A Serious Health Issue

H

hardee

New member
We spend approximatly 1/3 of our lives in this state and yet there is very much that we do not know about it or it's relationship to the rest of our lives.

As some of you know, my other passion is Sleep and all its little quirks and curves. Since this is the beginning of National Sleep Awareness Week, I am going to make an effort to share some things about sleep that may be useful in our daily lives, and, to keep on target here on the C-Brat site, some things that may be helpful and may increase our enjoyment in our common passion, C-Dory’s and being on the water.

True story from our sleep lab where we do overnight sleep tests. A middle aged gentleman arrives at the sleep lab and in preparation for the procedure the technician asks what provided the motivation for him to come in for a sleep test. After a short pause, the sheepish answer is, “I’m tired of my wife poking me to wake me up when the traffic light turns green.”

Humorous, yes, until you realize this might be the guy coming toward you on the 2 lane at 55 and he may or may not be awake.

Then there was the story of the portly professor who sat down at his desk after passing out a 10 point quiz to be done at the beginning of the class session. As was his habit, he would lay his head down and take a short snooze while the quiz was being completed. This time the class had pre-planned to arrange a surprise for him. As the students finished their quizzes, they quietly got up and left the room as he sprawled on the desk, snoring the session away. Not sure how long he slept, but he was still snoring as the last quiz was placed on his desk. And he had been telling them that he was just resting his eyes while they were writing. Wonder what time he woke up?

We smile and in fun we should, but in all seriousness we should also take a look at ourselves, our spouses, family and consider our sleep health. National sleep awareness week is here, March 3-9, 2008. For more information take a look at the National Sleep Foundation web site at: http://www.sleepfoundation.org .

Have a great night, always,

Harvey H.
Registered Polysomnographic Technologist
And what else, a boat named the
SleepyC :moon

Edit: change of thread title -- HH
 
Excellent advice! Although this topic is getting somewhat more publicity in recent years it is still largely under the radar. We're not just talking about 'annoying snoring' here. Not only do sleep disturbances lead to detrimental drowsiness during the day, sleep apnea can profoundly influence blood pressure and cardiovascular health.

Somewhat surprisingly, a colleague who runs a sleep lab at the Portland VA told me that a significant number of referrals come from nephrologists who often treat difficult cases of high blood pressure. They do all the tests, and try all the meds with little success, so they send them to the sleep lab for an evaluation. Lo and behold, they DO have sleep apnea. Once properly diagnosed, and treated with a positive air pressure device to eliminate the snoring, the blood pressure usually drops dramatically over the next 4-8 weeks.

Closely related is the incidence of strokes and sudden cardiac arrest, particularly in the early morning hours. My dad died following an arrest at about 7 AM 23 years ago, and in retrospect it seems likely that this was a contributing cause (virtually unrecognized at the time, even by most of the docs). There were other problems (diabetes and circulation, and a previous heart attack 15 years earlier), but put them all together . . .

It's worth taking a look at the web site!

iggy
 
significant number of referrals come from nephrologists who often treat difficult cases of high blood pressure. They do all the tests, and try all the meds with little success, so they send them to the sleep lab for an evaluation. Lo and behold, they DO have sleep apnea. Once properly diagnosed, and treated with a positive air pressure device to eliminate the snoring, the blood pressure usually drops dramatically over the next 4-8 weeks.
Click to expand...

So does the incidence of nocturia, or frequent trips to the bathroom for night time urination.

