Sleep disorders epidemic, study reports

[varkam]

Judith Graham
Chicago Tribune
Wednesday, April 5, 2006
Link

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CHICAGO — Tens of millions of people are suffering fatigue-filled days and wakeful nights as television, the Internet and other distractions contribute to an escalating epidemic of sleeplessness in America, according to a major new government study.

An astonishing 50 million to 70 million Americans experience chronic sleep disorders, while millions more are sleep deprived, according to the report by the Institute of Medicine, an arm of the National Academy of Sciences.

<snip>

A growing body of scientific evidence links insufficient sleep — less than seven to eight hours a night — to conditions such as hypertension, diabetes and depression. The direct and indirect costs total an estimated "hundreds of billions of dollars" each year.

Yet the medical profession is ill-prepared to diagnose and treat people who don't get enough sleep, and federal health agencies haven't given the issue the attention it deserves, the Institute of Medicine said in the study, released Tuesday.

<snip>

....

[LiberalEsto]

1. How can anyone sleep at night with * in charge?

Many of us sleep-deprived are yearning for a good night's rest in January, 2009.

[enlightenment]

2. Interesting that they don't mention external factors - long work

hours, shift work, etc - until the third paragraph. Guess the idea is to convince folks that they're in total control of their sleep deprivation.

If doctors want to learn how to treat it, they need to focus public attention on the things people cannot easily change. It's easy to say "lay off the TV and internet" or "lose weight and get more exercise," but when the sufferer leaves the doctor to go to their second (or third) job or has to run and pick up the kids at daycare so they can get them to grandma before they rush off to the night class they're taking to 'improve their skills,' then the doctors are missing the point.

I'm not blaming the doctors -- but the article has an irritating slant (maybe I'm just cranky because I didn't sleep well last night . . .)

[varkam]

3. I feel you on that one

I guess you could say I'm a shift-worker - on the weekends I run sleep studies and during the week I'm in classes during the day, and I've been doing it for two years now. I think a big problem with at least some of our sleep issues are the demands that are placed on us simply by virtue of trying to make ends meet. Seems the common refrain in the American workplace, especially since the 80's is work more, work harder, work longer. Yet it might just be that if we're doing six things at once on three hours sleep, we might just be producing less. Interesting paradox, I think.

But, what I take to be the bigger issue is how many people who have actual, bonafide sleep disorders (such as restless legs, periodic limb movement disorder, REM behavior disorder, obstructive sleep apnea, etc.) don't know they have them. And the sad truth is that, at least in the case of OSA, there are numerous other effects aside from feeling fatigued (e.g. putting you at higher risk for CVAs, heart failure).

[enlightenment]

4. "Running" as in you're the primary researcher, a grad researcher,

or a participant? Sounds interesting, regardless!

As to people knowing that they have a bona fide sleep disorder -- considering the number of uninsured and under-insured folks out there, it's not too surprising that they don't know. Until you reach the point where you literally cannot function, you're not going to spend the time and money to try and find a doctor who can accurately diagnose those conditions. It seems like many of them require the sort of sleep studies you run -- and I suspect they're not cheap.

Even if everyone could be accurately diagnosed, this is not just a medical problem; it can't be resolved just by treating the conditions that result - the institutional causes have to be treated as well.

And I am undoubtedly preaching to the choir -- sorry!

:)

[varkam]

5. Running as in...

My full job title is a polysomnographic technologist (a mouth full, I know) - I usually just say sleep tech. I don't work at a research lab (though GlaxoSmithKline is supposed to be throwing research our way, but I'll believe it when I see it). What we do is mostly clinical stuff - evaluating people for sleep disorders such as OSA or treating them via CPAP.

I think another big factor in the equation is just that people don't know or aren't as aware about sleep and it's effects as they are other areas of health and medicine. Plus, the effects of sleep disorders are sometimes a "the water is getting hotter" scenario. People end up getting more and more fatigued, but it's a gradual shift and it's hard for some to recognize as a pattern.

[enlightenment]

6. What a great title -- it parses out

perfectly!

I do agree with the 'water is getting hotter' scenario -- gradual shifts are hard to recognize; sometimes I think about all the little aches and pains that come with age and how I give them so little notice (aware but don't care). I suspect I wouldn't have been as complacent in my 20s!

CPAP -- is that the gizmo that you wear at night to keep you breathing?

[varkam]

7. CPAP - Continuous Positive Airway Pressure

You betcha. Most of the units are a bit bigger than a shoebox, but they mostly fit on people's nightstand. They deliver pressurized, filtered room air that acts as a pneumatic splint to keep the airway open. They deliver the air through a mask that either fits over the mouth and the nose, the nose only, or has "pillows" that just go into the nostrils (depending on what's most comfortable for someone, and what's best for the person from the technical and medical standpoints as well).

There's a few different flavors of CPAP - AutoPAP, BiPAP, w/ or w/o C-FLEX, etc. But that's the general gist of what they do. I'd say most patients I see in the lab (~70%) have a somewhat difficult time getting used to, but then after they get comfortable with their mask and start breathing at night, they swear by it. The other 30% or so either can't tolerate the mask, or they just don't respond to treatment (weird, but it does happen).

[enlightenment]

8. I suspect I might be one of the minority

- I hope I never have to find out!
Thanks for the information -- and for indulging my curiosity in such a satisfactory fashion!

[varkam]

9. Glad I could be of service n/t