Sleep disorders can be prevented with lifestyle changes

Kendra Stiles

MANHATTAN, Kan. (U-WIRE) — In the United States, an estimated 55 million people have trouble sleeping or have some sort of sleep disorder, cardiopulmonary experts at Manhattan, Kan.’s Mercy Regional Health Center said.

Sleep apnea

More than 80 different sleep disorders exist, but obstructive sleep apnea syndrome is the most common. The word ‘apnea’ is Greek for “without breath,” according to the American Sleep Apnea Association’s Web site. Obstructive sleep apnea syndrome is a disorder caused by the narrowing of the opening in the back of the throat, said Don Hedden, cardiopulmonary director at Mercy Regional.

“Obstructive sleep apnea occurs when you have brief periods of time where you stop breathing at night,” he said. “It happens because the air passage at the back of the throat is partially blocked.”

When the air passage is obstructed, the brain senses an extra effort to breathe, and this disruption causes the person to wake up. After waking, the person’s air passage clears, taking the extra stress off the brain, which leads to the person quickly falling back to sleep, Hedden said. This disorderly cycle can occur hundreds of times in one night, but it is uncommon for the person to remember any of it.

Hedden said the muscles in the throat naturally relax when we sleep, and it is normal for the air passage to narrow. However, it is a cause for concern when the obstruction is so severe a person stops breathing during the night.

“The main cause for concern with sleep apnea is not that it keeps a person from sleeping the whole night through,” he said. “It causes harm to other parts of your body, so that’s why it’s important to get it treated.”

Diana Fritz, registered respiratory therapist and sleep technologist at the Mercy Regional sleep lab, said sleep apnea keeps a person from getting enough deep sleep. The rapid-eye-movement phase and stages three and four of the sleep cycle are when we get deep sleep, and those with sleep apnea get little to none of it. We typically spend 50 percent of the night in stage two of the sleep cycle,” she said. “Twenty-five percent of the night should be spent in the REM stage and 20 percent should be spent in stages three and four. However, those who have sleep apnea get hardly any, and that’s why they’re so tired during the day.”

Fritz said more than 1,500 fatalities per year and 100,000 accidents per year occur because of sleep apnea and other sleep disorders. Twenty-four hours without sleep is equivalent to a blood alcohol level of 0.93.

“There was recently a court case in Salina (Kansas) where a truck driver had sleep apnea but stopped his treatment,” Hedden said. “He fell asleep while driving, crossed the median and killed a mother and her 10-month-old baby. He’s now facing charges for manslaughter.”

Fritz said untreated sleep apnea can cause several severe health problems, including high blood pressure, heart attack, stroke and depression. The main effect of sleep apnea is loss of oxygen to the brain, which causes the heart to work harder. The heart tries to compensate for the lower level of oxygen and, in turn, puts itself under extra stress, which leads to more severe medical conditions. Sleep apnea also has been linked to diabetes and attention-deficit hyperactivity disorder in children, narcolepsy and insomnia.

Hedden said narcolepsy and insomnia are disorders most people are familiar with, but they are actually much less common than sleep apnea.

Insomnia occurs when someone has difficulty falling and staying asleep. Narcolepsy is when one uncontrollably falls into deep sleep.

“Insomnia is a transient thing most of the time,” he said. “It’s usually self-limiting, and it resolves itself naturally. True cases of narcolepsy are almost rare, and the consequences are less significant except for the person with the disorder.”

Insomnia and narcolepsy also have less of an effect on the rest of the body, Hedden said, and most of the cases treated in the sleep lab involve sleep apnea. Both disorders are less of a cause for concern for doctors than apnea because of the dangers apnea can cause for others as well as the person with the disorder.

Snoring

Those who do not have sleep apnea often are affected in less traumatic ways. Fritz said snoring is often a tell-tale sign of sleep apnea, but not everyone who snores has the disorder.

“Snoring is not supposed to happen,” she said. “It’s not natural. A lot of times, a bed partner of the person who snores will be concerned and try to get that person to seek medical treatment. The soft tissue in the back of the throat collapses, and the tongue moves to the back, so sometimes snoring is just a result of that.”

Treatment

Hedden said Mercy Regional’s sleep lab usually treats 10 to 12 patients per week. Patients come in and stay for the night while lab technologists monitor their sleep.

Lab techs attach a series of sensors to the head and legs of patients and sensory belts across their chests.

The sensors feed information about brain activity, eye movement, heart rate, muscle tone, oxygen level and the breathing rate into a polysomnograph, which records everything for lab techs to examine.

Patients who appear to have sleep apnea are treated with a Continuous Positive Airway Pressure mask, which they wear when they go to bed. CPAP, as the treatment is called, helps open the back of the throat by feeding a steady stream of pressurized air through the nose.

“CPAP is the primary treatment we offer for patients who have sleep apnea,” Fritz said. “Other options are surgery or an oral appliance from the dentist. It’s a hard plastic mouthpiece, which pulls the lower jaw forward and causes the back of the throat to be bigger.”

Fritz said sleep disorders have been a problem in the past, but people are more aware of them now than ever before.

The sleep-aid industry is growing rapidly, and prescription drugs such as Ambien and Lunesta are appearing all over the market.

“I think people are finding out that this really is a big problem,” she said. “Until everybody hears about it, that’s the way it’s going to be. We’re actually in the middle of a big marketing project right now.” However, Fritz said prescription drugs usually are not the answer for anyone who has a significant sleep disorder.

“You have to sleep seven to eight hours for one of those drugs to work,” she said. “If you sleep less than that, it will cause you to fall asleep later, because you’ll still be tired. I’ve seen recent studies with some of the prescription sleep aids, and they actually cause more sleepwalking, talking, eating and driving.”

Sleep Hygiene

Though millions of people have sleep disorders, Fritz and Hedden both said they usually can be prevented by exercising, eating right, practicing good “sleep hygiene” and staying healthy in general.

Hedden said middle-aged people are more likely to develop sleep disorders, so young people should take care of themselves now.

To practice good sleep hygiene, Hedden said people should avoid caffeine, alcohol and cigarettes before bed, try to stay on the same sleep schedule and turn bedtime preparations into a ritual. Obesity often leads to sleep apnea; therefore, exercising and eating right also are important.

“Most of the time, it’s not a disorder,” Hedden said. “It’s what we do to ourselves. The way we take care of our bodies now will affect our health years down the road.”

Staying on a consistent sleep schedule can be tough, especially for college students who often have to stay up late studying. However, Fritz said occasional breaks in the habit won’t interfere too much. Daytime naps are OK for the most part, but sleeping too long encourages grogginess and the need for more sleep. Twenty-minute power naps are usually the best cure for afternoon sleepiness.

“You need to give your body what it wants, which is a long, consolidated sleep pattern,” Hedden said, “or else you won’t get the quality of sleep you’d get otherwise.”

Kendra Stiles

Kansas State Collegian