What does it mean to get a good night’s sleep? It means getting enough of it and waking up feeling refreshed.
I think we can all agree that when we do not sleep well, our lives — most noticeably, our work, schooling, parenting and driving — suffer. If we lose enough sleep, our health can seriously suffer, as well.
How much sleep we need and get depends on our age and time in our life. Most adults require seven to nine hours of sleep per night; teens need a little more.
Parents of newborns (and of new drivers), menopausal women experiencing night sweats, workers on-call and people who are ill or taking medication might wake several times per night. The lucky ones fall back to sleep easily, but not everyone is lucky.
According to the National Sleep Foundation, one-fourth of the population regularly doesn’t get enough sleep. My experience supports this figure.
Every day in my clinic, I see patients with sleep issues. From chronic lifelong
By Priya Oolut, M. D.
insomnia to bizarre dream enactment, many of my patients are anxious about the night and falling asleep.
Sleep anxiety builds over time. Eventually, the original issue is no longer the initial cause of sleep disturbance but rather the anxiety itself.
Take, for example, a young mother I saw several months ago. She had 3-year-old and 6-year-old children. Her difficulty staying asleep began when the children were infants. She would wake up to feed them around 2 or 3 a. m. and then had difficulty falling back asleep. As her kids grew and they began to sleep through the night, she was unable to break the cycle of waking at that time.
Another example is a man who came to me because if he did not get help with his sleep, his wife was going to divorce him. Several times a month, he would wake up screaming and punching at nonexistent objects. Sometimes, his wife would be that object.
She was tired of being hurt, so she began to sleep in another room. This action weighed heavily on their relationship and on the patient. He began to associate nighttime with loneliness and anxiety. We discovered he had a disease called REM-behavior disorder.
When patients come to a see a sleep specialist they are often at their wits’ end. My job as a sleep physician is to identify the underlying disorder or triggers and to break down barriers to treating them.
For instance, many people with insomnia (trouble falling asleep) begin thinking of themselves as insomniacs and resist change. It can take weeks or months to fix the situation, but with the help of relaxation, biofeedback (control of one’s bodily function through monitoring of brain waves, blood pressure and muscle tension) and new sleep habits, it can be done.
Note that sleep medications are rarely the first line of therapy as they tend to mask, rather than treat, the problem.
Sometimes, physicians need objective data about what is happening during sleep and will order a sleep study. In the sleep lab, the patient is observed through the use of various diagnostic equipment, which will aid in the development of an effective treatment plan.
While this can seem like the worst situation for someone who has difficulty sleeping anyway, our goal is to pinpoint exactly what the disturbance is that is causing restless sleep.
The most common problem is sleep apnea, a condition in which the airway closes many times at night. I have seen patients who stop breathing up to 120 times per hour!
Besides interfering with sleep, apnea can also lead to long-term health problems such as heart attacks, high blood pressure and strokes. I tell my patients that having sleep apnea is as dangerous as having high blood pressure or diabetes and must be treated.
REM-behavior disorder and sleep apnea are just two of many sleep disorders that can cause a great deal of stress in a person’s life. Other problems include leg movements at night, seizure activity or dream enactment. Some people sleep too much.
With proper diagnosis and treatment, however, patients can go on to better manage their sleep disturbances and disorders.
If you are experience sleeping difficulties, take it seriously — and know there’s hope. Make an appointment with your physician right away to discuss what treatment option is best for you.
PRIYA OOLUT, M. D., is a board-certified physician in internal medicine, pulmonary disease, critical care medicine and sleep medicine at Pacific Medical Centers. Pacific Medical Centers (www.PacMed.org)has locations in Beacon Hill, First Hill and Northgate.