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New Directions - A Good Night's Sleep Is Vital to Your Health

New Directions Fall 2010

A Good Night's Sleep Is Vital to Your Health

Date: October 1, 2010

Chuck Leger
Chuck Leger, Director of Pastoral Care at Suburban Hospital

Now that the school year has begun, many parents have struggled to get their children to bed earlier to ensure they get enough sleep after a lax summer routine. Frustrating as this might be, grown-ups should not overlook their own need to get a good night’s sleep or they may find themselves at risk for serious health problems.  

“There is now evidence showing a link between a sleep disorder and increased risk for high blood pressure, heart disease, stroke, diabetes, and obesity,” says Dr. Carolyn Wang, medical director of Suburban Hospital’s Sleep Disorders Center and member of Johns Hopkins Community Physicians. She points to a recent study in the American Journal of Respiratory and Critical Care Medicine, which concluded that sleep apnea, a common sleep disorder that affects 18 million people in the United States, is significantly associated with the risk of stroke. The study showed that in men, there was an incremental rise in stroke risk that correlated with a rise in apnea severity. “Since stroke is the third leading cause of death in the United States, this is cause for concern and more studies need to be done,” says Dr. Wang.

Another example of the correlation between a serious disease and sleep problems is the epidemic of obesity. Doctors have known for some time that people who are overweight have a greater incidence of sleep apnea. “Contributing factors have to do with neck and chest anatomy.  Excess tissue and fat contributes to the collapse of an airway that already has diminished muscle tone during sleep,” says Dr. Wang. “Sleep problems can improve once a person slims down.” 

At the same time, slimming down may be easier if that person has a better night’s sleep. In a study conducted by the Howard Hughes Medical Institute and Stanford University, the duration of sleep as an important regulator of body weight and metabolism was studied. The study looked at metabolic hormones that regulate our feelings of fullness or hunger, leptin and ghrelin, and the association between short sleep time and increased body mass index (BMI). The study concluded that in Western societies, where chronic sleep restriction is common and food is widely available, changes in these hormones that regulate the appetite, coupled with abbreviated sleep, may contribute to obesity.

“In order to learn more, we need to continue to study the relationship between sleep disorders and major diseases,” says Dr. Wang. A good start, she says, is for doctors and patients to make sleep part of the discussion during any medical exam or visit.  

How do you know if you have a sleep problem?

We seem never to tire of poking fun at the picture (or maybe your reality) of a snoring spouse seemingly in a deep sleep while the other partner is wide awake and suffering, but this is one of the telltale signs of the most common form of apnea, called obstructive sleep apnea (OSA).  It is often the partner of the snoring person who insists they get help, before the sleep disorder is identified. Another way people suspect they have a problem is if they experience excessive daytime sleepiness.

“Sleep apnea occurs when you interrupt your breathing during sleep,” says Dr. Wang. “At times the person is not even aware of the resulting arousals that punctuate sleep as they are so brief, but the sleep they get is not restorative sleep.” As a result, Dr. Wang explains that the deepest and most restorative sleep, Delta sleep (stage N3), is limited in a person with obstructive sleep apnea.

Also, the Rapid Eye Movement (REM) stage of sleep, which is important for learning and memory, tends to come later during the night and accumulate during early morning hours. Therefore, it may not last long enough in an individual with interrupted sleep. Later on that day, when the person should be awake and alert, he may feel excessively tired and fall asleep inappropriately. 

There are many different types of sleep disorders and they differ in severity. For a definitive diagnosis, your physician can refer you for a sleep evaluation. At the Suburban Hospital Sleep Disorders Center, sleep evaluations take place in a safe and comfortable environment under the direction of Dr. Carolyn Wang, medical director, and Dr. James Yan, associate medical director. Evaluations include the following:

  • Initial screening/evaluation
  • Overnight sleep study
  • Multiple sleep latency testing
  • Continuous Positive Airway Pressure (CPAP) and bi-level Positive Airway Pressure (BiPAP) Titration
  • Consultation with a sleep specialist

Treatment plan and follow-up

If a sleep-related breathing disorder is diagnosed, treatment may include lifestyle modification, medications, dental devices, surgery, or, most commonly, the use of a breathing device such as a continuous positive airway pressure (CPAP) mask. 

“Sleep is the new vital sign for good health,” says Dr. Wang.

If you are living with a chronic disease, a sleep evaluation can give you peace of mind, a better night’s sleep, and place you on the road to better health.

To learn more | Go to Sleep Center, or call 301-896-3939.