National Sleep Awareness Week: Not a Snooze

March 7 - 13 marks National Sleep Awareness Week, an educational campaign to remind people about the importance of sleep. It’s believed that the vast majority of sleep disorder cases go undiagnosed, and therefore many people suffer unnecessarily.

However, a lack of quality sleep can be dangerous and lead to motor vehicle accidents, if not to other types of health risks. If you have one or more of these signs of a sleep disorder, please contact your primary care doctor:

• Daytime sleepiness
• Frequent nighttime urination
• High blood pressure
• Irritability or moodiness
• Loud, irregular snoring
• Memory loss
• Morning headaches
• Poor concentration

If you’re a loud snorer who doesn’t feel rested enough during the day, you may be unwittingly putting your heart at risk. That’s because you could have untreated Obstructive Sleep Apnea (OSA), a disorder directly linked to several cardiovascular syndromes that cause premature death. OSA, in which the upper airway becomes blocked repeatedly during sleep, is a condition that’s estimated to affect 24 percent of men and 8 percent of women.

Over the past decade, several studies have linked OSA to high blood pressure. Patients who require three or more medications to control hypertension have an 80 percent chance of having OSA. Also, compared to the general population the prevalence of OSA is significantly higher among patients with chronic heart failure (50 percent higher), atrial fibrillation (50 percent higher) and coronary artery disease (40 percent higher). For patients with these heart conditions, a sleep study is crucial; if their OSA goes undiagnosed and untreated, they will have a doubled risk for death during the next 5 years.

Given OSA’s direct connection to the heart, it’s important for all OSA patients that it be treated as soon as possible. However, it’s believed that between 80 percent and 90 percent of people with OSA have not yet been diagnosed. Please talk with your doctor as soon as possible if you have one or more of these symptoms:

• Cessation of breathing during sleep, and then waking up with a gasp (most often observed by another)
• Loud, irregular snoring
• Restless sleep with frequent (and possibly unnoticed) awakening
• Morning headache, dry mouth and/or sore throat
• Daytime sleepiness
• Irritability and/or impaired concentration
• High blood pressure

A sleep disorder can only be diagnosed through a sleep study, in which things such as one’s breathing, heart rate, muscle movements and blood oxygen levels are measured while he or she sleeps. Both Sinai and Northwest hospitals have American Academy of Sleep Medicine accredited sleep centers, where sleep studies are performed on all nights of the week. For more information about either center, please contact 410-601-WELL (9355).
-Holly Hosler

Daylight Savings Ends Sunday

If you have trouble sleeping, there's good news - you are getting an extra hour this weekend.

Don't forget to adjust your clocks an hour back at 2 a.m. Sunday due to the end of Daylight Savings. But you may also want to pause this weekend to ask if you are one of the 60 million Americans who has a sleep disorder.

A lack of quality sleep is often responsible for car crashes and mistakes and accidents in the workplace, not to mention that it can make you feel miserable.

Some sleep disorders, like obstructive sleep apnea (OSA), exact a heavy toll on one’s health. OSA has been linked to high blood pressure, heart attack and stroke. OSA, in which the upper airway repeatedly becomes blocked during sleep, is a condition that affects 24 percent of men and 8 percent of women. Symptoms include loud, irregular snoring; restless sleep with frequent (and possibly unnoticed) awakening; and waking up with a headache, dry mouth and/or sore throat.

Other common sleep disorder symptoms include daytime sleepiness; frequent nighttime urination; irritability or moodiness; memory loss; and poor concentration.

If you haven’t been getting a good night’s sleep lately, you owe it to yourself – and to your long-term health – to talk with your doctor about having a sleep study and seeing a sleep specialist.

Sleep studies are covered by most insurance plans. If you have a referral from your physician for a sleep study and consultation, appointments for a sleep study are available seven days a week at the sleep centers at Northwest and Sinai. To schedule a sleep study, call 410-601-9355.

Skimping on Sleep Can Impact Health

Short on sleep? Join the crowd. Many of us have too much to do and not nearly enough time to do it – and often sleep pays the price.

Health care workers can face exceptional challenges, especially medical residents, who can log up to 80 hours a week. While the number of hours can seem grueling, a few years ago the number was much higher. But six years ago, the Accreditation Council for Graduate Medical Education (ACGME) instituted a new policy that limited residents to working a maximum of 80 hours a week, explains Charles Albrecht, M.D., the program director for the Johns Hopkins/Sinai Hospital Residency Program in Internal Medicine and interim chief for Sinai Department of Medicine. Hospitals realize the importance of physicians getting enough rest, he says.

