News from Eisenhower Medical Center
Vital to Our Health and Well-being
Sleep. It is a non-negotiable, vital part of our existence, as important as food and water and the air that we breathe. Without it, we start to crumble — physically and emotionally, and in some instances, we become a danger to ourselves and others. Sleep is the ingredient we need to function fully, to be clear and coherent, to make good judgments and to be at the top of our game.
Sleeplessness affects every aspect of our lives: relationships, work, memory and mood. Increasingly, we are learning the absolute necessity of getting those seven or eight hours of sleep each night.
The amount of Americans suffering from sleep problems is staggering — over 85 million. “. . .sleeping well is vital to aging well.”
The 2003 Sleep in America poll (National Sleep Foundation) indicated that poor health, and not age, is a major reason why many older people in America have sleep problems. Richard L. Gelula, chief executive officer for the National Sleep Foundation, states, “The fact that a person is 60 or 70 years old doesn’t preclude the possibility of sleeping well and benefiting from this restorative process to remain vital and active. That’s why we must drive home the message that sleeping well is vital to aging well.”
Finding relief from sleep disorders may be as simple as changing one’s sleep routine or as complicated as needing surgery. New technologies now allow us to monitor sleep for those suffering from sleep disorders, from chronic insomnia to obstructive sleep apnea. “Eisenhower Medical Center’s Sleep Disorder Center is the gold standard for sleep studies,” observes Jill Sanderson, Coordinator, Sleep Disorder Center. “What is unique to Eisenhower is the level of privacy for each patient. Private bedrooms, bathrooms and showers are available for each individual. There’s even a plasma television in each room.”
Staffed by physicians and other medical professionals who specialize in sleep medicine, the Sleep Disorder Center is a clinical lab that performs diagnostic studies of patients whose physicians suspect a sleep disorder.
“Typically, patients see their primary care physician who often refers them to a pulmonologist [lung specialist], neurologist, ENT [ear, nose and throat specialist], or allergist for an initial work-up,” explains Sanderson. “Once it’s determined that a sleep study is medically necessary, the patient is referred to our lab.”
“The patient will spend a night in our lab, usually arriving at 8 or 9 p.m. We attach monitors to track respiration, oxygen levels, and brain and muscular activity throughout the night. In the morning, the patient wakes at the usual time and returns home or to work.”
Sanderson adds, “If we start intervention on a sleep disorder that first night, the patient often feels better the very next day. Our physicians go though the data to evaluate the sleep problem and those results are sent to the referring physician.”
One of the most common types of sleep disorders seen at the lab is obstructive sleep apnea. Chronic insomnia, restless legs syndrome, REM (rapid eye movement — sleep with mental activity occurring and during which one dreams) movement disorders, and narcolepsy are also quite common.
Obstructive sleep apnea is characterized by repetitive episodes of upper airway obstruction during sleep, and there is usually a reduction in blood oxygen saturation. The upper airway can be obstructed by excess tissue in the airway, large tonsils, or a large tongue. The obstruction may also be due to problems with the nasal passages or the structure of the jaw. Some of the effects include loud snoring, high blood pressure, morning headaches and difficulty concentrating.
Sanderson emphasizes the gravity of obstructive sleep apnea, a potentially life-threatening disorder. “It has been shown to be a factor in one out of five people with congestive heart failure. Individuals with atrial fibrillation are more prone to have obstructive sleep apnea. Higher incidents of glucose resistance, a precursor to diabetes, have been attributed to obstructive sleep apnea. It affects all organs because they are oxygen starved.” “Eisenhower Medical Center’s Sleep Disorder Center is the gold standard for sleep studies.”
The most common sleep disorder is insomnia, which can be caused by stress, environmental noise, extreme temperature change, jet lag and the side effects of medicine. It can be situational or transient, meaning it can last only a few nights. Chronic insomnia is a condition that lasts more than a month and may be related to a medical, behavioral or psychiatric problem.
Restless legs syndrome (RLS) is a discomfort in the legs, often described as a crawling, tingling or prickling sensation. One variation of RLS is periodic limb movement in sleep (PLMS), characterized by leg movements or jerks. It is usually the sleep partner who reports these symptoms!
REM movement disorder occurs when the paralysis that normally accompanies rapid eye movement sleep is absent, enabling the sleeper to “act out” his or her dreams. This can result in violent behavior and injuries to the sleeper or sleeping partner. Most common in older men, this disorder responds well to medication.
Narcolepsy is a chronic disorder affecting the part of the brain that regulates sleep and wakefulness. No matter how much they sleep, people with narcolepsy experience an irresistible need to sleep. These “sleep attacks” can last from 30 seconds to more than 30 minutes, and can occur at work, while talking or driving a car.
Sanderson also points to the increase in sleeplessness in children. “We’re finding that learning disabilities can be traced to sleep apnea and sleep deprivation in some children. Obesity is also linked to sleep disorders, and has become epidemic in children.”