Rupee-1
January 20th, 2017 by sleepcureblog

 

We at Sleep Cure Solutions get frequent calls from patient’s who have been advised Sleep Study by their GP/Doctor. The most common question asked is “How much will the Sleep Study cost ?This is  part of an exercise they embark upon trying to check and compare the cost with various service providers .The answer to this question is so baffling that it leaves them even more confused. We regularly get patients who are quoted anywhere from 2,000 to 20,000 Rupees for a Sleep Study !!!

To get them out of this dilemma and to Empower them I am elaborating on some key points about the Costs of Sleep Studies.

- At present time none of the health insurances in India cover the cost of a sleep study thus it is mostly out of pocket expense.

- There are different levels of Sleep Studies and all sleep studies are not the same.
- A level 1 sleep study (Polysomnography) is an in lab sleep study. The costs of this can vary depending upon the hospital it is being done and the cost in Delhi /Gurgaon/NCR vary between Rs 15000 to 20000. Although it has been the ‘gold standard’ for long but advancements in technology and the portability many patients may not require and can avoid having to sleep in a lab. However patients with co-morbidities should undergo in-lab study.
- Home sleep test (HST) – these are gaining popularity around the world. It should be emphasized that all HST’s are not the same.
- A comprehensive Home Sleep Study (attended level 2 study) is the most popular level of testing. This involves a trained technician putting on the leads and sensors and observing the sleep in your bedroom. The titration is done wherever required. This sort of testing is not possible in the West where it is not possible to have techs staying overnight thus does not find much mention in the medical literature. Sleep Cure Solutions team has the experience of over 3000 such tests and have mastered this testing pathway. These tests typically costs between Rs 8000 – Rs 12000.
- Level 3 sleep tests (unattended level 3 HST) are self- administered (sometimes techs may be asked to administer this just to jack up the costs) sleep tests to rule in Sleep Apnea and are done where the Sleep Apnea is very obvious and there are time and cost constraints. There is no monitoring of sleep (no EEG, EMG, EOG) but just the cardio-respiratory parameters during sleep. There is no provision for titration in this. These tests cost between Rs 2000 to Rs 5000.
As with any other modality it is very important to understand & ensure some of the basics and things like who is recommending the test, who is going to do it, what are the credentials of the Sleep Physician etc.Unfortunately the Sleep Medicine Healthcare Sector is unregulated and Vendors (suppliers of CPAP machines) are doing Sleep studies left right and centre often at throw away prices without really understanding the science and leaving behind a trail of unsatisfied customers. They often have ‘fixed reports’ all advising buying a CPAP machine
As an empowered customer it is your duty and right to get the best service that your money can buy but that would mean doing your homework.
Sleep Cure Solutions with it’s unique business model of utilizing the strength of our backend operations( helping subsidize our local work) is able to provide services at about 30% less cost to the patients. We have been at the forefront of training and are playing a pioneering role in the emergence of Sleep Medicine. The service is led by an American Board Certified Sleep Physician  who has been mentoring physicians in this region. We feel happy and privileged to pass on the benefits of our business model, and our expertise to our patients.

Author :Dr Prerana Garg is the Medical Director at Sleep Cure Solutions. She believes that by doing full disclosure and transparency about everything we do in our practice–especially when it comes to cost we can build trust with our patients and we should not shy away from it.

Posted in Sleep Study Tagged with: , , , , , , , , , , , , ,

healthy sleep habits and tips
November 7th, 2016 by Sleep Cure Solutions

We spend almost one-third of our life sleeping. And if you try to combine the hours we sleep in our life time, it’s huge, it’s really huge.

But why do we sleep every day? What makes us feel sleepy every night? And why do we feel good when we wake up from a full night’s sleep?

