You may literally have to add it to your to-do list, but scheduling a good night’s sleep could be one of the smartest health priorities you set. It’s not just daytime drowsiness you risk when shortchanging yourself on your seven to eight hours. Possible health consequences of getting too little or poor sleep can involve the cardiovascular, endocrine, immune and nervous systems. In addition to letting life get in the way of good sleep, between 50 and 70 million Americans suffer from a chronic sleep disorder—insomnia or sleep apnea, say—that affects daily functioning and impinges on health. Consider the research:
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1) Less may mean more. For people who sleep under seven hours a night, the fewer zzzz’s they get, the more obese they tend to be, according to a 2006 Institute of Medicine (IOM) report. This may relate to the discovery that insufficient sleep appears to tip hunger hormones out of whack. Leptin, which suppresses appetite, is lowered; ghrelin, which stimulates appetite, gets a boost.
2) You’re more apt to make bad food choices. A study published in the October 15, 2008 issue of the Journal of Clinical Sleep Medicine found that people with obstructive sleep apnea or other severely disordered breathing while asleep ate a diet higher in cholesterol, protein, total fat, and total saturated fat. Women were especially affected.
3) Diabetes and impaired glucose tolerance, its precursor, may become more likely. A 2005 study published in the Archives of Internal Medicine found that people getting five or fewer hours of sleep each night were 2.5 times more likely to be diabetic, while those with six hours or fewer were 1.7 times more likely.
4) The ticker is put at risk. A 2003 study found that heart attacks were 45 percent more likely in women who slept for five or fewer hours per night than in those who got more.
5) Blood pressure may increase. Obstructive sleep apnea, for example, has been associated with chronically elevated daytime blood pressure, and the more severe the disorder, the more significant the hypertension, suggests the 2006 IOM report. Obesity plays a role in both disorders, so losing weight can ease associated health risks.
6) Auto accidents rise. As stated in a 2007 report in the New England Journal of Medicine, nearly 20 percent of serious car crash injuries involve a sleepy driver—and that’s independent of alcohol use.
7) Balance is off. Older folks who have trouble getting to sleep, who wake up at night, or are drowsy during the day could be 2 to 4.5 times more likely to sustain a fall, found a 2007 study in the Journal of Gerontology.
8) You may be more prone to depression. Adults who chronically operate on fumes report more mental distress, depression, and alcohol use. Adolescents suffer, too: One survey of high school students found similarly high rates of these issues. Middle schoolers, too, report more symptoms of depression and lower self-esteem.
9) Kids may suffer more behavior problems. Research from an April issue of the Archives of Pediatric and Adolescent Medicine found that children who are plagued by insomnia, short duration of sleeping, or disordered breathing with obesity, for example, are more likely to have behavioral issues like attention deficit hyperactivity disorder.
10) Death’s doorstep may be nearer. According to three large studies published in the journals Sleep and the Archives of General Psychiatry, people over age 30 who slept five hours or less per night had approximately a 15 percent greater risk of dying—regardless of the cause—over the periods studied, which ranged from six to 14 years.
If you think that snoring is bad for your health, think again, for a study has suggested that the nocturnal snorts, whistles and wheezes can give you a long and healthy life, particularly if you are elderly.
Researchers in Israel have carried out the study and found that people aged over 65 years who suffer from a snoring -related condition, called sleep apnoea, tend to live longer than those who do not snore.
According to the researchers, this is because short bursts of hypoxia — interrupted breathing — actually have a protective effect on the elderly people by conditioning their cardiovascular system to cope with lack of oxygen.
This means that when oxygen supplies are cut off, as in a heart attack or stroke, the body is better able to cope, they said.
But the study has found that the effects of sleep apnoea do not have the same effect in younger people — in fact, middle-aged men in particular are at a higher risk of heart disease, the Daily Mail paper reported.
The researchers at Technion Institute have based their findings on an analysis of more than 600 elderly people over a period of four years — they found fewer heart-related deaths than in a control group of ‘healthy’ volunteers.
The findings of the study have been presented at a meeting of the European Association for Sleep Research in Glasgow.
