Trouble sleeping? It may be more serious than you think. But there are resources to get you sleeping better than ever.
Everyone has the occasional sleepless night: A thunderstorm, crying baby, or a looming work deadline can all conspire to keep you from getting the sleep you long for. But for some people, the grogginess and irritability that result from a bad night of sleep can evolve into a chronic problem. Sleep disorders—including snoring, severe insomnia and sleep apnea—chip away at a patient’s quality of life and can set the stage for severe health problems if left untreated.
“During the course of our lives, we should be spending about one-third of our time asleep. And that time does not get enough respect,” says Dr. Michael Nolledo, a pulmonologist who is the director of the Institute for Sleep Medicine at Deborah Heart and Lung Center in Browns Mills. “We treat sleep as an afterthought, but good sleep is very important and can really get you so many benefits, starting with better performance at work and at school.”
It can be tough to determine whether your sleepless nights are a short-term nuisance or a sign of a significant problem, but doing so can put you on a path to better health. Here’s a look at some of the most common sleep problems.
The truth about snoring
Snoring provides fodder for many a sitcom writer. On TV, a husband snores, a wife complains, and after a few jokes, the problem is easily resolved.
In real life, men, women and children all suffer from the effects of snoring. It damages the quality of sleep for the person who snores, and whoever may be close enough to be disrupted by the noise. In fact, doctors say that most people who seek medical help for snoring do so at the request of their bed partner.
When a patient first seeks help with snoring or other sleep problems, he or she will receive a thorough checkup of the nose, throat, neck and chest, explains Dr. Scott Schaffer, who serves as the head of Advocare’s ENT Specialty Center in Marlton. “We will also examine them lying down, in order to replicate the sleeping position,” Schaffer says.
He notes that most sleep problems result from a narrowing of the airway, and once doctors can identify why and at what point the airway becomes restricted, they can treat the root cause. Allergies, swollen tonsils and adenoids are primary causes of snoring. Doctors are likely to recommend allergy medication to relieve those symptoms, or antibiotics to cure any infection that may have inflamed the tonsils or adenoids.
Pediatric patients may have their tonsils or adenoids removed. This step cures most young patients of snoring, Schaffer says. Older patients may benefit from losing weight or from surgery, if snoring is caused by an anatomical problem like a deviated septum.
Take your breath away
Snoring may go hand-in-hand with a more severe sleep disorder: sleep apnea. This disorder, also caused by a restricted airway, means that a person stops breathing during sleep for at least 10 seconds at least five times an hour.
Dr. Jonathan Kass, of Cooper University Health Care in Voorhees, says sleep apnea can exacerbate a wide range of other health problems.
“Any issue you have becomes more severe with sleep apnea,” he says. “It can contribute to hypertension, cardiovascular issues, and severe strokes, including risk of death. It makes blood sugar harder to control; it increases memory problems, and heightens the risk of seizures in patients with seizure disorders.”
In the short term, sleep apnea means that every night brings “non-restorative sleep,” he says. The brain wakes the patient up in order to restore the breathing. Patients will wake up feeling as if they haven’t slept at all.
A primary cause of sleep apnea is obesity, because the extra tissue narrows the airway, which in turn stops the patient from breathing. Extra weight creates extra tissue in the body, including at the base of the throat. Many patients with sleep apnea will benefit from losing weight, doctors say. If they cannot lose weight on their own, some may be referred for bariatric weight-loss surgery.
Kass says about 25 percent of sleep apnea patients are not overweight. Some have malformed jaws or low muscle tone through the airway. Schaffer also notes an unusual subset of sleep apnea patients: weightlifters, whose bulky chests inhibit their breathing capacity.
One of the most effective treatments for sleep apnea is a machine known as the C-PAP, for continuous positive airway pressure. The machine provides a steady stream of air, which the patient takes in through a face mask while sleeping.
“The C-PAP works 100 percent of the time,” says Kass. “However, you have to give yourself some time to get used to it, and that requires some patience.”
Schaffer notes that the more severely the airway is restricted, the tighter the C-PAP should fit, although they are adjustable. “It’s uncomfortable for a while, but it will work, and your body will relax, and you can finally get the sleep that will help you feel better.”
Most adults experience an occasional sleepless night. But for some, bouts of insomnia occur so frequently that sleeplessness begins to take a toll on work performance, and if you’ve ever experienced that, you know just how distressing it can be. You may even find yourself dozing off in dangerous situations, such as when you’re driving.
Dr. Kass says “situational insomnia” can generally be pegged to a specific source of stress—an upcoming wedding, pressure at work, or an illness, among others. This type of insomnia generally improves once the stressful situation improves.
If the sleepless nights continue, that may qualify as “chronic insomnia,” he says. It typically has a psychological cause, and in those cases Kass may recommend counseling for his patients to address the stressful issue or cognitive behavior therapy to improve sleep habits.
No matter what you decide to pursue when the day breaks, when facing insomnia during the night, Kass says that it’s generally not helpful to stay in bed. “If you can’t fall asleep in 30 minutes, get up and do something very boring,” he says. “No TVs, no computers, no exciting book. I commonly have patients buy a textbook, and have them read that when they can’t sleep. It doesn't work for everyone but it can help some.”
Setting the stage for better sleep
Minor sleep issues can be improved by making a number of other small changes in the bedtime routine, including the following tips offered by our physicians:
• Limit the use of cell phones and computers in the hours before you intend to fall asleep.
• Don’t eat or exercise immediately before bedtime.
• Drink most of your fluids earlier in the day to reduce the need to use the bathroom in the middle of the night.
“If you have difficulty falling asleep or staying asleep, you need to look at lifestyle factors,” says Nolledo. “Many people are attached to their Smartphone or their laptop, and feel compelled to respond at all times. That creates poor sleep hygiene.”
Schaffer and Kass say a key strategy in improving sleep is to wake up at the same time every day. That means people shouldn’t try to make up for bad sleep one night by sleeping in the next morning. Over time, doctors say, a consistent wakeup time helps the body establish a set schedule for falling asleep.
Staying dedicated to a healthy sleep pattern can have a positive impact in all of your day-to-day activities, doctors say. And with a restful night’s sleep, brighter mornings—and better days—are sure to follow.
Published (and copyrighted) in the Art of Living Well pull-out section of Suburban Family Magazine, Volume 5, Issue 6 (August, 2014).
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