These questions need answers – and for centuries, the curious species, we-the-mankind, have been trying to decode sleep. Read more of this article »

Posted in SCORING, Sleep Study Tagged with: , , ,

April 29th, 2015 by sleepcureblog

Rupee-1

We at Sleep Cure Solutions get frequent calls from patient’s who have been advised Sleep Study by their GP/Doctor. The most common question asked is “How much will the Sleep Study cost ?This is  part of an exercise they embark upon trying to check and compare the cost with various service providers .The answer to this question is so baffling that it leaves them even more confused. We regularly get patients who are quoted anywhere from 2,000 to 20,000 Rupees for a Sleep Study !!!

To get them out of this dilemma and to Empower them I am elaborating on some key points about the Costs of Sleep Studies.

- At present time none of the health insurances in India cover the cost of a sleep study thus it is mostly out of pocket expense
- There are different levels of Sleep Studies and all sleep studies are not the same.
- A level 1 sleep study (Polysomnography) is an in lab sleep study. The costs of this can vary depending upon the hospital it is being done and the cost in Delhi /Gurgaon/NCR vary between Rs 15000 to 20000. Although it has been the ‘gold standard’ for long but advancements in technology and the portability many patients may not require and can avoid having to sleep in a lab. However patients with co-morbidities should undergo in-lab study
- Home sleep test (HST) – these are gaining popularity around the world. It should be emphasized that all HST’s are not the same.
- A comprehensive Home Sleep Study (attended level 2 study) is the most popular level of testing. This involves a trained technician putting on the leads and sensors and observing the sleep in your bedroom. The titration is done wherever required. This sort of testing is not possible in the West where it is not possible to have techs staying overnight thus does not find much mention in the medical literature. Sleep Cure Solutions team has the experience of over 3000 such tests and have mastered this testing pathway. These tests typically costs between Rs 8000 – Rs 12000.
- Level 3 sleep tests (unattended level 3 HST) are self- administered (sometimes techs may be asked to administer this just to jack up the costs) sleep tests to rule in Sleep Apnea and are done where the Sleep Apnea is very obvious and there are time and cost constraints. There is no monitoring of sleep (no EEG, EMG, EOG) but just the cardio-respiratory parameters during sleep. There is no provision for titration in this. These tests cost between Rs 2000 to Rs 5000.
As with any other modality it is very important to understand & ensure some of the basics and things like who is recommending the test, who is going to do it, what are the credentials of the Sleep Physician etc.Unfortunately the Sleep Medicine Healthcare Sector is unregulated and Vendors (suppliers of CPAP machines) are doing Sleep studies left right and centre often at throw away prices without really understanding the science and leaving behind a trail of unsatisfied customers. They often have ‘fixed reports’ all advising buying a CPAP machine
As an empowered customer it is your duty and right to get the best service that your money can buy but that would mean doing your homework.
Sleep Cure Solutions with it’s unique business model of utilizing the strength of our backend operations( helping subsidize our local work) is able to provide services at about 30% less cost to the patients. We have been at the forefront of training and are playing a pioneering role in the emergence of Sleep Medicine. The service is led by an American Board Certified Sleep Physician  who has been mentoring physicians in this region. We feel happy and privileged to pass on the benefits of our business model, and our expertise to our patients.

Author :Dr Prerana Garg is the Medical Director at Sleep Cure Solutions. She believes that by doing full disclosure and transparency about everything we do in our practice–especially when it comes to cost we can build trust with our patients and we should not shy away from it.

Posted in Sleep Study Tagged with: , , , , , , , , , , , , , ,

December 12th, 2014 by sleepcureblog

  What is a Sleep Study?

Sleep study is an overnight observation of an individual’s sleep.  This involves monitoring number of physiological parameters simultaneously like  EEG (brain activity), the eye moments (EOG), the chin tone (EMG), breathing (nasal flow), breathing efforts, Oxygen level, heart rhythm (ECG).

Sleep is not a unitary phenomenon .It is divided into different stages like REM sleep (dreaming sleep) and Non REM sleep which is further subdivided into three stages.  The nature has made sleep like an orchestra with different notes at different points and diseases like Sleep Apnea disrupt this rhythm. This can be easily deciphered by a well conducted comprehensive sleep study.

