Home Sleep Tests Offer Patients a New Alternative

A new and exciting trend in sleep testing is quickly gaining traction around the country: home sleep testing. Reimbursement for the home sleep test has only recently been approved, and more and more accredited sleep centers around the country are providing access to home sleep tests, as well as most major hospitals.

The home sleep test provides an excellent opportunity for sleep professionals to gauge a patient’s sleep tests needs from the comfort of their own home. It’s an excellent alternative to conducting a sleep test in a lab, a practice that many patients often find intimidating. It’s surprisingly simple, too.

First, the patient is given a brief questionnaire to determine if they’re at risk for a sleep disorder. If the patient’s results suggest they may have a sleep disorder, they’ll be given a lightweight and unobtrusive home sleep test device to take home and use overnight. This device records respiration, including both breathing and sleeping. The next morning, the patient returns the device to the sleep center, where experts download data from the unit’s memory card and prepare the results for the patient. If it’s determined that the patient does, in fact, suffer from a sleep disorder, more testing will be arranged.

Some common signs of sleep disorders include:

- Snoring
- Insomnia
- Brief periods of not breathing and/or choking or gasping during sleep
- Waking during sleep and restless sleep
- Excessive daytime sleepiness and falling asleep at inappropriate times
- Personality changes/disorders
- Depression
- Loss of concentration
- Morning headaches

If you believe you’re suffering from a sleep disorder, you should seek medical help from a physician or sleep expert immediately. There’s no need to fear a sleep test, especially with the new home sleep test option.

Wake Me When Its Over

It’s no secret that today’s tough economic times are the cause of many headaches for anyone that has to worry about supporting themselves or a family. Many are struggling with anxiety over losing a job at a time when unemployment rates are at an 11-year high). That anxiety has begun to translate into sleepless nights.

Recently, a study of more than 1,100 workers found that 9 out of 10 were losing sleep over money worries. The reason is simple – if you’re feeling threatened over your financial situation or anything else, you’re likely to have difficulty sleeping. Any perceived threat triggers a “fight or flight” response in which adrenaline is released in the body. Adrenaline produces vigilance and alertness, making sleep impossible.

During times of stress, it’s critical to maintain both quantity and quality of sleep. Like food and water, sleep is a corner stone of good health. Proper sleep enables peak performance. It also helps fend off colds and the flu (and keeps sick days to a minimum).

While there’s no quick fix for economic woes, there are some steps that help ensure a healthy night’s sleep:
· Keeping a regular routine – wind down the same way each night, at the same time, and wake up at the same time each morning
· Sleep in a relaxing, dark and cool environment, and avoid the use of electronics in the bedroom, such as TV’s and computers. This will help your brain to release sleep-inducing hormones.
· Don’t toss and turn – if you can’t sleep, get out of bed and engage in a relaxing activity, such as reading. Only return to bed when you are relaxed and sleepy.
· Don’t face the clock and watch minutes tick by, which will also add to your anxiety.

If you go for more than two weeks with disrupted sleep, it’s time for professional help. Board-certified sleep specialists are physicians trained to diagnose and treat more than 80 known sleep disorders.

What Will They Say Next?

As I continue to watch the race to the White House, I can’t help but note the various gaffes that keep popping out of the candidates’ mouths. Watching it all makes me wonder whether some of these verbal slip-ups can be attributed not to incompetence but to sleep deprivation.

As I said in my last blog, it’s no secret that these candidates are enduring a whirlwind schedule. We all know how foggy and fragmented we feel when we’re sleep deprived—imagine being in that state and living with microphones and cameras in your face 18 hours a day.

No wonder we turn on the nightly news and hear Senator Obama referring to Penn State’s beloved football team, the Nittany Lions, as the “Nitally Lions.” Is it any surprise that Senator McCain spoke of the non-existant “Iraq-Pakistan” border?

These silly verbal missteps could easily be indications of improper rest and maybe even exhaustion.

