Sleepless in Swindon - man who slept 14 minutes a night enters land of nod

· Doctors diagnose worst case of sleep apnoea in UK
· Machine to keep airways clear 'changed my life'

For almost two decades, Philip Skeates woke up dog tired, even though he had just spent a good 12 hours in bed. He would get up for breakfast, then stagger back to bed until noon. By eight at night he was nodding off.

Eventually his wife persuaded him to seek medical help. Her husband, 39, was completely exhausted, and she was suffering too.

To the amazement of experts, he was diagnosed with one of the worst cases of sleep apnoea - a condition that causes the airways to close - that had ever been seen in Britain.

It meant that Skeates stopped breathing every 40 seconds or so during the night. He would briefly wake up, without properly regaining consciousness, and then fall back to sleep. And the process would begin over again.

Doctors estimated Skeates was only actually sleeping for a few seconds at a time, and for less than 15 minutes in total every night. "Every day I would get up feeling exhausted," he said. "I couldn't concentrate and I was ratty with my family. I couldn't understand it because I would fall asleep in my chair by 8pm and not get out of bed for 12 hours. But in fact I was hardly getting any sleep at all. It was miserable for me and it just wasn't fair on my family."

He finally visited his GP because his snoring - an effect of the condition - was so loud that his wife, Lisa, 40, a teaching assistant and their three children, were kept awake. She also became alarmed at how quiet and still her husband became in between the bouts of loud snoring.

Skeates was referred to the Great Western hospital near the family home in Swindon, Wiltshire, where his sleep was monitored and the results were startling.

Doctors found he stopped breathing 90 times an hour. "The doctors said it was one of the worst cases they had ever seen," he explained. "I was really only getting 14 minutes of sleep."

Happily, Skeates is now getting a good night's rest for the first time since the early nineties. The hospital arranged to have a continuous positive airway pressure machine installed at Skeates's home. It contains an oxygen mask and tube which he must wear while he sleeps. The equipment forces air into the lungs and keeps the airways clear.

His snoring stopped instantly and within weeks he was feeling refreshed after just seven hours of sleep. He has lost weight and is learning to love life again.

Skeates said: "This has changed my life. The very first night I had it I noticed a difference the next morning. Now I wake up in the morning feeling so much more refreshed."

Professor John Straddling, consultant chest physician at the Churchill hospital in Oxford, said there were around 300,000 sufferers of sleep apnoea in Britain though only about one in five is diagnosed.

He said: "Many GPs and primary care trusts are unwilling to diagnose sleep apnoea although it has a horrendous impact on these patients' lives. This affects us all. Undiagnosed patients cost the NHS a lot of money as they get older, and the condition affects us all in the form of road accidents."

Lisa Skeates said the cure had "reawakened" their marriage. "It's been wonderful. Phil is so much more energetic and cheerful. For 17 years the snoring got worse and worse until it was like sleeping next to a pneumatic drill. It was horrendous.

"At most, I would get a couple of hours sleep, and I'm a teacher so it was terrible. The children sleep upstairs and they could hear it through the floorboards. I tried earplugs and sometimes, when it was really bad, I would go and sleep on the sofa just to get a bit of rest.

"Now we have a laugh together again and we're also able to do things as a family which we never did before because he was always so tired. I've also been able to have a good night's sleep for the first time in years."

FAQ: Sleep apnoea

What is sleep apnoea?
It's a relatively common condition that occurs when breathing stops or gets shallow during sleep, with pauses lasting for 10 to 20 seconds or more

Who gets it?
According to the British Snoring & Sleep Apnoea Association, it occurs in around 4% of men but is very rare in women

What are the symptoms?
People with apnoea often do not know they have problems breathing at night. They tend to snore loudly (though not everyone who snores has sleep apnoea) and not feel rested when they wake

Are there different types?
The most common form is obstructive sleep apnoea, where not enough air flows into the lungs, causing blood oxygen to fall. When normal breathing returns, it usually starts again with a loud snort or choking sound. Another form is central sleep apnoea, a neurological condition that stops all breathing during sleep. A person with this form is normally woken by an automatic breathing reflex, so ends up getting very little sleep

How dangerous is it?
Besides tiredness, if left untreated, sleep apnoea can increase the risk of high blood pressure, heart attacks or stroke

Can it be cured?
In most cases, it can be treated with a device that keeps a person's airways open during the night using a flow of pressurised air into the throat. There are also drugs that can help. Milder cases can be treated with a slight change in lifestyle: avoiding alcohol or muscle relaxants can help. Losing weight and quitting smoking is also suggested. Sleeping at a 30-degree

 

NOISE RAISES BLOOD PRESSURE IN SLEEP - STUDY

Intrusive noise such as aircraft, traffic, or a snoring partner, causes blood pressure to rise even as we sleep, new research has shown.

Scientists made the discovery after monitoring 140 sleeping volunteers at their homes near Heathrow and three other major European airports.

They found that participants’ blood pressure went up noticeably after a “noise event” - a sound louder than 35 decibels.

Typical causes were passenger jets flying overhead, traffic passing outside, or snoring.

Aircraft noise produced an average increase in systolic “heartbeat” blood pressure of 6.2 millimetres of mercury (mmHg).

