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Sleep Experts Offer Little Known Facts on Sleep
Problems
National Sleep Awareness Week set to begin March 27
March 13, 2006- Senior citizens too many plagued
with sleeping problems can look forward to a barrage of information
about insomnia during National Sleep Awareness Week beginning March 27.
Two experts, however, have jumped the gun with their list of sleep
factoids they call, "Wow, I didn't know that!"
Ilene Rosen, MD and Richard Schwab, MD, with the
University of Pennsylvania Division of Sleep Medicine, spend their days
examining and explaining to patients what may be causing their lack of
sleep.
Little Known Fact #1-
● Getting up during the night to urinate may be a sign of sleep
apnea.
Explanation- When you stop breathing because of
closure of the passageway between the back of the throat and the
windpipe, the brain works very hard to keep your oxygen levels up. It
sends signals to your respiratory muscles, especially your diaphragm, to
work harder. This increased work of the muscles of the chest cause
pressure changes in the chest, which are felt by the heart muscle. The
stress on the heart muscle causes the muscle cells to secrete a
substance, which fools the kidneys into making urine! (Rosen)
Little Known Fact #2-
● Decreased interest in sex or impotence can be a sign of sleep
apnea.
Explanation- Patients with sleep apnea often
complain of decreased libido and lose their interest in sex. Some of
this is related to sleep deprivation that results from sleep apnea.
Sleep apnea can also cause impotence. Treatment of sleep apnea can
improve libido and may help impotence. (Schwab)
Little Known Fact #3-
● Alcohol is a terrible sleep aide.
Explanation- Although alcohol will cause sleepiness
and may help a patient to initially fall asleep, it actually causes
significant sleep disruption later in the night. Any type of alcohol
(beer, wine, liquor) will disturb sleep. Alcohol will also worsen
snoring and sleep apnea. Alcohol should never be used as a sleeping
aide. (Schwab)
Little Known Fact #4-
● Waking up and feeling awake, but being unable to move, may be a
sign of a serious sleep disorder.
Explanation- Sleep paralysis is sometimes also
referred to as the "witch is riding your back." It occurs when the brain
awakens from Rapid Eye Movement (REM) sleep. During normal REM sleep,
the brain is very active (it is the time of the night when dreaming
often occurs.)
During this stage of sleep, the brain sends a
signal to the skeletal muscle in the body and paralyzes, or immobilizes,
them. The only muscles that work are the diaphragm, the main muscle that
helps us breathe and the eye muscles (hence, the name "rapid eye
movement" sleep).
If the brain awakens before the signal that
immobilizes the muscles is turned off, the person will wake-up but still
be paralyzed. This can be a very scary experience that lasts for a few
seconds and then breaks. Although normal people can have sleep
paralysis, this can also be a symptom of sleep deprivation, sleep
fragmentation and narcolepsy. (Rosen)
Little Known Fact #5-
● If you need two or more medicines to control your blood
pressure, you may have obstructive sleep apnea. This is even more likely
if you are overweight.
Explanation- Studies have shown that patients with
difficult-to-control hypertension (defined as requiring two or more
medications) have a higher prevalence of obstructive sleep apnea. While
we don't know the cause, patients with refractory hypertension who also
have sleep apnea are noted to have decreases in blood pressure and
better-controlled blood pressure once they are placed on CPAP
(continuous positive airway pressure masks worn to improve and prolong
sleep). (Rosen)
Little Known Fact #6-
● Exercise or eating within three hours of going to bed could be
the reason you are having trouble falling asleep.
Explanation- While exercise will help you relax, in
general, and usually helps consolidate sleep, exercising too close to
bedtime will delay the time your body unwinds and is able to fall
asleep. The chemicals that increase in your body immediately after
exercising and eating are associated with increased wakefulness and will
delay the time your body feels ready to sleep. (Rosen)
Little Known Fact #7-
● Heartburn during sleep may be a sign of sleep apnea.
Explanation- Patients with sleep apnea often
complain of heartburn during sleep and treatment of sleep apnea will
improve the heartburn. (Schwab)
Little Known Fact #8-
● If you work the night shift and are having
trouble going to bed during the day, try wearing dark sunglasses -- in
all types of weather -- on the commute home.
Explanation- Our ability to stay awake and fall
asleep is a function of two processes. First, there is a homeostatic
switch that drives sleep that is located in the brain. As soon as we
wake up, chemicals build up in our brain. The build-up of these
chemicals is associated with the need to go back to sleep at the end of
the day.
Counteracting this drive for sleep is the
biological clock. The clock function with a rhythm that drives our
wakefulness, known as the circadian rhythm. Early in the morning, after
being up all night, the sleep hemostat is primed for sleep. However,
although the circadian clock has just hit its lowest point in its curve,
the exposure to daylight on the commute home "reminds" the clock that
the day is beginning and the circadian drive for wakefulness increases.
Thus, wearing dark sunglasses will "fool" the clock
into thinking it is still dark and delay the clock enough to allow for
sleep to occur after the night shift is over. (Rosen)
Little Known Fact #9-
● Falling asleep at movies or watching TV can be a sign of sleep
apnea.
Explanation- Patients with sleep apnea have
frequent arousals at night secondary to recurrent apneas (no airflow).
These arousals cause significant sleep fragmentation, which results in
daytime sleepiness. Commonly, patients with sleep apnea will fall asleep
after dinner, watching TV or at a movie in a theater. Such patients can
also fall asleep at red lights while driving. (Schwab)
More about this report
Dr. Ilene Rosen - on-line bio:www.uphs.upenn.edu/sleepctr/faculty/Rosen
Dr. Richard Schwab - on-line bio:www.uphs.upenn.edu/sleepctr/faculty/Schwab
The University of Pennsylvania has one of only two
comprehensive sleep divisions in the entire country; we have both an
academic and a clinical arm including many different areas of medicine
and expertise. As sleep medicine continues to emerge as a new field of
medicine, clinically, we offer 20 beds to sleep patients at several
different PENN Sleep Center locations throughout the Greater
Philadelphia region. Academically, we're doing some fascinating research
here in many areas of sleep medicine. For more information, go on-line
to:
www.uphs.upenn.edu/sleepctr/
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