So how can the candidates (and you at home) make sure you get proper rest and lead a gaffe-less existence? Here are a few simple lifestyle tips just about anyone, politician or no politician, can apply to ensure adequate rest:

- Get up and go to sleep at the same time, even on weekends.
- Make sure your bedroom is dark.
- Take all electronics out of the bedroom, and turn your illuminated clocks to the wall.
- Avoid caffeine or alcohol after about 5 pm
- Exercise at least 3 hours before bedtime.
- Allow yourself an hour to unwind before sleep.

The Great Candidate Sleep Watch

You don’t have to be an expert in politics to know that the last two years of the presidential candidates’ lives have been a whirlwind. As they attend rallies, debates, and other media opportunities, they stint on one of life’s undeniable essentials: sleep. And it shows. Getting fewer than 7 hours of sleep on consecutive nights can lead to sleep “debt.” Sleep debt produces irritability and cognitive impairment. People get snappish and the ability to think, respond, and reason are all diminished.

Perhaps sleep debt is why candidates on the campaign trail make so many verbal blunders from the amusing (McCain’s “I’m a conservative liberal Republican” and Obama’s “Israel is a strong friend of Israel’s”), to the alarming (McCain’s reference to the nonexistent “Iraq-Pakistan border” and Obama’s to the “57 states”).

Not only candidates but also average Americans keep schedules that are simply exhausting. In fact, over the past century, the amount of sleep that Americans get has decreased by 20 percent. Because of advances in technology, we now live in a 24/7 society. Cable television and the Internet are available 24 hours a day. Workers carry Blackberry devices and are accessible to their employers on nights and weekends. Kids stay up texting their friends. It’s as though we’ve all adopted a “campaign trail” schedule. Lack of sleep has many serious effects including:

· Driver fatigue and a 20 percent increase in car crashes
· Impaired judgment, cognitive speed, spatial orientation and motor function
· Obesity
· Depressed mood, poor memory and difficulty concentrating.

As the election approaches, I’ll be blogging about sleep deprivation symptoms that I’ve observed the candidates demonstrating along the campaign trail. It’s my hope that by doing so, we’ll all come to realize the signs of sleep deprivation more easily, and will adjust our schedules to make sure we’re getting the proper rest we need to avoid sounding like an exhausted presidential nominee. I’ll provide tips that the candidates, and you, can use to work proper sleep habits into busy schedules. This will help you to avoid embarrassing goofs, but it’s also critical if you want to keep yourself in good health.

Check back soon for the first installment of the Candidate Sleep Watch.

ADD, ADHD or...a sleep disorder?

Here’s a common situation that plays itself out often around the country – a parent takes their child to the doctor, and explains that their child has difficulty focusing on schoolwork or is unable to accomplish simple tasks at home. After receiving a quick rundown of the symptoms, the doctor diagnoses the child with Attention Deficit Disorder (ADD) or Attention Deficit Hyperactive Disorder (ADHD). What follows this disturbing diagnosis is usually a prescription for the ADD/ADHD medication-of-the-month, and a feeling of guilt from most parents for having to medicate their children in such a way.

But what if all that wasn’t necessary? There’s a disturbing trend developing - the misdiagnosis of sleep disorders as ADD or ADHD. Many parents, AND doctors, are simply unaware of that fact that ADD and ADHD share many of the symptoms as sleep disorders. Most doctors are more aware of and educated on ADD and ADHD, so their first instinct is to assume a child is suffering from one of those disorders and to recommend a medication to solve the problem. In reality, the problem may be as simple as the child not getting an adequate amount of sleep because of a sleep disorder they’re unknowingly suffering from.

According to recent research published in the journal Pediatrics, children with increased daytime sleepiness and other symptoms of sleep disordered breathing have an increased chance of inattention and hyperactivity (often associated with ADD or ADHD)—especially young boys. The study also concluded that between 7 and 12 percent of children snore regularly, putting them at high risk for sleep disordered breathing problems, such as obstructive sleep apnea. When children do not get the sleep their bodies require, they are at risk for health, performance and safety problems, often resulting in difficulties at school.

