Lifestyle Choices

When we battle with the night, our sleep is non-refreshing and non-restorative. The daytime consequences range from drowsiness to decreased productivity, increased accident rates, health problems and a reduction in the quality of life. In fact, fatigue is the most common complaint heard by doctors.

Many sleep disorders go unreported because the troubled person is not awake or alert when the symptoms appear. These individuals are chronically exhausted but do not know why, and may be regarded by others as simply lazy.

Sometimes the symptoms of sleep disorders can be quite bizarre — practically unbelievable — and sufferers may not understand their own actions. They may be afraid of the stigma associated with their behaviour, or they may fear the revelation of underlying psychiatric illness and therefore avoid admitting to others, including those who can help, that they have a problem. Consider the following real-life experiences taken from the files of the American Sleep Disorders Association:

• The sleeping woman who awoke to find herself in a grocery store aisle wheeling a cart filled with fifty-six boxes of cornflakes.

• The woman who drew a map of the United States on her bedroom

wall and then filled in the capitals of every state — all in her sleep.

• The air traffic controller whose only way to keep from falling asleep on the job was to stand while working.
• The woman who gained over forty pounds eating chocolates while she slept.
• The man in the back of a moving trailer who sleepwalked out of the door and was killed on the road.
• The sleeping woman who drove to the airport, bought a plane ticket, and flew halfway to California before waking up.

Some of these anecdotes may appear humorous at first glance, but people with sleep disorders really do suffer, as might innocent others. Imagine being on the same road with someone driving in his sleep, or being a passenger in a Boeing 747 on final approach, your fate in the hands of a jet-fatigued pilot or an air traffic controller who is barely awake. Or imagine sharing a bed with someone who snores loudly, or who kicks, punches and thrashes hundreds of times each night. Hardly restful for either of you. Think of that ninety-year-old California man who strangled his wife of sixty-two years to death because she kept him awake at night with her persistent cough.’

Because sleep deprivation and fatigue are so pervasive in our stress-filled, hectic society, many doctors consider lack of alertness, low energy levels and moodiness to be within the normal range of functioning. They sometimes dismiss such commonplace complaints as not being symptomatic of a legitimate medical illness. Even when a patient complains of falling asleep at inappropriate times during the day, or describes rather bizarre nocturnal behaviours, a sleep disorder often remains undiagnosed and untreated.’

As recently as 1985, Dr William Dement reported: “There is not One single medical school that devotes systematic and valid attention to sleep disorders.”‘ Historically, doctors have been ill-prepared to recognize sleep disturbances, or even ask sleep-related questions when taking a patient’s medical history. The National Commission on Sleep Disorders Research, in America, searched a primary-care-practice database of 10 million patients expecting to find the estimated 100,000 cases of a common and life- threatening sleep disorder, obstructive sleep apnoea. They found only seventy-three instances where the diagnosis was made.’

Sleep medicine, established as a recognized medical speciality in 1996, is still in its infancy. Yet giant strides are being made. Medical schools and continuing medical education programmes are beginning to offer training in sleep disorders medicine. For example, the number of sleep disorder centres in the United States has increased from a handful in the early 1980s to 1,500 as of 1997.

Might you have a sleep disorder that requires treatment from a health-care professional or sleep centre? If you answered true to any of the items on Self-test D, or if any of the disorders described in the rest are the same as what you experience, consider seeking the help of a sleep specialist. Doing so could vastly improve your quality of life, or even save your life.

Dyssomnias

The dyssomnias are disorders of sleep that produce difficulty in initiating or maintaining sleep, or produce excessive sleepiness. They include insomnia, sleep apnoea, narcolepsy, restless legs syndrome, periodic limb movement disorder, hypersomnia and delayed or advanced sleep phase syndrome.

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