health & wellness
Join the crowd sleep deprivation is reaching
near-epidemic proportions.
Ronelle Grier
Contributing Writer
W bile sleep may be in short sup-
ply for many people, there is no
shortage of questions and theo-
ries on the subject. How much sleep do we
need? Is it possible to get too much sleep?
Why do some people wake up tired after
sleeping all night? What is REM sleep? What
causes snoring, and how can it be treated?
Some claim to function well on four or
five hours of sleep, but it is far more com-
mon to hear people complain about not
getting enough sleep, especially in a society
where non-stop communication is pos-
sible and often expected. While more and
more activities are crammed into our lives,
there is still no way to increase the number
of hours in a day. The result is widespread
sleep deprivation among children and
adults, a near-epidemic condition that
comes with a host of serious and far-reach-
ing consequences.
Experts agree that insufficient sleep can
lower the body's ability to fight infection
and increase the risk of heart disease and
stroke. Accumulated sleep deprivation can
cause headaches, depression, memory issues
and decreased coordination, which can lead
to accidents and injuries.
Dr. Sheldon Kapen, professor, neurolo-
gist and sleep specialist
who recently retired as
Chief of Neurology at the
John Dingell Veterans
Administration Medical
Center in Detroit, says
adults need between
seven and eight hours
Dr. Kapen
of sleep, while children,
adolescents and teenagers
require as much as 10-12
hours.
"If you sleep one-and-a-half to two hours
more on weekends than during the week, it's
a sign of sleep deprivation',' he said, adding
that one cannot "catch up" if the sleep debt
is chronic rather than occasional.
Kapen said aging can cause insufficient
sleep because the neurological pathways
that influence sleep are affected in much the
same way as pathways that affect memory.
Puberty and adolescence also introduce bio-
chemical changes that can disturb sleep.
"The most successful sleepers are babies','
he said.
Dr. Evandro Silveira of Medical Center
Pediatrics in West
Bloomfield sees many
teens who suffer from too
much stimulation and
too little sleep because
of homework, extracur-
ricular activities, and
continuous access to cell
Dr. Silveira
phones and computers.
"These kids are young
and full of energy; when they're constantly
connected, ifs a bad combination. They
don't know when to turn it off',' said Silveira,
who recommends 8-10 hours of sleep for
teenagers and 10-12 hours for younger
children.
Judy Lipson, licensed counselor and edu-
cational strategist, believes it is important
to understand why a child or teen is not
getting enough sleep. Conditions such as
ADHD or certain medications can affect the
ability to fall or stay asleep; so can excessive
use of computers and video games.
Lipson, who has a private practice in West
Bloomfield, suggests a bedtime routine with
calming activities such as a warm bath,
reading or quiet music, especially for young-
er children. For teens, she recommends
turning off the computer and cell phone at
a specified time, doing yoga or tai chi, and
limiting exposure to negative news.
"Avoid computer, video and TV right
before bedtime; the light from the monitors
stimulates the brain and nervous system
and releases cortisol, a hormone that is
connected with stress:' said Lipson, adding
that those of all ages should stay away from
caffeine and aerobic exercise right before
bedtime.
Many busy people accept sleep depriva-
tion as a way of life without realizing the
potential risks to health and safety.
The NHTSA (National Highway Traffic
Safety Association) reports that "drowsy
driving" causes more than 100,000 crashes a
year, resulting in more than 40,000 injuries
and 1,550 deaths. According to the organi-
zation's website, the actual figures may be
much higher because fatigue is underre-
ported as the cause of many accidents.
Noted health expert, surgeon and author
Dr. Mehmet Oz said,"Most of us don't get
enough sleep, and that plays a significant
role in our aging ... plus lack of sleep is
associated with mental decline and overeat-
ing, which leads to major aging conditions ..
. yet we go on our way, trudging through our
daily lives tired, defeated, sluggish, caffeine-
infused and longing to sledgehammer the
alarm dock at 6:07 every mornine
Insomnia And Apnea
According to Kapen, the most prevalent
form of sleep disorder is insomnia, a generic
term for the inability to fall asleep or stay
asleep for an extended period of time. While
insomnia can be caused by stress, depres-
sion or medication, the most common
physiological cause is sleep apnea.
When apnea is present, the airway nar-
rows or collapses during sleep, preventing
sufficient air from entering the lungs. When
this happens, natural breathing movements
increase, which usually cause the person to
wake up, often several times an hour. Each
event causes a decrease in oxygen that in
turn raises blood pressure. Obesity increases
the risk of apnea. Those with apnea do not
get the benefit of REM (rapid eye move-
ment) sleep, which is the deep restorative
stage that comprises approximately 20 per-
cent of a normal sleep cycle.
Symptoms of sleep apnea include feeling
tired after a full night of sleep, falling asleep
during the day, and loud and persistent
snoring.
"Usually a spouse will recognize apnea
because heavy snoring is the first sign:'
Kapen said.
A sleep study conducted by a physician
specializing in this field is the most accu-
rate way to diagnose sleep apnea. Once the
diagnosis is made, treatment options may
include a CPAP (continuous positive airway
pressure) machine, a customized oral appli-
ance or even surgery, usually in cases where
an anatomical obstruction exists.
The CPAP machine uses mild air pressure
to keep the airways open. It includes a mask
or other device that fits over the nose and/
or mouth and a tube connecting the mask
to the machine's motor, which blows air into
the tube. The masks come in many shapes,
sizes and materials and can be designed to
be worn with eyeglasses or accommodate
oxygen tubes. Nasal pillows, small flexible
mushroom-shaped cones that fit into each
nostril, are another option.
A CPAP machine was life changing for
Jeff Fox, 60, a West Bloomfield attorney,
husband and father who often nodded off
while watching movies or sitting at his desk
in the middle of a workday. "I thought I was
getting five or six hours of sleep, but I was
always tired:' he said.
About four years ago, Fox became frus-
trated with his chronic fatigue and heavy
snoring and did some Internet research,
which led him to believe he was suffer-
ing from sleep apnea. A sleep study con-
ducted by a physician at DMC Huron Valley
Hospital in Commerce Township confirmed
Fox's suspicions. His doctor prescribed a
CPAP device to alleviate the problem. The
first night Fox used the machine the results
were instantaneous.
"I drove to Lansing the next day, and it
was the first time I was able to stay awake
during the whole drive without stopping;
he said.
Fox uses a CPAP device known as a
Bi-PAP, which has two different specifica-
tions for breathing in and out. The mask
covers Fox's nose and is designed to accom-
modate his beard.
"I look like a fighter pilot, but it's not
uncomfortable, and I know if I don't wear it,
I'll be tired tomorrow. I won't sleep without
it',' said Fox, who takes the device along
when he travels.
Debbi Ross of Bloomfield Township was
diagnosed with sleep apnea and fitted with
a CPAP device, but she found the mask too
uncomfortable to use on a regular basis. She
continued to suffer from insomnia until her
Trouble Sleeping on page 74
July 26 2012
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