Losing Sleep
Many Indians do not know that they have sleep disorders. Night shifts,bad eating habits are to blame :Doctors
For many years,a 57-year-old man had been the butt of jokes among his friends and relatives because he snored rather loudly. Of late,however,he had started sleeping during the daytime. While driving,he would doze off waiting at the traffic signal or even while attending to a customer.
When it started interfering with his daily routine,he went to the doctor and was diagnosed with sleep apnoea. Four months later,thanks to medication and a machine called C-pap (which keeps oxygen levels high throughout the night),he says his life is back on track.
If these symptoms ring a bell,you are not alone. A recent study by the University of Wisconsin School of Public Health linked sleep apnoea to cancer. The common sleep disorder has now become a dreaded disease.
Doctors say lifestyle changes,odd working hours,demanding jobs and changing food habits (higher caffeine consumption) end up reducing the amount of sleep people get.
Given emerging facts,these figures may just be the tip of the iceberg,says Dr M S Kanwar,senior consultant of sleep medicine,respiratory medicine and critical care at Indraprastha Apollo Hospital. India,he says, is well on its way to becoming a sleep-deprived nation.
In 2004,a hospital-based study in Mumbai by Dr Z F Udwadia and his team found 19.5 per cent respondents suffering from sleep disordered breathing,which means that the person has disrupted sleep,and 7.5 per cent were suffering from obstructive sleep apnoea (snoring) with complaints of daytime sleepiness. The figures are alarmingly high as the study focussed on just two sleep disorders.
Approximations based on population data from western countries suggest incidence of sleep disorders could be as high as 30 per cent,of which 10 per cent may suffer from classical insomnia — an inability to fall asleep.
Sleep disorders are often linked to obesity as weight and sleep apnoea were found to have a correlation. A sleep apnoea patient says he lost five kg in four months of treatment.
Sleep disorders are broadly classified into three categories — inability to fall asleep,inability to stay awake and abnormal behaviour during sleep. The last is often linked to a number of neurological and psychiatric ailments and the first two are nearly always corollaries of each other. One reason for increasing incidence of sleep disorders is shift duties.
Working at odd hours,especially throughout the night,sends the circadian rhythm of the body for a toss. Circadian rhythm,by definition,is any biological process that repeats itself in a 24-hour cycle.
Circadian rhythm is heavily influenced by both external factors (sunlight,temperature) and internal factors (hormones). When an individual works at night,external cues push the body towards sleep. People who work at night try to sleep during the day,when external cues push the body towards wakefulness. Over long periods,this has a detrimental effect on the quality of sleep. This also applies for people who have developed a habit of staying awake for long at night even if they are not working.
“The study linking sleep apnoea to cancer has changed the perception of sleep disorders because the increase in incidence of cancers has somehow mirrored that of sleep disorders. There is a known link between lack of oxygen supply to cells and their uncontrolled mitotic division,which essentially is cancer. Sleep apnoea causes oxygen deprivation,so it is a link worth exploring,” says Dr Kanwar.
While work pressures and stress can often trigger sleeplessness or by extrapolation,cases of extra sleepiness,matters are often made far worse by the tendency to self-medicate. It is not advisable for any disease,but for sleep disorders particularly,the short-term “Band-Aid” — sleeping pills — can have devastating consequences on long-term prognosis of the problem.
“Like fever,sleep disorder is a symptom of something else being wrong with the body. But when people start popping sleeping pills indiscriminately,they reach a point when their body’s threshold for such pills has risen so much that regular dosages do not work. That aggravates the problem. There is a cause-effect relationship between sleep,depression and anxiety. The circle works both ways,” says Dr Manvir Bhatia,senior consultant of sleep medicine,Medanta Medicity.
Therapy,counselling and use of machines like C-pap are among the most common options to tackle sleep disorders. Sleep deprivation is associated with hypertension,hyperglycemia,greater risk of heart attack,stroke and dyslipidemia.
Do’s and don’ts
Maintain sleep hygiene — regular hours of sleep,ideally on the same bed. A schedule which goes haywire too often could be a problem
The bedroom is for sleeping. Try and refrain from sacrificing sleep for Internet surfing or playing computer games
If you have trouble falling asleep because there are too many stressors,try maintaining a sleep diary to jot down those points that disturb you in bed
Exercise is often a good sedative simply because it tends to wear the body down. And if stress is the reason for your sleep problem,try yoga
Do not snack in the middle of the night even if you have been awake for long
If sleepiness starts interfering with your daily routine and you find yourself dozing off in the middle of a conversation at the wheel,go to a doctor
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