Scott Webb (Host): There are many keys to better health and one of them is sleep. And my guest today is here to talk about the importance of sleep and ways in which he can help if we have sleep disorders or feel like our health is just being compromised by poor sleep. I'm joined today by Dr. Tapan Desai. He's board-certified in Critical Care Medicine, Pulmonary Medicine and Sleep Medicine, and he practices at Franciscan Health.

 This is the Franciscan Health Doc Pod. I'm Scott Webb. Doctor, it's great to have you here today. We're going to talk about better sleep and what that means. And hopefully, it means better health and we're going to learn from you today. So, how does improved sleep play a role in our health?

Dr. Tapan Desai: Well, I think, improved sleep has multiple influences on our health. Not only do we have regeneration and improvement in functionality and thinking, but it creates significant rest, reduces cortisol levels for stress. It improves our recovery and allows for nocturnal hormones to be secreted.

Host: Yeah, that all sounds right. And of course, we're all humans here. You're human. We're all humans, right? This isn't AI. So, you know, we all know the benefits of sleep and getting enough sleep and the right sleep and all of that. So, maybe you can just talk about some of the common sleep disorders and how those disorders really do impact our health.

Dr. Tapan Desai: Yeah. Number one, you know, sleep does improve memory learning, mood regulation, cognitive performance, those types of things. But the big things I think patients need to know is that not only does it help immune system support, it helps our heart health, it improves weight and metabolism, which is impacting a lot of our patients, diabetes, and hormonal balance. How these impact certain conditions, so conditions such as, you know, obstructive sleep apnea, which a lot of people know about, which is the cessation of breathing at night causing fractured sleep, insomnia, which impacts a lot of our patient population.

There are two types of insomnia, sleep onset, which is the difficulty to fall asleep, and then sleep maintenance, which is difficulty staying asleep. And, you know, there are a myriad of factors as to why those occur. And then, there are other sleep issues, things that are less common in our community, but are common in the sleep community, which would be like things like narcolepsy, excessive daytime sleepiness, circadian rhythm certainly in our patient population, shift work issues in patients that work second and third shift.

Host: Sure. Yeah. So, let's talk about the signs and symptoms. Is it just that we wake up tired or we're just kind of foggy or we nod off in the afternoon? Like, how do we know when, you know, it's just the nature of our lives and what we've been dealing with and we're having a sleepy day, or is it one of those things where it's like every day we're just dragging? Is that like a sign of, you know, time to speak to you?

Dr. Tapan Desai: Yeah. I think those are all well thought through. I think the things that I say, some things that are a little bit more subtle, like, "Would you enjoy your day more if you slept better? Would your work productivity be better?" You know, it's often difficult to discern between fatigue, tiredness. Everyone always says they're tired. But I always ask my patients, "Are you sleepy or are you tired?" And that's a good question to ask yourself, like, "Are you fatigued, just life fatigue, family fatigue, work fatigue? Or are you truly sleepy?" So, those are important. I think falling asleep while driving-- important-- falling asleep at the office or unable to stay up through a movie or a sports event are often good questions to ask ourselves.

Host: Yeah. Right. If you're at a fever game, right, you know? And you're nodding off at that game, that that might be a sign that you're--

Dr. Tapan Desai: That might be a problem.

Host: Yeah. That you're tired, not fatigued. And I'm going to chew over that the rest of the day. It makes me wonder, are some people more prone to sleep disorders? And if so, why is that?

Dr. Tapan Desai: Yeah. There are certain populations that are prone to sleep disorders often after menopause. A lot of women have issues after the age of 60, 65. There's a loss of estrogen. And so therefore, we get insomnia. And oftentimes, women outpace men for obstructive sleep apnea. I think patients that are slightly heavier, they often have signs and symptoms of obstructive sleep apnea, and then there's a genetic predisposition. For patients, they'll probably know that their parents snored or they had restless legs, and those are, you know, some things that we should consider in our history.

Host: Yeah, I was going to ask you about family history. It's been sort of passed down through my family, that we're a family of snores, if you will, you know, and that it's just the nature of our family. But is that a thing, like family history, poor sleep, bad sleep, snoring, all that stuff?

Dr. Tapan Desai: Yeah, I think poor sleep, bad sleep is not a thing. Often patients say, "Hey, well, my father slept poorly, so I know I'm going to sleep poorly." Sleep is a function of our day, how we rest, and making sure that our sleep environment is as particular as our day environment. But there is a genetic component or a family component to multiple conditions such as sleep apnea or restless legs.

