Chronic Sleep Deprivation

A Public Health Epidemic

BY JOANN PETASCHNICK

Studies show that more than a third of American adults are not getting enough sleep on a regular basis. Poor sleep can make us overweight and sick with headaches, high blood pressure, diabetes, depression or an impaired immune system. In 2011, the Centers for Disease Control and Prevention even declared insufficient sleep a public health epidemic in the U.S.

“As a nation, we are not getting enough sleep,” says Dr. Mouhammed Rihawi, a sleep and pulmonary medicine physician and the medical director of the Sleep and Pulmonary Clinic at Ascension St. Francis Hospital. “Chronic sleep disorders may include insomnia, restless leg syndrome (RLS), and obstructive or central sleep apnea. Sleep apnea can lead to heart failure, stroke or even death if not properly treated. National Institutes of Health data tell us that we need more than the 6 ½ to 7 hours (of sleep) the average American gets.”

Sometimes, the problem is that we just stay up too late at night and rise too early in the morning, depriving ourselves of the sleep we all need. “Our circadian rhythm or internal body clock may be thrown off, but we can try to make up for that sleep debt over a weekend or holiday if the debt is not too large,” Rihawi says. The normal circadian clock is set by the light-dark cycle over 24 hours. 

Teens are often victims of lack of sleep, says Dr. Dan Taché, a dentist with special accreditation in sleep medicine who works with Snoring and Sleep Apnea Treatment Centers, a division of TMJ & Orofacial Pain Treatment Centers of Wisconsin. “Teens need 8 to 10 hours of sleep each night to function best, but most don’t get it. One study showed that only 15 percent reported sleeping 8 ½ hours on school nights. Here is where parents need to take charge, making sure to set a bedtime when electronic devices are put away, including phones,” he says. 

Physicians and dentists — with few exceptions — receive little formal education in sleep medicine, but that is changing.  “Dentists, although their license to practice does not permit them to diagnose, are in a good position to identify patients who are at risk for sleep-related breathing disorders,” Taché says. Many of these patients may complain of tight jaws upon awakening caused by teeth grinding. If there is evidence of teeth grinding, dental students are taught to suspect a breathing problem during sleep and refer that patient to a qualified sleep specialist for evaluation or for further treatment from an ear, nose and throat specialist. If he does recognize it in a patient, Taché will refer them for a sleep study.

A sleep study, or polysomnography, may be done when patients are referred to a sleep clinic. A sleep study monitors brain waves, blood oxygen, heart rate and breathing as well as eye and leg movements. RLS, a disorder of the nervous system, is frequently to blame for disrupted sleep. “We see it in kids and adults of all ages, even 2- or 3-year-olds, because it can be inherited. Many times, children will report feelings of leg ‘growing pains.’ If this occurs around bedtime, you can be pretty certain that the child has a movement disorder that can lead to fatigue, attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). Identification is the key. Kids with parents who have been diagnosed with RLS probably do not have pain from growing; they have RLS just like their parents, and it may be treated in the same manner because it is often caused by poor intake of iron,” Taché says. Once identified, RLS can often be treated with oral iron supplements with great success. 

Sleep apnea, in which breathing is interrupted, is another common sleep disorder that can be successfully treated if treatments are complied with, adds Taché. “Adherence to treatment is a big problem. As effective as the CPAP (continuous positive airway pressure) machine is, people don’t stick with it, but they do tend to use the mandibular advancement devices that reposition the jaw seven to one over the CPAP.” He notes that when sleep apnea is severe, requiring higher pressures that can be hard for the patient to adapt to, an oral device can be provided to be used along with the CPAP, making the CPAP more comfortable to use. 

It’s best to get help with your sleep problems, experts say. Over time, missing sleep wears down your immune system, making it more difficult for your body to fight off viruses and diseases. Effects of sleep deprivation on your immune system can slow down your recovery time if you do get sick, and increase your risk of getting sick after being exposed to a virus or bacteria. 

Understanding how lack of sleep affects your health can allow you to make healthier decisions for you and your family. “Sleep habits — or sleep hygiene, as we call it — such as going to bed at the same time each night, rising at the same time each morning, and turning off or removing televisions, computers and mobile devices from the bedroom can help people get the healthy sleep they need. That also includes no caffeine and evaluation of prescriptions being taken,” Rihawi says. 

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