FOCUS ON SLEEPING: This is the newly furbished Sleep & Breathing Centre at Manipal Hospital where you may check in for a 24-hour monitored polysomnogram to check out snoring/sleep apnea problems which interfere with a good night’s sleep; pulmonologist Dr Prabhu Prasad (inset) says one in five suffer from sleep deprivation today for several critical and not-so-critical reasons

By Pankajbala R Patel

OR RATHER put it this way: When did you last sleep like a baby? From the sound of it only babies sleep like a dream in the secure warmth of their bed or someone’s loving arms! As we grow older and the years of life’s wear and tear catch up with us and get compounded, it is as if most of us are trying forever to catch up with sweet sleep. Most of us don’t appreciate how sleep keeps us young until we find ourselves tossing and turning in bed once the lights are off…trying to sleep. Yearning for sleep to come, pining for sleep.

If we don’t sleep we `wake up’ the next morning feeling like death warmed over, lacking in energy and perhaps stare at the walls in depression. Sooner or later we start popping sleeping pills so that artificial sleep arms us for the next day’s routine. Artificial sleep is artificial and never leaves one feel as refreshed as natural sleep.

This is to say lack of sleep and the use of sleeping pills to sleep have their own repercussions. It is a very huge problem in the world today because we no longer live stress-free lifestyles and says Dr Prabhu Prasad, consulting pulmonologist at Manipal Hospital, Goa, “According to a study it is seen that almost every one in five are sleep deprived today. Approximately 20.3 depend on sleeping pills. The most common sleep related breathing disorders are snoring and sleep apnea. Obstructive sleep apnea (OSA) is characterized by repetitive episodes of complete or partial interruption of ventilation during sleep caused by a collapse of the upper airway. Obstructive apneas are associated with on-going increasing respiratory efforts and cause intermittent arterial oxygen de-saturation, systemic and pulmonary arterial blood pressure fluctuations and sleep disruption. Other diseases like diabetes, high blood pressure, heart attack, dysfunction of the nervous system, are also associated with sleep deprivation.”

In fact, he says, lack of sleep is a huge problem in urban India. Also people have forgotten to sleep in the darkness of the night. It is darkness which generally induces sleep and not light…it is sleep which recharges the battery of our body’s chemistry. So if you are not sleeping well, with or without sleeping pills, perhaps it is time you go for a check-up and find out if it is a physical or a psychological barrier which is affecting normal sleep?

Lack of sleep can be resolved once the problem is identified. The very common sleep apnea is considered a serious medical condition although you may not think so and continue to neglect it for years on end. Lack of sleep (six to seven hours of sleep is considered normal even for adults) can aggravate daytime fatigue, high blood pressure or heart problems, type 2 diabetes, metabolic syndrome and stroke. Snoring goes largely neglected but this eventually can lead to a worsening of symptoms of something far more worrisome…today there are treatments both medically or/and technologically oriented for loss of sleep and you may want to look at the different ways you may get back to sleeping soundly.

Very often it’s just a weakness of the parageneal muscles or weakness of tongue muscles which leads to the air passage becoming vulnerable with fall in pressure. It is idiopathic and mostly affects those across 60 years plus, plus. Nowadays, there is a machine called continuous positive airway pressure (C-PAP) which is like a nebulizer perhaps which comes with a tube and a mask which is worn when going off of to sleep. This machine works when the airway passage collapses and makes adjustments to keep it free for breathing, “it is a mechanical correction or a splinting of the airway.”

According to Dr Prabhu Prasad these machines are made in India now but before recommending it he usually advises a patient to get a polysomnogram done over 24 hours. Polysomnogram is the technical term for sleep-testing and consists of monitoring several parameters simultaneously on a polygraph. The parameters most frequently monitored are EEG, EOG (eye movement), ECG, chin EMG (muscle activity), bilateral anterior tibilis (legs) EMG, nasal/oral airflow, abdominal and thoracic effort and Sa92. Polysomnograms are usually performed in sleep rooms set up to simulate a home atmosphere and the patient is monitored through the night, then the test results are analysed and interpreted and treatment recommended by a competent medical person.

In some cases surgery like uvuloplasty which is tricky and dicey is recommended but it is really ill-advised for senior citizens and the surgery itself may not be effective. In such cases non-invasive treatment like using a breathing aid machine like the C-PAP is more useful although it may cost over half-a-lakh of rupees! With Indian companies manufacturing it the price may come down.

Interestingly, there’s something called obstructive sleep apnea and central sleep apnea, and symptoms manifest themselves as loud snoring, choking, dry-ness of mouth, headaches, and confusion upon waking in the early hours of the morning. Many long-distance drivers are prone to drowsiness and when they fall asleep on the wheel the symptoms manifest and lead to road accidents. If you suffer from sleep apnea in any form be cautious while driving and abroad where long distance driving is well-organised many drivers may pull up at well-designed sleep stopover places to catch some sleep before proceeding on their trip. Roughly 20 to 30 per cent of accidents are due to drivers who fall asleep at the wheel.

Those who are obese, who suffer from cardiovascular disease, diabetes, or any other ailment which compromises their airways, should not wait, but seek treatment early. In other words, if you’re a regular snorer laughing your snores away (even if the wife complains bitterly), or if you’re breathing through your mouth rather than your nose at night, if your mouth is dry as sawdust, if you’re losing sleep and becoming more and more irritable, don’t wait in denial for too long! Better you seek some professional advice from a doctor soon and get back some sweet sleep in your life.