The science of sleep
MU doctors know the importance of a solid snooze
If you yawn all day at your desk, even after coffee, you’re not alone. If you find yourself wide-eyed in the middle of the night, you’re not the only one. If your spouse complains that you kick and snore in your sleep, you’re not unique.
In a National Sleep Foundation poll, 75 percent of respondents reported at least one symptom of a sleep problem. MU neurologist Pradeep Sahota knows why. “We spend one-third of our lives in sleep,” he says, “but we never really pay attention to that part.”
Sahota pays attention, though. He leads the sleep disorders center at University Hospital, where he and colleagues monitor and treat more than 1,000 patients per year. People are starting to wake up to the importance of sleep, he says; the center has seen a nearly ten-fold increase in sleep studies since it opened in 1990.
Beyond sleepiness
Neurologist Pradeep Sahota reviews an overnight sleep study, a 21-channel recording of multiple variables, including brain activity, muscle movement, eye movement, breathing and heart activity.
Sahota and colleagues study a number of sleep disorders, from insomnia to excessive sleepiness. They also test for other disorders, including Restless Legs Syndrome (just what it sounds like) and sleep apnea, in which obstructions in the airway can cause interruptions to breathing and sleep.
“Imagine 300 to 400 interruptions of sleep during the night for years and years,” he says. “When we put a CPAP (breathing machine) on patients for the first time, the next morning they wake up and say, ‘This is the best I’ve ever felt.’ That’s because some of them probably have forgotten what it’s like to get a good night’s sleep.”
Doctors at the center monitor brain waves, muscle movements, airflow and other variables, all while trying to provide a comfortable environment for overnight observation. Such observation is crucial for proper diagnosis.
In the short term, patients need efficient sleep to function well at work and in life and to be healthy in general. In the long term, they need efficient sleep to ward off such life-threatening conditions as hypertension, heart disease and stroke — all possible results of sleep disorders, among other factors.
When bedtime stories aren’t enough
Pulmonologist Zarah Ner monitors patient Michelle Algya in the children’s sleep lab at University Hospital. Photo courtesy of the School of Medicine
At the children’s sleep lab, pulmonologist Zarah Ner runs a smaller version of the center on smaller patients. The parallels don’t stop there. “Sleep disorders can cause inattentiveness in school, daytime sleepiness and learning problems,” Ner says.
The leading problem is obstructive sleep apnea, often caused by enlarged tonsils or adenoids, but Ner and two technicians monitor for other disorders, too. The anxiety of such testing can be high in children, so Ner encourages them to bring their own pajamas, plus stuffed animals and favorite blankets. Parents sleep in the room with them.
Since the lab opened in January 2005, Ner has seen nearly 250 patients. In milder cases, the goal is to diagnose sleep disorders and, in turn, to eliminate the daytime problems they cause. In more extreme cases, the work can help prevent pulmonary hypertension, or the enlargement the heart that results from the low oxygen that comes with apnea.
Whether in children or adults, the importance of sleep is clear. To Sahota, the fact that doctors can help is clear, too: “Here is a problem where we can do something, and ‘Bang!’ — it has a dramatic effect on your life immediately.”