Sleep
A Guide to Common Sleep Disorders
Insights with Dr Anup Desai (Sleep Physician) 
 
Sleep is such an important aspect of our lives. We spend a large portion of our day doing it. If we don't get enough or the quality is poor, we feel lousy and can impact our health greatly.
 
Quality sleep often is neglected and is a factor to be taken into consideration when visiting your doctor when unwell. 
 
Getting a consistently good night's sleep will help you build the mental, physical and emotional resilience that you need to face the stresses of our modern world.
 
Dr Anup Desai shares his insights below...
 
Sleep Specialist Dr Anup Desai
Dr Ron spoke with Dr Anup Desai a sleep physician Dr Ron has been working with for a number years, to gain a clearer understanding of sleep. 
 

A sleep physician is a medical doctor who went to medical school then specialises as a General Consultant Physician, learning all aspects of medicine.

Further study in the field of sleep and respiratory disorders as a sub-specialty makes you a sleep physician.

Dr Desai took his studies even further and completed a Ph.D. in Sleep Medicine and a Postdoc overseas. Overall completing seventeen years of study!

The Common Sleep Disorders
Dr Desai says :
 there are many sleep disorders and often the focus is just on conditions like snoring and even breathing disorders, but it is important to realise there's a whole range of conditions
Snoring is essentially a noise problem affecting relationships and partner dynamics. But it is also an important clue to a more serious narrowing of the airway causing your problem, a symptom of obstructive sleep apnoea.
 
When you snore there is a partial narrowing of the airway creating turbulent airflow and vibration resulting in the noise of snoring.
Obstructive sleep apnea is very similar to snoring. But instead of a partial narrowing of the airway, the airway closes completely. Your brain has to wake up for you to start breathing again. Resulting in disturbed sleep.

Apart from being tired, sleep apnea has some pretty serious consequences. Health conditions linked to obstructive sleep apnea include hypertension, increased risk of heart attack and stroke, increased risk of arrhythmias and diabetes and an increased risk of mortality.
 

REM sleep is an important stage of sleep which impacts our memory. When you snore or have sleep apnea, you tend to get less REM sleep.

During REM sleep your muscles are most relaxed. It is during this stage of sleep your airway is most likely to collapse.

Central sleep apnea is a condition in which people stop breathing in their sleep. It is not related to a blocked airway. The drive for breathing is absent.
 
Sone medical conditions cause central sleep apnea including heart failure and strokes. Sometimes it is caused by high altitude or certain medications.
Hypoventilation occurs when you don't breathe enough while sleeping. It may happen as a result of being overweight, or some medications, or there may be a chest wall deformity that limits the mechanics of breathing.
 
How can we address sleep problems?
The first place to start is a sleep study, especially if you know you already have a sleep disorder.
 
"A sleep study is basically measuring the quality of a person's sleep with particular reference often to breathing." says Dr Desai.
 
We have a look at the brain activity by placing EEG leads. This allows us to determine whether or not the patient is asleep. It also shows us which stage of sleep they are in.
 

Eye movements are also observed. "So we can see very easily if it's rapid eye movement sleep versus non-rapid eye movement sleep and also how much sleep is going on." says Dr Desai.

Breathing is measured by a cannula in the nose and bands across the chest. This allows us to measure the difference between airflow and effort.

Other aspects that are looked at include body position, heart rate, and leg movements.

 
Getting too much sleep can also a problem
Dr Ron Ehrlich had a patient who told him she doesn't have a problem sleeping. She can sleep anytime and anywhere. She will often sleep for twelve hours at night. And yet, she is still always tired.
 

Sleeping for twelve to sixteen hours per day is as much of a problem as only sleeping for five hours per day.

It is of even greater concern if you are still tired after sleeping this much. It indicates there is also a sleep disorder disturbing her sleep.

 
How to Manage Sleep Apnea
Obviously if it is weight related, the patient is advised to lose weight.
 

Mouth splints are an option for people who have mild sleep apnea. It is a mouth guard covering both top and bottom teeth. They are joined and push the lower jaw forwards to keep the airway open.

There are also some surgical procedures performed to keep the airway open.

CPAP (continuous positive airway pressure) machines pump air into the airway to stop it from closing. The pressurized air acts as a splint. It is used for people who have moderate to severe sleep apnea.

 
Key Message
Sleep is the most important part of the day. Sleep should be prioritised to maintain good health.
Do not ignore it, particularly if you're chronically tired.
 

Even if you don't have an identifiable disease you can always improve your sleep!

Take a deeper dive into the importance of sleep and sleep quality in the deep dive sleep pillar.

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