Definition:- Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called apneas (Greek: ?p???a (ápnoia), from a- (a-), privative, p??e?? (pnéein), to breathe), lasts long enough so that one or more breaths are missed, and occurs repeatedly throughout sleep. The standard definition of any apneic event includes a minimum 10 second interval between breaths, with either a neurological arousal (a 3-second or greater shift in EEG frequency, measured at C3, C4, O1, or O2), a blood oxygen desaturation of 3-4% or greater, or both arousal and desaturation. Sleepapnea is diagnosed with an overnight sleep test called apolysomnogram.
Clinically significant levels of sleep apnea are defined as five or more episodes per hour of any type of apnea (from the polysomnogram). There are three distinct forms of sleep apnea: central, obstructive, and complex (complex is a combination of central and obstructive) making up 0.4%, 84% and 15% of cases respectively. Breathing is interrupted by the lack of effort in central sleep apnea; in obstructive sleep apnea, breathing is interrupted by a physical block to airflow despite effort. In mixed sleep apnea, there is a transition from central to obstructive features during the events themselves.
Regardless of type, the individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body (sequelae). Symptoms may be present for years, even decades without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.
Many people consider snoring a minor annoyance, but it can signal a potentially serious condition called sleep apnea (temporary interruptions in breathing during sleep).
An article in the June 13, 2001, issue of The Journal of the American Medical Association reports an association between sleep-disordered breathing and a genetic marker called apolipoprotein E ?. The authors speculate that this marker may be one of many genetic factors that make someone susceptible to developing sleep-disordered breathing.
Sleep apnea is disturbed or interrupted breathing during sleep. For those affected by sleep apnea, there can be many temporary interruptions in breathing, each usually lasting about 10 seconds, throughout the sleep period. These interruptions in breathing can occur as often as 20 to 30 times per hour.
Because some of the symptoms of sleep apnea occur during sleep, they may be recognized first by people with whom one shares living quarters.
* Heavy snoring, although not everyone who snores has sleep apnea
* Struggling to breathe during sleep
* Interruption in breathing during sleep followed by a snort when breathing begins again
* Being excessively sleepy during the day
* Falling asleep during activities that require attention and concentration, such as driving, working or talking
If you are experiencing these symptoms, see a doctor; you may have sleep apnea or some other condition that needs medical attention.
Causes of Sleep Apnea:-
* Obstructive— Partial or complete obstruction of the airway, which can be caused by relaxation of the muscles of the throat, soft palate, and tongue during sleep * Central— Problems with signals from the brain that control breathing
For mild cases of sleep-disordered breathing one can
* Sleep on one’s side instead of back
* Avoid drinking alcohol before sleeping
* Avoid using sleeping pills
* Avoid smoking or using other tobacco products
* Lose weight, if overweight
The most common medical treatment for sleep apnea is continuous positive airway pressure (CPAP), which is a therapy that uses pressure from an air blower to circulate air through the nasal passages and upper airway. The patient wears a mask over the nose that is connected to the air pressure hose, and the air pressure is adjusted to keep the airway open during sleep. Other therapies include dental appliances that change the position of the jaw and tongue, and various surgeries to keep the airway open during sleep.
Special situation: surgery and anesthesia in patients with sleep apnea syndrome
Many drugs and agents used during surgery to relieve pain and to depress consciousness remain in the body at low amounts for hours or even days afterwards. In an individual with either central, obstructive or mixed sleep apnea, these low doses may be enough to cause life-threatening irregularities in breathing.
Use of analgesics and sedatives in these patients postoperatively should therefore be minimized or avoided.
Surgery on the mouth and throat, as well as dental surgery and procedures, can result in postoperative swelling of the lining of the mouth and other areas that affect the airway. Even when the surgical procedure is designed to improve the airway, such as tonsillectomy and adenoidectomy or tongue reduction – swelling may negate some of the effects in the immediate postoperative period.
Individuals with sleep apnea generally require more intensive monitoring after surgery for these reasons.
Loud snoring can seriously affect your memory.In what will come as a stern warning for 36 million Indians, American and Indian scientists have for the first time jointly discovered that people with obstructive sleep apnea (OSA) suffer tissue loss in brain regions that help store memory.
The study focused on structures called mammillary bodies – involved with the processing of recognition memory on the underside of the brain.