This is a result of the normalizing of the oxygen level in the blood stream, as a result of the restoration of normal respiration as the positive airway pressure holds the airway open. The elimination of the apnea periods, which cause the blood oxygen level to descend below the optimal levels, and the lack of respiration, or breathing for periods extending from 10-15 seconds to as much as 90 - 120 seconds. This causes the carbon dioxide levels in the blood to raise above the normal level, making the blood acidotic, and causing the kidneys to work to normalize the blood ph level, which inturn produces urine at a higher rate than is required in the nonsleeping daytime. So, long story short, if someone is up to the bathroom every 2-3 hours all night long, but can go 6-8 hours in the daytime, It is not probably not an enlarged prostrate or irritable bladder syndrome. It may very well be Obstructive or Central Sleep Apnea and it should be checked out with a Sleep Specialist. No needles, catheters, or surgery for a sleep test. Just a night out with some rather wiry people :smile

Harvey H.
Registered Polysomnographic Technologist
and wouldn't you know it, a boat named
SleepyC :moon
 
iggy
Thanks for the testimonial. Sleep is a great field, and touches nearly every part of our lives.
Have a great night, Always
Harvey
SleepyC :moon
 
The Sleep Foundation site Harvey suggested is a wealth of good information. This statement, from the site, sums it up "The bottom line is this: Adequate sleep is as essential to health and peak performance as exercise and good nutrition. If you aren’t getting enough, talk to your physician. You deserve it."

Great advice, Harvey. Thanks.
 
great subject! i'd probably add the following, getting younger while growing older is not an easy task but is accomplishable. it takes discipline, desire and pride in how one looks. i would suggest that a regular and routine workout consisting of both free weights and machines, coupled with clean diet, less sugar and sodium, perhaps 3 or 4 ounces of red wine, rather than beers and/or mixed drinks, and of course, no tobacco, will make us fit, trim and happy and i might say, better captains, spouse, parents and friends.
while i'm not an expert, i do have years of experience regarding fitness training, so if you have any questions, just email me and i'll answer them as best as possible.
best regards
pat
www.autohomelife.net
3rd. place mr. cincinnati, heavy weight
4th place mr. cincinnati, under 200lbs
4th place mr akron, ohio
1st place and best lifter, canton open power life
(450 bench, 600 squat, 600 dead lift
1st place and best lifter amelia open
(410 bench, 575 squat and 605 dead life
 
Harvey,

Great message and well put! Liked your article in the PDN too. I wanted to thank you before I took my afternoon nap!
 
I agree very strongly.....Just explain that to my wife and I will be happy....something about coming home from work and finding me asleep on the couch...makes her crazy.... or maybe it's those 3 or 4 oz of medicinal wine that does ???
At first I read that wrong...and thought 3 or 4 glasses.... Hey thats Great !
After all. once a bottle is opened it would be a shame for it to go bad...

I would make a Wonderful Wino

Joel
SEA3PO
 
As promised, and to get back in keeping with the National Sleep Awareness Week theme for this thread, tonight there is a bit of news about a couple of hormones that you may not have heard of. These are produced in deep or delta sleep and have a major affect in controlling our appetite and metabolism.

So, tonight the little secret of sleep, or more correctly, sleep deprivation or poor quality sleep gets let out of the bag. As I think most of us know, sleep isn’t just going to bed, becoming unconscious and staying there until the alarm goes off. Sleep is an active process, in an unconscious state. While we are unconscious of our surroundings, our brain and body are busy doing some very wonderful things. Normal sleep consists of 4 sleep stages, (1 through 4) and REM or Rapid Eye Movement sleep, that are phases that we go through in a somewhat regular pattern called our “sleep architecture”. It is basically a repetitive cycle of 1,2,3,4, and REM and in normal sleep the pattern is repeated 4-5 times through the night. Each Sleep stage has its own duration, function and markings, and the cycle is approximately 90 minutes in length. That’s normal sleep. When we deprive the body of the normal number of cycles, or interrupt the patterns, the changes result in abnormal patterns and cycles.

For our study tonight, sleep deprivation deprives us of stages 3,4 and REM, by shortening their duration. During sleep Stages 3&4 or Delta sleep, 2 of the hormones produced are leptin and gherelin, which are critical in appetite regulation and carbohydrate metabolism and storage. Scientists at the Columbia University Medical Center recently discovered that people who logged five hours of sleep a night were 60 percent more likely to be significantly overweight than those who managed to get seven to nine hours. One reason behind the bulge: Tired people eat more. "Sleep deprivation increases hunger by altering levels of leptin and gherelin, hormones that regulate appetite," explains study author James E. Gangwisch, Ph.D. For this reason alone, anyone trying to loose weight should be getting at least 7 hours of sleep or more per night.

