World Health Day: Sleep Health In India - Dr Bharat Gopal

Sleep health is a multifaceted sleep-wakefulness pattern that is adaptable to individual, social, and environmental needs and supports both physical and mental health. Sleep is a biological necessity, and sleep deprivation or undiagnosed sleep disorders are detrimental to one's wellness, happiness, and safety. Good sleep health is characterized by subjective satisfaction, quality and quantity of sleep, and sustained alertness during waking hours.

For optimal cognitive performance, mood, psychological health, and cardiovascular, cerebrovascular, and metabolic health, individuals must get enough quality sleep. The ResMed 2023 sleep survey suggests that 58% of respondents from India believed snoring to be a sign of sound sleep and that they were not aware that it could be a risk factor for Obstructive Sleep Apnea (OSA) and other sleep-related problems. Contrary to popular belief, snoring does not necessarily signal a good night's sleep, reinforcing the significance of raising awareness of sleep disorders in India.

Sleep apnea is a disorder in which the muscles in the throat relax to the point of collapse, restricting airflow. This deprives the body and brain of oxygen by causing breathing to become shallow or even halt for a few seconds or minutes at a time. Lack of deep sleep increases the chance of developing serious health issues and can lead to significant weariness. Sleep apnea is characterised by frequent breathing pauses that can stress and even harm the cardiovascular system as a whole.

Untreated sleep apnea can eventually cause the development of risk factors for AFib like diabetes and hypertension. Atrial fibrillation is four times more likely to occur in people with sleep apnea (AFib). It has also been demonstrated that sleep apnea directly causes arrhythmias when a person is asleep. Whenever a person with sleep apnea is startled awake by a lack of oxygen, the heart encounters mechanical stressors and chemical changes that may contribute to the development of AFib.

Mr RL, a 55-year-old male who was obese with a BMI of 36, was hospitalised six months ago after experiencing a severe episode of Afib that required cardioversion to safeguard his life. The patient was examined by me for H/o Snoring because he did not smoke and had no other comorbid conditions. His extensive medical history strongly suggested that he had sleep apnea, which was validated by a sleep study.

He was advised to use CPAP therapy coupled with weight loss. The patient rejected the idea of CPAP therapy. His subsequent identical instances within a month caused him to be admitted to a different hospital. On his follow-up consultation, he was recommended to utilise CPAP therapy, along with his medications, and since then he has not experienced a recurrence in the past four months.

The hypothalamus, a part of the brain that controls food and energy expenditure, might suffer negative effects from lack of sleep. Being sleep deprived can cause people to experience hunger for a longer period of time and drive people to consume more calories than necessary, particularly from foods that are high in fat and carbohydrates and can result in gaining weight. Changes in hormone levels brought on by sleep, particularly those of leptin and ghrelin, can also lead to an unbalanced hunger.

Obesity hypoventilation syndrome (OHS) impacts individuals who are overweight or obese and causes shallow or sluggish breathing. The respiratory system becomes fatigued because the body has to work harder to breathe, which can result in an excessive amount of carbon dioxide with insufficient oxygen in the blood. Obstructive sleep apnea (OSA), which involves periods of missing or decreased breathing during sleep, is frequently linked to the syndrome and causes daytime sleepiness and frequently interrupted awakenings.

Sleep apnea causes numerous sleep disturbances, preventing people from sleeping soundly and leaving the feeling of fatigue during the day. Obstructive sleep apnea (OSA) is a common breathing problem associated with sleep that can result in a number of fatal illnesses. OSA affects numerous organ systems on a structural level. When left untreated, it can exacerbate certain conditions and increase the risk of stroke, metabolic disorders, diabetes, depression, hypertension, and heart disease.

Untreated OSA has also been linked to cognitive dysfunction, decreased productivity at work, and a higher risk of injury and fatality causing motor vehicle accidents. Untreated OSA patients frequently experience drowsiness, hypersensitivity, and irritability. These signs of sleep deprivation quickly become the norm if sleep apnea is not treated, which makes individuals unhappy and deprives people of the energy and concentration they need to live full, meaningful lives.

The government and the private sector should work together to implement initiatives aimed at enhancing India's healthcare system. Initiatives to enhance education and knowledge of the significance of sleep and related sleep disorders should be prioritized. It will drive people of all ages to prioritise sleep in their daily schedules, which will ultimately assist individuals to bring out their best selves.

Patients must be transparent with their physicians because open communication fosters patient confidence, clarifies matters for doctors, and results in long-term improvements. The key takeaway here is that we need to adopt a healthy sleep routine. A healthy sleep cycle has various positive effects on our general well-being and promotes both physical and mental health.

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