKER_01 0:32

Hello, I'm your host, Dr. Anthony Gonzalez. Welcome back to a new episode of Baptist Health Talk, where we answer your most searched questions on trending health topics. Well, summer is in full swing, and let's be honest, a lot of us are staying up later, traveling more, and tossing and turning through hotter nights. All of that can really mess with our sleep. So today we're diving into what actually happens to your body when heat, extra daylight, disturbed routines, and sleep supplements all collide. And more importantly, what can you do about it? So we're waking up refreshed all summer long. We are joined today by Dr. Edward Messerhane, sleep medicine physician. Thank you for being here, Ed.

SPEAKER_02 1:19

Tony, thank you for having me and happy to be here in the Baptist Health Studios talking anything and everything, sleep. All righty.

SPEAKER_01 1:25

So why does summer seem so challenging for sleep in these summer months?

SPEAKER_02 1:31

Absolutely. So being in South Florida, you know the topic here, it's hot, hot, and even hotter, right? And so when you dysregulate body temperature, it can dysregulate your melatonin levels, and that alters your sleep, right? And so the heat, the humidity, the longer days, all that plays in with your circadian cycle, which is our body's sleep rhythm. And that dysregulates our melatonin levels, right? And so that can alter our sleep during the summer.

SPEAKER_01 1:55

And so how does the heat affect our ability to fall asleep and stay asleep as well?

SPEAKER_02 2:00

Yeah. So many people don't recognize that there's many signals that happen for us to fall asleep, right? So there's about four or five things that have to happen for us to be able to fall asleep. The first thing is sunlight goes down, right? So now it's the summer, it's later and longer days, right? So that can alter, and that's the first step. So the sunlight has to go down for our body to get into the ribbon of sleep. The second signal is the social signal, right? You're going to sleep, the next person's going to sleep in my house, everybody's going to sleep. So it must mean that it's time for me to go to sleep. Third, your body temperature has to drop. Obviously, the hotter it is, the hotter your internal body temperature, and the longer it takes for the body temperature to drop. Once you reach below that critical set point in your body, in your core body temperature, your melatonin levels can rise. And melatonin is a natural hormone that our brain produces to signal us to sleep, right? So if I delay sunlight, if I delay everybody else going to sleep, if I delay the drop in my core body temperature, I'm going to delay my melatonin release and I'm going to delay myself falling to sleep. And that's the physiology, or that's what happens inside our body. And so these are some of the changes that we see during the summer months.

SPEAKER_01 3:08

All right. So you started off talking about the hot, hot, hot, especially in South Florida. What are some practical ways that we can keep cool so people can have a better night's sleep?

SPEAKER_02 3:17

Absolutely. So this starts basically by keeping a cool temperature inside your house and specifically inside your bedroom, right? So one of the things that I like to implement is already by four, five, six o'clock in the afternoon, we start cooling down the house, right? It sets that mood, it sets the temperature. And many people don't realize we have to set our temperature probably into the mid-60s or high 60s here in South Florida to combat not only the heat, but to get our body in the right mood for sleep, so to speak. And so uh that's one of the things that we need to do. There's also a lot of technological stuff that we can have in our house now, right? Nest thermostats for the rooms and specific to certain areas of the house, uh, a lot of these cooling beddings and sheets that are available, uh, all these things help set the mood and set the body temperature right for sleep.

SPEAKER_01 4:01

And so all summer travel often will throw off your sleep schedule as well. So what happens with that summer travel?

SPEAKER_02 4:08

Yeah. So summer travel, what typically happens is let's say, first of all, we're staying in the same time zone. Well, we're traveling. So we're out and about. We're typically more physically active, right? We're exploring a new city, and so we're burning more energy, we're increasing our core body temperature, we may be out with family, we may be drinking specifically alcohol, and and all these things will dysregulate our circadian cycle. If you add on top of that, the fact that many people travel to Europe and now you're changing time zones, specifically when you change more than two or three time zones, you add the jet lag component, right? And that then dysregulates our body's internal clock to the clock of where we're at in that new time zone, right? And so all these factors combined the alcohol, the late days, increased physical activity, the entertaining and engaging with other people. And if you have jet lag on top of that, it will work to dysregulate and and affect your sleep.

SPEAKER_01 4:57

So let's let's focus on that jet lag. You mentioned the jet lag. So how is it exactly how does the jet lag confuse our internal body clock?