What are different levels (types) of Sleep studies?

There are 4 types -

Level 1 study being the gold standard where are all the above mentioned parameters are observed and attended to by a well-trained sleep technologist  and the recordings are scored by scoring technologists and reviewed by Sleep physician who interprets the same and provides with the final diagnosis and recommendation. The Sleep Specialist then discusses the report and advises the next line of treatment.

Level II study is similar to level 1 but not attended by the sleep technologist  and therefore there is a possibility of potential loss of data.

Level III study involves monitoring  of just two parameters mainly the breathing  and the Oxygen level without monitoring the brain activity and the sleep.

Level IV study is only monitoring the Oxygen level overnight.

In most situations Level 1 study is required however sometime the Sleep physician may conduct a simpler test.

What are the different forms of Sleep Studies?

Diagnostic studies - In these only the diagnostic gear is used; this can be level 1 to level IV study.

Titration studies – which involve titration with CPAP or the BiPAP :this can be performed only in level 1 study setting .

Sleep studies are generally conducted in a split night format in which the first part of the night is the Diagnostic arm and in the later half Therapeutic part where titration with CPAP is done. Split night studies are only possible with the level 1 format where a trained sleep technologist will conduct this study under the guidance of a Sleep Specialist.

 

Sleep study is a very powerful monitoring tool which gives us opportunity to peep into one’s mind and health. It’s utility goes much beyond diagnosing simple Sleep Apnea and extends to diagnosing conditions like periodic limb movement, Sleep architecture problems, Parasomnias, Complex Sleep Apneas, Bruxism, loss of REM Atonia etc.

Eyes cannot see what our mind does not know” is old saying very apt for the field of Sleep Medicine in the region. Device companies in order to fuel the growth of devices are trivializing the sleep diagnostics pushing vendors to conduct sleep studies in a completely unregulated environment; the quality of these can put any regulator to shame. Nevertheless each patient need to be an empowered consumer and decide for themselves what is best for their health.

Who needs a sleep study:

People complaining of the following symptoms need to be screened for Sleep Apnea and may require a Sleep Study

  • Snoring
  • Episodes of choking in the night
  • Morning headaches
  • Unrefreshing /Disturbed Sleep
  • Abnormal movements during night
  • Excessive Daytime Sleepiness.
  • Patients with comorbid conditions like Diabetes, heart failure, depression, fibromyalgia, atrial fibrillation, obesity

Author: Dr Himanshu Garg

Posted in Patient Information Tagged with: , , , , , , , , , , ,

December 7th, 2014 by sleepcureblog

It is wee hours of the morning and the clock has just struck 2 am, but for Ms Anita  sleep is still elusive. She has spent hours tossing and turning in the bed trying to switch off from work. Her stress is further escalating thinking of next day’s engagements and the impact lack of sleep would have on them. Her anxiety is further attenuating any chances of sleep. She somehow manages to get through the next day but starts to get anxious walking to her bedroom that night and this cycle repeats itself. Things eventually reach a stage when the very thought of sleep makes her anxious. Thanks to our booming economy more and more are finding themselves entrapped in this web and turning into insomniacs leading to an insomnia epidemic. Ideally the economic prosperity of a society should not be achieved at the cost of a massive sleep debt of its people but we have already gone too far out. Nonetheless the nature, significance and myriad causes of sleep difficulty remain poorly understood by health care providers and the public at large.

In the modern society sleep should be equated to charging our mobiles, which is very much an active process and not merely a state of rest. Lack of proper charge would only impair its working and utility the next day. Insomnia definitions have been similarly widened from simply meaning lack of initiating or maintaining sleep to include its daytime consequences. These include fatigue, excessive daytime sleepiness, social and occupational impairment, irritability and mood changes. All of these consequences place a considerable economic burden on its sufferers, their employers, health care system and the society.

