Written By Donna Engle
Gary LeGates learned one morning what sleep deprivation can do to your brain. The 61-year-old Westminster man, a retired language teacher, had been waking up feeling tired. His wife, Ninette, told him that he stopped breathing sometimes at night. But that morning, LeGates, who is visually impaired, had trouble fixing cereal. He had reprogrammed the radio, but couldn’t remember the location of his favorite station.
Within 20 minutes, LeGates was fine, but the incident prompted him to consult his family physician. The doctor concluded that the morning confusion might be caused by a drop in blood oxygen during sleep, and referred LeGates to the Carroll Hospital Center’s Sleep Disorders Center for testing. The diagnosis: sleep apnea, a temporary suspension of breathing that occurs repeatedly during sleep. The interruption jolts the sleeper out of deep restorative sleep into less-restful, lighter sleep. LeGates was fitted with a CPAP, a continuous positive air pressure machine that uses air pressure to keep a sleeper’s airways open. He now wakes refreshed.
Whether from sleep disorders, poor sleep habits or other causes, approximately 70 million American adults have chronic or intermittent problems sleeping, according to the National Science Foundation. One-fourth of us admit we do not get enough sleep to be alert the next day, a problem that costs employers an estimated $18 billion a year in lost productivity. More than three-fourths of partnered adults say their partner has a sleep-related problem, most often snoring.
But inadequate sleep is not just an adult problem.
“Sometimes youngsters just put their heads down on their desks and fall asleep in class,” said Bob Mitchell, principal of Ebb Valley Elementary School in Manchester.
When sleeping in school becomes a pattern for a child, Mitchell talks with him and his parents. Often, the child is not getting the 10 to 11 hours of sleep recommended for elementary- school children.
Ebb Valley students who suffer from sleep deprivation are no different from students at Manchester, Freedom or Robert Moton, other county elementary schools where he has been principal, Mitchell said. Reasons for the lack of sleep are common. Some children are over-scheduled; soccer practices that do not end until 9:30 p.m., for example. Sometimes it is “just one more” video game or TV show. Moreover, parents’ commutes may require that they drop children off at day care centers by 6:30 a.m.
“An occasional late night is not a bad thing, but when it becomes routine, if it’s continual with youngsters, it’s going to become a problem,” Mitchell said. “The effects of lack of sleep really do hit young kids hard. When they’re tired they’re inattentive, they get cranky. It makes it more difficult for them to learn and can even affect their growth.”
Westminster pulmonologist, internist, critical care and sleep medicine specialist Dr. Natvarlal Rajpara, founder of the Carroll Hospital Sleep Disorders Center, has seen the numbers of patients with sleep-related problems increase over his 29 years of practice. He attributes the increase to greater public awareness and greater willingness to bring the problem to a doctor’s attention, and increased obesity, which has been linked in studies to decreased hours of sleep.
Dr. Rajpara’s rule of thumb: “If you have persistent difficulty falling asleep, and lack of sleep interferes with your activities, seek medical attention.”
The most common complaint Dr. Rajpara hears is insomnia, a general term for chronic inability to fall asleep or remain asleep for an adequate period of time. He diagnoses insomnia by talking with the patient, then, if there is a possibility of sleep apnea or a less common sleep disorder such as restless leg syndrome (crawling, aching or tingling sensations) or narcolepsy (extreme daytime sleepiness) he orders a study at the Sleep Center.
With snorers, Dr. Rajpara looks at possible links to diseases such as diabetes, heart failure or stroke. Snoring may be a sign of sleep apnea. It may be linked to medications. Some snorers may be helped by a uvulopalatopharyngoplasty (UPPP), said Dr. Rajpara. A UPPP is a surgical procedure to widen the airway by removing remove excess tissue in the throat. He also recommends that snorers avoid alcohol and tobacco and, if they are overweight, lose weight.
If you are having trouble sleeping, you may need to see your — dentist? Westminster dentist Dr. Gary Imm got involved in dental sleep medicine after finding increasing sleep apnea among his patients.
“I wanted to help people find a way to prevent it,” he said. If a child’s airway development indicates a potential problem, Dr. Imm looks at whether tonsil structure could be changed to create more space for the tongue, and whether the child is breathing through his nose properly.
Dentists and physicians cooperate in diagnosis and treatment, Dr. Imm said. He works with physicians on sleep issues, referring children who may need surgery, but he can help patients grow up with orthodontically correct teeth positions. He refers adults at high risk of sleep apnea. If the diagnosis is mild to moderate sleep apnea, dental appliances that bring the lower jaw forward to keep the airway open have been proven as effective as CPAPs, and adults may be more willing to use the appliances than the air pressure machines.
Experts advise a regular schedule for good sleep. But for some, that is not easy. For instance, Carroll Emergency Communications Center dispatchers work 12-hour shifts, two days, two nights, then four days off.
“One of the stresses of a 911 operator is that we can’t sleep like a firefighter (between calls). We’re constantly busy,” said Randy Waesche, 911 coordinator.
Waesche never had problems sleeping in 20 years as a night shift dispatcher. But as he grew older, he found the schedule more difficult to tolerate, and changed to daytime work in 1994.
The price a sleepless night exacts may be lowered mental sharpness, productivity, emotional balance, vitality and even weight gain; research shows that sleepy brains crave junk food. Younger people can tolerate the schedule variations more easily.
“Your internal clock varies from person to person,” said Waesche. “But after 3 a.m., your body says it’s time to be asleep. So if you’re on duty and you get off at 7 a.m., that’s when you’re fighting the urge to sleep.”
How to Sleep
- Go to bed and get up at about the same time every day.
- Get vigorous exercise at least six hours before bedtime; mild exercise at least four hours before bedtime.
- No caffeine within six hours, no smoking before bedtime.
- No alcohol within an hour of bedtime.
- It may help you fall asleep, but disrupts the second half of the sleep period, leaving you tossing and turning at 4 a.m.
- Have a sleep-inducing bedroom, dark, cool and quiet, as well as a comfortable bed.
- Do not go to bed either hungry or stuffed.
- If you do not fall asleep within about 15 minutes, get up and do something relaxing, then go back to bed when you are tired.
- Use sleeping pills sparingly. Carroll sleep expert Dr. Natvarlal Rajpara prefers not to prescribe them, but if he does, only for a short period of time.