Brevard Haynes, MD: Sleep Specialist
TOPIC: Sleep Awareness
Monday, December 19, 2011
Kelly Carden, MD: Sleep Specialist
News notes provided by webmd.com
How much do you know about sleep disorders? Review these statements and learn which are true and which are not.
Health problems have no relation to the amount and quality of a person's sleep.
False: More and more scientific studies are showing correlations between poor quality sleep and/or insufficient sleep with a variety of diseases, including high blood pressure, diabetes, and depression. For example, insufficient sleep can impair the body's ability to use insulin, which can lead to the development of more severe diabetes. Patients with poorly controlled diabetes and sleep apnea have improvement of blood sugar control when treated for sleep apnea. This is also found in patients with high blood pressure and sleep apnea. When the sleep apnea is treated, the blood pressure also improves. In addition, too little sleep may decrease growth hormone secretion, which has been linked to obesity.
Older people need less sleep.
False: The average adult needs a total sleep time of seven to nine hours per day. While sleep patterns usually change as we age, the amount of sleep we generally need does not. Older people may sleep less at night due, in part, to frequent night waking, but their need for sleep is no less than that of younger adults.
Snoring can be harmful.
True: Aside from bothering other people, snoring is not harmful. However, it can be a sign of sleep apnea, a sleep disorder that is associated with significant medical problems such as cardiovascular disease and diabetes. Sleep apnea is characterized by episodes of reduced or no airflow throughout the night. People with sleep apnea may remember waking up frequently during the night gasping for breath.
You can "cheat" on the amount of sleep you get.
False: Sleep experts say that most adults need between seven and nine hours of sleep each night for optimal health. Getting fewer hours of sleep will eventually need to be replenished with additional sleep in the next few nights. Our body does not seem to get used to less sleep than it needs.
Teens need more sleep than adults.
True: Teens need at least 8.5 to 9.25 hours of sleep each night, compared to an average of seven to nine hours each night for most adults. The internal biological clocks of teenagers can keep them awake later in the evening and can interfere with waking up in the morning.
Insomnia is characterized only by difficulty falling asleep.
False: One or more of the following four symptoms are usually associated with insomnia:
Daytime sleepiness means a person is not getting enough sleep.
False: While excessive daytime sleepiness often occurs if you don't get enough sleep, it can also occur even after a good night's sleep. Such sleepiness can be a sign of an underlying medical condition or sleep disorder such as narcolepsy or sleep apnea.
Your brain rests during sleep.
False: The body rests during sleep, not the brain. The brain remains active, gets recharged, and still controls many body functions including breathing during sleep.
If you wake up in the middle of the night and can't fall back to sleep you should get out of bed and do something.
True: If you wake up in the night and can't fall back to sleep within about 15-20 minutes, get out of bed and do something relaxing. Do not sit in bed and watch the clock. Experts recommend going into another room to read or listen to music. Return to bed only when you feel tired.
Getting too little sleep may impact weight.
True: How much a person sleeps at night can impact their weight. This is because the amount of sleep a person gets can affect certain hormones, specifically the hormones leptin and ghrelin, that affect appetite. Leptin and ghrelin work in a kind of "checks and balances" system to control feelings of hunger and fullness. Ghrelin, which is produced in the gastrointestinal tract, stimulates appetite, while leptin, produced in fat cells, sends a signal to the brain when you are full. When you don't get enough sleep, it drives leptin levels down, which means you don't feel as satisfied after you eat, and increases ghrelin levels, stimulating your appetite so you want more food. The two combined can set the stage for overeating, which in turn may lead to weight gain.
Are You Getting Enough Sleep?
The amount of sleep a person needs depends on many factors, including age. For example, in general:
However, experts say that if you feel drowsy during the day, even during boring activities, you haven't had enough sleep.
The amount of sleep a person needs also increases if he or she has been deprived of sleep in previous days. Getting too little sleep creates a "sleep debt," which is much like being overdrawn at a bank. Eventually, your body will demand that the debt be repaid. We don't seem to adapt to getting less sleep than we need, while we may get used to a sleep-depriving schedule, our judgment, reaction time, and other functions are still impaired.
Too little sleep may cause:
The Dangers of Sleep Deprivation
Many studies make it clear that sleep deprivation is dangerous. Sleep-deprived people who are tested by using a driving simulator or by performing a hand-eye coordination task perform as badly as or worse than those who are intoxicated.
Sleep deprivation also magnifies alcohol's effects on the body, so a fatigued person who drinks will become much more impaired than someone who is well rested.
Driver fatigue is responsible for an estimated 56,000 motor vehicle accidents and 1,500 deaths each year, according to the National Highway Traffic Safety Administration. Since drowsiness is the brain's last step before falling asleep, driving while drowsy can -- and often does -- lead to disaster. Caffeine and other stimulants cannot overcome the effects of severe sleep deprivation.
