Sleep Your Way to Better Health

May is Better Sleep Month

Tossing and turning throughout the night? Do you daydream about a good night’s sleep? While not getting the recommended seven to nine hours of sleep a night may seem like a minor problem, it can be more serious than most people think. While Don Davis was undergoing treatment at Piedmont Fayette Hospital (PFH) for another health problem, he found out just how serious a sleep problem can be.

In 2007, Davis’s PFH doctors began to notice a problem in his sleeping. He periodically stopped breathing during the night. This problem had been affecting him for about three years, but he did not think it was serious enough for him to seek treatment.

At the encouragement of his doctor, Davis decided to visit the Sleep Center at PFH to determine what was causing his sleep problems. He went to the Sleep Center for an initial consultation where they explained to him the entire process of his sleep study. Davis returned for his visit a few weeks later and thought that he slept soundly through the night of his study. Instead, he found out that he suffered from sleep apnea.

“I always knew that I was tired during the day, but I never knew that it was related to sleep apnea,” said Davis. “I was relieved to find out what the problem was and anxious to get it rectified.”

Davis returned to the sleep center to undergo a sleep evaluation for his treatment. He now uses a Continuous Positive Airway Pressure (CPAP) machine to help him sleep throughout the night. Davis returns to the sleep center for checkups and has noticed a great difference in his sleep since beginning his treatment.

“I would definitely recommend a trip to Piedmont Fayette’s Sleep Center for anyone who is tired in the middle of the day or has shortness of breath. It is well worth it, I have more energy and feel better,” said Davis.

Connie White-Daniel, RPSGT, clinical manager of the Piedmont Fayette Hospital Sleep Center, encourages individuals with sleep issues to learn about the diagnosis and treatment options available.

“The proper quality, as well as proper amount of sleep time can have an incredible effect on your health and your daily routine,” said White-Daniel. “We work with our patients to help them develop a healthy sleep pattern so they are able to have energy for the important activities in their lives.”

May is Better Sleep Month and Piedmont Fayette Hospital is encouraging you to make the effort to improve your sleeping habits. Approximately 70 million people in the United States are affected by a sleep disorder. Forty million Americans suffer from a chronic sleep disorder, and an additional 20-30 million are affected by intermittent sleep-related problems.

There are more than 80 different forms of sleep disorders affecting people of all ages. National Sleep Foundation (NSF) found that sleep deprivation and sleep disorders are estimated to cost Americans more than $100 billion annually in lost productivity, medical expenses, sick leave, and property and environmental damage. Common symptoms of sleep disorders to be aware of are daytime fatigue, inability to sleep for long periods of time, and breathing difficulties during sleep.

“Some things people do not realize about sleep are the effects it has on long and short-term memory as well as regulating hormones,” said White-Daniel. “This includes growth hormone which is important for children to grow but also affects the aging process in adults.”

Some of the more common sleep disorders are insomnia, sleep apnea and snoring. Insomnia is an experience of inadequate or poor quality sleep as characterized by one or more of the following sleep complaints: difficulty initiating and maintaining sleep and waking too early in the morning. Obstructive sleep apnea is a disorder in which breathing is briefly and repeatedly interrupted during sleep and can cause fragmented sleep and low blood oxygen levels. Snoring is defined as “breathing during sleep with hoarse or harsh sounds as caused by the vibrating of the soft palate.” Snoring can be an indication of sleep apnea, a risk factor for vascular complications such as hypertension and congestive heart failure. Snoring may cause fragmented sleep which may lead to daytime dysfunction.

Piedmont Fayette Hospital’s Sleep Center is a six-bed facility which provides diagnosis and treatment of all sleep-related disorders for adults and for children over the age of three. The Sleep Center works with primary care physicians and specialists to provide comprehensive care for adults and children who have trouble falling asleep and staying asleep during the night, excessive daytime sleepiness, insomnia, snoring, sleep apnea and other sleep-related conditions.
The Sleep Center has a group of seven multi-disciplinary physicians, all of whom are either board-certified or board-eligible sleep specialists. They are also board-certified in their respective primary fields of otolaryngology, neurology, or pulmonology. People who experience sleep-related problems should discuss their symptoms with the primary care physician or other medical specialist. For more information, call the Piedmont Fayette Hospital Sleep Center at 770-719-6031 or visit www.fayettehospital.org.
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Note to People with Scarred and Stiffened Lungs: Monitor Your Sleep Before Severe Fatigue Sets In

Family, friends and neighbors remember Lisa Sandler Spaeth as an active mother of two in Potomac, Md., with a lot on the go, juggling her son’s baseball games and her daughter’s horseback-riding lessons with numerous committee obligations, organizing women’s activities at her local synagogue. Add to this Spaeth’s thriving home business turned wholesale supplier - making custom hair accessories for children - which she founded with her mother.