Tomorrow, how 9 or 10 hours can really only be 3 or 4. What can make it be that way.

Good night all,

Harvey, wishin' he was on the

SleepyC :moon
 
What if we are going to bed early enough and sleeping all night and then find we need a nap or are too sleepy to stay awake during the day? Is there some reason that we are sleepy in the daytime even if we think we sleep well through the night? Yes, there is. Maybe more than one reason.

Whether we wake to consciousness or not, there are several things that will cause our brain to wake from our state of sleep. These are called arousals, and can occur for a number of reasons, but the result of the arousal, from whatever the cause, is that our brain does not get to stay in the restful sleep stage. This sleep, arousal, back to sleep, wake with arousal and back to sleep again and again results in a decrease in restful sleep.

So what are these arousals? Frequently, as in the case of Obstructive Sleep Apnea, they are the result of our brain figuring out that we are in a state of eminently deteriorating safety. In other words, if things continue in the way they are going, you are going to be in a seriously unhealthy situation, as in, you would die. The situation goes like this. We go to bed, we relax, we go to sleep, and our muscles that protect our airway relax and when that happens our airway collapses either partially or fully, blocking the path that the air takes to go in and out of our lungs. The oxygen level in our blood drops, and at some point below where our normal oxygen level should be, our brain wakes up enough to send a signal that the airway muscles need to wakeup so we can breath. That arousal takes us out of our sleep for a long enough to take 4,5,6 or 8 breaths. Not long enough to remember but long enough to affect our sleep continuity. The progression from light to deep sleep has been interupted causing us to revert back to a wakeful state and then slowly descending into sleep again, just in time to need to wake up and breath again. Lack of refreshing sleep causes an increase in our sleep debt and consequently an increase in daytime sleepiness and decrease in alertness level. This cyclic pattern results in nearly as much awake time as sleep time and though we may think we have slept 8 hours, in fact we may really have only gotten 4 hours of sleep. No wonder we are still tired in the morning. A blood pressure check would reveal that it is higher first thing in the morning than it was just as we went to bed.

What causes these arousals? Snoring, Apnea, Hypopnea, leg movements, external stimulus, (Like someone else’s snoring,) or a poke in the ribs by a bed partner that is tired of listening to the snore. All of these can affect the level of wakefulness, or daytime sleepiness. Daytime sleepiness affects how we function, our health and safety, and our relationships. Untreated, sleep disorders can seriously affect our health, leading to Congestive heart Failure, high blood pressure, stroke, obesity, and diabetes or sudden death or injury from falling asleep while driving.

The preceeding is pretty much how Obsructive Sleep Apnea affects our sleep. Tomorrow a bit on what other affects it has on our health.

Don't forget to check: www.sleepfoundation.org
for National Sleep Awareness Week :wink:

Harvey 10/585
SleepyC :moon
 
“This statement, from the site, sums it up "The bottom line is this: Adequate sleep is as essential to health and peak performance as exercise and good nutrition. If you aren’t getting enough, talk to your physician. You deserve it."
_________________
El and Bill on Halcyon”
Click to expand...


Thanks, El and Bill for the support. Healthy, adequate sleep is a wonderful thing. There are times, though, that some folks think they are “getting enough”, maybe because they are spending the “requisite” 8 hours in bed – oblivious to their surroundings when in actuality that may not be the case. As seen in the previous post, there is more involved than just going to bed, getting unconscious and getting out of bed in the morning.