Insomnia can be either acute or chronic. While most of us might have experienced acute insomnia as a transient problem that resolves quickly when precipitating circumstances like stress, sudden schedule changes or transient illness abates but one has to be careful and it should not be always taken lightly as most of the chronic insomnias start as acute condition as illustrated.

Insomnia can also be classified as either primary or co-morbid. Wherever an underlying cause can be found it is called co-morbid insomnia. Some of the common culprits are acute or chronic pain, chronic medical or psychiatric ailments, drugs or substance use. Often a definite cause cannot be found and primary insomnia is assumed. We are only beginning to unmask the mysteries of its causes and at this stage it appears that it might be an end result of appropriate environmental exposure in genetically predisposed individuals. The clinical assessment of insomnia is based on a careful interview, often supplemented by questionnaires, psychological testing and sleep diaries. At times an overnight polysomnography may be required which means sleeping in a controlled and observed environment in a sleep laboratory where the physician is able to record the brain waves and many other parameters in order to compute total amount of time spent in different stages of sleep.

It must be strongly emphasized that sleeping pill are not the management of choice for insomnia and should be used only as a last resort. Besides problems like adverse effects and habit-forming tendency they do not completely mimic the natural sleep. For example   the most commonly used sleeping pills, benzodiazepines, have a tendency to decrease the percentage of slow wave or deep sleep thus diluting the refreshing effect of sleep. Therefore rather than applying the ‘band-aid’ of a sleeping pill every attempt should be made to hunt down and treat the cause. In cases where this is not successful foremost attention should be paid to good sleep hygiene. This involves having a regular sleep-wake schedule, ensuring a comfortable sleeping environment (18- 22C is ideal), eliminating any noise and light, avoiding any tea, coffee or alcohol before sleeping, avoiding naps and resisting looking at the clock in the night. It is amazing how effective these simple steps alone can be in helping to solve the problems of so many people.

Cognitive behavioral therapy is the next therapeutic option. It employs different approaches leading to changes in behavior or cognition to improve sleep. It seeks to eliminate irrational beliefs about sleep and fears of not sleeping.

When nothing else seems to be working and drugs seem to be the only option left, it is best to discuss the options with your physician who can go over the risks and benefits of one drug over the other. These should always be taken under strict medical supervision least you fall prey to their habit forming potential or suffer side effects. Fortunately some of the newer drugs in development will better address some of these concerns and should provide better options in future.

 

Posted in Insomnia Tagged with: , , , , , , , , ,

Insomnia
November 13th, 2014 by sleepcureblog

Insomnia is a common, annoying and a potentially debilitating human malady yet it’s nature, ubiquity, significance and myriad causes remain poorly understood.

What is Insomnia?

Insomnia occurs when there is adequate opportunity to sleep (different from Sleep Deprivation where inadequate opportunity results in sleeplessness).

What are the complications of Insomnia?

complications of Insomnia

Integrative approaches in treating Insomnia

  • Eight days of TakraDhara
  • Seven days of Yoga & Pranayama training
  • Herbal internal medicines to overcome presenting complaints as mentioned above

Integrative approaches in treating Insomnia•	Herbal internal medicines to overcome presenting complaints as mentioned above

Series of 150 patients at Medanta under the guidance of Dr Himanshu Garg, Sleep Specialist and Prof Geeta ( Head Ayurveda)with either sleep initiation or maintenance insomnia with end points- tapering off hypnotics and relief in Insomnia were subjected to Integrative medicine therapies with a success rate of 80%

 

Posted in Insomnia Tagged with: , , , , , , , , , , , , , , , ,

October 11th, 2014 by sleepcureblog

“Think of this as a prearranged  marriage arranged by people who best understand your interest and once you decide to sleep together the relationship is for lifetime. Going ahead you may not like few things about your new partner but mostly it will be fine’ is the mantra given to me by guru about using CPAP, something I try to tell all my patients. If you have been prescribed to “sleep with the CPAP”, before you embark on this journey few things you should be sure about;

