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Help Me Sleep!

Thu, Jul 21, 2011

"Help me sleep!"  It's one of the common requests we hear patients make. 

In many cases, we find that the reason for their poor sleep is because they have an underlying and usually undiagnosed 'sleep disordered breathing' condition.  Sleep disordered breathing (SDB) includes conditions ranging from snoring (which in itself is a loud, clear signal that the airflow into the body while asleep is impaired) right through to very serious medical conditions such as obstructive sleep apnoea (where the patient stops breathing frequently while asleep).

People suffering from SDB conditions, particularly the more serious ones, often complain of feeling tired when they wake and also during the day.  In many cases, the level of sleepiness is so great that they will regularly fall asleep in front of TV or when sitting around.  In some cases this happens during meetings.  In other cases it happens while sitting at the office desk.  In particularly worrying cases, it happens while the person is driving or operating machinery.

When SDB is the cause (as it very often is), the reason for the tiredness / sleepiness is because the body never properly rests and recuperates during the sleep period.  Snoring alone is enough to reduce blood oxygen levels, raise blood pressure and cause extra strain on the heart.  More severe conditions, such as sleep apnoea, lead to dramatic drops in blood oxygen levels and extraordinary strain on the heart -- which is why ischaemic heart disease is clearly linked to sleep apnoea.

Sleep apnoea, where the sufferer stops breathing for at least 10 seconds and up to 2 minutes at a time, happens many times per hour -- but the sufferer is never aware of the condition because it happens while they are asleep.  After each 'apnoeic event' the sufferer will experience a 'micro arousal' where they will wake very briefly while the body starts breathing again, but they will have no conscious awareness of ever having woken.

As a result, the undiagnosed SDB sufferer might think they're getting a solid 8 hours sleep through the night (for example), but the reality might be that they've actually experienced a hundred or more micro arousals during that time.  As a result, instead of getting solid, restful and regenerative sleep, the person is instead having a high number of very short and shallow naps. 

Waking tiredness is one of the first obvious indications of this problem.  By rights, we should wake feeling more rested and refreshed than we will feel at any other time of the day.  If we have had a sufficiently long period of sleep, but wake feeling tired, this indicates the quality of the sleep is poor.

Interestingly, when people go to their doctor, pharmacist or other healthcare providers and say "Help Me Sleep!", the typical solution (sleeping pills or some other type of sedative medication) often exacerbates the problem.  The problem is the sedative (whether it's prescribed, herbal or something like alcohol) will lead to a greater degree of relaxation in the muscles which keep our upper airway open.  As a result, the soft tissue of the upper airway (the tongue, soft palate, uvula and pharyngeal walls) can collapse into the airway -- thus causing the snoring noise or the apnoea.

Ultimately, if you find yourself saying "Help Me Sleep" or wishing for better quality sleep, the best first step is to arrange a diagnostic sleep study.  This can be done in the privacy and comfort of your own home and will determine whether an SDB condition exists, what type of condition it is, and what form of treatment would be best to deal with it.

To discuss or arrange a sleep study, call today on 1300 246 637.

If you have a question or comment to make about this issue, leave a note in the 'Comments' box below.  We'd love to discuss the topic with you.

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