Sleep Disorders take a huge toll on your health - Sleep Apnoea FAQ

Most mornings, Don Moser would wake up as tired as if he had never gone to bed.  But it wasn’t until his wife prodded the 55-year-old warehouse supervisor to go to a doctor about his snoring that he found out why.  

Moser was diagnosed with sleep apnoea, a condition in which Moser’s breathing would be choked off as he slept, forcing his body to rouse itself so he could breath again.  

Without knowing it, the Mount Hermon man woke up as many as 600 times a night.

Moser’s condition is one shared by 18 million groggy people in this country (USA).

But sleep apnoea is not the only thing turning America into a nation of sleepyheads.

There are 84 recognized sleep disorders - from insomnia, to teeth-grinding to leg twitching - that keep us tired.

There is shift work and a 24/7 lifestyle that just seems to have less room for sleep.

And parenthood, which has us running from soccer to school plays to violin lessons and anxious nights wondering how we will pay for everything.

Just how sleepy are we?

Witness the fact that before Thomas Edison invented the light bulb, Americans slept an average of 10 hours a night, according to the National Sleep Foundation.

Now we sleep an average of 6.9 hours a night.  In fact, the National Institutes of Health estimated some 70 million people in the United States have some kind of sleep problem.  All of which wouldn’t seem too bad unless you consider the consequences of inadequate sleep.  Heart disease, diabetes, obesity, traffic and workplace accidents, and even road rage have been attributed to sleep problems. The Chernobyl nuclear plant disaster, for instance, was the fault of sleepy shift workers.  And when scientists deprived rats of sleep, they found that the animals, who normally live two to three years, died in about three weeks.  

Although, obviously, no similar study has been done in humans, it does serve as a kind of rodent wake-up call, letting us know that maybe grabbing ZZZs is more important than we think.

Luckily, there are ways to do just that.

·       "I’m so tired, I haven’t slept a wink.

·       "I’m so tired, my mind is on the blink."

·       "I’m So Tired," by The Beatles

Dr. Aaron Morse’s Santa Cruz office looks like a combination medical clinic and Best Western motel.  Four rooms sit off the main hallway, each outfitted with a comfortable bed covered in a flowered spread and curtains at the windows.

It’s here that Morse, a pulmonologist, does his work.  "Commonly, I’ll hear people say, ‘I sleep six or seven hours, and I feel more tired when I wake up than when I went to bed,’" says Morse, a thin, athletic-looking man with greying hair.  

They fight nodding off in front of the computer at work and fall asleep the minute they sit down to watch TV.  That may not be normal tiredness, Morse says.

It may be a sign of a sleep disorder.  Among the more common disorders are restless leg syndrome in which prickly, crawling sensations keep sufferers awake, and insomnia which leaves people begging for shut-eye.  But one of the most common - and dangerous - disorders is sleep apnoea, according to Morse.  

A person with sleep apnoea will try to breathe, creating a suction that collapses their windpipe.  Air flow stops, the sleeper’s blood oxygen level falls and the brain responds by waking the sleeper enough to activate the upper airway muscles and open the windpipe.  

Often, the sleeper does not even realize they have been awakened.  Sleep apnoea can lead to morning headaches, fatigue and concentration problems.  But the more dangerous side effects include being at a higher risk for stroke, heart attacks and high blood pressure, Morse says.  In addition, people with sleep apnoea are four to seven times more likely to get into a traffic accident.  

At Morse’s clinic, tired patients will either take a sleep monitor home or head into one of the four sleep study rooms for a night.  There, they will be hooked up to a machine that monitors brain waves, eye movements, oxygen levels, heart rate, respiration and leg twitches, while a sleep technologist monitors their sleep.  

If a person suffers from sleep apnoea, the treatment can be as easy as having them lose weight or learning to sleep on their side, or as complicated as surgery.

But the most effective treatment is the use of a Continuous Positive Airway Pressure (CPAP) machine which sends a steady stream of air into a sufferer’s nose to keep his or her throat from becoming blocked.

