BY DURDANA ALI MALIK
Unlike what most people believe, sleeping is not just a lazy pastime. It is an active state essential for mental and physical restoration. Recent studies on sleep disorders have shown that a significant number of people of all ages fail to get a good night sleep.
And to complicate matters further (giving the rest of us sleepless nights!) at least 84 sleeping disorders have been identified, which interfere with ones quality of life and personal health. These include problems with staying awake or staying asleep with an irregular sleep-wake cycle, sleep-walking, bed-wetting, nightmares, insomnia, restless legs syndrome, snoring and sleep apnea syndrome.
Some sleep disorders are potentially fatal.
Talking to Dr Atiq ur Rehman, Head of the Department of Neurology at the Fatima Memorial Hospital, Shadman, where the latest sleep lab was inaugurated I learnt about some crucial facts listed below.
Sleep Apnea Syndrome:
It is the most common sleep disorder. Sleep Apnea is a condition in which breathing stops and starts during sleep. It is usually associated with snoring. This makes it one of the most common medical disorders that the adult population suffers.
This can affect anyone, but tends to be more common in overweight people. Almost all Sleep Apnea patients are regular snorers. It affects more males than females, but with women fast bridging the lifestyle gap, it wont be long when they will be sharing equal numbers. It is also more common in people as they get older.
The Sleep Apnea syndrome refers to people with Sleep Apnea at night who, consequently, also have excessive daytime drowsiness, which prevents them from performing their daytime tasks with an acceptable level of responsibility and concentration.
Do I have it?
There is no way to be certain without detailed testing whether someone has Sleep Apnea. However, the following signs and symptoms or a combination of these should alert a person and his physician to the possibility of Sleep Apnea syndrome.
— Unusual sleep during the day and snoring at night
— Told by spouse or partner that his/ her snoring is interrupted by periods when he/ she does not breath properly
— Despite sufficient sleep, feeling un-fresh in the morning
— Waking up several times at night for no particular reason
— Memory or construction problems that are not easily explained
— Daytime fatigue
— Excessive daytime sleep
Excessive daytime sleepiness is a frequent complaint with potentially severe consequences including impaired job performance, automobile accident and a reduced ability to enjoy the pleasure of life. Daytime sleepiness can be a symptom of an undiagnosed medical disorder.
Insomnia is the inability to fall asleep or to stay asleep. Poor sleep during the night can be a serious problem in itself and can result in decreased wakefulness, concentration and performance during the day.
Sleep-walking and related symptoms:
Walking, talking, screaming and performance of other behaviours in sleep are important symptoms which are too often ignored. Sleep-walking presents a danger of accidental injury and, furthermore, can be a sign of medical illness or psychological stress.
Narcolepsy is characterised by inappropriate irresistible daytime sleep attacks. In this case, patients do not get normal night sleep or extended and daytime sleep attacks.
What sort of investigations can be done for these sleep disorders?
Several different types of investigations may be performed. First some routine blood tests might be ordered to check the blood hemoglobin -.oxygen level and carbon dioxide. There are several other tests that may or may not be ordered depending on how severely a physician feels that a particular patient is affected. These tests might include X-rays of the chest, neck or sinus heart investigation such as ECG, and Echocardiogram. Ultimately, if it is suspected that a patient has a significant sleep disorder, some detailed evaluation of their breathing status at night will be required. This might vary from an oxygen monitoring device that can be worm at home to a complete overnight sleep study referred to as POLYSOMNOGRAPHY. This is performed in a sleep laboratory.
What is polysomnography?
Polysomnography consists of the simultaneous recording of several physiological variables. This involves monitoring of several body functions with electrodes that are attached to the surface of the body; usually sleep studies are performed during the night to see the clinical changes and correlate them with EEG recordings. The entire sleep study facilities are now available at the Fatima Memorial Hospital, Shadman.
GUIDELINES FOR GOOD SLEEP:
— Get up about the same time every day, even if its a holiday
— Go to bed when you are sleepy, sounds obvious, but adults often fight sleep as badly as toddlers do, by continuing to watch TV, talk or browse!
— Establish relaxing pre-sleep rituals, such as a warm bath, a light bedtime snack or 10 minutes of reading
— Exercise regularly. If you exercise vigorously, do this at least 6 hours before bedtime. Mild exercise such as simple stretching or walking should be done at least 4 hours before bedtime
— Maintain a regular schedule. Regular times for meals, bedtime etc.
— Do not eat drink anything containing caffeine within 6 hours of bedtime. Avoid drinking alcohol
— Avoid smoking close to bedtime
— If you take naps, try to do so at the same time every day. For most people, a mid afternoon nap is most helpful.
— Avoid sleeping pills or use them conservatively. Most doctors avoid prescribing sleeping pills for a period of longer than 3 weeks. Never drink alcohol while taking sleeping pills.