After a series of unexplained health scares–including loss of consciousness while driving, and breathing and sleep difficulties which culminated in seizure-like symptoms–Kevin Slater knew he was experiencing more than a severe allergic reaction. As a management consultant who specializes in diversity, executive development, and strategic solutions management, his extensive and hectic business travel schedule took him across the U.S. and Europe roughly 20 days out of the month and exposed him to compromised air quality and a smorgasbord of environmental elements that were less than conducive to good health. He recalls “sitting in a meeting with a major corporation and I couldn’t breathe. My throat began to close up and I was given an [adrenaline shot] to calm things down.†But symptoms continued and worsened.
Another time during a weekend of classes for an executive M.B.A., Slater began coughing and then experienced syncope, or lost consciousness. After the dye used for an MRI resulted in a botched and inconclusive result, Slater began his own search for answers. And what he’s learned is that his body may be reacting to a lack of sleep.
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In today’s competitive and global environment facilitated by instant technology tools and systems, many professionals regard sleep as a luxury for lazy teens, the elderly, or the less ambitious. Even if they believe that eating and exercising are important for maintaining their stride, the thought is if anything can be sacrificed, it’s sleep. But sleep is among the most important factors in maintaining good physical health and mental acuity. Sleep is a restorative function that the body requires to replenish energy and vitality and perform at its best, says Dr. Steven Y. Park, a national expert in sleep medicine, head of the Sleep-Wake Disorders Center at New York’s Montefiore Hospital, and author of Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired (Jodev Press L.L.C. ; $24.99).
In fact, inadequate sleep is associated with a number of chronic diseases and health conditions–such as cardiovascular disease, obesity, diabetes, and depression. In Slater’s case, chronic breathing challenges led to difficulty sleeping. He was averaging four hours a
night. As a result, his lack of sleep may have caused increased electrical activity in the brain, which resulted in seizure-like bouts of unconsciousness. “I slept sitting up, if not I would be totally congested.†Cross-Atlantic flights took on nightmarish proportions, Slater recalls. “The higher the altitude, the more congested I got and the more difficulty I had breathing.â€(Continued on next page)
Struggling to Sleep
Among the many types of sleep disorders are sleep apnea, repeated breathing obstructions while sleeping; narcolepsy, a chronic disorder of the central nervous system caused by the brain’s inability to control sleep and wakefulness and which often culminates in falling asleep spontaneously but unwillingly at inappropriate times; bruxism, involuntarily teeth grinding or clenching, usually while sleeping; and delayed sleep phase syndrome, where your sleep is delayed, causing you to sleep later and awake later than a normal sleep pattern.
It is difficult to measure the number of Americans with sleeping disorders because most are undiagnosed, their symptoms dismissed as a regular factor of modern living. But according to an analysis of the 2005-2008 National Health and Nutrition Examination Survey administered by the Centers for Disease Control and Prevention, short sleep duration was found to be most common among blacks (53%) compared to whites (34.5%) or those of other ethnicities (41.7%).
Sleep apnea, one of the most common sleep disorders, affects 4% of men and 9% of women, with 90% of sufferers age 65 or under going undiagnosed. The most common trait of obstructive sleep apnea (OSA) is snoring, which is often dismissed as a component of aging, weight gain, or stress. But Park says it is a major indication of breathing obstruction, which translates to insufficient blood oxygen to the brain. OSA occurs in all age groups and both sexes, but there are a number of factors that increase risk, including having a small upper airway (or large tongue, or tonsils); being overweight; having a recessed chin, small jaw, or a large overbite; a large neck size (17 inches or greater in a man, or 16 inches or greater in a woman); smoking and alcohol use; being age 40 or older; and ethnicity (African Americans, Pacific-Islanders, and Hispanics). Some sufferers may be genetically predisposed.
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Insomnia, characterized by difficulty falling asleep and waking up often during the night, is perhaps the most common of sleeping disorders. A symptom of psychiatric disorders such as anxiety and depression, if the condition is ongoing for weeks, months, or years it can be the sign of an underlying health condition. In fact, any of these sleep conditions can be the result of or lead to serious health challenges such as asthma, diabetes, heart disease, or neurological conditions.
Breathing and Sleep
According to Park, there is a definitive link to breathing obstruction, blocked pathways, and difficulty in sleeping. There are instances, he says, where people experience an interruption in their breathing (or upper airway resistance syndrome) even when they don’t have OSA. When this happens it alerts the body that you’re not breathing and the brain wakes you up to light sleep as a defense mechanism. “This puts your nervous system on edge so that you’re not fully asleep. A fast-paced, high anxiety lifestyle will exacerbate this condition. It becomes even more difficult to shut down your mind when it’s time to go to sleep,†Park says. In general, the combination of disturbed sleep and oxygen starvation may lead to hypertension, heart disease, and mood and memory problems. Other symptoms are wide-ranging, such as difficulty concentrating, depression, irritability, sexual dysfunction, learning and memory difficulties, and falling asleep while at work or on the phone.