At low pressure, the device feels like a refreshingly cool breeze. At higher pressure, it’s like sticking your head out a car window at 50 mph.  

For Dr. Nick Niven, one of Morse’s patients, getting used to the machine took a little work - at first, he says, the headgear felt like he was wearing an Inca mask.

But when Niven woke up feeling refreshed the first day after using the machine and found himself still energized in the afternoon, he was a convert.

"Some people say they have a love-hate relationship with the CPAP machine," Morse says, "but the mask is almost always effective."

·       “Now I lay me down not to sleep.”

·       “I just get tangled in the sheets.”

·       “Who Needs Sleep?" by the Barenaked Ladies”

When Dr. Allison Chan goes out to dinner parties, everybody wants to talk about insomnia with her.  That’s because Chan is part of the prestigious Stanford Sleep Clinic, and insomnia is something most people know about.

Some 60 million Americans have insomnia frequently or for extended periods of time, according to the National Institutes of Health.  But almost all of us have experienced a few nights of frustrating clock-watching.

The majority of people who have chronic insomnia have a predisposition to it, according to Chan.  But it is usually some event - a death in the family, a divorce or an illness - that starts the sleeplessness rolling.  

For those first nights, insomnia is a normal response to trauma, but after awhile people start becoming anxious.  They will lay in bed watching the clock and tapping their fingers, willing sleep to come.  

"Habits will develop which perpetuate the insomnia," Chan says. "So it goes from an acute episode to chronic insomnia."

And who is more likely to suffer from insomnia?

According to a study by the National Sleep Foundation, women who have children in the household are those who report more insomnia symptoms.  Insomnia also tends to increase with age, according to the National Institutes of Health.

The best treatment for chronic insomnia is not sleeping pills, but cognitive behavioral therapy, Chan says.  

"It helps people effectively manage insomnia for the long term," she says.

"Wake up little Susie, wake up."

"Wake Up Little Susie" by the Everly Brothers

If you think sleep problems are only for adults, you’re wrong.  More than two-thirds of children reported having sleep problems, according to a 2004 study.  

Kids can get sleep apnoea, according to Morse, who has an entire family outfitted with CPAP machines.

There is also some evidence sleep apnoea may be misdiagnosed as Attention Deficit Hyperactivity Disorder, according to Morse.

"When kids get sleepy, they often get hyper," Morse says.  To some it may look like ADHD.

Teenagers and college students also are at risk for sleep problems.

About 7 percent of adolescents develop something called delayed sleep phase syndrome, Morse says.

"It’s a resetting of the circadian clock," Morse says.  "The body doesn’t let you sleep until 2 or 3 in the morning."  That’s a fine schedule if you’re an artist or a freelance computer programmer, but if you’re a teenager and have to be at school by 8 a.m. that can be a problem.  Ditto for college students.

Add to that the pressure of term papers and tests, the allure of late-night chat rooms and parties - a 24/7 life fuelled by energy drinks like Red Bull and espressos - and it may be even harder to fall asleep.

Then, the off-kilter sleep schedule, Morse says, "is like a permanent case of jet lag."

And after years of that kind of living, sleep behaviours may be hard to undo.

·       "I lit out from Reno, I was trailed by twenty hounds

·       "Didn’t get to sleep last night until the morning came around."

·       "Friend of the Devil" by the Grateful Dead

"Why do we sleep at all?" asks Morse.  "The question is: Why do we need to be awake?"

Sleep is still something of a mysterious function, but it appears to serve a number of purposes.  

Some studies show sleep deprivation hurts the immune system, and others suggest sleep is necessary for our nervous systems to work properly, according to the National Institutes of Health.

In children and teenagers, growth hormones are released during deep sleep.  And cell damage from things like stress and ultraviolet light seems to be repaired better during deep sleep, making the term "beauty sleep" appear to be true.  

And obesity is associated with sleep deprivation.  A sleepy person may not feel like exercising which results in weight gain - a vicious cycle since obesity is one of the factors in sleep apnoea.  There also is some evidence that not getting enough sleep causes a reduction in the amount of growth hormone which increases the chance of weight gain.  

