Sleep deprivation seen as health threat

By ALYSSA HARVEY aharvey@bgdailynews.com | Jan 17, 2017 | BGDailyNews.com

When it comes to sleep, many people aren’t getting enough.

The American Sleep Association said 37 percent of 20- to 39-year-olds report short sleep duration. Forty percent of 40- to 59-year-olds report short sleep durations.

The ASA reported 35.3 percent of adults report less than seven hours of sleep during a typical 24-hour period. The ASA said 100,000 deaths occur each year in U.S. hospitals because of medical errors, and sleep deprivation has been shown to be a significant contributing factor.

There are more than 80 sleep disorders that a sleep specialist can address, said Dr. Michael Zachek, Graves-Gilbert Clinic director of the Physicians Center for Sleep Disorders. The clinic has six sleep specialists who assist primary care doctors in dealing with sleep problems.

The most common sleep disorder is obstructive sleep apnea, Zachek said.

“Typically there’s a complaint that the husband or wife is snoring and stops breathing or a complaint that they’re extraordinarily sleepy during the day. It affects their job and daily living,” he said. “It’s particularly troubling in Kentucky. Many people in this region have been gaining weight.”

Zachek diagnoses sleep apnea, which is seen more often in overweight patients, with a home sleep apnea test.

“Frequently a patient can begin treatment on the date of diagnosis,” he said. “The most common treatment is the CPAP, an automatic device that learns the patient’s breathing and adjusts to the patient. It prevents blockages from occurring.”

Patients may opt for a mandibular advancement device, which is something a dentist makes, Zachek said.

“It holds the jaw forward, pulling the tongue out of the back of the throat,” he said.

Sometimes surgery is used for sleep apnea, but most patients prefer to try different things first, Zachek said.

“Children can have large tonsils and adenoids. The University of Louisville found that children have poor performance in school and decreased learning ability,” he said. “You want to alleviate that by removing their tonsils and adenoids. Sometimes we use medication to relieve nasal obstruction.”

Insomnia is difficulty getting and staying asleep or feeling like sleep is not restorative, Zachek said.

“Insomnia affects up to one-third of the entire population at some time during our lives,” he said. “It can be caused by trauma, the loss of loved ones, changing jobs or other situations.”

Many people have difficulty with insomnia because they’ve developed bad habits about sleep, such as reading or watching television in bed, sleeping at odd hours, staying in bed too much and drinking caffeine too late in the day, Zachek said.

“Caffeine lasts in the body for eight to 13 hours. If you take it in after the noon hour it may keep you up,” he said. “It may cause frequent sleep interruptions.”

Insomnia is usually short-lived and doesn’t need medical attention, Zachek said.

“It can be treated with sleep aids for a short period of time. Physicians don’t usually like to treat it with pills long, as they don’t work as well as treating patients with behavioral modifications,” he said. “We can educate them on how to sleep more normally with cognitive behavioral therapies for insomnia. Patients can keep those habits with them life-long.”

Adolescents are susceptible to sleep phase delay, Zachek said.

“Teenagers want to stay up late and sleep late. It’s part of the maturation process,” he said. “Unfortunately, that can cause problems in school as children have difficulty getting to sleep and are still sleepy during the first and second period. The University of Kentucky demonstrated that starting school at a later start time reduced the number of accidents of kids going to school.”

Treatment includes making sure children get out of bed at the same time every morning and exposing them to bright light in the morning, but avoiding bright light in the evening, Zachek said.

“Treat them with regularization of sleeping habits,” he said. “Avoid bright light from screens you’re staring directly into.”

Tips to get to sleep

Tri-Star Greenview Regional Hospital Respiratory Supervisor Tuyen Trinh, a licensed sleep therapist, said sleep deprivation can cause other health problems.

“Every time you stop breathing, your heart is pumping harder,” she said. “It can lead to high blood pressure and stroke.”

Headache and fatigue are symptoms of not having enough sleep, Trinh said.

“People cover it up with caffeine when the body is telling you, ‘I need your help.’ Everyone wants to do more, but we can’t,” she said. “We just keep on until something stops us in our tracks. It’s hard for use to shut down, especially with electronics. We’re expected to perform 24 hours a day.”

Sleep deprivation is widespread, Trinh said.

“We don’t have to wait for anything,” she said. “Every time we shut our eyes we think there’s some reason we should be awake.”

Greenview lets people check out an RUSleeping device, a small sleep monitor with a cannula that tells how many times you stop breathing during sleep. Then they bring it back and get their results.

“You wear it all night and bring it back,” Trinh said. “You will be scared at how much you’re not sleeping.”

RUSleeping isn’t a gold standard, though, Trinh said.

“Once you find out, you should follow up with your primary care doctor to see if you should have a sleep study,” she said.

There are behavioral modifications people can use to make sure they get enough sleep, Trinh said. For instance, power down cellphones, tablets, televisions and digital clocks.

“Cover them up. Shut them down,” she said. “You’re not going to miss anything. It’s there.”

Trinh had other tips to help people get more sleep.

•It’s OK to take a 20-minute nap, but do it early. To overcome a nap, take a short walk, drink a glass of ice water or call a friend.

•If sleep positioning is an issue, there are some ways to get comfortable. For back pain, get a leg pillow and tuck it under your knees. For a good position in bed, you have to have the right pillow. Align the nose with the center of the body if you sleep on your side.

•Allergens may be a problem. Use an air-tight dust cover to prevent that. Seal your mattress.

•Save the bed for sex and sleep only.

•Keep the temperature of the room between 68 and 72.

•Set you body clock. Go to bed and wake up at roughly the same time every day, including weekends.

•Regular exercise helps you sleep better, but avoid it three to four hours before bed.

•Finish eating at least one hour before bed. Don’t eat heavy or big meals before you go to bed.

•Alcohol may initially make you sleep, but you’ll end up all night using the bathroom. Warm milk and some tea products are a better choice.

•Avoid tobacco products. Like caffeine, nicotine is a stimulant and can keep you awake.

•Keep pets off the bed. They can make your sleep cycle short.

•Dim you lights two or three hours before bed. Use 15-watt bulbs to read. Studies have shown any light you have on when you sleep can affect sleep, even smoke alarm lights.

•When you feel like your mind is constantly running, jot everything down and your mind will let go. When you’re writing it down, you’re assured you won’t forget it.

•Illnesses such as depression and acid reflux or medication can keep people from sleeping. Know when to see your doctor.

Everyone needs good sleep, Trinh said.

“Sleep is a big issue that needs more attention than what we give it,” she said. “We all have some type of sleep issue, but it’s undiagnosed.”

The Medical Center Sleep Center

The Medical Center Sleep Center is in the Riverside Building at 825 E. Second Ave. It is accredited by the American Academy of Sleep Medicine. Some of the disorders it treats include restless leg syndrome, insomnia and narcolepsy. It also works with children with issues such as night terrors, bed wetting and teeth grinding as well as other things that can affect children.