At issue as well, is “talking to your physician.” In 2005-6 there was a study done, (I believe by New England Journal,) asking board certified Family Practice physicians how many included any reference to sleep quality, quantity, snoring, or movement, in either an annual physical review or a new patient physical. The response, less than 5% asked for any sleep related indicator. If they are seeing 20-25 patients a day, which is not uncommon, that is one or less, patients per day. (Of note here, of the three diagnosis, Diabetes, Hypertension & Congestive Heart Failure, 50% of those patients have a Sleep Apnea, either undiagnosed or diagnosed.) Unfortunately, though there is an increasing presence of sleep information in the general media, it still occupies a very low priority in the average medical office.

In an early, post iggy referred to some of the contributing or possible complications of Sleep Apnea. The most common complication can be the most devastating. That is excessive daytime sleepiness, which can lead to daytime napping or drifting off to sleep at inappropriate times or places. If this occurs driving down the hiway, a fatal car crash could be the result. (See the example of one of our patients, mentioned in the opening post of this thread.) From the US National Traffic Safety Administration, “Drowsiness is a causative factor in 100,000 police reported crashes annually, involving 76,000 injuries and 1,500 deaths.” This is nearly 5% of all car crash fatalities.

There are mounting studies that show that untreated Sleep Apnea is a contributing factor in a whole laundry list of serious debilitating diseases. High Blood Pressure, Congestive Heart Failure, Coronary Artery Disease, Stroke is a beginning list. Other associations that have been shown include, GERD (gastroesophegeal reflux disease), which is a physics exercise in vacuum, tubes and tanks; Obesity, which is both a cause and result, and Diabetes follows in this line, often being a result of chronic obesity. There are also some studies that show a relationship between the loud snoring and hearing loss in both the snorer and the bed partner.

Sleep Apnea is a disorder that is commonly miss diagnosed, because of some of its symptoms. Insomnia, (of which there are many types of,) often gets the credit for the frequent awakenings, or the delays in what is thought to be sleep onset due to the fall asleep-arousal cycle discussed earlier. Another frequently confused diagnosis is Enlarged Prostate (or BPH), because of the frequent wakening for nighttime urination. For the Sleep Specialist these are fairly strait forward differentials, for the general medical office, a patient may have a very convoluted track to reach the correct diagnosis and effective treatment.

Since healthy sleep is so important to our health, it is important that it be looked after as well, just as our dental care is done on a regular routine, we should have a routine to take care of our sleep. Sleep Hygiene will be looked at in a future post.

Some good help available on the National Sleep Foundation . Org website. Enjoy and sleep well.

C-Brats, It is National Sleep Awareness Week. It is my sincere hope that this weeks efforts do more than just occupy space here, but do help to increase awareness that our sleep really is important, and just like I don;t want to read of anyof you involved in a boating accident, I don't want to hear of any of you involved in a car crash or having a stroke because somewhere along the line we just thought snoring was obnoxious or funny.

Harvey "The Sleep Guy" wishin he was on the
SleepyC :moon
 
While reading this post I was thinking how hard it has been for me to fall asleep lately and zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz
zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz
 
Hey Sleep Guy...two I'll toss in a couple q's.

#1 - What's the prevailing wisdom on naps, as a substitute for missed night sleep? Does one need the 8 hours all at once?

I often stay up waaaaay later than I should, and given the morning canine commotion around the Da Nag household, sleeping in is rarely an option. However, assuming I can get away with it, a 2+ hour nap the following day is pretty common.

#2 - Any tips for falling back asleep? When my head hits the pillow, I'm out almost immediately, and usually until morning. But if something wakes me in the middle of the night, man...I can stare at the ceiling for 2 hours.
 
Harvey-

I want to say thank you for bringing this topic of sleep apnea to everyone's attention because it is such major undetected problem.

I have the whole syndrome of related problems that surround sleep apnea and know how difficult a problem it can be to recognize and manage without some professional help.

Thanks for your contribution!

Joe. :teeth :thup
 
OK we will do some “Answers” here now.

