Chronic Insomnia

Archive for January, 2010

Sleep deprivation is costly physically, mentally, financially and can many times affect others besides the sleep deprived. Sleep is the only time during which the brain’s cerebral cortex – the portion of the brain responsible for memory, attention, perceptual awareness, thought, language, and consciousness – is not in a state of quiet alertness, so only during sleep may the brain properly rest and regenerate for optimal functioning. When a person has chronic insomnia, neurons may begin to malfunction and the person’s behavior will be visibly affected. Their general physical health will suffer, as well.

In the early stages of sleep deprivation, your brain will work harder and less effectively toward even simple tasks. The ability to concentrate will be one of the first noticeable effects. Memory soon becomes impaired, as does the ability to problem solve, make decisions, and generate new ideas.

Short term effects of sleep deprivation are:

• Memory and cognitive impairment – Your ability to think clearly and process thoughts and information will be affected by even the earliest stages of drowsiness.
• Diminished alertness and performance – If your sleep routine is disrupted for one night by as little as 90 minutes, your daytime alertness is reduced by one third.
• Slowed reaction time – In a study published in the journal Occupational and Environmental Medicine in 2000, researchers in New Zealand and Australia revealed that sleep deprivation has some of the same hazardous effects as being intoxicated, carrying serious risk due to its affect on coordination, reaction time, and judgment.
• Risk of automobile or occupational injury – In that same Occupational and Environmental Medicine study of 2000, researchers warned that drivers who have not slept in 17 to 19 hours performed worse behind the wheel than those with a blood alcohol level of .05 percent, the BAC limit for drunk driving in most European countries.
• Poor quality of life – Because of a sleep deprived person’s inability to think clearly, process thoughts, and remain alert, the majority of activities that one may typically enjoy throughout daily life become less enjoyable. Even watching television, going to a movie, engaging in conversation, reading, or outdoor activities are not as enthusiastically appreciated or pursued as when one is not sleep deprived.
• Irritability and moodiness
• Slurred speech
• Lower libido
• Tremors

Long term sleep deprivation and untreated sleep disorders cause even bigger problems, including:

• Obesity – A common effect of sleep deprivation is dramatic weight change. Hormone levels, including leptin and ghrelin which affect feelings of fullness and appetite, are imbalanced by lack of sleep. Leptin falls, encouraging increased hunger. Ghrelin rises, producing a lack of satisfaction from food. Through this imbalance and the sleep deprived body’s confusion regarding when to stop eating and how much to eat, weight is easily gained.
• Psychiatric problems, including depression and other mood disorders – A 2007 Harvard Medical School study in conjunction with the University of California at Berkeley documented that sleep deprivation causes the brain to become incapable of appropriately reacting to emotional events in a controlled, suitable manner.
• Fetal and childhood growth retardation – A 1999 study conducted by researchers at Pennsylvania State University’s College of Medicine’s Sleep Research and Treatment Center found that sleep deprivation suppresses growth hormones.
• Microsleeps – Very similar to blackouts from intoxication, microsleeps occur when the brain is significantly sleep deprived. The brain shuts down and falls into 10 to 60 second sleeps without the person experiencing them even being aware that the microsleeps are occurring and presenting significant driving, occupational, and other dangers.

Other documented long-term health affects from sleep deprivation are:

• Attention Deficit Disorder (ADD)
• Mental impairment
• High blood pressure
• Heart attack
• Heart failure
• Stroke

Regardless of whether you’re sleep deprived for a short period of time or over extended periods, your daily life is vastly affected. Sleep deprivation presents physiological problems, emotional and mental problems, and even occupational risks. Lack of sleep does not have to become an accepted way of life, as there are solutions available after proper diagnosis by a qualified practitioner.

PAP (positive airway pressure) is a technique of respiratory ventilation that is used mainly in the treating of sleep apnea. A CPAP machine (Continuous Positive Airway Pressure)  is a low-pressure portable air generator that is connected to the nose or face by tubing and is worn while resting. This system was developed in Sydney Australia in 1981 by Professor Colin Sullivan and is now used in many intensive care units as a type of ventilation. A CPAP treatment can be very effective in treating of both central and obstructive sleep apnea. Many patients tend to see an improvement in the quality of their sleep and life due to the treatment after just the first night’s use.

A CPAP machine is typically the size of a shoebox but is sometimes even smaller. It works by forcing air in the airway passage at a high enough pressure to prevent apneas. It can be prescribed for use in both central and obstructive sleep apnea. The pressure of the machine is adjusted according to the sleep apnea of the patient. The machine increases the pressure of air in a person’s throat so the airway does not collapse as breathing.

Obstructive sleep apnea begins as the upper airway starts to narrow as muscles relax while sleeping. This causes the reduction of oxygen in the blood which in turn causes a person to awake from sleeping. The CPAP machine stops this from happening by providing compressed air through a hose so breathing becomes possible again, thus reducing or even preventing hypopneas and apneas.

Central sleep apnea is something that occurs much less and is associated with the central nervous system function. The body repeatedly stops breathing while sleeping because the brain stops sending signal temporarily to the muscles that control the body’s breathing. The CPAP machine is the most common treatment for sleep apnea.

It must be understood that the air pressure and not the air movement is responsible for preventing the apneas. Before putting on the mask and while the machine is on, air flow is circulating into the mask. As the mask is placed on the head, it becomes sealed to the face as the air flow stops. From then on it is only the air pressure that provides the needed results. This also tends to help with loud snoring that is many times associated with sleep apnea.

A CPAP machine is simple to use as long as the user completely understands how it works and keeps it very clean. The pressure needed is normally determined by a doctor after thorough review of the patient after having been supervised by a sleep technician overnight. A complete machine will have one of the following:

~a mask covering the nose only, called NCPAP (nasal continuous positive airway pressure)
~a mask covering the mouth and nose
~prongs that slide into the nose

Because a CPAP machine is a medical device, it must have approval from the FDA (Food and Drug Administration) before than can be made available for sale. Because of this, a CPAP machine can only be obtained with a doctor’s prescription.

There are many different CPAP manufacturers that provide several types of machines with various features. Once someone has been diagnosed with sleep apnea and has been prescribed the CPAP as therapy, he or she can choose a machine among the several that are offered. A CPAP machine is usually covered under insurance as a durable medical equipment benefit. It most often bought or purchased with a home health care company.