Missing Your ZZZs? Your Doctor Can Help

SIOUX FALLS (Aug. 1, 2007) - You're yawning throughout the day, a little cloudy in the mind and nodding off during that long but important meeting. Feeling exhausted after a poor night's sleep is familiar to most of us - and all too familiar to some. Sleep problems often come and go. But for some women, sleep troubles signal a deeper medical issue.

Several things can cause women to wake up just as tired as they were when they went to bed, said Dr. H. Nicolas Dagher with Avera Pulmonary Associates. Night-time demands of babies and young children may be to blame. While parental roles have shifted, it's still most often the mom who gets up to check on a crying child, Dagher said. Another cause is insomnia, perhaps triggered by the stress of job responsibilities or financial obligations. "Sleep is basically a mind game. If you can't shut off your mind, you won't be able to sleep," Dagher said.

Insomnia is tricky, because one issue might trigger it, and something else may cause it to continue, such as sleep environment. "The worst thing you can do for insomnia is to just throw medication at it," he said. A better solution is getting to the root cause of insomnia, as well as learning good "sleep hygiene," which has nothing to do with the cleanliness of the bedroom, but everything to do with healthy sleep habits.

Sleep can be disrupted by restless leg syndrome (RLS), sometimes brought on in women by an iron deficiency, Dagher said. The most common sleep disorder - sleep apnea - fools you into thinking you got a full eight hours of sleep, "but you wake up feeling like you were run over by a train," Dagher said.

According to the New England Journal of Medicine, 2 percent of women and 4 percent of men between the ages of 30 and 60 have sleep apnea, characterized by interrupted or reduced breathing during sleep. Only 10 percent of people who have this disorder seek treatment, even though sleep apnea is linked to serious conditions such as high blood pressure and cardiovascular disease.

The most common type of sleep apnea is called obstructive sleep apnea, in which something physically blocks the airway during sleep, such as soft tissue in the back of the throat. Other than waking up tired, symptoms of obstructive sleep apnea include snoring and waking up gasping for breath. The disorder is diagnosed through a sleep study in a sleep lab. This test, also used to diagnose other sleep disorders such as narcolepsy, can be compared to spending the night in a motel - other than being wired to monitors, similar to an EKG.

Sleep apnea can begin in childhood, especially in kids who have trouble with their adenoids or upper airways, Dagher said. If kids are behind in school, labeled as a slow learner or inattentive, sleep disorders should be ruled out first. "Any snoring in a young child should be investigated aggressively," he said. In women, obstructive sleep apnea is more common after menopause. Women who weigh more than average are also more likely to develop the condition.

While surgery is an option, the most common treatment for obstructive sleep apnea is use of a CPAP (continuous positive airway pressure), which is an air pump with a mask worn over the nose or nose and mouth to keep airways open. Along with the medical benefits of getting adequate oxygen throughout the night, patients feel better, thanks to two to three hours of added refreshment each night.

Are you among the 40 million Americans who suffer from some type of sleep disorder? Take this brief quiz:

• Do you feel that your sleep is unsatisfactory?
• Do you have trouble falling asleep or staying asleep?
• Have you been told that you walk, talk, moan or grind your teeth while you sleep?
• Have you been told that your legs twitch or kick in the night?
• Do you lie awake feeling worried or anxious?
• Do you ever awaken suddenly, gasping for breath?
• Do you feel extremely sleepy during the day?
• Have you been told that you snore?
• Do you have attacks of sudden physical weakness?

If you answered "Yes" to any of the above questions and it interferes with your daily life, talk to your physician. Or, call Avera McKennan's Sleep Diagnostic Center at (605) 322-REST (7378).