Sleep & Sleep Apnea
Sleep is imperative for overall health and wellness. Sleep apnea has greater effects on the body than interruptions to overnight rest. Dr. Vinod Mehta discusses the importance of sleep.
Featuring:
Vinod Mehta, MD
Vinod Mehta, M.D. is with Palouse Pulmonology & Sleep Medicine, part of the Pullman Regional Hospital Clinic Network. He specializes in pulmonology and sleep medicine and is board certified in Internal Medicine and Sleep Medicine. His is a member of the American Academy of Sleep medicine and his specialist areas of interest are bronchoscopy and sleep studies. To make an appointment, please call (509) 338-6000. Transcription:
Bill Klaproth (Host): Sleep apnea affects many people, making it almost impossible to get a good night’s sleep, which is necessary for optimal health and living a quality life. And here to talk with us today about sleep and sleep apnea, is Dr. Vinod Mehta, an internist, pulmonologist and sleep medicine specialist at Pullman Regional Hospital. Dr. Mehta, thank you so much for your time. First off, let me ask you this. What is sleep?
Vinod Mehta, MD (Guest): So, coming first of all to the definition of sleep; in 1830, Robert McNish revised the definition of sleep. He said it was suspension of sensorial power in which the voluntary functions are absent, but the involuntary functions such as circulation, respiration and other functions controlled by the autonomic nervous system remain intact. However, we now know that sleep neither is the absence of wakefulness, nor is it simply the suspension of sensorial power. Sleep proceeds from a combination of passive withdrawal of afferent stimuli to the brain and the simultaneous activation of discreet neurons in selected brain areas. It is a much more complicated process and research is going on. But in a nutshell, your body can be compared to a battery. It needs to be recharged on a regular basis or it will get run down or maybe even die. Sleep is required for the process of rejuvenation.
Host: That’s very interesting. I like your analogy. Sleep is like a battery, we need to recharge it. So, Dr. Mehta, why is sleep so important to our overall health?
Dr. Mehta: So, if someone is not able to sleep well; it creates a lot of problems with physical and mental wellbeing. In 2014, a poll that tracks American sleep behavior and trends, reported that 45% of the Americans say that poor or insufficient sleep affected their daily activities at least in the past seven days. The Seattle School Districts changed their time, the start up time for schools for middle school and high school from 7:50 a.m. to 8:45 a.m., thereby giving extra time for sleep to their students. They later on reported that the little difference in the start up time made a lot of difference in daytime sleepiness and the grades of the students improved. So, sleep duration of less than seven hours is more likely to be associated with poor general health and low overall physical and mental health, causing poor quality of life than those who sleep more than seven hours. If we could identify the underlying cause of insufficient sleep; we can help millions of people to sleep better and thereby improve the overall physical and mental wellbeing.
Host: So, it’s easy to see why sleep is so very important. Dr. Mehta, can you tell us what is your experience in sleep medicine?
Dr. Mehta: Yes. I have been passionate about sleep since I was doing my fellowship in 1984. At that time, we just had become aware about sleep medicine and there were no sleep labs. I was a fellow and used to record patients’ nighttime sleep and make a diagnosis of sleep apnea. In 1988, I started a sleep lab for Griffin Spaulding Regional Hospital in Georgia, from scratch. And we progressed from one to two sleep rooms and then blossomed into a six-room sleep lab. I was the director of sleep there for many years and opened another two-bed satellite sleep lab clinic and took care of eight beds for that hospital. I’m experienced in reading pediatric and adult sleep studies for the last more than 25 years.
Host: And Dr. Mehta, thanks for sharing that with us. Who should see a sleep medicine physician?
Dr. Mehta: Any person who has issues with sleep, not getting adequate sleep or sleeping too much in the daytime, thereby bothering with their daily day to day activities in life or hampering their focusing during work while they are awake. So, any of those combinations can be a person who needs to see a sleep doctor.
