Penn Sleep Physicians Ask “Are You Aware
National Sleep Awareness Week Set to Begin March 27
(Philadelphia, PA) - Ilene Rosen, MD, and Richard
Schwab, MD, with the University of Pennsylvania
Division of Sleep Medicine, spend their days examining and explaining
to patients what may be causing their lack of sleep. As we approach National
Sleep Awareness Week, set to begin on March 27th, these sleep physicians
are offering up some “Wow, I didn’t know that!” factoids
when it comes to us and our very treasured zzzzz’s.
Little Known Fact #1 - Alcohol is a terrible sleep aide.
Explanation - Although alcohol will cause sleepiness
and may help a patient to initially fall asleep, it actually causes significant
sleep disruption later in the night. Any type of alcohol (beer, wine,
liquor) will disturb sleep. Alcohol will also worsen snoring and sleep
apnea. Alcohol should never be used as a sleeping aide. (Schwab)
Little Known Fact #2 - Getting up during the night to
urinate may be a sign of sleep apnea.
Explanation - When you stop breathing because of closure
of the passageway between the back of the throat and the windpipe, the
brain works very hard to keep your oxygen levels up. It sends signals
to your respiratory muscles, especially your diaphragm, to work harder.
This increased work of the muscles of the chest cause pressure changes
in the chest, which are felt by the heart muscle. The stress on the heart
muscle causes the muscle cells to secrete a substance, which fools the
kidneys into making urine! (Rosen)
Little Known Fact #3 - Decreased interest in sex or
impotence can be a sign of sleep apnea.
Explanation - Patients with sleep apnea often complain
of decreased libido and lose their interest in sex. Some of this is related
to sleep deprivation that results from sleep apnea. Sleep apnea can also
cause impotence. Treatment of sleep apnea can improve libido and may help
Little Known Fact #4 - Waking up and feeling awake,
but being unable to move, may be a sign of a serious sleep disorder.
Explanation - Sleep paralysis is sometimes also referred
to as the "witch is riding your back." It occurs when the brain
awakens from Rapid Eye Movement (REM) sleep. During normal REM sleep,
the brain is very active (it is the time of the night when dreaming often
occurs.) During this stage of sleep, the brain sends a signal to the skeletal
muscle in the body and paralyzes, or immobilizes, them. The only muscles
that work are the diaphragm, the main muscle that helps us breathe and
the eye muscles (hence, the name “rapid eye movement” sleep).
If the brain awakens before the signal that immobilizes the muscles is
turned off, the person will wake-up but still be paralyzed. This can be
a very scary experience that lasts for a few seconds and then breaks.
Although normal people can have sleep paralysis, this can also be a symptom
of sleep deprivation, sleep fragmentation and narcolepsy. (Rosen)
Little Known Fact #5 - If you need two or more medicines
to control your blood pressure, you may have obstructive sleep apnea.
This is even more likely if you are overweight.
Explanation - Studies have shown that patients with difficult-to-control
hypertension (defined as requiring two or more medications) have a higher
prevalence of obstructive sleep apnea. While we don’t know the cause,
patients with refractory hypertension who also have sleep apnea are noted
to have decreases in blood pressure and better-controlled blood pressure
once they are placed on CPAP (continuous positive airway pressure masks
worn to improve and prolong sleep). (Rosen)
Little Known Fact #6 - Exercise or eating within three
hours of going to bed could be the reason you are having trouble falling
Explanation - While exercise will help you relax, in
general, and usually helps consolidate sleep, exercising too close to
bedtime will delay the time your body unwinds and is able to fall asleep.
The chemicals that increase in your body immediately after exercising
and eating are associated with increased wakefulness and will delay the
time your body feels ready to sleep. (Rosen)
Little Known Fact #7 - Heartburn during sleep may be
a sign of sleep apnea.
Explanation - Patients with sleep apnea often complain
of heartburn during sleep and treatment of sleep apnea will improve the
Little Known Fact #8 - If you work the night shift and
are having trouble going to bed during the day, try wearing dark sunglasses
-- in all types of weather -- on the commute home.
Explanation - Our ability to stay awake and fall asleep
is a function of two processes. First, there is a homeostatic switch that
drives sleep that is located in the brain. As soon as we wake up, chemicals
build up in our brain. The build-up of these chemicals is associated with
the need to go back to sleep at the end of the day. Counteracting this
drive for sleep is the biological clock. The clock function with a rhythm
that drives our wakefulness, known as the circadian rhythm. Early in the
morning, after being up all night, the sleep hemostat is primed for sleep.
However, although the circadian clock has just hit its lowest point in
its curve, the exposure to daylight on the commute home "reminds"
the clock that the day is beginning and the circadian drive for wakefulness
increases. Thus, wearing dark sunglasses will "fool" the clock
into thinking it is still dark and delay the clock enough to allow for
sleep to occur after the night shift is over. (Rosen)
Little Known Fact #9 - Falling asleep at movies or watching
TV can be a sign of sleep apnea.
Explanation - Patients with sleep apnea have frequent
arousals at night secondary to recurrent apneas (no airflow). These arousals
cause significant sleep fragmentation, which results in daytime sleepiness.
Commonly, patients with sleep apnea will fall asleep after dinner, watching
TV or at a movie in a theater. Such patients can also fall asleep at red
lights while driving. (Schwab)
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