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Healthy Sleep Contributes to a Healthy Life… MWJ interviews Dr. Edward Shaefer, HC Center for Lung & Sleep

Author: 2 January 2017 No Comment

Maryland Women’s Journal freelance writer Jeannie Finnegan interviews Dr. Edward Schaefer, is Board Certified in Internal Medicine, Pulmonary Disease, and Sleep Medicine and is on staff with the Howard County Center for Lung and Sleep Medicine. – Healthy Sleep

Healthy Sleep Contributes to a Healthy Life… Jeannie Finnegan interview with Dr. Edward Schaefer

Why is healthy sleep important?

Sleep is important is because, to put it simply, we all generally feel bad when we don’t get enough sleep.   The brain and the body need time to rest, and there are a number of critical physiological processes that occur during sleep such as hormone balance (insulin, sex hormones).  Certain hormones are released preferentially during sleep rather than during the day.  Proper rest allows us to recoup energy for the next day.  Lack of sleep can cause us to have trouble with work and with relationships.  A healthy quality and quantity of sleep are necessary for us to thrive.

 

What are the side effects of sleep deprivation?

Fatigue, which can lead to reduced energy, lack of ability to concentrate, which can lead to car accidents, machinery accidents, and a host of other mishaps, some of which can be dangerous or life-threatening, are all possible side effects of sleep deprivation.  In addition to these weighty side effects, we’ve all experienced memory problems, attention problems at work, and being miserable companions when we are overly tired.  Sleep deprivation can adversely affect quality of life.

 

How much sleep do I need and why?

In general, it is recommended that adults get 7 to 9 hours of sleep each night.  Sleep requirements change throughout our lives, however.  Babies and teens need even more sleep as these ages involve major growth periods, but as we age (middle age and older), we tend to need less sleep.

 

At what point should I see a doctor about a sleeping problem?

If sleep problems interfere with work or relationships, we recommend talking to your primary care physician who may refer you to a sleep center for further diagnosis and treatment.  Some other signs of a sleep disorder include:   your partner says you stop breathing during sleep; you sometimes sleepwalk; you fall asleep at work.

Conditions such as adult-onset diabetes, cardiac arrthymia and high blood pressure can be worsened or exacerbated by undiagnosed sleep apnea.

 

What causes a sleep disorder?

This is a complex question, but here are some common causes of sleep disorders:  Sleep apnea or choking during the night is often caused by obesity; certain medications and drugs can cause apnea (sedatives, narcotics, antihistamines, alcohol); Insomnia and nightmares can be caused by medications such as blood pressure meds or psychiatric meds for anxiety/depression.

 

How common are sleep disorders?

Some studies suggest that 15% of middle aged men have sleep apnea and perhaps 5% of same-aged women.  The incidence of sleep apnea increases with age – Sleep disordersthere is a relationship between weight and apnea, and many people get heavier as they age.  There is a higher incidence of sleep apnea for post-menopausal women.

I understand that you have a dedicated sleep center?

Yes.  At our sleep center, we have a 6-bed sleep unit where we conduct out-patient, in-lab sleep studies.  Patients come in and are hooked up to various monitors for monitoring oxygen, heart rate, and other factors.

 

How does the sleep center diagnose sleep problems?

In addition to a patient sleep study, we conduct a thorough evaluation that includes an interview, examination, and possibly monitors to take home (home sleep study).

 

What are the most common sleep disorders you treat?

Insomnia, snoring, sleep apnea, circadian rhythm disorders, narcolepsy, nightmare disorder, and periodic limb movement disorder are the most common disorders we treat.

Of the patients who see us for sleep complaints, over 50% have sleep apnea and most of these also complain of snoring.  Snoring and sleep apnea are closely aligned.

 

  • Apnea – repeated episodes of halted breathing during the night and can be accompanied by choking.
  • Insomnia – inability to fall asleep or stay asleep (can be present with or without sleep apnea)
  • Circadian rhythm disorders – problems with getting up too early or falling asleep too late often due to work shift issues.  First responders (police/fireman), military personnel often struggle with shift work circadian rhythm disorders caused by the natural forces driven by the sun affecting the sleep center in the brain.
  • Other sleep disorders include “parasomnias” such as sleep walking/talking, night terrors, etc.  Sleep walking can be dangerous and lead to someone falling down stairs, leaving the house while asleep, falling from a balcony, etc.  Many sleep walkers have sleep apnea as well.  If this is treated, parasomnias are reduced.