SPEAKER_02 5:05

Yep, absolutely. So so again, typically you have to cross at least two or three time zones for that to be a significant issue, right? The first thing I tell my patients it's it's harder to travel east than it is to travel west. Okay. So the reason for that is you have to think about when you travel to Europe, right? So when we travel to Europe, typically it's at least a six hour time, five to six, sometimes seven hour time change, right? So when it is six p.m. here, it's midnight over there, right? And so it's harder to get there and stay up later into the night, right? And so what I tell my patients a lot of times, if if you're gonna be able to travel for an extended period of time, we want to start adapting your schedule before you leave. Traveling west is easier because it's hard it's easier for us to delay our time for sleep. So it's harder for us to say, okay, it's 6 p.m. here in Miami. When I get to Spain, it's midnight, right? But I'm not sleepy and tired because for me it's 6 p.m. So it's harder for me now to push to you know, say 6 a.m. in Madrid when it's midnight here in Miami, right? So traveling west is easier because we can typically end up staying up later. It's easier for us to do that, right? So I tell my patients if you're gonna travel and you're gonna be there for an extended period of time, we can work to fix your schedule leading into the trip and coming back from the trip. However, if you're going for three or four days, it's very hard to fix that, right? So what I tell my patients is stay hydrated, avoid caffeine, avoid excessive alcohol, and you know, sort of not hope for the best, uh, but but stick to your routines as much as you can. And, you know, when you get back into your regular time zone, you'll get back into your to your regular.

SPEAKER_01 6:43

Well, you mentioned uh Europe. And obviously in Europe, here as Americans, we're used to bringing that air conditioning way down. You mentioned into the 60s, but in a lot of European cities and European hotels where we stake, where we stay, the air conditioning is very weak. So what happens to our sleep in that room? Is there anything we can do to compensate for that?

SPEAKER_02 7:02

Yeah, absolutely. And so you're right, right? These cities that are older, that have been around for longer periods of time, that their sort of centroid systems are likely non-existent, and these uh sort of individual systems per room are not strong enough for the heat that they're they're they're feeling. And of course, you know, with some of the climate change that we've seen now, I I know recently in London it was about 108 degrees, right? They're not used to those temperatures and the systems are not built for that, right? And so what I tell my patients is look, you can pack anything portable, portable fans for the rooms, humidifiers or dehumidifiers, anything that can help, uh, any maybe cooling pillow, cooling blanket that you can take with you will help significantly. Wow.

SPEAKER_01 7:38

Okay. So you mentioned already melatonin, and you talked about that. We have an internal melatonin, but obviously melatonin is one of the most popular sleep supplements out there. So, what are some of the biggest misconceptions people have about melatonin?

SPEAKER_02 7:50

Absolutely. So, melatonin is a natural hormone that we all produce. I tell my patients we produce about half to up to one milligram of melatonin, natural endogenous production of melatonin. And so a lot of the misconceptions on it is that I need 10 and 20 and 30 milligrams of melatonin. Okay. So the first thing I say to that is, well, you don't need that much because there's only about five to six milligrams worth of receptors in your brain. So anything more than that is not going to do anything because it's not gonna attach to anywhere in your brain. It's not gonna send a higher signal. Okay. That's the first thing. And then we talk about different levels of melatonin depending on what we're trying to treat, right? So melatonin can be used for circadian rhythm problems, right? Dysregulations in your circadian cycle for jet lag. It can be used for insomnia, it can be used for certain parasomnias or dream enactment behaviors at night. And so depending on what we're trying to treat, we'll indicate the dose. The other thing is, you know, the common misconception that if I get a one milligram bottle melatonin, it has one milligram, right? These supplements are natural and they're not regulated by the FDA, right? They've actually done a study where they took 30 different samples of melatonin, one milligram samples of melatonin, and they found anywhere from 0.2 milligrams up to two milligrams in a one milligram pill melatonin, right? So, so sort of compounds and and natural supplements are what I call the Wild West. There's no regulations. So you want to make sure you try to get something as reputable as possible, right? And so um melatonin, you know, is a safe natural supplement to use under the right indications and for the right condition that you're trying to treat.

SPEAKER_01 9:19

So I guess the recommendation in summary is yes, you can take it to help you sleep. You only need a milligram, maybe take uh and if you take a milligram, you're gonna absorb and have a milligram in your body, or or is it broken down, you know, by the by the intestines, by the gut?

SPEAKER_02 9:34

Yeah, absolutely. So so it's pretty viavailable, right? So once we ingest it and our gut breaks it down, we absorb it, right? Uh the one milligram dose is a dose that we typically use for circadian rhythm, or if I'm trying to shift your clock or for jet lag. And what's very important to that is the timing that you take it, right? So if I'm trying to shift somebody's clock, I may say, well, I want you to take this three hours before bed or six hours before bed, or the desired bedtime is this, so I'm gonna have you take it at this time. For insomnia, the typical dose or the therapeutic dose range is typically between three and six milligrams, right? So I may suggest to my patient get a three milligram tablet, start with one, maybe escalate to two. And then again, I have patients that are taking 20 and 30 milligrams and say, listen, that's not not doing anything, right? So if if six is not doing it, 30 is not going to, right? And so we may have to talk about other treatment options at that point in time.

