April 28, 2011

USA: Waking Up To The Importance Of Sleep

HARTFORD, Connecticut / The Hartford Courant / Health News / April 28, 2011

More Of The Sleep-Deprived Are Seeking Help

Courant: Sleep Disorders
BY WILLIAM WEIR, bweir@courant.com
The Hartford Courant

For at least 20 years, Michael Gionfriddo was tired most days. It wasn't a matter how long he slept; he could sleep for 12 hours and wake up exhausted. So last summer, he got tested at New Britain Hospital. After one night of observation, they found the problem: He woke up 94 times without knowing it.

"I had severe sleep apnea," said Gionfriddo, 53, a chef at Hartford Hospital. "The doctors told me that it was so bad that I was getting more rest during the day than at night."

It used to be that people with sleeping problems figured that there wasn't much they could do about it. But an increase in awareness about sleep disorders is changing that.

Dr. Meir Kryger, director of sleep education and research at Gaylord Hospital, said that when he entered the field of sleep disorders in the 1970s, very little was known about the health effects of sleep deprivation. When he told people that he studied sleep, most people thought he analyzed dreams.

But the general public is beginning to catch on to the importance of sleep, he said. Kryger estimates that there were fewer than five accredited sleep disorder centers in the state 20 years ago; now there are more than 15.

"The growth has been explosive, and the same can be said on a national level," he said. The numbers bear him out. Fifteen years ago, the American Academy of Sleep Medicine had 2,256 doctors who were members. Today, the number is 8,683.

Joe Zangrilli, administrative director of sleep medicine at Gaylord, said the new awareness has a lot to do with the fact that doctors can now do more for the chronically sleepy.

"It wasn't until 1984 that we had a treatment for obstructed sleep apnea, one of the most destructive sleep disorders," Zangrilli said.

One of the most common treatments for apnea is the use of continuous positive airway pressure, in which the patient wears a mask while sleeping. Connected to a machine, the mask pumps air to keep the wearer's airways open during the night. Before that step, the patient has to be diagnosed, which usually happens through overnight observation. For instance, Gaylord's six sleep centers in the state (which since last year have been managed by the Massachusetts-based Sleep HealthCenters) have hotel-like rooms where the patients sleep. As many as 24 wires are attached to the patient to measure breathing, heart activity and brain waves. Meanwhile, technicians observe the patient via video camera.

Gionfriddo, who was treated at New Britain Hospital, said he ended up seeking help at the urging of his wife.

"She couldn't stand it anymore," he said. "The snoring and the not breathing, that would scare her and she'd have to wake me. She didn't want to sleep in the same room with me until I got help."

He got fitted for a mask, which he said took about a week to get used to. Now he feels great.

"It's taken five strokes off my golf game, easy," he said. "I have so much more energy in the afternoon."

Snoozing On The Job

A few high-profile cases involving sleep deprivation have also raised awareness of sleep disorders. In February, for instance, an air traffic controller fell asleep on the job for five hours. In the past two months, there have been two more reports of napping air traffic controllers. In the past two years or so, Zangrilli said, trucking and transportation companies have referred employees to sleep labs to make sure they're not sending sleep-deprived workers out on the roads.

"In the '80s, it was about the quality of the roads, and in the '90s, it was about the quality of the trucks, and now it's about the quality of the driver," Zangrilli said.

Measuring sleepiness is becoming more sophisticated, said Dr. Daniel McNally, medical director of the Sleep Disorders Center at UConn. A newly developed test involves measuring the velocity of the patient's blinks with special eyeglasses (the slower the speed of the blink, the sleepier the person).

While much of the recent attention has focused on people in high-risk positions, McNally said he's glad that word is getting out to the general public. Sleep deprivation is far more common than people realize. And the older people get, he said, the more likely they are to suffer from it.

McNally said that if you were to present a very long lecture to a group of 10-year-olds, they would likely be bored and most would fidget. But they probably would stay awake.

"That's the last well-rested generation," he said. But, by the time they reach middle school and high school, pressures build up — homework, technology, TV shows and peers who stay up later. And the pressures and activities don't let up at college or by the time they start working.

It doesn't help that we often consider a lack of sleep a sign of our industriousness. McNally said people often overestimate how well they function on little sleep.

"The number of people who need only five hours of sleep is very small," he said, "and the number of people who think they only need five hours of sleep is much more."

"It is so common — they'll say, 'I can get by on 5 hours,' but if you measure their function, they're not really getting by," he said. "That's the equivalent of having two drinks and coming to work, in terms of impairment."

So how much sleep do people need? It varies, McNally said, but the average person needs seven to eight hours a night.

"Whatever's enough so that you're not sleepy the next day," he said.

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