Snoring often is the first sign that patients always come to see me, because they think that snoring is often indicative of a disease. But I always say that snoring is part and parcel to a disease, but not the sign of it. So, you can have primary snoring because of a deviated septum or some abnormal anatomy, but is not reflective of sleep apnea. But oftentimes, sleep apnea or poor sleepers have snoring.

Host: Right. I see what you mean. So, let's talk treatment options. That's always the million-dollar question. How do you help folks?

Dr. Tapan Desai: Yeah. So, you know, treatment for each condition varies. And each condition will dictate based on the clinical picture and each patient individually. We pride ourselves on individualizing therapy. But in general, sleep apnea has, you know, three to four modalities of treatment, depending on severity. There are things like, just simply conservative management, losing weight, sleeping on one side, avoiding supine sleep, avoiding alcohol, avoiding late nights, and avoiding eating late at night to CPAPs, which everybody has heard of.

But there are new techniques for sleep apnea such as hypoglossal nerve stimulators. It's sort of on TV now, Inspire. And there's a new hypoglossal nerve stimulator coming down the pipeline and dental devices that patients may not know about. There are things like cognitive behavioral therapy, and then a myriad of treatment factors for other conditions.

Scott Webb: Yeah. So, a lot of options out there, but it does occur to me, it seems like we talk more about sleep disorders now. And I'm wondering from an expert, are they more prevalent today than they were before or just more folks coming to the doctor and saying, "Help me. I am tired all the time"? Like, is it nutrition, lifestyle, stress? Like if I'm right, then it seems like it's more prevalent. Why is that?

Dr. Tapan Desai: Yeah. I think it's not that it's more prevalent. I think that the recognition is higher. I think that all of us are trying to improve our wellness, if you will, and our health. And, you know, we're reading about it more. It's on social media. And a lot of people, with the advent of GLP, people are focusing on their weight, and they realize that sleep is a huge portion of that. That's number one.

Number two, wellness. Number three, getting stronger and feeling better. I think people are just recognizing it and it's there to be assessed.

Host: Yeah. Are there things that we can do? You know, commonly, Doctor, in these podcasts, I learned that, yes, the experts can help, but oftentimes we need to help ourselves. So, are things that we can do, as you say, maybe losing some weight, getting some exercise? You know, like what part do we play in helping ourselves?

Dr. Tapan Desai: Yeah, I think that's a great question. I think all of those are important. I think we tend to focus on weight loss and nutrition. But I think sleep is a global sort of problem that we need to improve in terms of habit. So, making sure that we go to bed at the same time every night. You know, sleep, it's like brushing your teeth if you, it only works if you do it right. So, not staying up late at night, not falling asleep on the couch like we all do, watching the Bears Game or the Colts game, ensuring that we take 20 to 30 minutes prior to bed and sort of come off the ledge, if you will. You know, meditate, do some intentional journaling can all help sleep.

And then, making sure that we don't sleep with our pets, making sure that the room is cool, making sure that the room is dark, all of these things, which we call sleep hygiene, should be utilized.

Host: Yeah, I'll often find one of our cats like sleeping on my wife's head, you know, and she's always the one complaining that she doesn't get enough sleep. I'm like, "Well, a lot of that probably the cat on your head," you know, that is messing with your sleep hygiene, if you will. You know, Doctor, I feel like we just scratched the surface today, but good to put this information out there to help folks to know that help is available, to know that can help themselves. Just final thoughts and takeaways.

Dr. Tapan Desai: I think that sleep disorders is becoming a much larger topic and a bigger part of wellness. I think that, in our community specifically, it impacts our community directly. It impacts adults, parents, but also children. And so if there is some concern, you know, we would encourage our patients to seek out help.

Host: Yeah, that's the main thing. I know we all suffer and a lot of us are perhaps fatigued, but also tired, you know, that dreaded combo. And we just need to help ourselves, realize that there's experts out there at Franciscan Health, reach out, do our part and hopefully get some better sleep. So, thank you so much.

Dr. Tapan Desai: Absolutely. And we just want to remind our patients that we have seven providers, that can take care of their sleep disorders.

Host: And for more information, visit franciscanhealth.org and search sleep medicine. And if you found this podcast helpful, please share it on your social channels, and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.