Host: Got you and how many people are affected by sleep disorders?
Dr. Mehta: So about 70 million Americans suffer from sleep problems. Nearly 60% of them have chronic disorder.
Host: That’s a lot of people. So, let’s talk about sleep apnea, Dr. Mehta. What is sleep apnea? Can you explain that to us?
Dr. Mehta: Sure. The most common sleep disorder is, sleep apnea. Sleep apnea affects about 20 million Americans. So, by definition, sleep apnea is a cessation of airflow for more than ten seconds during sleep causing severe oxygen desaturations and arousals, thereby causing a lot of sleep fragmentation and overall sleep deficiency. So, because of sleep deficiency, this causes daytime sleepiness, snoring when they are sleeping, morning headaches, hypertension, diabetes, cardiac arrythmias and death. So, if this was diagnosed earlier, we could easily treat these patients with CPAP masks with very good benefits and prevent long-term complications for them.
Host: And what does a sleep study involve?
Dr. Mehta: A sleep study is a complex procedure that should be performed by a trained technologist whereby the brain waves, abdominal and chest muscle functions, electrocardiogram and oxygen saturations are monitored during sleep. The study may help in the diagnosis of sleep disorders.
Host: Got you. And is – can you explain who is at greater risk for sleep apnea? Do we know this?
Dr. Mehta: So, there are a number of factors which can put you at a higher risk for sleep apnea. Number one is the obesity. So, if the BMI is more than 32 to 35; they are prone to have sleep apnea. There is also familial reasons or family history of someone in the family has sleep apnea, makes you prone to a sleep disorder like sleep apnea. Number three, people with hypothyroidism, they are also prone to get easily sleep apnea. So, these are the usual factors. The other rare, lesser common reasons are people with jaw deformity like retrognathia or people who have swollen tongue or like people with Down’s syndrome; they have a bigger tongue and therefore they get sleep apnea easily. And many other not that common causes but there are many causes which can lead to sleep apnea.
Host: Really interesting and as you say, sleep is so important, and we all need to pay attention and try to get good sleep. Dr. Mehta, thank you so much for your time today. For more information, please visit www.pullmanregional.org, that’s www.pullmanregional.org. This is the Health Podcast from Pullman Regional. I’m Bill Klaproth. Thanks for listening.
Bill Klaproth (Host): Sleep apnea affects many people, making it almost impossible to get a good night’s sleep, which is necessary for optimal health and living a quality life. And here to talk with us today about sleep and sleep apnea, is Dr. Vinod Mehta, an internist, pulmonologist and sleep medicine specialist at Pullman Regional Hospital. Dr. Mehta, thank you so much for your time. First off, let me ask you this. What is sleep?
Vinod Mehta, MD (Guest): So, coming first of all to the definition of sleep; in 1830, Robert McNish revised the definition of sleep. He said it was suspension of sensorial power in which the voluntary functions are absent, but the involuntary functions such as circulation, respiration and other functions controlled by the autonomic nervous system remain intact. However, we now know that sleep neither is the absence of wakefulness, nor is it simply the suspension of sensorial power. Sleep proceeds from a combination of passive withdrawal of afferent stimuli to the brain and the simultaneous activation of discreet neurons in selected brain areas. It is a much more complicated process and research is going on. But in a nutshell, your body can be compared to a battery. It needs to be recharged on a regular basis or it will get run down or maybe even die. Sleep is required for the process of rejuvenation.
Host: That’s very interesting. I like your analogy. Sleep is like a battery, we need to recharge it. So, Dr. Mehta, why is sleep so important to our overall health?
