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Living Healthy -- Common Medical Q&As;
  Sleep: You Need it for Good Health

In a recent study, 40% of adults claimed to be so sleepy during the day that they had difficulty accomplishing their daily activities. According to Antoine Badlissi, MD, a pulmonologist at Caritas Carney who directs the sleep service, many people don't realize that sleep-the amount and the quality-is critical to how they function during their waking hours.  Badlissi answers some questions about sleep.

Q. Why is sleep such a hot topic?

A. As a society, we're not getting enough sleep.  The major sleep disorders-sleep apnea, which affects abou 8% of adults, insomnia, restless legs syndrome and REM behavior disorder-all rob people of a healthy night's sleep. But most people ignore thier symptoms and go on feeling miserable. We have become a 24-hour society, and sleep is being held hostage.  If we have to do something, whether it's related to our work or our social life, we steal an hour from our sleep.

Q. What happens when someone doesn't get enough sleep?

A. Their productivity decreases, their behavior is affected, and their overall health may suffer. Sleep apnea puts people at risk for high blood pressure.  Thousands of motor vehicle accidents occur each year as a result of people falling asleep at the wheel. The Exxon Valdez accident is a good example of how a sleep-deprived individual can cause a public health disaster.

Q. What causes sleep apnea?

A. It is caused by the airway in the throat becoming blocked or collapsing during sleep. As a result, people snore loudly and actually stop breathing, sometimes for as long as a minute.  In some individuals, this bockage is due to anatomy, such as throat structures that are too large. But often sleep apnea results because the muscles in the throat and neck relax too much-something that can occur when an individual is overweight or drinks too much alcohol before bedtime. The main treatment is CPAP, which stands for continuous positive airway pressure, in which the person wears a mask over the nose or mouth that blows enough air to prevent the throat from collapsing during sleep.

Q. Is snoring by itself a problem?

A. Snoring by itself is not a problem except for the person whose sleep is being disrupted. Spouses of snorers, on average, get approximately one hour less sleep per night than a person who's not sleeping with a snorer. So, while snoring doesn't necessarily mean the person has sleep apnea, the heavier the snoring is, the greater the chance that sleep apnea is the cause. If someone who snores wakes up in the morning and doesn't feel refreshed, that individual probably has sleep apnea. 

Q. What happends during a sleep study?

A. First we ask the individual to complete a sleep questionaire, which helps us to understand the problem and the role lifestyle factors might play.  Then the person spends the night in the sleep lab, where all aspects of sleep are measured, including oxygen level, brain waves, eye movement, snoring, etc.  The sleep lab is located in a quiet part of the hospital and is quite comfortable.  Dr. William DiBassio, a neurologist, and I review the findings and send them to the patient's primary care physician along with treatment recommendations and/or referral to a specialist.

Q. Do naps have a role to play?

A. People in Europe and many other places feel they do. A short afternoon nap or siesta is probably fine for most people; studies have shown that naps do increase productivity. But a long nap--a half-hour or more--can disrupt the ability to sleep at night.  So for some people, a nap might not be good.

Q. When should someone seek help for a sleep problem?

A. If you are nodding off during the day--in meetings, in church or while you are driving--there is a good chance that you are sleep-deprived, and this is a problem. Many people don't see this behavior as a problem, but it is. You should see your primary care physician, who can decide if you need treatment or perhaps a sleep study, which can lead to a definitive diagnosis. If your physician decides to refer you, contact the Caritas DoctorFinder, and they will schedule a sleep evaluation.