By Francesca Sullivan
We spend a third of our lives sleeping. Most of us take it for granted and we know little about what goes on while we are sleeping, even though the balance of when and how we sleep is crucial to our physical and mental well-being. This becomes evident when suffering from temporary disruptions in our normal sleep pattern, through jet-lag for example.
For some people, trying to get a good night’s sleep becomes a pressing problem that impacts their overall health, and has far-reaching implications. Cairo West Magazine talked to Dr. Shahira Loza, a sleep disorder specialist, about the symptoms and treatment of sleep disorders, and how to enjoy the ultimate good night’s sleep.
CWM: What are the main types of sleep disorders, and their causes? Are any of them dangerous?
SL: Sleep disorders affect all ages, from tiny infants to older adults and every stage in between. Because they can impact on the body in different ways, the area of sleep medicine is of interest to many sub-specialties in general medicine. It is the study of body rhythms ,timing and physiologic changes during sleep , since these are the key to diagnosing and treating most sleep problems. If you are not getting the right amount of healthy sleep at the right time, the effects are potentially very dangerous. You are likely to fall asleep when you don’t want to, which might be fine when you are sitting in front of the television, but catastrophic if you are in a car driving at seventy miles per hour!
Research has shown that sleep deprivation is the cause of many accidents at work; even events such as the Chernobyl disaster have been linked to this problem. All sleep disorder symptoms should be taken seriously, but falling asleep at inappropriate times is considered a red flag for sleep specialists.
Another potentially dangerous symptom is snoring, which might be caused by repeated interruption of breathing or sleep apnea, during which the patient stops breathing for up to ten seconds while sleeping. It is thought to affect six percent of men and 3% of women, though recent research put this figure much higher. The result of sleep apnea is at the very least sleepiness and fatigue during the day, but it can also contribute to hypertension and diabetes, making their condition harder to manage.
Sleep apnea is very easy to diagnose with the right equipment in a Sleep laboratory where brain waves, heart rate and breathing are recorded , but the problem is that most sufferers don’t know that they have it. They might have been told they snore, for example, but this may or may not imply apnea. Following diagnosis, according to the severity Sleep apnea can be treated by behavioral approach, surgery, dentists or in the most severe cases a device giving continuous positive airway pressure during sleep( CPAP). Other physical movement disorders, such as RLS (Restless Leg Syndrome), Periodic Limb Movement Disorder can also be addressed after being recorded in a sleep lab.
How many hours of sleep does the average adult actually need, or does it depend on the quality of sleep?
This is genetically determined, and it varies from five hours to eleven hours. Since the early 1950’s sleep patterns have been recorded in terms of brainwaves, with four different stages of sleep ranging from light to deeper stages followed by Rapid Eye Movement stage, REM sleep, the four stages are repeated in four to five cycles during a night sleep What is important is that you have enough deep sleep and REM sleep during a whole night sleep.
What advice do you have for people with chronic insomnia?
Insomnia is not a disorder, but a symptom, and research shows that between seventy to ninety percent of causes are psychological. Depression and anxiety are two of the most important causes of insomnia, so for a solution you must go to the root of the problem. But insomnia is also an example of not understanding the body’s timing and natural sleep rhythms. As sleep doctors we categorize people as larks or owls, but this can change during different life stages. Some people have a constitutional tendency to wake up late. Adolescents, for example, have ‘delayed phase syndrome’; they are biologically programmed to sleep late and wake up late. For this reason some schools and colleges in the USA have experimented with starting classes at one pm instead of nine am! (If you think you can catch up on your sleep over the weekend, delayed-phase people watch out, or you will change your sleep pattern).
Conversely, older adults tend to sleep early and wake early. So when an older person complains that they always wake up in the night, ask them what time they went to bed. If they slept at eight pm it would be quite natural for them to wake at three am!
To combat insomnia respect your natural sleep rhythm and try to wake up every morning at the same time. Don’t go to bed until you are sleepy, and follow the well-tested advice of not taking stimulants such as caffeine (tea, coffee, chocolate) before sleeping. Instead try eating something containing tryptophan: bananas, apples, or dairy products. It is not very healthy to eat a large meal straight before sleeping, especially if to have a tendency to reflux.
Daily exercise is useful, but it is also a stimulant, so finish at least five hours before bed-time. And be aware that alcohol is a muscle relaxant and may initially help you sleep, but as soon as it is fully absorbed into your system it will start to act as a stimulant and wake you up again.
How much has the use of smart phones and other devices impacted people’s sleep patterns?
The bedroom should be a place for sleep and sex only, though some people have no problem with a TV in the bedroom. Just don’t switch it on when you wake up and can’t get back to sleep! And beware of digitally devices though, including smart phones and clocks. People with insomnia tend to be checking them continuously, and that can cause stress.
Are there any nutritional supplements that can help?
Self- medication with sleeping pills is not advisable except under the supervision of a doctor. In some cases – sleep apnea for example – they can actually make the problem worse. The same goes for so-called ‘natural’ herbal remedies, other than mild examples such as chamomile tea.
What’s the best way to combat jet-lag?
For people who work shifts or travel a lot, sleep disruption is difficult to deal with. If you have to catch a plane to New York, attend a business meeting and come back the next day, you will have no time to recover your sleep pattern when you are there. Try to use light and darkness to fool your body into sleeping and being awake. Medication may also help, but consult a doctor first.