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Snooze malfunction
Published in Al-Ahram Weekly on 22 - 07 - 2004

Do you have trouble sleeping, sleep unintentionally or snore? Vivian Salama investigates the plight of the restless
Wake up, Egypt! Sleep disorders affect more people than you may think. As a nation, it seems our circadian rhythm, or our body's 24-hour clock, likes the late hours. But after a while, long nights and early mornings will take their toll.
Doctors have diagnosed 84 kinds of sleep disorders including excessive sleeping, restless leg syndrome and nightmares. To determine whether one suffers from a disorder, doctors look to their quality of rest first. "We first want to know if the quality of sleep is good -- that the patient is not waking too many times at night, not snoring at night and not moving a lot," said Dr Shahira Loza, a sleep medicine consultant at the Cairo Centre for Sleep Disorders. In cases of poor sleep quality, doctors often find that the problem results from a medical condition or psychological problem.
At the Cairo Centre for Sleep Disorders, Loza and her colleagues first ask their patients a series of questions in hopes of finding an obvious answer to their restlessness. "We also look to see if the patient is on any medications that may effect sleep," Loza said.
If the problem's source remains unknown, doctors will often record the patient's sleep patterns by monitoring a full night's sleep and naps the following day. After analyzing breathing patterns, body movements and the rate at which a patient falls asleep, doctors can begin to develop a treatment plan.
Six kinds of sleep disorders typically plague patients, according to Loza. The most common one, known as obstructive sleep apnea, results from a cessation of breathing during sleep -- a major cause of excessive daytime sleepiness. "Patients with this disorder have no problems breathing during the day," Loza said. "But while they're asleep, the tissues and muscles in their upper airway relaxes to the point of obstruction."
When this occurs, patients will snort or gasp for air. A simple splint, worn by the patient, assists with breathing and helps prevent breathe obstruction, Loza said. "I tell them it's like sleeping with an air conditioner."
Insomnia is another well-known problem. According to the New England Journal of Medicine, about one-third of the world's population experiences insomnia during a given year, with 17 per cent reporting chronic problems. Insomniacs have difficulty falling asleep, wake up too early, are unable to maintain sleep, or simply sleep poorly. Doctors cite depression as the major cause.
Unlike insomniacs who sleep too little, narcoleptics sleep too much. "Narcoleptics can fall asleep while watching television, but they can also fall asleep while driving," said Loza, describing the disease as a total loss of muscle tone while a person is still awake. According to Loza, in about 90 per cent of patients who suffer from excessive sleep, the cause is a medical abnormality. "It is genetic, so some people have a predisposition to narcolepsy," she said.
Still others spend a sufficient number of hours sleeping, but at the wrong time of day. Circadian rhythm disorder, as it is known in medical parlance, can be normal for those who work odd shifts or are jet lagged. But the disease most often plagues adolescents and the elderly.
Teenagers live according to a different clock, said Loza. "Their brains sleep at four o'clock in the morning, and don't wake up until the following afternoon." For the elderly, it is the opposite. "People often say, 'My mother suffers from insomnia. Please give her a sleeping pill.' But all you need to do is ask them, 'What time do you go to bed?'" explained Loza.
Finally, Loza urges people to look out for sleeping problems such as restless leg syndrome or periodic limb movement, or unusual activity while asleep such as nightmares, sleep walking or sleep talking. Everyone's body has special needs, and so it is your duty to listen to your body when it calls for rest.
"I tend to sleep for a minimum of eight hours. Otherwise I feel fatigued and I have to drink coffee every two hours," joked Omneya Gubara, 25. "I go to sleep around 2.00am," said Sherif Mansour, 33, a human resources manager from Cairo. "I try to get around six hours of sleep a day. But due to stress and obligations, I usually sleep less than five," he said.
A siesta mentality naturally overcomes us during these hot summer days. But according to Loza, the heat is not really putting you to sleep. "Neither the heat, nor the heavy meal, nor boring lectures will put you to sleep," she said. "All that it does is remove the stimulation that is keeping you awake." Experts say there is nothing wrong with afternoon shut-eye, but keep it short. Ideally, daytime naps should range from 15 to 45 minutes in length, so not to throw off your body's clock.
As for getting that quality sleep that specialists call essential, Loza suggests sleeping everyday around the same time for the same number of hours. Do not expect to suddenly change this time from one day to another without it wearing you out. Also, the bed should remain off limits until bedtime. "People who have insomnia always tend to change their bedrooms into a living room and a kitchen," Loza joked. Avoid heavy meals before sleeping, and try to leave at least four hours between working out and bedtime, so not to boost your body's adrenaline, experts agree.
Finally, if you are not getting eight hours of sleep per night, rest assured. Experts say most people can get along with less. "As long as you don't fall asleep when and where you don't intend to, you're getting enough hours," Loza said. And remember that sleep should be uninterrupted, so hitting the alarm clock's snooze button for an hour does not count.
Stay cool this summer, get plenty of rest and remember, your body works hard during the day -- you owe it some quality rest at night!


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