Here’s a real-life example for you – I treated a young boy, whose mother had been told he was suffering from ADHD. Ever since he was a baby, her son would go to sleep and wake up every two hours. This continued as he grew, and resulted in his waking up for school totally exhausted. By 9:30 in the morning, he was staring into space and falling asleep in class. As a result, he wasn’t focusing in school, his grades were slipping and he had become extremely irritable. My patient’s mother was told that her child was “a candidate for referral” – meaning he should be evaluated for a disorder such as ADD or ADHD. He underwent a full battery of evaluations – visiting with a variety of different medical professionals. He was ultimately prescribed medication for ADHD, which affected him quite adversely – it made him jerky, caused his pupils to tremble, and affected his sleeping patterns so that he actually slept LESS. Eventually, his neurologist suggested that he undergo a sleep study, and it was determined that what was originally believed to be ADHD was actually a sleep disorder. After beginning his treatment for the sleep disorder, his mother has seen a complete change in his schoolwork, behavior and health.

So please don’t ignore any symptoms your child may be exhibiting – make sure to educate yourself about ALL the possible culprits. If your doctor immediately diagnoses your child with ADD or ADHD after hearing the symptoms, make sure to discuss the possibility of a sleep disorder with them. It doesn’t hurt to ask, and it may just save your child from additional suffering. The sooner you begin asking questions, the sooner you may see a change in your child’s behavior, grades, and more importantly, their health.

Is your snoring habit killing you?

Is a loved one’s snoring habit keeping you up at night (or are you keeping them up with your snoring)? Don’t be so quick to ignore it. A recent study by the University of Wisconsin found that people with untreated sleep apnea (a condition characterized by episodes of stopped breathing during sleep) are at THREE TIMES greater risk of dying from ANY cause than those without the condition. These are alarming results, as sleep apnea affects more than 18 million Americans, and many more that aren’t even aware they have the disorder. Many of those affected, AND their doctors, often overlook the seriousness of the symptoms being exhibited.

As if that news wasn’t striking enough, researchers also found that the more pauses in breathing during sleep, the greater the risk was for death. People who had 30 or more pauses in breathing each hour they were asleep, compared to those with five or fewer, were found to be five times more likely to die of heart-related causes.

This study is hard, scientific proof that people MUST start taking their snoring habits (and other sleep problems) seriously. Snoring, a common symptom of sleep apnea, is often the cornerstone of jokes between friends – “My husband snores so loud he could wake the dead,” etc., but the reality is, that habit most couples view as “annoying and inconvenient” can actually be deadly, as evidenced by the University of Wisconsin study. It can also lead to high blood pressure, heart disease, weight gain, mood swings, and memory problems, just to name a few.

The results of this study are alarming, but what many don’t realize is that it is incredibly easy to address the symptoms of sleep apnea. A simple, non-invasive overnight sleep study can help your doctors to determine if you suffer from the disorder, and treatment is often very simple – most sleep apnea patients are given a CPAP (Continuous Positive Airway Pressure) machine to use while they sleep at night. This machine ensures that the patient’s breathing is uninterrupted while they sleep, significantly lowering their health risks. That’s right, no surgery or medication is required -that is, if you’re diligent and take the steps to determine if you’re suffering from this silent killer before it wreaks havoc on the rest of your body.

If sleeping were an event in the Olympics…we’d all be losers

Tonight, the world will watch as the 2008 summer Olympics get underway in Beijing. The Olympics are a time of world unity, competitiveness and…sleep deprivation? Between the viewers who are staying up at all hours of the night to catch their favorite sports live on TV to the athletes who have sacrificed everything (including good sleeping habits - a quick review of the Olympics official Web site,www.nbcolympics.com, will produce various references to sleep such as “she often naps on the mats at the gym” and other similar phrases in reference to the athletes), there’s no question that sleep is taking a back seat to the grand prize.

