Do you snore? Part III
The problem of Sleep Apnea, a serious disorder
Shakespeare said it best:
"Sleep that knits up the raveled sleeve of care, the death of each day's life, sore labor's bath, balm of hurt minds, great nature's second course, chief nourisher in life's feast." (from ‘Macbeth’)
Now that you know all the dangers of insomnia, sleep apnea and other sleep-related disorders, we can focus our attention on how to get a good night’s sleep and wake up rejuvenated. ‘Sleep Medicine’ has become a medical specialty mainly because of the high prevalence of these problems and its dangers to your health and the society. There are two primary concerns that need proper attention.
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Insomnia –
For a number of people, lack of continuous restful sleep is difficult and bed has become an enemy but it need not be. Sleeping pills will help for a while, but just like diet pills for obesity, it is not an answer. However, for sleeping well in the long term, proper sleep hygiene should be established first. This means we should all have enough mental discipline to adopt a few behavioral changes. Here are some of them.
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Keep regular hours, go to bed and wake up at the same time every day – even during weekends and holidays.
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Make your bed room comfortable and conducive to sleep. Create a nice environment; dim the lights, put on pleasant music, set the right temperature and avoid watching late night TV. May be you can read a nice book if that helps you to doze off.
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Avoid coffee and tea and any caffeinated beverages at least 8 hours before you hit the sack. A glass of sweetened milk before bed time may help since carbohydrates tend to make you drowsy.
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Exercise regularly, of course, not before bedtime. This is good for general health also.
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Yoga and meditation: Research shows that those who do at least 15 minutes of meditation twice daily reported a restful slumber. Regular yoga practice helps you to relieve your anxiety, relax and reduce the stresses of daily life.
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A few minutes of pranayama just before you lie down to sleep will help you, according to integrative medicine guru Dr Andrew Weil. Try this exercise: Take a deep breath to the count of 4, hold it to the count of 7 and exhale to the count of 8. Do that 5 times before sleeping and you are ready.
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Finally, forget all your worries, unfinished work, to-do-jobs for tomorrow, etc., and just simply surrender to sleep. You can handle all these issues the next day. Tell yourself: “Nothing to do, nowhere to go.” And if you are a believer, you can surrender yourself to God. There … you feel relaxed already and ready to sleep!
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Sleep apnea
Patients who are suspected to have OSA (obstructive sleep apnea) or hypopnea (slowing down of breathing/ respirations/ mt ) will need to consult a sleep specialist first. The next step is to undergo a sleep study in an accredited sleep lab (polysomnography or PSG). That means spending one night in the lab, being wired up and fitted with a mask and, monitored during sleep. Believe me it is not bad, I have gone through it myself. From the special chart generated by the study, episodes of Apneas (A) and Hypopneas (H) are counted and the AH index calculated. The following chart can be used to decide the severity of the illness.
AH 0 - 5 Normal AH 5 -15 Mild Sleep Apnea AH 15 – 30 Moderate Sleep Apnea AH > 30 Severe Sleep Apnea
The ideal management for OSA is delivering continuous positive airway pressure delivered through a CPAP mask or similar device placed comfortably on your face when you are ready to go to sleep. The mild air pressure delivered into your nostrils keeps the airways open. The CPAP machine consists of three parts:
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A mask or similar device that fits over your nose and mouth. Straps keep the mask in place while you're wearing it.
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A spiral flexible tube that connects the mask to the machine's motor.
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A motor and heated humidifier that blows air into the tube.
There are several types of masks, nasal tubes, motors and machines by different companies and you can select the one that fits snugly on your face and easy to operate. Also, home health care agencies such as Lincare will come to your house and explain everything about the machine.
Now you know why we fuss about your sleep. Sleep is not just to give rest to your weary body at the end of the day but it also promotes a number of restorative and healing functions. Just like you are what you eat, “You are also what you sleep!” Because sleep deprivation can affect your body metabolism, eating habits leading to excess weight, aggravate diabetes and increase your stress level. So, get a good night’s sleep and wake up in the morning with vigor and vitality, ready to take on the day.
Readers are recommended to listen to the CD, “Healthy Sleep,” by Andrew Weil and Rubin Naiman.
This concludes the series on sleep.
Dr. M. P. Ravindra Nathan is a Brooksville cardiologist.