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For Slater, it was a respiratory ailment that affected his ability to get proper amounts of sleep. After more than 18 years of coping and rigorous self-advocacy, several months ago his condition was diagnosed as Aspirin Exacerbated Respiratory Disorder, a rare allergy triggered by any item that contains aspirin or aspartame. The condition ranks among the growing number of invisible disabilities that encompasses environment-based respiratory illnesses. “Diet and exercise are key components but so is maintaining emotional balance and well-being,†Slater says of managing his health. He uses salt room therapies to clear his breathing passage, meditates, and practices deep breathing exercises. “I start each morning with gratitude and awareness for what I have and I don’t take more than I can handle in a given day. The organizations and people I work with must be synergistically positive and progressive.â€
Park agrees that mental and emotional feelings play a role in managing sleep challenges. In treating patients, he looks at the complete picture and analyzes a number of potential contributing factors including stresses, thought process, and patterns of behavior. Treatment integrates traditional and non-traditional methods, such as Chinese medicine, acupuncture, deep breathing, yoga, and meditative exercises to calm the nervous system.
Treatments and Recommendations
Sufferers have used a variety of popular methods such a melatonin or natural, homeopathic, or supplemental treatments, all of which a have varying degrees of success. Sleeping pills are a popular solution. They are also one of the most prescribed pharmaceutical drugs in the U.S. But in a recent study, they have been found to cause early death for users. Park points out that having insomnia itself, minus the added danger of prescription medication, increases one’s chance of dying. He explains, “Short/long sleepers, that is patients with too short or too long sleep length, have higher rates of negative health consequence such as depression, diabetes, heart disease, and other underlying conditions.â€
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Sleep specialists recommend a variety of therapies and treatments. Foremost among them is the Cognitive Behavioral Therapy for Insomnia (CPT-i). This therapy method necessitates creating a list of behavioral and cognitive patterns. During the therapy session, the patient’s behavior is assessed and categorized including stressors. Information gathered is grouped according to the 3P model for insomnia: predisposing factors, precipitating factors, and perpetuating factors. Park explains, “Precipit
ating factors disappear with time. We look at perpetuating habits such as remaining in bed but unable to fall asleep. After 20 minutes, get out of bed. You don’t want to associate bed with being awake.†Lifestyle changes are important in mitigating symptoms of sleep apnea. Bed, Park insists, is only for sleeping and sex, not for eating, television watching, or using phones and laptops. Late night eating also contributes to insomnia as the process of digestion interrupts the sleep pattern. It also perpetuates breathing challenges. And too much light at night prevents a rise in melatonin levels resulting in a delay and disruption of the normal sleep cycle.Choice of a specific treatment depends on the patient’s diagnosis, medical and psychiatric history, and preferences. One of the most common methods used to diagnose sleep apnea and determine its severity is a sleep study, which may require an overnight stay at a sleep center. The sleep study monitors a variety of functions during sleep including sleep state, eye movement, muscle activity, heart rate, respiratory effort, airflow, and blood oxygen levels, through the use of a continuous positive airway pressure mask (CPAP), which fits over the nose and/or mouth. Another method of treating sleep apnea that Park uses is a dental appliance, worn at night, which pushes the lower jaw and tongue forward and thereby opens the airway.
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Getting Enough Rest
Although sleep experts have long espoused the benefits of achieving optimal sleep time of seven to eight hours per night, Park concedes that individual sleep needs vary and it is therefore difficult to pinpoint the optimal sleep time for everyone. “Some people are rested at six to seven hours, others at nine to 10 hours, if so, that’s your optimal sleep. If, however, you are not refreshed after substantial time or if you need more sleep but keep waking up this signals a problem.†Park says that sufferers who do not fit the common profile of a common sleep disorder may experience other symptoms, which include being tired despite length of sleep, headaches, migraines, digestive problems, low or high blood pressure, and lightheadedness. He explains, “The inability to sleep well also interferes with the body’s hormone balance. In women, therefore, it may result in worsening pre-menstrual and menopausal symptoms.â€
As for Slater, he understands the importance of paying attention to what his body is telling him and keeping it all in balance. “After more than a few brushes with death, I understand what’s relevant. It doesn’t mean you stop living. You make choices and eliminate certain things and come to understand that you can live happily with what remains.â€