Sleep Disorders in Adults (cont.)

MODERATOR:
What else did the 2005 Sleep Poll look at?

KRYGER:
The 2005 poll showed that about one-half of the American population sleeps well and one-half of the American population sleeps poorly.

The part that sleeps well includes, surprisingly, senior citizens, many of whom actually slept more and felt better during the daytime than many of their younger population.

For the first time the American Sleep Foundation created profiles of sleepers in the poll. What was very interesting about the half that did not sleep well is that there were three groups of such people:

  • One group were what were called dragging duos. These were people who were partnered, employed, and in part, workaholics, doing work activities within an hour of going to bed and getting up early in the morning. About one-quarter of these people said that their intimate relationships were affected because of sleepiness.
  • Another group of poor sleepers were individuals who were overworked, overweight, and over-caffeinated. This group was also workaholic, having the longest work week (47 hours). They often slept less at night than the other groups, averaging 5.2 hours a night and had to compensate by napping during the daytime. This group drank much more coffee, averaging four cups per day. This group tended to be obese, as well.
  • Now the next group that slept poorly, and they made up about 1 in 7 of the population, had medical conditions including depression that played an important role in their poor sleep. They had other medical conditions such as hypertension and diabetes. This group was the most likely to use sleeping pills or sleep aids. Many in this group were females. Many people in this group also had problems with their relationships, including intimate relationships, because of sleepiness. This group had the worst sleep of all five groups that were found.

The point that I'd like to make about the people that don't sleep well is that very often the cause is lifestyle. It is their work, their schedule, their overindulging in caffeine, and in one group it is medical conditions. The last group was more likely to have sleep disorders such as sleep apnea and restless legs syndrome as well.

MEMBER QUESTION:
I have both sleep apnea and I'm bipolar. At night I can't sleep at all but then I can fall asleep on the couch without my CPAP for an hour at a time. Is that OK?

KRYGER:
No. If someone has sleep apnea, they should use their CPAP [continuous positive airway pressure] machine whenever they sleep, unless their doctor tells them otherwise. The reason is that most people with sleep apnea cannot sleep and breathe at the same time and their brain wakes up in order for them to start breathing again, so that a short sleep during the daytime will not usually make them feel any better.

MEMBER QUESTION:
Do you need to lay flat on your back while using a CPAP? Is the humidifier the best CPAP to have? How many hours are considered good for you to have the CPAP on?

KRYGER:
The CPAP should be effective in whatever position you are comfortable in. You don't have to lie on your back for it to be effective. Most doctors recommend that people use the CPAP as much as possible when they sleep. We don't know for sure how many hours of CPAP usage per night would result in the best response but it is believed that you should wear it as much as you can when you are actually sleeping. Humidifiers are now available with most CPAP machines and whether a person needs a humidifier depends on many factors including the humidity of where they are living. So if it is very dry where you are living, there is a greater chance you'll need a humidifier. Different types of humidifiers are available, and this is something you check with your doctor and whoever is supplying your equipment.

MEMBER QUESTION:
I have been very worried about my sleep for a while. I have MS, which does affect my sleep, I know. But I seem to function OK during the day, and then after work, once I sit down after chores, I always fall asleep in my recliner. I can't seem to stay awake. I wake up around 1 a.m., and still have to finish chores (I'm a single mom of a 16-year-old), bathe and give myself my Copaxone shot (MS drug). I get to bed around 2:00 to 2:15 a.m. and have to get up at 5:30 a.m. for work. I also snore, loudly (according to my son, from way down the hall).

I am worried that I have sleep apnea. I do wake up sometimes, but feel it's my snoring that did it. By the way, I am NOT overweight at all. I have been doing this for several years. I am single, so don't have a partner to pay attention to any stopped breathing.

What should I say to my primary care provider? I talked to him already, and he dismisses it as allergies and says the snoring is just from that. He gave me Zyrtec.

KRYGER:
There are many reasons why someone with multiple sclerosis or other neurological conditions may become very sleepy during parts of the day. With some neurological conditions, sleep apnea is common, and the only way to reliably diagnose it is with a sleep test.

People with neurological disorders may also have excessive movements when they are sleeping, and these movements may also actually result in sleepiness during the daytime. This is something else that should be picked up in the sleep test.

People should also remember that sleep is controlled by the brain, and a condition that affects the brain may also lead to sleepiness.

Finally, people should be aware of the fact that their medications may be the source of the problem. When I say medications, I don't mean just prescribed, but also over-the-counter medications which may be making them sleepier. This might include, for example, some antihistamines.



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