SPEAKER_01 10:21

All right. So let's talk about another uh common uh belief that a bad night's sleep can ruin the rest of your week.

SPEAKER_02 10:28

Yep. Yep. That's a hot topic, and that's something that I see in my practice every day, right? And when patients have a bad night, well, everybody has a bad night, right? We are humans, and at any point in time in our lives, we can have a bad night. And what I try try to tell my patients is leave it at that. One bad night has no uh uh reproduction or repercussions, right? So you have a bad night, okay, you have a bad day. What happens is patients then overcompensate by over-caffeinating, stopping exercise, stopping their routine, thinking they can't go to work. And it's no, keep your routine and the next night you'll sink up again. And then what happens to a lot of people is one bad night, two bad nights, and then, well, is tonight gonna be bad? And then, well, what if tonight is bad? Tomorrow I have to do this, and I have to sleep tonight. And then if I don't sleep tonight, and and then, but I have to sleep tonight, and then so they're carrying this worry about being able to sleep, they develop a performance anxiety, right? They develop a somnophobia, a fear of sleeping, right? And then all of a sudden, now it's another night, another night, and now you develop a chronic insomnia three, four, six months later, which becomes very hard to get out of. So one bad night is exactly that. One bad night. You have a bad day, you have a better night the next night, and you'll recover, right? So one bad night's not going to ruin your whole week. As long as you adjust appropriately and you compensate and compensate as well. Right. And a lot of that is keeping your routine, right? So I had a bad night. What does the number one people do? Oh, I'll just sleep later. Well, you shot yourself on the foot because now you're messing with your shakadian cycle. Oh, I won't go to work today. Well, now you stay inside the house. Now your body temperatures, your rhythms, your light rhythms are dysregulated. So that can lead to another bad night, right? And um, and then a lot of times it's, well, I need a medication. No, you don't need a medication sleep. You just had a bad night, right? And so, you know, sort of saying, let's stay cool here, let's stay calm, let's stay collected, don't change anything. And the next night or two nights from now, you'll sink back up and you'll be fine.

SPEAKER_01 12:18

Well, you mentioned alcohol and caffeine, and obviously the effect is year-round, but in summer it seems to shift because we're consuming both a lot more. So, what are the changes and the patterns in summer specifically that affect us and hit our sleep differently in the summertime?

SPEAKER_02 12:34

Yeah, absolutely. So let's talk about alcohol first, right? To start that conversation. Alcohol is actually, uh, when you look at it, a sleep inducer, right? So a lot of people will resort to alcohol to fall asleep. And I always say, well, that's a double-edged sword, right? First of all, you know, there's all these other repercussions about alcohol. We'll leave that out of this topic of conversation. It's not really for this. But I will tell you that alcohol is a terrible sleep maintainer, right? So it can maybe help you fall asleep, but you will pay the price in the middle of the night when you metabolize it, right? And so it will maybe help you fall, but now in the middle of night you wake up and you have a rebound insomnia, which means not only you woken up, you're wide awake, right? And so now it's very hard to fall back asleep, right? And so a lot of this middle of night insomnia is attributable to alcohol. And then of course, you know, maybe the kids are out of school, we're getting together some with somebody or family or friends on a Tuesday night, on a Wednesday night, on a Thursday night, things that we wouldn't really do during our normal routines. And all of a sudden now I'm having more and more bad nights, right? So that's the thing with alcohol. As we talk about caffeine, the first thing I tell my patients is we don't know how fast people metabolize caffeine, right? I'm sure you've been out to dinner with a friend or a family member and you see the guy or the family member have a shot of coffee after dinner at 10 o'clock at night. It says, doesn't affect me. I'm gonna go right to bed in half an hour, right? And you say, Well, if I drink a cup of coffee at 12 noon, my night's shot, right? And so caffeine metabolism is very patient and person dependent, right? General recommendations I'll tell my patients is look, no caffeine six to eight hours before your planned bedtime, right? So maybe after lunch, you have a, you know, maybe a little pick-me-up, but really after that, lay low. I don't want to see the 5 p.m. I got home from work, let me take another one or after dinner, right? If it doesn't affect you, well, it doesn't affect you, right? But naturally and normally, I'm gonna say six to eight hours before no caffeine.

