Sleepy at the wrong time

A Hagerstown doctor says Americans have 'poor sleep hygiene'

April 05, 2010|By CHRIS COPLEY
  • Dr. Abdul Waheed, sleep specialist at the Sleep-Breathing Disorders Center north of Hagerstown, and center employee Anna Mae Stottlemyer demonstrate the use of a continuous positive airway pressure device. A CPAP helps regulate breathing, prevents snoring and allows deeper sleep.
By Chris Copley,

I've always considered sleep something of a chore. It's something I have to do at some point because my body gets tired and my mental sharpness deteriorates. During sleep, I can't be productive, so it seemed like a waste of time.

Basically, I sleep when I'm forced to.

So I was wary when I spoke with Dr. Shaheen Iqbal, one of four sleep specialists with the Sleep-Breathing Disorders Center, north of Hagerstown. I felt like a sinner curious about the life of a priest. I wanted to learn more about sleep and sleep disorders, but I didn't want to reveal my own "sinful" sleep habits.

I needn't have worried. As we talked in his office, Iqbal put me at ease. He said most Americans do not get enough sleep.

"A short sleep time is common in the United States, more than in other countries," he said. "We are a 24-hour country, and people are awake at all hours. Then there are night shifts, and there's TV in bedrooms - or laptops - that keeps people awake 45 to 60 minutes longer each night (after going to bed)."


Many Americans have bad sleep habits - what Iqbal called "poor sleep hygiene." Just as good dental hygiene promotes dental health, good sleep hygiene promotes normal, healthy sleep.

Our own worst enemies

Normal, healthy sleep varies from person to person, according to the American Academy of Sleep Medicine. But here's a general description: Healthy sleep begins with going to bed at the same time each night, falling asleep within 15 minutes of lying down, and getting seven to eight and a half hours of restful slumber.

But many people do not have normal, healthy sleep. Sometimes, they are their own worst enemies.

Iqbal said people undermine their sleep in two ways. They do things in the late afternoon or evening that can affect that night's sleep (see sidebar).

Also, a person's lifestyle has an impact on his or her sleep night after night, Iqbal said. Smoking, being overweight, being inactive - these lifestyle choices can affect sleep. These things must be addressed in order to solve some sleep problems, he said.

"There are some patients who I will tell, 'Quit smoking and see me in three months,'" he said. "To someone else I'll say, 'Ask your husband to sleep in another room. His snoring is keeping you awake.' To others I say, 'Lose weight.' Weight has a lot to do with sleep apnea."

Diagnosing sleep problems

Poor sleep can lead to problems, some minor, some serious. One common complaint, Iqbal said, is a feeling of sleepiness during the day. Nodding off while watching TV might not be a problem, but driving when drowsy is.

"Sleepy drivers are no better than drunk drivers," he said. "Actually, they're worse, because there are no tests to detect a sleepy driver."

The American Academy of Sleep Medicine lists 84 disorders of sleeping or waking. But most people have one of a handful of common disorders. Iqbal said common problems include narcolepsy (falling abruptly into REM sleep during the day), bruxism (grinding teeth during sleep), and periodic limb movement of sleep.

But the main problem has to do with obstructed sleep apnea, which leads to snoring or related breathing problems.

"Seventy or 80 percent of my visits are due to sleep apnea or to obesity," he said. "They stop sleeping to wake up and breathe. This happens 5 to 120 times an hour."

Undergoing a sleep study

Most insurance companies are increasingly willing to cover sleep disorders. But they want a specific diagnosis, and determining a diagnosis sometimes requires a stay overnight at a sleep center.

The process of going through a sleep study is simple. A patient consults with a sleep specialist such as Iqbal. If the patient qualifies for a sleep study, he or she will arrive at the sleep center at about 9 p.m. Technicians will attach more than a dozen monitors, measuring breathing, chin motion, chest expansion, eyelid motion and other aspects of sleep. An infrared camera will record the patient's motions all night.

Then the patient will sleep in a room at the sleep center. Patient's rooms are set up like small hotel rooms. They sleep - or try to sleep - through the night and go home the next morning.

A different technician evaluates and scores the results of the study. A few weeks later, the patient meets with a physician again to go over the results of the sleep study. The study might indicate surgery, Iqbal said. It might indicate that a patient should use a continuous positive airway pressure machine (CPAP), a device that helps regulate nighttime breathing.

Or maybe a patient simply needs to change their lifestyle - stop smoking, eat less before bed, avoid watching TV or surfing the Web at bedtime.

Sleep is an active time

Sleeping is important. The body is doing much more than just resting when it sleeps, Iqbal said.

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