The team scanned the brains of 43 OSA patients, using MRI to collect high-resolution images of the entire brain, including slices of the mammillary bodies. The structures’ small size makes them difficult to measure by conventional MRI.
When they compared the results to images of 66 control subjects, the scientists discovered that OSA patients’ mammillary bodies were nearly 20% smaller, particularly on the left side.”The findings are important because patients suffering memory loss from other syndromes, such as alcoholism or Alzheimers disease, also show shrunken mammillary bodies,”said lead author Rajesh Kumar, assistant researcher in neurobiology from SGPIMS.
“Our findings, therefore, demonstrate that impaired breathing during sleep can lead to a serious brain injury that disrupts memory and thinking,”said principal investigator Ronald Harper, professor of neurobiology at UCLA.”The fact that patients’ memory problems continue despite treatment for their sleep disorder implies a long-lasting brain injury,”Harper added.
Sleep apnea occurs when a blocked airway repeatedly halts the sleeper’s breathing for 10 seconds, at least five times per hour of sleep. Untreated OSA can cause high blood pressure, ultimately causing heart attacks and stroke. It also increases risk of diabetes, impotency, irregular heartbeats and automobile accidents due to excessive daytime sleepiness.
ENT specialist from AIIMS K K Handa says nearly 60% of those who snore suffer from OSA.”I am not surprised by this finding, especially because OSA reduces oxygenation to brain tissues and the central nervous system. At present in India, even children are suffering from OSA,”Dr Handa added.
Definition Hypersomnia refers to a set of related disorders that involve excessive daytime sleepiness.It is characterized by reoccuring episodes of excessive daytime sleepiness or prolonged nighttime sleep. Different from feeling tired due to lack of or interrupted sleep at night, persons with hypersomnia are compelled to nap repeatedly during the day, often at inappropriate times such as at work, during a meal, or in conversation. These daytime naps usually provide no relief from symptoms. Patients often have difficulty waking from a long sleep, and may feel disoriented. Other symptoms may include anxiety, increased irritation, decreased energy, restlessness, slow thinking, slow speech, loss of appetite, hallucinations, and memory difficulty. Some patients lose the ability to function in family, social, occupational, or other settings.
Description:
There are two main categories of hypersomnia: primary hypersomnia (sometimes called idiopathic hypersomnia) and recurrent hypersomnia (sometimes called recurrent primary hypersomnia). Both are characterized by the same signs and symptoms and differ only in the frequency and regularity with which the symptoms occur.
Primary hypersomnia is characterized by excessive daytime sleepiness over a long period of time. The symptoms are present all, or nearly all, of the time. Recurring hypersomnia involves periods of excessive daytime sleepiness that can last from one to many days, and recur over the course of a year or more. The primary difference between this and primary hypersomnia is that persons experiencing recurring hypersomnia will have prolonged periods where they do not exhibit any signs of hypersomnia, whereas persons experiencing primary hypersomnia are affected by it nearly all the time. One of the best documented forms of recurrent hypersomnia is Kleine-Levin syndrome, although there are other forms as well.
There are many different causes for daytime sleepiness that are not considered hypersomnia, and there are many diseases and disorders in which excessive daytime sleepiness is a primary or secondary symptom. Feelings of daytime sleepiness are often associated with the use of common substances such as caffeine, alcohol, and many medications. Other common factors that can lead to excessive daytime sleepiness that is not considered hypersomnia include shift work and insomnia. Shift work can disrupt the body’s natural sleep rhythms. Insomnia can cause excessive daytime sleepiness because of lack of nighttime sleep, and is a separate disorder.
Causes and symptoms:Hypersomnia can be caused by genetics (heredity), brain damage, and disorders such as clinical depression, uremia and fibromyalgia. Hypersomnia can also be a symptom of other sleep disorders such as narcolepsy, sleep apnea, and restless leg syndrome.
People who are overweight may be more likely to suffer from hypersomnia. This can often exacerbate weight problems as excessive sleeping decreases metabolic energy consumption, making weight loss more difficult.
Another possible cause is an infection of mononucleosis, as several instances of hypersomnia have been found to arise immediately after such an infection (Dr. Givan, MD, Riley Hospital).