SPEAKER_01 14:27

All right. So we've talked about obviously problems with sleeping in the summer, but when should somebody be really concerned, their poor sleep may be a sign of an underlying sleep disorder or another health health issue.

SPEAKER_02 14:40

Yeah, absolutely. And so we can negate the fact that, well, the summer months are the summer months, and you know, after that, right? Some of these difficulties may go away. But if you see persistent issues with, I never wake up restored, I never wake up refreshed, I didn't get a full battery charge, I feel beat up, I feel worse when I wake up in the morning than when I went to bed after having supposedly slept six, seven, eight hours, right? Um, that's a sign that maybe something's going on, right? Sleep fragmentation is a big one, right? I see people wake up three, four, five times a night and said, How is it possible that you go to bed and you can't sleep six hours straight? And people are like, I mean, like, I haven't done that in 20 years. I'm just like, well, hey, right. So, so fragmented sleep, breathing issues at night, like snoring and sleep apneas, uh, fragment uh waking up, insomnias, dysregulation of your of your of your sleep schedule, all that needs to be evaluated if it becomes a persistent issue. And a lot of times what people don't understand about sleep disorders is sleep, obviously, for the most part, it's a nighttime phenomenon, unless you are um working at night and sleeping during the day. But for the most part, sleep is a nighttime phenomena. Well, remember that it's a circadian rhythm, right? Means circa around DN the day. So your body sees sleep actually as a 24-hour phenomena, not as a nighttime and daytime phenomena. So we've programmed ourselves because of historically the industrial revolution and working longer days to sleep in one phase and sleep from you know 10 o'clock at night to six o'clock in the morning, right? Um, but if you don't give your body the right inputs, your body's gonna want to naturally, because it's a kidney rhythm, do it in a 24-hour cycle. So we've learned to condense ourselves and sleep in that nighttime phase, right? But if you have an issue at nighttime, it can affect your night. But it can also affect your day, right? So sleep is a systemic condition as I see it, right? It affects from your hair down to your toes. And and when you don't sleep well at night, it's not only gonna affect your night, likelihood it's gonna affect your day.

SPEAKER_01 16:35

One thing we didn't talk about is the amount of sleep. Yeah. And obviously it depends on the quality. So just give us a brief overview. Does the amount of sleep you need vary by individual, by age? Yep, and uh, and then how do we measure the quality of that sleep?

SPEAKER_02 16:49

Yeah, absolutely. So sleep as a natural part of aging, right? When we see kids, infants, babies, toddlers, they're gonna sleep 14, 15, 13, 12, right? And as we age, we sleep naturally a little bit less. Now, for adults, right? Seven to nine hours is what we have all been trained to say to our patients and discuss with our patients. Recent studies, more in the last two or three years, actually came out and said that probably about seven and a half is sort of the ideal and the perfect, right? And now a recent study, like in the last month, said between seven to seven fifteen is probably what is ideal and perfect, right? Um In other words, no more, no less. Well, so so less than six is dangerous, okay, right? So that's insufficient sleep syndrome. And for the most part, those patients have um um higher rates of disease and conditions and complications and death. Also, interestingly, more than 10 hours a day is not good, right? So these patients are higher risk of disease and complications and and and because maybe these other diseases they're sleeping more. It's hard to understand really why that happens. But less than six is a, you know, red flag. More than 10 is a red flag. Again, seven to nine, but you know, studies are sort of saying um seven, seven and a half is probably what is ideal, right? And of course, that will vary with age. The other common misconception is that as we get older, right? 50, 60, 70, right, we sleep less. The answer to that is that's actually a uh a myth. That's not actually true. We sleep the same as we age, right? As after being an adult, seven to nine hours. What happens is we're more fragmented as we age, but because we have some more natural flexibilities, we're retired or whatnot, we can make up by increasing our time in bed, right? So you'll see older patients will have typically more time in bed to kind of catch up for their sleep fragmentation, but they end up sleeping the same seven hours or eight hours that they've been sleeping pretty much all their life.

SPEAKER_01 18:46

Wow. Incredible. So very helpful. Very helpful. Thank you very much. This has been such a helpful conversation because summer is a season when so many people are traveling and staying up later, dealing with the heat, trying to figure out why their sleep feels off. Thank you for sharing this insight, Ed. Thank you for having me. I appreciate it. So remember, viewers, be sure to hit that subscribe button on our channel right here to keep up with the latest health and wellness information and tips from our experts. You can also find Baptist Health Talk on Apple Podcasts, Spotify, or wherever you listen to podcasts.

SPEAKER_00 19:23

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