  • Who has prescribed you the CPAP; is the person a qualified sleep physician who has personally looked at your sleep study raw data to make that judgment. Unfortunately this is often not the case in the subcontinent where HME providers in order to push the sales are doing sleep tests and giving out invalidated reports. As an empowered patient you should understand what’s in your best interest.
  •  Do you understand the need of CPAP- like any chronic disease management you need to have insight about the disease, the implications of non-treatment and mechanism of action of the therapy?  This is a critical part of your physician’s job which impacts the success of the therapy.
  • Have you had a successful CPAP titration study; this helps the physician understand your pressure requirements and which machine shall best suit you. Different physicians/sleep services will use different pathways in lab/at home for doing this. This is followed by few days of trail of CPAP so that you can become accustomed to using this every night.
  •  Are you satisfied by your mask- Most Titration studies and /or CPAP trials shall give you the opportunity to try a few of these to see with which you are most comfortable. The step is the key to success of this therapy.
  • Do you understand how to operate the CPAP-it’s important for you to understand some of the basic operations; most HME suppliers will be happy to demonstrate the same for you.
  • Have you considered the need of accessories- most important being that of a humidifier; many machines come with inbuilt humidifiers with others it can be easily added. The other accessory to think about is the battery backup especially in the subcontinent where electricity is often erratic.
  • Have you been explained about other potential problems- these could be eye problems because of leak, nasal bridge ulceration due to pressure, aerophagia etc.
  • Do you have a follow up plan- No prescription is complete one; you must work one out with your physician.
Sleeping With CPAP - A Prearranged marriage

Sleeping With CPAP – A Prearranged marriage

One you have ensured all of the above  you are ready to SLEEP WITH THE CPAP TO A WHOLE NEW TRANSFORMED LIFE!!

Posted in CPAP Tagged with: , , , , , , ,

img1a
March 13th, 2014 by sleepcureblog

WORLD SLEEP DAY – HOW IT BEGAN

World Sleep Day (WSD) has grown steadily since its inception. The first WSD was held on March 14th 2008, under the slogan ‘Sleep well, live fully awake’. The 2009 WSD operated under the slogan “Drive alert, arrive safe” and had participants from 13 major markets, including 49 separate articles, mentioning “World Sleep Day”. 2010’s WSD slogan was “Sleep well, stay healthy” and experienced continued growth of international coverage. The 2011 WSD slogan was “Sleep well, grow healthy”—with emphasis on promoting quality sleeps for all ages. The 2012 World Sleep Day slogan was “Breathe easily, sleep well” held on March 16, 2012. The 2013 slogan was “good sleep, healthy aging” held on March 13, 2013. For 2014 the slogan is “restful sleep, easy breathing, healthy body” and will be held on March 14, 2014.

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http://epaper.jagran.com/ePaperArticle/08-mar-2014-edition-Gurgaon-page_22-350-5192-244.html

WSD is an annual event intended to be a celebration of sleep and a call to action on important issues related to sleep. It is organized by the World Sleep Day Committee of the World Association of Sleep Medicine (WASM), and aims to lessen the burden of sleep problems on society through better prevention and management of sleep disorders. The world sleep day is on the Friday before the March equinoxes, and therefore, the date changes each year. The following are future World Sleep Day dates: 2015 is March 20, 2015; and 2016 is March 18, 2016.

WSD is co-chaired by committee members Antonio Culebras, MD, professor of neurology at SUNY, Upstate Medical University, Syracuse, New York; and Liborio Parrino, MD, assistant professor of neurology at Parma University, Italy; with support from WASM’s Executive Director Allan O’Bryan and the Executive Committee.

WSD events take place primarily online at www.worldsleepday.org, featuring educational and historical videos, education materials, and public service announcements. 50 national delegations assist with the local organization of these events.

