Do we need sleep?

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    ‘The recommendations of the National Sleep Foundation and experts in the field are abstinence from any stimulant, coffee, alcohol, television, arguments before bedtime, and to seek medical help if they think they are having sleep problem and/or snoring, or not getting enough rest at night.’

    THE best way to answer that question convincingly is for you not to sleep for one night, or more. If you are still alert and feeling well after this trial of sleep deprivation, ask yourself the same question and you will have the answer.

    Alpine swifts fly continuously (non-stop from Switzerland to West Africa) for six months, with no sleep; bullfrogs can survive without sleeping for months; giraffe and elephants sleep about 30 minutes a day; walruses can stay awake for 84 hours; calves of killer whales and baby dolphins remain fully awake for the first few months of their lives. We, on the other hand, need a restful sleep every day, to maintain health and normal function.

    “Most American adults sleep poorly,” the National Sleep Foundation said on a study of 1506 adults that was reported in Washington by the Associated Press, and many other studies.

    The findings are obviously applicable to most of us in general.

    Lack of sleep translates to lesser mental acuity and concentration, poorer health, greater driving hazards, reduced productivity, and diminished sex drive. Inadequate sleep increases our risk for major illnesses, like high blood pressure, diabetes, heart disease, stroke, Alzheimer’s, and even cancer.

    Sleep experts recommend a minimum of 7 to 9 hours of sleep in 24 hours. The survey showed that adults sleep an average of 6.9 hours a night. The few minutes to 3 hours of sleep deprivation is enough to cause problems.

    Seventy-five percent of adults reported they frequently have difficulty in sleeping, like problem in initiating sleep, waking up often during the night, and/or snoring, waking up too early, and feeling unrefreshed and tired. Many also stated that they ignored the problem, and some do not even think they actually have any sleep deficit. Only about 50% of those surveyed stated they were able to sleep well most of the time. Twenty five percent thought their sleep problem had adverse effects on their daily routines.

    Richard Gelula, the chief executive officer of the Sleep Foundation, said there’s a link between sleep and quality of life. “People who sleep well, in general, are happier and healthier,” said Gelula. “But when sleep is poor or inadequate, people feel tired or fatigued, their social and intimate relationship suffer, work productivity is negatively affected, and they make our roads more dangerous by driving while sleepy and less alert.”

    Quality besides quantity

    Obviously, the quality of sleep, besides the number of hours, is very important. Chris Drake, senior scientist at the Henry Ford Sleep Center in Detroit and co-chair of the 2005 poll task force, stated that some of the nation’s sleep habits can be attributed to an “always-on-the-go society.”

    The commercial world of today stretches business to 24 hours a day, with 24-hour pharmacy, restaurants, casinos, supermarkets, etc., so people tend to stay up late, watch late night shows on television, surfing the web on the internet, etc. All these reduce people’s time to sleep. And some people even need more than 9 hours of sleep to feel refreshed and rested.

    This study also showed (1) Sixty percent of adult stated they have driven a vehicle while drowsy from lack of sleep the past year; and 4 in 10 reported they have had an accident or near accident because of tiredness or falling asleep at the wheel; (2) seventy five percent claim their partner has a sleep problem, snoring as the most common complaint; (3) four out of 10 of those surveyed reported lack of sleep adversely affected their sexual relationship, having lost interest in sex, having poorer performance or having sex less often; while (4) seventy percent claimed that their physician never asked them about their sleep.

    Lack of sleep reduces the normal “recharging time of our body battery, our energy source” causing a chain of reactions in our physiology and body chemistry. This “lo-bat” condition leads to physical and mental stresses to our system. All these alter the normal homeostasis (internal balance) within us, weakening our immune system, and increasing our risk of developing metabolic diseases, hypertension (high blood pressure), stroke and heart attack, among others, or aggravating existing illnesses.

    The recommendations of the National Sleep Foundation and experts in the field are abstinence from any stimulant, coffee, alcohol, television, arguments before bedtime, and to seek medical help if they think they are having sleep problem and/or snoring, or not getting enough rest at night.

    Obstructive Sleep Apnea (OSA)

    About one billion people in the world have Obstructive Sleep Apnea (frequent prolonged breath holding leading to oxygen deficit), majority undiagnosed, dismissed as “normal snoring.” The prevalence of OSA in the United States is about 25 million, according to the American Academy of Sleep Medicine. Untreated OSA reduces the integrity of the white matter fiber of many areas in the brain. More than 90 percent of people with OSA have heart irregularity, due to diminished oxygen in the body because of frequent (more than 100 times during sleep in some people) prolonged breath holding (apnea). Many obese persons and snorers (not all) have OSA. Untreated, OSA increases the risk for major illnesses from sleep deficit listed above, including cancer.

    For people who usually feel tired and sleepy in the middle of the day, a sleep study is needed to confirm the diagnosis. Sleep and rest deficit are unhealthy and shorten longevity. The only effective treatment for OSA is the use of Continuous Positive Airway Pressure (CPAP) machine, to keep the collapsing (obstructed) airway by the throat open, and humidified air pushed into the lungs with measured gentle pressure. This prevents dangerous breath holding (also stops snoring permanently) and enables the person to have good level of oxygen while asleep. CPAP prevents potentially fatal heart irregularity and heart attack due to hypoxia (lack of oxygen) with frequent breath holding (apnea). All the items on the market claiming to prevent or cure OSA are ineffective and are actually very harmful as their use delays proper diagnosis and early treatment. CPAP mask or nasal pillow, which is surprisingly comfortable to use and even psychologically “addicting” for the protection and sense of security it offers, is one of the wonders in medicine.

    In our own hands

    We are not born with a set destiny. Our future depends on our discipline and behavior.

    What we do or not do to our body mostly determines our health. The prescription for a healthy lifestyle, for maintenance of good health, disease prevention, and maximal longevity, besides regular medical check-up, includes the following ingredients: Adequate refreshing sleep, rest and relaxation, total abstinence from tobacco, strict moderation in alcohol intake, daily exercises (like brisk walking), low-fat, low-cholesterol, low-carb, high-fiber diet (vegetables, fruits, grains, nuts, etc), and, equally important, having a happy and positive attitude in life.

    The main objective of this column is to educate and inspire people live a healthier lifestyle to prevent illnesses and disabilities, and achieve a happier and more productive life. Any diagnosis, recommendation or treatment in our article are general medical information and not intended to be applicable or appropriate for anyone. This column is not a substitute for your physician, who knows your condition well and who is your best ally when it comes to your health.

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    Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, a Health Advocate, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian foundation in the United States. Visit our websites: philipSchua.com and FUN8888.com    Email: [email protected]