Dr. Mehta: So, if someone is not able to sleep well; it creates a lot of problems with physical and mental wellbeing. In 2014, a poll that tracks American sleep behavior and trends, reported that 45% of the Americans say that poor or insufficient sleep affected their daily activities at least in the past seven days. The Seattle School Districts changed their time, the start up time for schools for middle school and high school from 7:50 a.m. to 8:45 a.m., thereby giving extra time for sleep to their students. They later on reported that the little difference in the start up time made a lot of difference in daytime sleepiness and the grades of the students improved. So, sleep duration of less than seven hours is more likely to be associated with poor general health and low overall physical and mental health, causing poor quality of life than those who sleep more than seven hours. If we could identify the underlying cause of insufficient sleep; we can help millions of people to sleep better and thereby improve the overall physical and mental wellbeing.
Host: So, it’s easy to see why sleep is so very important. Dr. Mehta, can you tell us what is your experience in sleep medicine?
Dr. Mehta: Yes. I have been passionate about sleep since I was doing my fellowship in 1984. At that time, we just had become aware about sleep medicine and there were no sleep labs. I was a fellow and used to record patients’ nighttime sleep and make a diagnosis of sleep apnea. In 1988, I started a sleep lab for Griffin Spaulding Regional Hospital in Georgia, from scratch. And we progressed from one to two sleep rooms and then blossomed into a six-room sleep lab. I was the director of sleep there for many years and opened another two-bed satellite sleep lab clinic and took care of eight beds for that hospital. I’m experienced in reading pediatric and adult sleep studies for the last more than 25 years.
Host: And Dr. Mehta, thanks for sharing that with us. Who should see a sleep medicine physician?
Dr. Mehta: Any person who has issues with sleep, not getting adequate sleep or sleeping too much in the daytime, thereby bothering with their daily day to day activities in life or hampering their focusing during work while they are awake. So, any of those combinations can be a person who needs to see a sleep doctor.
Host: Got you and how many people are affected by sleep disorders?
Dr. Mehta: So about 70 million Americans suffer from sleep problems. Nearly 60% of them have chronic disorder.
Host: That’s a lot of people. So, let’s talk about sleep apnea, Dr. Mehta. What is sleep apnea? Can you explain that to us?
Dr. Mehta: Sure. The most common sleep disorder is, sleep apnea. Sleep apnea affects about 20 million Americans. So, by definition, sleep apnea is a cessation of airflow for more than ten seconds during sleep causing severe oxygen desaturations and arousals, thereby causing a lot of sleep fragmentation and overall sleep deficiency. So, because of sleep deficiency, this causes daytime sleepiness, snoring when they are sleeping, morning headaches, hypertension, diabetes, cardiac arrythmias and death. So, if this was diagnosed earlier, we could easily treat these patients with CPAP masks with very good benefits and prevent long-term complications for them.
Host: And what does a sleep study involve?
Dr. Mehta: A sleep study is a complex procedure that should be performed by a trained technologist whereby the brain waves, abdominal and chest muscle functions, electrocardiogram and oxygen saturations are monitored during sleep. The study may help in the diagnosis of sleep disorders.
Host: Got you. And is – can you explain who is at greater risk for sleep apnea? Do we know this?
Dr. Mehta: So, there are a number of factors which can put you at a higher risk for sleep apnea. Number one is the obesity. So, if the BMI is more than 32 to 35; they are prone to have sleep apnea. There is also familial reasons or family history of someone in the family has sleep apnea, makes you prone to a sleep disorder like sleep apnea. Number three, people with hypothyroidism, they are also prone to get easily sleep apnea. So, these are the usual factors. The other rare, lesser common reasons are people with jaw deformity like retrognathia or people who have swollen tongue or like people with Down’s syndrome; they have a bigger tongue and therefore they get sleep apnea easily. And many other not that common causes but there are many causes which can lead to sleep apnea.
Host: Really interesting and as you say, sleep is so important, and we all need to pay attention and try to get good sleep. Dr. Mehta, thank you so much for your time today. For more information, please visit www.pullmanregional.org, that’s www.pullmanregional.org. This is the Health Podcast from Pullman Regional. I’m Bill Klaproth. Thanks for listening.