Deep sleep may also help people function better emotionally.

All of which is a good enough reason to make sleep a priority in your life - even if you weren’t impressed by the statistic that sleep deprivation and disorders cost Americans over $100 billion in lost production, medical expenses, sick leave and property damage each year, according to the National Sleep Foundation. 

Which leads sleep doctors like Morse and Chan to recommend that you tell your physician about sleep problems you have? 

And that you value your sleep.

"Generally we ask people if they’re sleepy and what do they do about it?" says Marcia Stein, a spokesman for the National Sleep Foundation which puts out regular sleep surveys.

Their answers?

They just keep on with their daily lives.

To contact the Central Coast Sleep Disorders Center, call + 1-465-0586.  The Stanford Sleep Disorders Clinic is at + 1-650-723-6601 or www.stanfordhospital.com.

Contact Peggy Townsend at ptownsend@santacruzsentinel.com.

Sleep FAQs

 

How much sleep do we need?

Generally, infants require about 16 hours a day while teenagers need about nine hours.  Adults need about seven to eight hours of sleep each night, although some people can get by on as little as five.

Do older people need less sleep?

People tend to sleep more lightly and for shorter time spans as they age, even though they need about the same amount of sleep they did when they were younger.  Since older people sleep less at night, they may take naps in the daytime.  The change may be a normal part of aging or may result from medications and medical problems.

How much do we dream?

On average, we spend about two hours a night dreaming with most of our vivid dreams occurring during what is called REM sleep.  REM sleep is an active sleep where our heart rate and respiration fluctuate, but our bodies - except for our eyes and diaphragms - are paralyzed.  If something interferes with this paralysis, people may physically act out their dreams.

Can you cheat on the amount of sleep you get?

Getting too little sleep creates a ‘sleep debt,’ which can be hard to repay.  While we may get used to a schedule that doesn’t include a lot of sleep, it will catch up with us in health problems like obesity, high-blood pressure, irritability and being prone to accidents.

How do we know if we’re sleep deprived?

Interestingly, some people have gone so long without getting the right amount of sleep; it’s hard for them to tell exactly how tired they are.  But if you feel drowsy during the day even during boring activities; if you routinely fall asleep in front of the television; if you find yourself unable to stop yawning while driving; and if you wake up feeling tired, you may be sleep deprived.

What are symptoms of sleep apnoea?

Waking up tired, waking up with a headache, snoring, feeling sleepy all the time, being irritable and having problems with concentration may be symptoms of sleep apnoea.  Gasping for breath while sleeping and snoring also may be signals of sleep apnoea.

What problems do shift workers face?

Because those who work at night are at odds with sleep-regulating cues like sunlight, they often find themselves drowsy while at work. Shift workers have an increased risk of heart problems, digestive disorders and emotional problems. More accidents and mistakes also happen among shift workers. One study found medical interns on the night shift are twice as likely as others to misinterpret hospital test records.

Source: National Institutes of Health and the National Sleep Foundation

Tips for a good night’s sleep

 

·       Go to bed at a set time each night and get up at the same time each morning - even on weekends.

·       Try to exercise 20-30 minutes per day, but not right before you go to bed. For maximum benefit, exercise five or six hours before bedtime.

·       Avoid caffeine, which acts as a stimulant, and alcohol, which robs you of crucial REM sleep.

·       A warm bath taken about 90 minutes before bed helps you sleep by causing a drop in body temperature, which brings on sleep.

·       Set up a regular routine to wind down before bed.

·       If possible, wake up with the sun, which helps the body’s internal biologic clock reset itself each day.

·       An hour of exposure to morning sunlight will help you sleep better at night.

·       If you can’t get to sleep, don’t lie in bed. After 20 minutes, get out of bed and read a book, listen to soothing music or watch television until you are sleepy.

·       Maintain a comfortable temperature in your bedroom. Too hot or too cold may disrupt your sleep.

Source: National Institutes of Health USA.