Saturday 22 October 2016

HEALTH MATTERS: Don’t let sleep disorders keep you up at night

By Dr David Cohn

  Do you have a hard time falling asleep? Do you often wake up in the middle of the night? Do you feel tired during the day?
   Good sleep is essential to good health. Sleep disorders such as sleep apnea, insomnia, or restless legs syndrome can ruin a good night’s sleep and lead to a number of health problems.
   If you find yourself having difficulty falling asleep or sleeping through the night, or feel tired in the day despite getting an adequate amount of sleep, you may have asleep disorder.
   The Sleep Centre at University Medical Centre of Princeton, which is accredited by the American Academy of Sleep Medicine, provides a full-range of services to diagnose and treat sleep disorders in adults and children.
   Your daily health and performance are linked to your quality of sleep.
   You might think of sleeping as “down time,” but the fact is your brain remains active during sleep, and passes through several sleep stages. Certain sleep stages help ensure you have energy and are alert the next day. Without passing through the sleep stages, your reaction times when awake can be slow. Your focus, memory, and decision-making skills can be compromised, too.
   A number of chronic diseases and conditions such as diabetes, cardiovascular disease and obesity are linked to sleep disorders. Lack of adequate sleep can contribute to the onset of these diseases, and make them hard to treat.
In addition, lack of sleep can affect your mood. Of course, people tend to be irritable if they don’t get enough sleep, but continued lack of sleep can contribute to chronic depression or other mood disorders.
   The National Institute of Health (NIH) estimates that 40 million adults in the United State have a sleep disorder, most commonly insomnia, sleep apnea or restless legs syndrome.
   One of the most common sleep disorders is insomnia. When insomnia strikes, you may have trouble falling asleep or staying asleep. You might be up all night, or up too early in the morning.
   Sleep apnea is another common sleep disorder, affecting 12 million to 18 million U.S. adults, according to the NIH.
   Your breathing may stop while you sleep, or become very shallow. Sometimes you may not breathe for up to 60 seconds at a time, and breathing pauses may occur more than once every minute.
   The most common type of sleep apnea is obstructive — your airways become blocked, obstructing your breathing. When the airways reopen, you may snort or make choking sounds.
   People with sleep apnea also tend to snore loudly. However, snoring in and of itself does not mean you have sleep apnea.
   Additionally, restless legs syndrome is a common disorder that causes you to want to move your legs. An achy or creeping feeling may be present. Restless leg syndrome can make falling asleep and staying asleep difficult.
Signs you may have a sleep disorder include:
   • Difficulty falling asleep, consistently taking 30 minutes or more
   • Repeatedly waking up in the night, with difficulty falling back asleep
   • Waking up too early
   • Sleepiness in the day, frequent naps or nodding off
   • Being told you make sounds when you sleep: loud snoring, snorting, gasping, or choking sounds
   • Waking with a feeling of breathlessness or heart racing
   • Being told you stop breathing for short periods while you sleep
   • Uncomfortable sensations in your legs at night that interfere with sleep
   • Leg twitches or other abnormal movements during sleep
   A sleep study is typically the first step in diagnosing a sleep disorder. Because most people aren’t aware of their breathing or movement when sleeping, conducting a sleep study can help identify problems.
   A polysomnography test can assess your brain waves, your blood oxygen level, your heart rate and breathing, as well as eye and leg movement. Your sleep stages are monitored and any disruptions are noted.
Polysomnography is a painless and noninvasive test, usually performed overnight at a sleep centre. The measurements help doctors diagnose sleep disorders. For example:
   • Brain wave measurements can show exactly when sound sleep is disrupted
   • Blood oxygen levels, heart rate and breathing rate can reveal sleep apnea
   • Leg twitches or other abnormal movements that disrupt sleep can be observed
   All of these disorders are treatable, with solutions ranging from changing your sleep habits, to medication, to a device known as a CPAP to improve breathing during sleep.
   For patients who are unable to spend the night at a sleep centre, home sleep studies are often available.
   Although sleep needs vary by person, research indicates that most adults need at least seven to eight hours of quality sleep each night. The NIH estimates that one-third of Americans get fewer than seven hours of sleep nightly.
For a good night’s sleep, try these tips:
   • Have a sleep schedule — go to bed at the same time every night and wake up at the same time each morning
   • Make your sleep area dark and relaxing
   • Use your bed only for sleeping, not for reading or watching TV
   • Get rid of distractions in the bedroom, such as gadgets and electronic devices
   • Avoid large meals before bed
      Make time for relaxation before you go to sleep
   • Avoid naps after 3 p.m.
   • Avoid caffeine and nicotine throughout the day
   • Avoid alcohol before bed
   Good sleep is essential for your health and well being, and sleep disorders are treatable. With proper diagnosis and treatment, you can sleep soundly.

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