The National Sleep Foundation says that if you:
you are probably too drowsy to drive safely.
Insomnia is itself often a symptom of other problems. Typical patterns of insomnia include the inability to fall asleep or stay asleep at night, waking up earlier than usual, and daytime fatigue. Most people with insomnia don't fall asleep in inappropriate situations, like driving. If this does occur, it may signal that a medical disorder (such as sleep apnea) is the cause of insomnia.
Excessive daytime sleepiness is the primary symptom. Some people will deny sleepiness but feel fatigued. Other symptoms are snoring, snorting, and gasping sounds when you sleep -- often first noticed by a sleeping partner. Restless or unrefreshing sleep is also typical, as are headaches in the morning.
Excessive sleepiness during the day, alleviated by naps, is a symptom of narcolepsy. Dreaming during naps and experiencing dream-like hallucinations as you fall asleep are also warning signs. Loss of muscle control (called cataplexy) that occurs with emotion, such as laughing or anger, and the inability to move as you're going to sleep or waking up (called sleep paralysis) are also symptoms.
Restless Leg Syndrome
The primary warning sign is the irresistible urge to move your legs shortly after you get into bed, in the middle of the night after awakening, or even when wide awake during the day. It usually feels better if you get up to walk around or rub your leg. "Creepy-crawly" or twitching feeling in your calves, feet, thighs, or arms are symptoms of restless leg syndrome -- the sensations of discomfort can be quite varied. Kicking or twitching leg movements during sleep, and sometimes while awake, may be warning signs.
There are two types of insomnia: primary insomnia and secondary insomnia.
Insomnia also varies in how long it lasts and how often it occurs. It can be short-term (acute insomnia) or can last a long time (chronic insomnia). It can also come and go, with periods of time when a person has no sleep problems. Acute insomnia can last from one night to a few weeks. Insomnia is called chronic when a person has insomnia at least three nights a week for a month or longer.
Acute insomnia may not require treatment. Mild insomnia often can be prevented or cured by practicing good sleep habits (see below). If your insomnia makes it hard for you to function during the day because you are sleepy and tired, your health care provider may prescribe sleeping pills for a limited time. Rapid onset, short-acting medications can help you avoid effects such as drowsiness the following day. Avoid using over-the-counter sleeping pills for insomnia since they may have undesired side effects and tend to lose their effectiveness over time.
Treatment for chronic insomnia includes first treating any underlying conditions or health problems that are causing the insomnia. If insomnia continues, your health care provider may suggest behavioral therapy. Behavioral approaches help you to change behaviors that may worsen insomnia and to learn new behaviors to promote sleep. Techniques such as relaxation exercises, sleep restriction therapy, and reconditioning may be useful.
Sleep apnea is a serious sleep disorder that occurs when a person's breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times.
There are two types of sleep apnea:
Sleep apnea can affect anyone at any age, even children. However, risk factors for sleep apnea include:
If left untreated, sleep apnea can result in a growing number of health problems including:
In addition, untreated sleep apnea may be responsible for poor performance in everyday activities, such as at work and school, motor vehicle crashes, as well as academic underachievement in children and adolescents.
Sleep Apnea Treatments
Sleep apnea treatments range from conservative measures -- such as losing weight if you are overweight or changing sleep positions -- to surgery.
In mild cases of sleep apnea, conservative therapy may be all that is needed. Conservative approaches include:
Continuous positive airway pressure -- also called CPAP -- is a treatment in which a mask is worn over the nose and/or mouth while you sleep. The mask is hooked up to a machine that delivers a continuous flow of air into the nostrils. The positive pressure from air flowing into the nostrils helps keep the airways open so that breathing is not impaired. CPAP is considered by many experts to be the most effective treatment for sleep apnea.
Dental devices can be made that help keep the airway open during sleep. Such devices can be specifically designed by dentists with special expertise in treating sleep apnea.
There are minimally invasive office procedures -- such as the pillar palatal implant, somnoplasty, and injection snoreplasty -- that are designed to reduce and stiffen the soft tissue of the soft palate. While these procedures have been effective in treating snoring, their long-term efficacy in treating apnea has not yet been determined.
10 Tips FOR BETTER Sleep
We all have trouble sleeping from time to time. But you can make it easier to get a good night's sleep every night with these simple steps.
Some people find relief in making a list of all the stressors of the day, along with a plan to deal with them this can act as "closure" to the day. Combining this with a period of relaxation perhaps by reading something light, meditating, aromatherapy, light stretching, or taking a hot bath can also help you get better sleep. And don't look at the clock! That "tick-tock" will just tick you off.
Also, try not to drink fluids after 8 p.m. This can keep you from having to get up to use the bathroom during the night.