WORLD SLEEP DAY

WASM has issued the following declaration related to World Sleep Day:

WORLD SLEEP DAY DECLARATION:

  • Whereas, sleepiness and sleeplessness constitute a global epidemic that threatens health and quality of life,
  • Whereas, much can be done to prevent and treat sleepiness and sleeplessness,
  • Whereas, professional and public awareness are the firsts steps to action,
  • We hereby DECLARE that the disorders of sleep are preventable and treatable medical conditions in every country of the world. 

SLOGAN: RESTFUL SLEEP, EASY BREATHING, HEALTHY BODY

The objective of the 2014 slogan is to raise awareness of factors that are modifiable that can improve the quality of sleep and reduce the burden of fatigue and daytime somnolence. Interested persons should consult the ‘10 Commandments of Healthy Sleep’ for adults and children that have been posted on the World Sleep Day website. (www.worldsleepday.org)

RESTFUL SLEEP is one of the pillars of health. Three key elements of good quality sleep are:

  1. Duration: The length of sleep should be sufficient for the sleeper to be rested and alert the following day
  2. Continuity: Sleep periods should be seamless without fragmentation
  3. Depth: Sleep should be deep enough to be restorative

Failure to obtain quality sleep may lead to poor alertness, lack of attention, reduced concentration, decreased work and academic productivity, and even motor vehicle accidents.

EASY BREATHING during sleep is a treasured commodity. Sleep-related respiratory disturbances, or sleep apnea, can lead to numerous health problems, such as hypertension, heart disease, stroke and diabetes. When breathing in sleep is an effort, quality sleep is reduced. There are modifiable risk factors that can build up to disrupt easy breathing in sleep. People who are obese may have accumulation of fat in the upper airway that along with a thick, large tongue disrupt the easy flow of air. A large abdomen interferes with the pumping action of the diaphragm. Obesity which has become epidemic in developing countries can be controlled and when doing so, sleep apnea is prevented.

Children with large inflamed tonsils may have obstruction of the upper airway and significant sleep apnea. Sleep apnea in children may delay physical and mental growth. Removing the tonsils can be curative.

Some individuals take medicines that reduce the activity of the respiratory centers and aggravate sleep apnea. Among such medicines are the sedatives and ironically the sleeping pills. Codeine-containing pain killers may also reduce the force of the respiratory effort in sleep and worsen sleep apnea.

HEALTHY BODY is the premise that leads to a restful sleep. Sick individuals do not sleep well. Alleviating disease and avoiding unhealthful habits contribute to improve the quality of sleep.

GENERAL MESSAGES

  • World Sleep Day is an annual event to raise awareness of sleep disorders and the burden that they place on society. World Sleep Day 2014 will be held on March 14, 2014.
  • Most sleep disorders are preventable or treatable, yet less than one-third of sufferers seek professional help.
  • Sleep problems constitute a global epidemic that threatens health and quality of life for up to 45% of the world’s population.
  • Better understanding of sleep conditions and more research into the area will help reduce the burden of sleep disorders on society.

TALKING POINTS and KEY MESSAGES

Primary:

  • Research shows that we spend up to one-third of our lives sleeping. Sleep is a basic human need, much like eating and drinking, and is crucial to our overall health and well-being.
  • Sleep, like exercise and nutrition, is essential for metabolic regulation and balanced growth in children. There is evidence for a link between sleep duration and childhood obesity. The findings are more apparent in girls. Sleep duration is the effect of day-to-day variability of sleep-wake timing on weight regulation. 19,20
  • Breathing regularly during sleep is critical to maintain well-being and health. Persistent interruption of the breathing function during sleep is called sleep apnea. This is a pervasive and common disorder that affects 4% of men and 2% of women.22
  • Sleep apnea causes daytime sleepiness and fatigue, and may lead to conditions such as hypertension, ischemic heart disease, stroke, and diabetes.
  • Lack of sleep or poor quality sleep is known to have a significant negative impact on our health in the long and short term. Next day effects of poor quality sleep include a negative impact on our attention span, memory recall and learning.5 Longer term effects are being studied, but poor quality sleep or sleep deprivation has been associated with significant health problems, such as obesity, diabetes, weakened immune systems and even some cancers.6,7,8
  • Lack of sleep is related to many psychological conditions such as depression, anxiety and psychosis.9,10
  • Lack of sleep or poor quality sleep also leaves us more vulnerable to accidents. People who suffer some insomnia are seven times more likely to become involved in an accident causing death or serious injury than good sleepers.
  • Quality sleep is crucial to ensure good health and quality of life.