In some instances, the cause of the hypersomnia cannot be determined; in these cases, it is considered to be idiopathic hypersomnia.
Hypersomnia may also occur as a side effect of taking certain medications (i.e some psychotropics for depression, anxiety, or bipolar disorder).
People experiencing hypersomnia do not get abnormal amounts of nighttime sleep. However, they often have problems waking up in the morning and staying awake during the day. People with hypersomnia nap frequently, and upon waking from the nap, do not feel refreshed. Hypersomnia is sometimes misdiagnosed as narcolepsy. In many ways the two are similar. One significant difference is that people with narcolepsy experience a sudden onset of sleepiness, while people with hypersomnia experience increasing sleepiness over time. Also, people with narcolepsy find daytime sleep refreshing, while people with hypersomnia do not.
People with Kleine-Levin syndrome have symptoms that differ from the symptoms of other forms of hypersomnia. These people may sleep for 18 or more hours a day. In addition, they are often irritable, uninhibited, and make indiscriminate sexual advances. People with Kleine-Levin syndrome often eat uncontrollably and rapidly gain weight, unlike people with other forms of hypersomnia. This form of recurrent hypersomnia is very rare.
The causes of hypersomnia remain unclear. There is some speculation that in many cases it can be attributed to problems involving the hypothalamus, but there is little evidence to support that claim.
Demographics:
Hypersomnia is an uncommon disorder. In general, 5% or fewer of adults complain of excessive sleepiness during the daytime. That does not mean all those who complain of excessive sleepiness have hypersomnia. There are many other possible causes of daytime sleepiness. Of all the people who visit sleep clinics because they feel they are too sleepy during the day, only about 5–10% are diagnosed with primary hypersomnia. Kleine-Levin syndrome is present in about three times more males than females, but it is a very rare syndrome.
Hypersomnia generally appears when the patient is between 15 and 30 years old. It does not begin suddenly, but becomes apparent slowly, sometimes over years.
Diagnosis:
Hypersomnia is characterized by excessive daytime sleepiness, and daytime naps that do not result in a more refreshed or alert feeling. Hypersomnia does not include lack of nighttime sleep. People experiencing problems with nighttime sleep may have insomnia, a separate sleep disorder. In people with insomnia, excessive daytime sleepiness may be a side effect.
The Diagnostic and Statistical Manual of Mental Disorders, which presents the guidelines used by the American Psychiatric Association for diagnosis of disorders, states that symptoms must be present for at least a month, and must interfere with a person’s normal activities. Also, the symptoms cannot be attributed to failure to get enough sleep at night or to another sleep disorder. The symptoms cannot be caused by another significant psychological disorder, nor can they be a side effect of a medicinal or illicit drug or a side effect of a general medical condition. For a diagnosis of recurrent hypersomnia, the symptoms must occur for at least three days at a time, and the symptoms have to be present for at least two years.
An adult is considered to have hypersomnia if he or she sleeps more than 10 hours per day on a regular basis for at least two weeks, or if he or she is compelled to nap repeatedly during the day.
One diagnosis tool is the Epworth Sleepiness Scale, which helps determine the extent of EDS in a subject. A self test is available from Stanford University Medical School.
Treatments:Treatment is symptomatic in nature. Stimulants, such as amphetamine, methylphenidate, and modafinil, may be prescribed. Other drugs used to treat hypersomnia include clonidine, levodopa, bromocriptine, antidepressants, and monoamine oxidase inhibitors. Changes in behavior (for example avoiding night work and social activities that delay bed time) and diet may offer some relief. Patients should avoid alcohol and caffeine. No substantial body of evidence supports the effectiveness of these treatments. Stimulants are not generally recommended to treat hypersomnia as they treat the symptoms but not the base problem. Some researchers believe that treatment of the hypothalamus may be a possible treatment for hypersomnia.
Prognosis:
Kleine-Levin syndrome has been reported to resolve occasionally by itself around middle age. Except for that syndrome, hypersomnia is considered both a lifelong disorder and one that can be significantly disabling. There is no body of evidence that concludes there is a way to treat the majority of hypersomnia cases successfully.
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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
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