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Sleep Medicine
Over the past century, those living in the United States have cut their average nightly sleep time by more than 20%, with no evidence of less need for sleep.? Approximately 40 million Americans suffer from chronic sleep disorders and wakefulness related to sleep apnea, insomnia, and narcolepsy.
Unfortunately, 90% of all sleep disorders remain unidentified and under diagnosed, and millions of others suffer from inadequate sleep because of demanding work schedules and lifestyle factors.
Significant Impact of Adequate Sleep On Overall Health
28% of students admit to falling asleep in class.
Quality and quantity of sleep is very important to overall health throughout all phases of life.
Starting at a young age, interrupted sleep from a sleep disorder may lead to hyperactivity and poor school academic performance, which may be misdiagnosed as ADHD (Attention Deficit Hyperactivity Disorder).
Have you ever wondered why middle and high school adolescents (12 to18 years old) have a hard time making it to school in the morning?? The cause for tardiness is frequently related to insufficient sleep.? Contrary to popular belief, teens need 9 to 9-1/4 hours of sleep. Just two hours of sleep debt can manifest as excessive sleepiness in the classroom (28% of students admit to falling asleep in class).
The long slumber over the weekend is the body?s attempt to make up for loss of sleep on weeknights. ?Compounding the problem, a majority of parents polled (70%) think their children are getting adequate sleep. ?As teens move into their 20s, required sleep time decreases to between 7 and 8 hours. Adequate quality and quantity of sleep is important for restorative sleep.
Sleep Apnea
Sleep apnea is a common sleep?disorder that occurs when a person?s breathing is interrupted during sleep. In untreated sleep apnea breathing stops repeatedly during sleep, sometimes hundreds of times. This means the brain ? and the rest of the body ? may not get enough oxygen.
One in every 15 Americans are affected by at least moderate sleep apnea, and it is estimated as many as nine percent of women and 24 percent of men in middle-age are affected, undiagnosed and untreated.
- Obstructive (OSA): ?Due to closure of the upper airway with an associated lack of oxygen, snoring, gasping, and jerking. ?These stresses can lead to heart attack, stroke, irregular heart rhythms, and hypertension.
- Central (CSA): ?The signal to breath is delayed with no respiratory movement for 10 seconds or more.? This is associated with arousals from sleep and hyperventilation (rapid breathing). ?This arousal cycle is repeated throughout the night.
- Mixed (MSA): ?Starts as CSA and ends as OSA (see above)
Obstructive Sleep Apnea
OSA can occur at any age and exhibits the following symptoms:? Excessive daytime sleepiness, tiredness, lack of energy, fatigue, unrefreshed sleep, frequent napping, poor academic performance, difficulty waking up, snoring/gasping arousals during sleep, night sweats, as well as observed apnea (cessation of breathing) during sleep.
Charles Dickens in 1836 wrote The Pickwick Papers and described the character named Joe in this way: ?And on the box sat a fat and red-faced boy in a state of somnolence.? This is a classic description of a patient with OSA.
Patients with obstructive sleep apnea (OSA) are seven times more likely to have an automobile accident. ?Sleep-related accidents cost up to $46 billion a year, and the U.S. Department of Transportation (DOT) estimates that 200,000 reported automobile accidents each year are related to lack of adequate sleep.
OSA is a factor in 38,000 cardiovascular deaths annually, and also associated with difficult to control cardiac arrhythmias and more frequent strokes than the general population.
OSA Most Prevalent In the Obese
Obese patients are more likely to have OSA and have difficulty losing weight unless their OSA is treated.? There is also a direct OSA relationship with poorly controlled blood pressure, diabetes, acid reflux, swelling of the legs, and unusual movements during sleep.
Diagnosis
An attended sleep study by a Sleep Center technologist will provide the necessary information needed to diagnose most sleep disorders.
Treatment
Full face CPAP mask.
Treatment options for sleep apnea depend on the type and severity of apnea, prior and subsequent response and tolerance to treatments, available modalities, and the patient?s age. ?Treatment options include:
- Continuous Positive Airway Pressure (CPAP): ?There are many types and sizes of CPAP masks as well as different machine types to achieve the best comfort and control for sleep apnea. ?We try to achieve daily use of CPAP through education, training, troubleshooting of any problems, monitoring of compliance, and follow up with a Sleep Medicine Specialist on regular bases.
- Oral appliances can be custom made for those with mild-to-moderate sleep apnea in close collaboration between the Orthodontist and Sleep Medicine Specialist.
- Surgery is an option, especially in children with sleep apnea. ?In adults, close coordination between the Sleep Medicine Specialist and ENT surgical specialist, consideration for multistage surgeries, and proper post-surgical reassessments are necessary until the final goal of eliminating sleep apnea is achieved.
If you think you might have sleep apnea, see your doctor. Treatment is necessary to avoid heart problems and other complications.
At the Health First Sleep Center, we take a disciplined team approach to coordinate all aspects of care and maintain a laser focus on how best to meet the needs of our patients.
ABOUT THE AUTHOR
Dr. Toban
Dr. Moataz Toban received his Medical Degree from Ain Shams University Faculty of Medicine in Cairo, Egypt, completed both a Medical Internship and Residency at Brooklyn Hospital in New York as well as a Pulmonary, Critical Care and Sleep Medicine Fellowship at St. Louis University Hospital in Missouri.? After spending time on the academic staff at St. Louis University as an Assistant Professor, he opened a private Sleep Medicine practice in Columbia, Tennessee, and then relocated to Melbourne, Florida last year.? He is a member of the Health First Physicians Group practicing Pulmonary, Critical Care, and Sleep Medicine. His interests lie in the study and understanding of the complex relations of multiple medical disorders such as obesity, lung disease and smoking, sleep apnea, and pneumonia.
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