Importance of good-quality, restorative sleep

  • Good quality and restorative sleep is essential for day-to-day functioning. Studies suggest that sleep quality rather than quantity has a greater impact on quality of life and daytime functioning.
  • Healthy sleep in children will improve the child’s overall wellness. WASM has created the 10 commandments of Healthy Sleep for Children, available at www.worldsleepday.org.
  • Poor quality sleep has a greater negative impact on health, well-being and satisfaction with life than the quantity of sleep a person gets.
  • Quality sleep is responsible for alertness, improved functioning the following day and better quality of life. 

Consequences of sleep disorders

  • Sleep disorders cause significant individual and societal burden and create a serious public health problem.
  • Obstructive sleep apnea significantly impacts health and well-being.
  • Studies have shown that people with insomnia suffer from more symptoms of anxiety and depression than people without insomnia.
  • Insomnia has a negative impact in all areas of a sufferer’s life.
  • Insomnia can affect work performance, with a change in character and a drop in the quality of work. If the disorder remains untreated, this may even lead to reduced job prospects and loss of employment.
  • Directly or indirectly, disrupted sleep can have a negative effect on family life and relationships by affecting a person’s mood and the way in which they are able to perform daily activities and interact socially.

Extent of the epidemic

  • 35% of people do not feel they get enough sleep, impacting both their physical and mental health.
  • Insomnia affects between 30-45% of the adult population.
  • Obstructive sleep apnea (OSA) affects approximately 4% of male adults and 2% of the female population. 21 If not properly managed, OSA can have a significant impact on a person’s health and well-being.
  • Primary insomnia (insomnia with no underlying condition) affects 1-10% of the general population, increasing up to 25% in the elderly.
  • Restless Legs Syndrome is a common disorder and occurs in between 3-10% of the population, although the number of people affected and the severity of the condition differs between countries.
  • People who have OSA stop breathing repeatedly during sleep. OSA is caused by a blocking of the upper airway. The collapse of the airway may be due to such factors as a large tongue, extra tissue or decreased muscle tone holding the airway open.
  • Each breathing stop can last from 10 seconds to more than a minute and has a drop in oxygen associated with each event. The events may occur 5 to 30 times or more each hour. This puts a strain on the heart and can lead to a number of serious health conditions (U.S. Dept. of Health & Human Services, NIH, 2009).
  • Known consequences: some statistics
  • A US study has estimated:
  • The annual costs of insomnia to be between $92.5 billion and $107.5 billion.
  • 71,000 people receive injuries every year due to sleep-related accidents.
  • 1,550 people die because of sleep-related accidents.
  • 46% of individuals with frequent sleep disturbances report missing work or events, or making errors at work, compared to 15% of healthy sleepers. 

SLEEP BREATHING PROBLEMS

Obstructive sleep apnea is very prevalent, but under recognized. The Wisconsin Sleep Cohort Study estimated a prevalence of 24% among men and 9% among women in that state in the United States. In northern India, the prevalence of obstructive sleep apnea and obstructive sleep apnea syndrome is 13.7%. OSA is an independent risk factor for hypertension and other cardiovascular ailments. In children, sleep apnea may be the underlying cause of neuropsychological disturbances. Pediatric sleep apnea is typically associated with adenotonsillar hypertrophy.

Both adults and children should be formally investigated in sleep centers if sleep apnea is suspected, because both adult and pediatric sleep apnea is treatable and correctable; a correct and precise diagnosis is always required.