But Spaeth was also diagnosed with pulmonary fibrosis, a hard-to-treat disease that progressively damages the lungs and starves the body of oxygen. For two years after her diagnosis, until her death in May 2007, at age 44, Spaeth was beset by fatigue. Her energy levels sank as her lungs deteriorated. Breathing became difficult, and she could no longer attend many of the sporting events, trade fairs and women’s groups that filled her life.

It is with people like Spaeth in mind that researchers at Johns Hopkins and elsewhere have found what is likely to be the first evidence linking the extreme fatigue in the lung-scarring disease, which has no known cause, to the poor quality of sleep that results - as much as a 25 percent loss in body-rejuvenating R.E.M. sleep. And they have also gauged the detrimental effects this has on people’s daily lives, nearly halving test scores used to assess physical and mental quality of life.

In a report appearing this month in the journal Chest, senior study investigator and pulmonologist Sonye Danoff, M.D., Ph.D., who treated Spaeth, found more than twice the amount of nighttime sleep disturbances and double the number of daytime episodes of drowsiness among 41 men and women with so-called idiopathic pulmonary fibrosis than in people with healthy lungs.

“Physicians should strongly consider monitoring people with this scarring lung disease for sleep disorders as part of their standard care, because poor sleep has a profound effect on their quality of life,” says Danoff, an assistant professor at the Johns Hopkins University School of Medicine.

The latest study results back up previous research by Danoff and other sleep experts at Johns Hopkins, which showed that 18 of 22 people with fibrosed lungs had problems breathing while asleep. The majority of them dropped out of R.E.M. sleep during the night, losing 25 percent of total R.E.M. sleep time.

It is during the R.E.M. period that rapid eye movements occur (hence the name), that people dream and that the body recovers from the previous day and builds up energy for the next.

Pulmonary fibrosis makes people highly vulnerable to sleep problems, Danoff says, because they often breathe twice as fast to supply the body with oxygen. And just as breathing and other body functions naturally slow down at the onset of R.E.M. sleep, these people who depend on a higher rate of breathing are constantly being pushed to wake up from a lack of oxygen.

“Essentially,” she adds, “the body’s internal alarms go off as people enter the most rejuvenating part of sleep. And when people don’t get a good night’s sleep, they cannot function normally the next day. It’s a slippery slope that gets progressively worse over time.”

Also in this latest Johns Hopkins study are survey results assessing quality of life and quality of sleep, which showed that people with stiffened lungs and sleep problems have 40 percent lower scores in physical activities compared to the general U.S. population. Rated activities included basic tasks, such as going to the mailbox and walking to the car. Mental and social activities, such as carrying on a conversation with a store clerk or telephoning friends and family, were reduced 48 percent.
Sleep quality was assessed on a scale comprising 36 different sleep measurements, such as the length of time it took to fall asleep and overall time spent sleeping.

Moreover, the team’s analysis showed that sleep problems could not be predicted by other demographic factors, such as age, gender, race or weight. Nor were they linked, researchers say, with other lung function and more noticeable disease symptoms, including shortness of breath and cough.

“Because there is so much about pulmonary fibrosis that we cannot yet fix, we need to focus on what we can fix while we wait for research to catch up with treatments that can prevent or reverse the disease,” says Danoff.

Current treatments for pulmonary fibrosis are limited to steroids and other immune-system-lowering drugs that help slow down lung tissue deterioration as the thin walls of the air sacs stiffen and lose capacity to freely expand and contract.

More than 200,000 Americans suffer from pulmonary fibrosis, whose cause remains unknown. And the lung disease kills nearly 40,000 each year.

“If we had been able to treat Lisa Spaeth’s fatigue from poor quality sleep, then she might have had more time to lead her life as fully as she had been prior to getting sick,” says Danoff.

Despite Spaeth’s death, her zest for life carries on. Her mother, Froma Sandler, maintains the business. And through the encouragement of family and friends, more than a thousand people have donated to medical research in Spaeth’s honor. The largest-ever contributions arrived in May, just prior to the first anniversary of Spaeth’s death, when the Maryland-based Robert M. Fisher Memorial Foundation pledged $2 million to Johns Hopkins to help fund Danoff’s future studies into pulmonary disease.