 

Are sleep disorders different for men vs. women?

 Yes, women tend to experience more insomnia.  Women can also experience pregnancy-related sleep disorders, for example, pregnant women have more sleep apnea due to weight gain, have more interrupted sleep due to needing to use the bathroom during the night, etc.  Restless leg syndrome is also more prevalent for pregnant women.  This may be because some people with restless leg syndrome have low iron and pregnant women can tend to have low iron.  As mentioned earlier, sleep is complex and hormonal drives for breathing during sleep also change after menopause.

 

What are the most common sleep disorders among older adults?

 Over age 75, people tend to have more fragmented sleep rather than continuous sleep which causes increased fatigue during the day.

 

How does alcohol use interfere with a good night’s sleep?

Interestingly, people will often have a drink or two in order to relax and help them fall asleep.  However, while alcohol initially works as a depressant, 2-3 hours after consumption, alcohol stimulates wakefulness.  Alcohol is not the answer to insomnia.

In addition, after a couple of drinks, snoring and sleep apnea can become worse due to the effects of the alcohol on tongue and throat muscles.

 

How does napping affect a good night’s rest?

While there may be occasions or conditions during which a nap is helpful or appropriate, napping can actually work against a good night’s sleep.  Through the progression of a normal day, you gradually accumulate the “sleep drive,” the desire/ability to fall asleep.  If you take a nap, sometimes you alleviate or interrupt that sleep drive.  Think of it like having a generous snack before Thanksgiving dinner – you’re just not going to be as hungry.

 

Why am I such a light sleeper?

It is important to figure out why you are so easily awakened.  Perhaps you have a condition such as arthritis that creates discomfort while sleeping.  Maybe you take a medication that requires you to use the bathroom during the night, or you may have unrecognized anxiety or depression.  It is usually possible to identify what causes difficulty in experiencing a deep sleep.

 

Is there anything I can do to sleep better on my own or decrease the likelihood of developing a sleep disorder?

We generally ascribe to establishing regular sleep habits – regular rising/sleeping schedule, scheduling sleep like other important appointments, allowing sufficient time for sleep, not allowing other things to intrude on sleep time or interfere with a darkened room (i.e. watching television, checking cell phone, computer, etc. while in bed).

 

What about sleep aids? 

Sleep aids may be effective temporarily for short-term relief, but cognitive behavioral therapy is more effective than medications for long-term benefits.  It is important to identify poor sleep habits and start new ones that do not interfere with sleep but rather enhance them.  Keeping television on at bedtime, drinking coffee throughout the day, having no sleep routine, etc. all interfere with normal sleep.

Sleep is a NATURAL thing – if you need to take medicines to get a NATURAL response, we need to ask questions, including “What am I doing that is interfering with sleep?”

 

What would you like men and women experiencing sleep problems to know?

We have expertise in addressing your concerns.  Talk with your physician and if he/she think an evaluation is appropriate, we are here to help.  Although some sleep disorders require specialized treatments or devices, many sleep disorders can be effectively treated with cognitive/behavioral therapies, disciplined changes in routine, and other non-pharmaceutical interventions.

In addition, good sleep along with a healthy diet, optimal nutrition, exercise and weight management are all goals for living a healthy life.  It’s important to understand the interrelationship between sleep and other aspects of healthy living.

 

Do most insurances cover treatment for sleep disorders?

Yes.

 

I see that you are accredited by the American Academy of Sleep Medicine; why is that important to our readers?

This accreditation gives you confidence that we follow nationally recognized guidelines for evaluating and treating sleep disorders.

For more information on Sleep and Howard County Center for Lung & Sleep call 410-740-3635.

Howard County Center for Lung & Sleep 410-740-3635 www.howardlungandsleep.com

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