Sleep Disorders – When Should One See A Doctor?

Imagine starting the day without having slept enough or struggling to stay awake because of erratic sleep at night. These might be the early signs of a sleep disorder. Sleep disorders, in simple terms, are conditions that disturb the ability to sleep soundly. For an adult, 7-8 hours of sleep is very important to keep the body active, let it heal, and restore its chemical balance. Not sleeping enough or sleeping badly is known to affect these activities.

Common Symptoms of Sleep Disorders

• Incessant snoring at night
• Waking up abruptly in the middle of the night
• Waking up suddenly, gasping for breath
• Abnormal breathing patterns while asleep
• Difficulty in sleeping or remaining asleep
• Chest pain at night
• Daytime sleepiness
• Feeling tired in the morning
• Loss of concentration in the day
• Depressed or irritable mood

Doctors at the Respiratory and Sleep Medicine department at Medanta - The Medicity say, that any of the above symptoms could signify a sleeping disorder and should not be ignored. A very serious fallout of suffering and ignoring a sleep disorder is the risk of causing accidents.

“Sleep deprivation is linked to high chances of causing accidents while driving as the brain cells fail to communicate effectively, slowing down response time and causing mental lapses,” explains Dr. Bornali Datta, Associate Director, Respiratory and Sleep Medicine at Medanta.

Identifying the Causes

According to doctors, often there are conditions, internal and external, that make sleeping
seem like a difficult task.

• Respiratory diseases make it hard to breathe while sleeping. This leads to disturbed sleep, which if continues for a long period of time, can be classified as a sleep disorder.
• Joint problems like arthritis cause intense pain, leading to disturbed sleep patterns for long periods of time.
• Mental health conditions like depression frequently manifest in poor sleep quality.
• Certain medications for heart ailments, hypertension, allergy, asthma and cold may affect sleep at night.
• Erratic work schedules, especially working in the night, disrupts the body’s natural rhythm of sleep and wakefulness and could result in sleeping disorders.
• Excessive consumption of alcohol is known to block restorative sleep. It affects the normal production of chemicals that trigger and end sleep cycles. Alcohol also relaxes the throat muscles for too long, causing people to snore.
• Health conditions like obesity and hypertension share a cause-effect relationship with sleeping disorders. Sleep deprivation or having a sleep disorder has far greater ramifications for the body and is known to be linked to:
• Obesity: During sleep, hormones that control appetite, glucose and energy metabolism, are secreted. Less sleep causes an imbalance in these hormones. A sleep-deprived person is known to have decreased levels of leptin, a chemical that makes a person feel full and satiated. Conversely, they will have increased levels of ghrelin, a hormone that triggers hunger. These triggers, result in eating more than required, leading to obesity in the long-term.
• Poor heart health and high blood pressure: When someone suffers from a sleep disorder, the erratic sleeping and waking up is known to cause blood pressure levels to rise. High blood pressure has direct links with cardiovascular diseases.
• Diabetes: Sleep or the lack of it, alters the way in which the body processes glucose, making the person more susceptible to developing Type 2 diabetes.
• Immune System Imbalance: When a person sleeps, the body produces infection-fighting substances like cytokines which defend the body from viruses. Less sleep decreases the production of these substances, making the immune system weak.

Common Sleep Disorders

• Insomnia: A condition where the brain cannot stop being awake and alert.
• Symptoms: Difficulty in falling asleep, struggling to remain asleep, and fatigue in the morning.
• Obstructive Sleep Apnoea (OSA): A disorder where while sleeping, the throat muscles relax and obstruct the upper airways, causing breathing to stop and restart intermittently.
• Symptoms: Snoring and waking up abruptly at night gasping for breath.
• Central Sleep Apnoea: A condition where breathing stops because the brain fails to send proper signals to the muscles that control breathing. In this condition, a person stops breathing for about 10 to 30 seconds repeatedly, during sleep hours.
• Symptoms: Shortness of breath, abnormal breathing patterns while sleeping, and chest pain at night.
• Mixed Apnoea- This is a combination of obstructive sleep apnoea and central sleep apnoea. The throat muscles relax and obstruct the upper airways, at the same time the brain fails to signal the muscles that control breathing; the person struggles to breathe.
• Symptoms: Difficulty in breathing, abnormal breathing patterns, waking up gasping for breath, snoring and chest pain.

Uncommon Sleep Disorders

• Parasomnia- Abnormal behaviour displayed during sleep.
• Symptoms: Sleepwalking, sleep paralysis, and sleep aggression.
• Narcolepsy- A chronic neurological disorder where the brain fails to regulate the sleep-wake cycles.
• Symptoms: Chronic daytime sleepiness that involves falling asleep unexpectedly while doing regular activities like eating, working, talking and driving.

Treating Sleep Disorders

Sleep medicine doctors at Medanta recommend a sleep study whenever a patient shows signs of a sleep disorder. Sleep studies in Medanta Hospital are conducted in a sleep lab that has specialised equipment to record the patient’s breathing pattern, heartbeats, brainwaves, oxygen saturation levels, and movement of the eyes and limbs during sleep.

The study helps determine the extent of the problem and the treatment plan for it. A sleep study is conducted at night and is divided into 2 parts. In the first half of the night, the patient’s sleeping pattern is studied. After the diagnostic study, in the second half, the patient is generally treated with a CPAP or BiPAP, machines that deliver mild air pressure to help a person with apnoea, breathe. Further treatment steps are taken based on the reports generated in the sleep lab. Medanta has the capacity for two sleep studies each night, and on an average conducts 35-40 sleep studies on patients every month.