Diastolic pressure, the pressure between beats, was raised by 7.4 mmHg. Similar blood pressure rises were triggered by other noise sources such as traffic.

Blood pressure went up in direct relation to noise loudness, said the researchers, writing in the European Heart Journal.

For every five decibel increase in aircraft noise at its loudest point there was a 0.66 mmHg increase in systolic blood pressure.

The type of sound, or its origin, did not appear to be important. It was volume that mattered.

Dr Lars Jarup, one of the study authors from Imperial College London said: “We know that noise from air traffic can be a source of irritation, but our research shows that it can also be damaging for people’s health, which is particularly significant in light of plans to expand international airports.

“Our studies show that night-time aircraft noise can affect your blood pressure instantly and increase the risk of hypertension (high blood pressure).”

He said it is “clear” that new measures need to be taken to reduce noise levels from overhead aircraft, especially at night.

The new research followed recent findings by the same scientists which associated high blood pressure with living near an airport or under a flight path.

Residents who lived in one of these locations for at least five years were far more at risk of developing high blood pressure than those with quieter surroundings.

The study, published in the journal Environmental Health Perspective, showed that an increase in night-time aircraft noise of 10 decibels raised the risk of high blood pressure by 14% in both men and women.

High blood pressure, defined as a reading of 140/90 mmHg or more, is a known risk factor for heart disease, stroke, kidney disease and dementia.

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March 2008

Regularly getting 5 hours or less of shut eye a night does not appear to have a considerable influence body weight or waist size over time, according to  findings from a long-term study of British workers.

While some past research has identified a relationship between obesity and a lack of sleep, this research could not affirm which came first -- the lack of sleep or the weight problem.

To clarify whether lack of sleep over time might be related to obesity, Francesco P. Cappuccio and colleagues analyzed information from more than 10,000 white-collar British civil servants participating in a long term forward-looking study called the

Whitehall II study.

The men and women were first had their health assessed between 1985 and 1988 when they were between 35 and 55 years old. They were subsequently assessed every two years thereafter.

Cappuccio, of the University of Warwick Medical School, in Coventry, England, and colleagues analyzed nightly sleep duration and indicators of obesity among 5,021 of the study participants during the 1997 to 1999 assessment.

In this assessment, the investigators identified a 65 percent increased risk of obesity among people sleeping less than 5 hours a night compared with those sleeping 7 hours nightly.

But when they looked at measures of body weight and waist circumference again between 2003 and 2004 among 3,786 of these men and women who were not obese during the earlier assessment, they found no significant association between sleep duration and  future changes in body weight or waist circumference.

Taken together, these findings suggest that short duration of sleep might represent a risk marker as opposed to a causative factor for obesity, the researchers conclude in the latest issue of the American Journal of Epidemiology.

SOURCE: American Journal of Epidemiology,

February 2008

With late-night TV watching, Internet surfing and other distractions, Americans are getting less and less sleep, the U.S. Centres for Disease Control and Prevention said on Thursday.

And all this sleeplessness can be a nightmare for your mental and physical health, CDC experts cautioned, calling sleep loss an under-recognized public health problem.

Sleep experts say chronic sleep loss is associated with obesity, diabetes, high blood pressure, stroke, cardiovascular disease, depression, cigarette smoking and excessive drinking.

The CDC surveyed 19,589 adults in four states. Ten percent reported they did not get enough sleep or rest every single day of the prior month, and 38 percent said they did not get enough in seven or more days in the prior month.

The CDC survey was conducted in New York, Hawaii, Delaware and Rhode Island, asking people how many days in the prior month they got insufficient rest or sleep, without asking specifically how many hours they slept.

But the CDC released nationwide data collected separately showing that across all age groups, the percentage of adults reporting sleeping six hours or fewer a night increased from 1985 to 2006.

The National Sleep Foundation recommends adults get seven to nine hours of sleep a night. Children ages 5 to 12 should get nine to 11 hours and those 11 to 17 need 8-1/2 to 9-1/2 hours.

 

SLEEP IS VITAL

"At night, we're doing everything except for sleeping - we're on the Internet, we may be watching TV.  With these new lifestyles we have kind of taken sleep for granted as something that we can do when we have time or we can catch up on it on the  weekends," CDC behavioral scientist Lela McKnight-Eily, who led the study, said in a telephone interview.

"We don't realize that sleep is a vital part of overall health and that chronic sleep loss is related to both physical and mental health issues," she added. "It's getting worse."

Darrel Drobnich, National Sleep Foundation chief executive officer, added that several thousand people die on U.S. roads yearly in accidents involving drowsy drivers.

"Americans are definitely sleep deprived. They don't get the amount that even they say that they want," Drobnich said.

The CDC said 50 to 70 million Americans suffer from chronic sleep loss and sleep disorders in a country of 300 million.

The CDC four-state survey found that younger adults are more likely than older adults to report getting too little sleep. It also found overall that 30 percent of respondents said they got enough sleep every day of the past month, and 33 percent got  too little on one to six days in the prior month.

Lela McKnight-Eily urged people who often get too little sleep to see a doctor to see whether lifestyle issues are to blame or whether they might have a sleeping disorder. People can also try to establish a regular sleep schedule and avoid caffeine or other stimulants before bedtime, she added.  (Editing by Maggie Fox and Sandra Maler)