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Ask the Expert

Tired of Counting Sheep? Learn more about Sleep and Sleep Disorders

This Month's Ask the Doc is brought to you by Dr. James Yan, M.D., Ph.D. Dr. Yan is board-certified in Sleep Medicine and Neurology, and is the Associate Medical Director of the Suburban Hospital Sleep Disorders Center.  He is also a clinical assistant professor at George Washington University. Dr. Yan graduated from the University of Miami Medical School. He was trained at Georgetown University as a fellow of Sleep Medicine.

How important is sleep?
Sleep is a basic necessity of life, just as important as food and water. When we sleep well, we should awaken feeling refreshed and alert. When we don't sleep well, our jobs, productivity, relationships, health and well being are all put at risk.

How much sleep should I be getting?
The National Sleep Foundation reports that adults need 7-9 hours of sleep each day. Adolescents and teens need 8.5-9.5 hours of sleep a day, and infants and children need from 10-15 hours of sleep daily.

Are sleep disorders common?
Yes. One in three Americans suffers from a sleep disorder, causing great discomfort for millions of people both day and night. Different disorders include insomnia, narcolepsy, obstructive sleep apnea, nocturnal myoclonus or periodic limb movement, gastroesophageal reflux and snoring.

Snoring isn't a sleep disorder, is it?
Yes. Snoring can cause many problems, not just stress for the person sleeping with you. Snoring can reflect underlying medical problems. It might indicate the presence of obstructive sleep apnea. If you feel that your snoring is a problem, see your healthcare provider.

How would I know if I had a sleep problem?
You may have a sleep problem if you're feeling fatigued, taking naps, or falling asleep during the day or having trouble concentrating. Other symptoms may include difficulty initiating or maintaining sleep, muscle tension or pain in legs upon awaking, waking up with heartburn or being hoarse in the morning.

Are there any other indications I may have a sleep problem?
Having been told that you snore, gasp for breath, or appear to stop breathing when you sleep are also signs that you may have a problem.

What sleep problems can compromise my health?
Sleep disorders encompass a spectrum of problems that can be hazardous. Serious health issues associated with sleeping disorders can range from obstructive sleep apnea, to hypertension and heart failure.

Is there really a link between sleep disorders and cardiovascular disease?
Yes. Research studies have associated sleep problems with an increase in cardiovascular risks such as heart attacks, strokes, irregular heart rhythms and even death.

Treating my sleep disorder can improve my heart health?
Yes. Proper treatment of sleep disorders can improve cardiovascular outcomes. According to Sleep Services of America, 20% of sudden deaths in heart failure patients occur between midnight and 6 a.m. Unfortunately, this linkage between sleep and heart health is often ignored or unrecognized.

Do women have a reason to be concerned?
Yes. In contrast to men, women are less likely to have sleep apnea. However, they can develop sleep apnea if they are obese or post-menopausal. Women also have more potential to develop insomnia.

Are there things I can do to help me fall asleep?
There are many things you can do to help fall asleep. Avoid caffeine after noon time, exercise every day before 5:00 PM. Try warm baths, or warm milk before bed. Go to sleep only if you feel sleepy. Wake up at a fixed time daily. Use the bed only for sleep, don't watch TV or do work in bed. Don't stay in bed for too long if you can't fall asleep within a short period of time. Try soft music or meditation to calm you before sleep. If none of these work, and you have not been able to sleep soundly for more than a few days, seek medical care. Never take over-the-counter sleeping aids, including melatonin, without consulting your healthcare provider first. Your healthcare provider may be able to determine why you are not sleeping and provide some help.

What types of treatment are available if I'm found to have a serious sleeping problem?
At the Suburban Hospital Sleep Disorders Center, we can perform a sleep evaluation if your physician wants you to be seen by a Sleep Specialist. An overnight sleep study and daytime multiple sleep latency can be done if indicated. The testing can tell us your sleep pattern, and diagnose sleep apnea, narcolepsy, periodic limb movement, etc. After testing and evaluation, the treatment will be tailored to a patient's needs. A CPAP mask will be ordered for patients with sleep apnea. Medication will be ordered for patients with periodic limb movement. The patient might be referred to be evaluated by specialists in pulmonary care, ENT, psychiatry, neurology, and weight reduction. The Sleep Center also offers free support groups for sleep apnea patients and their families.

For more information on sleep, or to receive a consultation, call the Suburban Hospital Sleep Disorders Center at (301) 896-3039.



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