CAIRO WEST MAGAZINE WELLBEING
How do you conduct tests for disorders?
We use a sleep lab, basically a laboratory where the patient spends the night. We closely monitor brain activity, breathing, heart rate and any muscular movements. This gives us insight into probable causes, so we can decide how to proceed with treatment.
What is the normal healthy pattern of sleep, or does this have a natural and acceptable variation?
This is often influenced by genetic factors; number of hours required can range between 5-11 hours, although 8 hours is the average. Your body should let you know; when you have had enough you should wake up feeling rested. As you age you may experience a condition known as‘ greying of sleep’, wanting to go to bed earlier, and waking up at dawn, more in line with natural light patterns actually.
Sleep normally occurs in four stages, repeated in cycles throughout the night. Starting with the transition phase, the lightest stage of sleep, where you feel yourself drifting off. It is typically 5 to 10 minutes, just enough to allow your body to slow down and your muscles to relax. The second stage of sleep is still considered light sleep. Your brain activity starts to slow down, as well as your heart rate and breathing. Your body temperature falls a little and you’ re beginning to reach a state of total relaxation in preparation for the deeper sleep to come.
This is followed by the start of deep sleep, also known as slow wave sleep. During stage 3, your brain waves are slow Delta Waves. This is when you experience your deepest sleep of the night and it’ s difficult to wake someone up. Stage 3 occurs in cycles, almost 20 % of the total sleep time, the deep sleep of the first cycle being the longest. This is the time when the body does most of its repair work and regeneration.
The fourth stage is referred to as Paradoxical Sleep or REM sleep, which stands for the rapid eye movements that characterize it. During REM sleep, your blood flow, breathing, and brain activity increases. It is the stage during which we dream. An EEG would show that your brain is about as active as it is when you’ re awake. Another aspect of REM sleep is that the muscles of the body loosen to the point where they are almost paralysed. Scientists theorize that this may be nature’ s way of protecting us from acting out our dreams.
The first period of REM sleep of the night usually begins about 90 minutes after you start drifting off, and lasts for about a few minutes. As the night passes, the periods of REM sleep become longer.
What issues can impact normal sleep?
Pain is a factor, as well as heart problems, or digestive reflux. You should avoid eating heavy or spicy food late at night, but equally, going to bed on an empty stomach can keep you awake as well. Fruit or dairy products are light and digestible. Stimulants such as nicotine, caffeine, alcohol and even chocolate can cause insomnia. The current trend of working out in the gym in the evenings is one culprit; it increases the adrenalin in the system, which then takes time to wind down. And I must mention that addiction to television and Internet until late at night affects normal sleep. This amount of light and mental activity keeps the brain alert, just when it needs to relax.
How can disorders be treated?
We must conduct a full study, looking at family history, life-style, physical examination and lab tests with polysomnography, before making our diagnosis. We recommend behavioural and life-style changes, along with surgery or treatment with medications in cases that require further steps.
Do you see an increase in people turning to medication for sleep disorders?
Unfortunately yes, and people must be aware of the dangers especially with self-medicating. Sleeping pills should only be used under close medical supervision. As people become more aware that there are other ways of approaching the problem, hopefully we will see less use, and even abuse of these medications.
What natural methods can be used to improve sleep?
It is a great help if you can maintain a regular schedule, with small meals at specific times. Try to sleep and wake at the same time each day, rather than pushing yourself during the week then catching up on week-ends. Even with the hectic lives we lead at times these simple steps can make all the difference.
Dr. Shahira Fathy Loza, MB BCh, DPM & N Address: The Behman Hospital, 32 El-Marsad St., Helwan Tel: 02 2555 7551 – 2555 9602- 2555 7894- 2555 9603 Website: www. behman. com Email: s. loza @ behman. com
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