For the Olympians, balancing harsh training schedules with the everyday stresses of their normal lives, including school, work and caring for families, as well as dealing with the time change in China, can be a recipe for disaster when all is said and done. In addition to the everyday physical stresses their bodies undergo as a result of their dedication to their sport, many Olympians often travel all over the world to attend qualifying events and World Championships. This, of course, affects the body’s “internal clock,” known to scientists as the “suprachiasmic nucleus” (SCN). Shifts in schedule and in exposure to light can disrupt the work of the SCN and make humans feel out-of-sorts and tired.

While the Olympics bring this issue into focus right now, elite athletes aren’t the only ones subjected to the rigors of harsh schedules. In fact millions of high school athletes across the country are about to subject themselves and their internal clocks to similar hardships as a new school year begins. The pressures of balancing studying, homework, and performing well in their chosen sport can easily increase a high-school athlete’s stress level. The importance of sleep in this situation is even more apparent. Besides the obvious benefits of sleep, such as helping an athlete to stay focused and energized, sleep is a time for your body to repair damage caused by stress. Your cells produce more protein while you are sleeping, which helps to form the building blocks for cells, allowing them to repair damage.

So, while the dedication that Olympians display should be an inspiration to athletes everywhere, the sacrifices these athletes make should also be kept in mind. Their love and commitment to their sport come at a price – and that often includes depriving themselves of the benefits of a balanced sleep schedule. The bottom line is, while there is a competitive side to all of us, we cannot allow it to put our bodies at risk.

The Great Sleep Debate

Did you catch the recent TIME article in which Dr. Daniel Kripke, co-director of research at the Scripps Clinic Sleep Center in La Jolla, California, was interviewed about sleep? (You can check it out at www.time.com/time/health/article/0,8599,1812420,00.html.)

According to the article, in 2002 Dr. Kripke compared death rates among more than 1 million American adults who, as part of a study on cancer prevention, reported their average nightly amount of sleep. Dr. Kripke’s findings may surprise some of you:

· Studies show that people who sleep between 6.5 hours and 7.5 hours a night, as reported, live the longest. People who sleep 8 hours or more, or less than 6.5 hours, don’t live as long.

· Both very short sleep and very long sleep have been associated with depression, obesity, heart disease, and other chronic health problems.

Dr. Kripke’s findings fascinate me because I generally recommend that adults get between 7 and 9 hours of sleep per night, the amount that most adults need to fulfill their requirement for sleep. Unfortunately, we now live in a 24/7 society, and people often find themselves stinting on this necessity. For example, a recent National Sleep Foundation poll found that Americans are working too many hours and sleeping too few. Findings showed that 29 percent of Americans fall asleep or become very sleepy at work, while 12 percent say that sleepiness has caused them to be late to work. Add the stresses of work to everyday stresses at home, and it’s easy to see how most of us always feel so exhausted.

But that still leaves us with one question: what IS the ideal amount of sleep time? It’s important to consider that Dr. Kripke himself noted that the ideal amount of sleep varies for different individuals. In fact, the amount of sleep each of us needs is hardwired into our DNA. As Dr. Kripke mentions, “We don’t know if a short sleeper can live longer by extending their sleep, and we don’t know if a long sleeper can live longer by setting the alarm clock a bit earlier.” There are a lot of variables that need to be considered, both biological and societal.

While Dr. Kripke’s research provides an important starting point, more research needs to be done on this subject, especially because the amount of sleep is so variable from person to person. While no “ideal” amount of sleep has been established , there is an ideal range within which most people fall. But, while we all ponder what the “ideal” amount of sleep is, we should also be focusing our efforts on another sleep factor: the quality of sleep we’re receiving. There is just no denying the importance of quality sleep. If we don’t focus on relaxing our bodies during the sleep process, the amount of sleep received won’t matter anyway.