Naps OK or No? Naps are useful to catch up, as you appear to be using them. Many of us do that. In general, it is discouraged to nap in the day because the sleep requirement is preferably satisfied in one session. That facilitates the “normal” sleep architecture, mentioned back up the thread a ways, and allows for the smooth transition through the stages of sleep, and accomplishment and production of the necessary processes in healthy sleep.

The basic sleep requirement of 8 hours allows for 4-5 cycles of sleep. Shortening the sleep session, say an hour, leaves us in a sleep debt situation, by an hour. An hour nap, done in the following day, will catch that up. However, it also may have the unfortunate result of delaying our “go to sleep” mechanism for the coming night. This is why napping is discouraged, because it encourages delayed sleep onset. (This is one of the mechanisms that appear in some forms of insomnia.) If you only need 8 hours of sleep per night, you can’t sleep 1-2-or3 hours during the day and still go to bed at 10PM and expect to go to sleep then until 6 in the morning.) The one-hour nap in the daytime also is not long enough to allow for the brain to go through the sleep stage progressions to get into the deeper, refreshing and reorganizing sleep stages. So we loose out on the “good” sleep. A 2+ hour nap may get you through one sleep cycle. If so, it is quit probably going to delay the normal sleep onset that would come at your usual sleep time, and then also eliminate one or more cycles through the normal architecture of the night. So if a nap is taken during the day, the bed time should be delayed, an equal amount of time, However, the wakeup time should always remain at the same time every day.

Now for falling back asleep. First we should understand that each individual has a certain sleep requirement, be it 6.5, 7, 7.5, 8, 8.5, or 9 hours. It is commonly agreed that between 7.5 and 8 hour per night is the requirement for most people. There are some who deviate from the standard, and graphed on a Bell Curve, the top of the Bell would be at 7.75 hours.

So first, if the sleep debt is paid, the requirement is met, there is little to do to “Make yourself sleep” The Brain cannot be forced to go to sleep. However, if we have a waking moment, during sleep time, the best thing to do is keep the brain unoccupied, and return to sleep ASAP. Do not look at the clock, or think about the bills, or the rising price of boat gas, or how many post’s Joe has. Make an effort to “Keep it Blank” Change position if necessary, and relax, concentrate on slow relaxed breathing, think of a pleasant place or time. For me it works to think of being at a favorite lake, watching a sunset, and as the sun goes down it gets darker, start thinking about looking for the stars, and next thing I know my cell phone is playing “Happy Birthday” (my everyday alarm clock tune.)

You may need to get up and take care of business, (bathroom) or eat a LIGHT snack. While doing this keep the lights dim. We use night-lights so we do not turn lights on in the house at night. If sleep does not return in 15 to 20 min, then get up and go to the recliner, listen to quiet, relaxing music, or read light recreational reading, or a repetitious hand craft, (knitting, braiding or weaving etc), to keep from mental stimulation. Do this until sleepiness returns. Do not mentally punish yourself for being up. Transient insomnia is not uncommon, habit forming, or dangerous, if allowed to die it’s natural death, (a night or two 1-2 times a year.)

Sleep is an interesting phenomenon and for much more good information look at the National Sleep Foundation website, ( sleepfoundation.org )

Off to catch some ZZZZZZZZZZZZZZZZZz's of my own

Harvey
SleepyC :moon
 
Joe, I have some of them myself, Including Obstructive Sleep Apnea and am working hard to do something in my own life to decrease the effects of a life time of not real good to downright bad sleep hygiene. (Working nights, and days, eating whatever, whenever, and not a lot of exercise) I use CPAP and am working on lifestyle changes to decrease the weight and increase the heart health now.

Glad to share, and sorry it is so late for some of us.

Harvey, Hey, Where's my Pillow
SleepyC :moon
 
Good stuff there, Harvey - thanks for the info.

Oh...and I get my best sleep, about 20 miles to the west of you. Some might suggest being away from the stresses of CA life is the explanation, but I think there's just an excess of Sleep Fairies on the Oly Pen.

Nighty-night, all. :moon
 
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