"We are mandated to inform and teach about fatigue," Dr. Albrecht says. "We discuss with our physicians how to recognize the effects of a lack of sleep.

One point made is that residents should recognize whether their sleepiness stems from overwork or from a medical condition, such as hypothyroidism, or a psychological disorder, such as depression. That's true for everyone – ask your physician if you're getting more than eight to nine hours of sleep, but are still tired.

It's a common fallacy for people to think they can get by on four, five or six hours. The increasing recognition of sleep being critical to successful patient outcomes is a big improvement, Dr. Albrecht says. Nine years ago, when he was a resident, he remembers struggling to stay awake on the drive home after logging a long hospital shift. Since that's a danger for both the doctor and other drivers, Sinai started a transportation fund. If a resident feels sleepy before driving home, the transportation fund is available for use of a taxi.

Recommendations for getting a good night's sleep include making the room very dark, using earplugs, staying away from coffee or trying a cup of herbal tea. Experts also agree that nutritional and fitness routines are key components in a good night's sleep. Stick to a regular breakfast, lunch and dinner schedule, and don't work out too close to bedtime.

Al Kafrouni, M.D., who runs the Sleep Disorders Center at Northwest Hospital, says problems falling or staying asleep are among the symptoms of a sleep disorder.

"There are different modalities for treatment including pharmacotherapy, cognitive and behavioral techniques or a combination of these modalities," he says.

Another common sleep disorder is obstructive sleep apnea, which causes people to be excessively sleepy during the day and experience disruptive sleep during the night. It's also treatable, Dr. Kafrouni says.

In addition to cutting back on caffeine, exercise and good nutrition, Dr. Kafrouni advises:

• Avoid steady use of sleeping pills.
• Use your bedroom as a place to sleep, not as an office or place to watch television.
• Stop smoking.
• Avoid alcohol before bed.

To learn more about the Sleep Disorders Centers at LifeBridge Health, call 410-601-WELL (9355) or visit us at www.lifebridgehealth.org.

The Search for Sleep

Maybe you’re snapping at your children more, or guzzling coffee at a rate that would make Juan Valdez blush. It’s possible what you’re really looking for is a good night’s sleep.

Most Americans are sleep deprived, says Abdallah I. Kafrouni, M.D., a sleep and pulmonary specialist at Northwest Hospital in Randallstown.

“Nobody gets enough sleep anymore,” Kafrouni says. “Everyone thinks they can get away with four or five hours, when the average American in the 1920s got 8 to 8 1/2 hours of sleep."

Kafrouni offers the following tips for getting a good night’s sleep:

• Cut back on caffeine.

Kafrouni recommends no caffeinated drinks in the afternoon. In addition to coffee, soda and iced tea can contain enough stimulants to keep you awake at night.

• Avoid sleeping pills.

“Insomnia is extremely prevalent in our society, and some turn to sleeping pills,” Kafrouni says. Always talk to a physician before taking sleeping pills.

• Make your bedroom cool, dark, quiet and comfortable.

“Minimize as much as you can,” Kafrouni advises. This may include using earplugs and room-darkening shades. Other options include eye covers or a fan, which can both cool you off and drown out excess noise. These tricks can be especially important for night-shift workers who need to sleep during the day, he says.

• See a physician if you have insomnia, severe snoring or other breathing problems.

Insomnia can often be addressed through behavioral modifications, Kafrouni says. Obstructive sleep apnea impacts 10 percent of women and 20-25 percent of men

• Establish a bedtime routine.

“A routine is always great,” Kafrouni says. Set an established time to go to bed and wake up. And if you need the alarm in the morning, you haven’t gotten enough sleep, he says. Relaxing nighttime activities, such as listening to soft music or reading, are a signal to your body to start slowing down.

• Stop smoking.

"It’s not a healthy habit in any way," Kafrouni says. Even if they claim non-addiction, he says smokers will often reach for a cigarette first thing in the morning. For more information on quitting smoking, visit http://www.smokefree.gov/.

• Exercise.

While you should not work out less than an hour before bed, exercise helps you achieve a restful night of sleep, Kafrouni says.

• Choose a good mattress and pillow.

According to the National Sleep Foundation, the average life cycle for a mattress is around a decade. Putting allergy covers on pillows and mattresses can also cut down on dust mites, which may trigger allergies and interrupt sleep.

• Avoid alcohol before bed.

Alcohol is a sedative, so people often think it will work to help them fall asleep. But it's more likely to cause you to wake up in the middle of the night, thus disrupting your sleep.

For more information on the Sleep Disorders Center at Northwest Hospital, call 410-601-WELL (9355).