“This research funding will lay the groundwork for a more consolidated and comprehensive look at the many factors that may improve and extend the lives of patients with pulmonary fibrosis: from rehabilitation of the lungs to the development and testing of new medications to offset losses in quality of life from fatigue,” says Danoff.

Danoff plans to use some of the funding to support studies that monitor patients with pulmonary fibrosis for problems in sleep patterns, especially in deep-sleep R.E.M. patterns, to target for treatment.

Another phase of research, she says, involves testing new devices to support breathing during sleep and to see if these devices improve quality sleep time and abate fatigue.

Funding for this latest study was provided by a fellowship grant from the CHEST Foundation, the philanthropic arm of the American College of Chest Physicians, which also publishes the journal Chest, and by The Johns Hopkins Hospital’s General Clinical Research Center.

In addition to Danoff, other Hopkins researchers involved in these studies, conducted solely in Balimore, were Vidya Krishnan, M.D.; Meredith McCormack, M.D., M.H.S.; Stephen Mathai, M.D., M.H.S.; Maureen Horton, M.D.; and Nancy Collop, M.D. Additional assistance was provided by Shikhar Agarwal, M.D., from the Johns Hopkins University’s Bloomberg School of Public Health; Brittany Richardson, from the University of Maryland; and Albert Polito, M.D., from Mercy Medical Center.

Piedmont Fayette Hospital Encourages the Community to Catch More Zzz’s

The standard 8-hour business day is no longer the norm in America, according to the National Sleep Foundation’s (NSF) 2008 Sleep in America poll. The poll reports the average American’s work day is now nine hours and 28 minutes, while the average time spent in bed is six hours and 55 minutes – with six hours and 40 minutes spent actually sleeping. NSF recommends getting at least seven to nine hours of sleep each night. May is Better Sleep Month, and Piedmont Fayette Hospital encourages anyone concerned about their sleep habits to contact their physician.

There are more than 80 different forms of sleep disorders affecting people of all ages, and more than 70 million Americans have a sleep disorder. NSF found that sleep deprivation and sleep disorders are estimated to cost Americans more than $100 billion annually in lost productivity, medical expenses, sick leave, and property and environmental damage. Common symptoms of sleep disorders to be aware of are daytime fatigue, inability to sleep for long periods of time, and breathing difficulties during sleep.

“Everyone’s sleep needs are different, so when patients ask me how many hours of sleep they should get each night, I tell them sleep needs are individual and not only do different age groups need different amounts of sleep, but the amount of sleep one person needs to function best may be different than for someone else who is the same age and gender,” said Connie White-Daniel, RPSGT, clinical manager of the Piedmont Fayette Hospital Sleep Center.

According to NSF some of the biggest “sleep stealers” are stress, jet lag, shift work, lifestyle stressors, such as drinking alcohol and exercising close to bedtime, environmental interferences such as temperature or noise, physical factors, such as arthritis or back pain, and medications. Some tips for getting good sleep include:

· Avoiding caffeine, nicotine and alcohol in the late afternoon and evening.
· Exercising regularly, at least three hours before bedtime.
· Only using the bed for sleep.
· Establishing a regular, relaxing bedtime routine to “signal” the brain it is time to sleep.
· Avoiding napping during the day if having trouble sleeping at night.

Some of the more common sleep disorders are insomnia, sleep apnea and snoring. Insomnia is an experience of inadequate or poor quality sleep as characterized by one or more of the following sleep complaints: difficulty initiating and maintaining sleep and waking too early in the morning. Obstructive sleep apnea is a disorder in which breathing is briefly and repeatedly interrupted during sleep and can cause fragmented sleep and low blood oxygen levels. Snoring is defined as “breathing during sleep with hoarse or harsh sounds as caused by the vibrating of the soft palate.” Snoring can be a marker of sleep apnea, a risk factor for vascular complications such as hypertension, and it may lead to daytime dysfunction due to the fragmented sleep resulting from snoring.

The Piedmont Fayette Hospital Sleep Center is currently a four-bed sleep center expanding to six beds in late June and is the only hospital-based sleep center in the county that provides full-service diagnostic capabilities for people with sleep disorders. An experienced, multidisciplinary team of doctors, sleep technologists and other sleep disorder specialists provide total and comprehensive care for adults and children who have difficulty falling asleep or staying asleep, excessive daytime sleepiness, insomnia, snoring, sleep apnea and other sleep-related conditions. Talk to your doctor if you are experiencing problems related to sleep or for more information call the Sleep Center at 770-719-6031 or visit www.fayettehospital.org.