Sleep apnea is diagnosed with polysomnography in the sleep laboratory. Treatment with non-invasive positive airway (continuous positive airway pressure, or CPAP) ventilation is generally successful. For mild forms of sleep apnea, the application of oral devices can be beneficial. Surgery to remove excessive tissues in the oropharynx may be considered for individuals who cannot tolerate non-invasive equipment or who have obvious obstruction to airflow in the oropharynx by redundant tissue growth or large tonsils. There is proof that successful correction of sleep apnea with non-invasive positive airway pressure ventilation lowers mean blood pressure and may reduce the risk of myocardial infarction and stroke. Excessive daytime somnolence generally improves with successful treatment of sleep apnea.

WHAT YOU CAN DO ABOUT IT

  • Join in on the World Sleep Day 2014 celebrations.
  • Obtain more information at www.worldsleepday.org.
  • Help put more emphasis on the diagnosis and treatment of sleep disorders in general and of sleep breathing problems in particular.
  • Spread the message that more research is needed to completely understand sleep and to understand the causes of sleep disorders.
  • Be cognizant that most sleep problems can be managed by changing behaviours around sleep, medical therapy or cognitive behavioural therapy.
  • Be aware that patients suffering from sleep complaints, or who suffer from excessive daytime sleepiness, should see a physician and, if needed, obtain a consultation in a sleep center.

PRINCIPLES OF GOOD SLEEP

Violation of the 10 Commandments of Sleep Hygiene can cause poor quality of nocturnal sleep, short duration of sleep, fragmentation of sleep and serious sleep deprivation in adults.

10 COMMANDMENTS OF SLEEP HYGIENE FOR ADULTS

  1. Fix a bedtime and an awakening time.
  2. If you are in the habit of taking siestas, do not exceed 45 minutes of daytime sleep.
  3. Avoid excessive alcohol ingestion 4 hours before bedtime and do not smoke.
  4. Avoid caffeine 6 hours before bedtime. This includes coffee, tea and many sodas, as well as chocolate.
  5. Avoid heavy, spicy, or sugary foods 4 hours before bedtime. A light snack before bed is acceptable.
  6. Exercise regularly, but not right before bed.
  7. Use comfortable bedding.
  8. Find a comfortable temperature setting for sleeping and keep the room well ventilated.
  9. Block out all distracting noise and eliminate as much light as possible.
  10. Reserve the bed for sleep and sex. Don’t use the bed as an office, workroom or recreation room.

10 COMMANDMENTS OF SLEEP HYGIENCE FOR CHILDREN [AGES BIRTH TO 12 YEARS]

  1. Go to bed at the same time every night, preferably before 9:00.
  2. Have an age-appropriate nap schedule.
  3. Establish a consistent bedtime routine.
  4. Make your child’s bedroom sleep conducive – cool, dark, and quiet.
  5. Encourage your child to fall asleep independently.
  6. Avoid bright light at bedtime and during the night, and increase light exposure in the morning.
  7. Avoid heavy meals and vigorous exercise close to bedtime.
  8. Keep all electronics, including televisions, computers, and cell phones, out of the bedroom and limit the use of electronics before bedtime.
  9. Avoid caffeine, including many sodas, coffee, and teas (as well as iced tea).
  10. Keep a regular daily schedule, including consistent mealtimes.

World Sleep Day 2014 has partnered with sleep societies, commercial enterprises and individuals around the world to raise awareness about sleep-breathing problems. Visit our website www.worldsleepday.org for information on 2014 activities.

Bibliography

  1. Department for Transport, Sleep related vehicle accidents. http://www.dft.gov.uk/pgr/roadsafety/research/rsrr/theme3/sleeprelatedvehicleaccidentsno22?page=2 . Last accessed 18/12/08
  2. Ohayon MM, Zulley J. Correlates of global sleep dissatisfaction in the German population. Sleep 2001; 24: 780-787
  3. Wade AG, Zisapel N, Lemoine P. Prolonged-release melatonin for the treatment of insomnia: targeting quality of sleep and morning alertness. Ageing Health 2008; 4 (1): 11-12
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