World Sleep Day Special: Regular Sleep Healthy Future
Sleep in good quantity and quality is essential for physical, mental and emotional well-being. Sleep is a function of the brain. Sleep recharges the mind and the body. Growth hormone is secreted from brain in sleep and therefore lack of sleep affects growth adversely. Children's growth can be affected. Sleep has several functions including consolidation of memory and boosting of immunity.
Immunity has found a place in everybody's home during Covid-19 pandemic. Patients with obstructive sleep apnea are more prone to get infections including Covid.
The common sleep disorders are chronic partial sleep deprivation, insomnia and sleep disordered breathing (SDB). Obstructive sleep apnea is an important constituent of SDB, since it can life threatening.
The prominent symptom of OSA are snoring, which can loud and habitual and excessive daytime sleepiness. However, many patients may not experience classical daytime sleepiness but daytime tiredness may be prominent. Snoring can be mild particularly in the elderly. Unable to sleep well is also a common complaint. Nocturia and cognitive decline are prominent in the elderly.
There are several consequences of OSA viz-hypertension, insulin resistance, type 2 diabetes mellitus, myocardial ischemia and infarction, stroke, venous disorders like deep vein thrombosis, varicose veins, non-alcoholic fatty liver, erectile dysfunction, dementia, ophthalmic disorders and psychiatric disorders like depression, anxiety, emotional swings, bipolar disorders. A close association between OSA and cancer has also been reported.
The gold standard for diagnosing OSA is by performing Attended Polysomnography (level 1) in hospital equipped with ICU. Anybody can get an emergency event in night and if it coincides with sleep study then we require services of ICU.
The widely accepted mode of therapy for OSA is by using Continuous Positive Airway Pressure while sleeping. This therapy has been found to be highly rewarding. Increasing insulin sensitivity and thereby improving glycemic status has been reported.
There has been an increase in sleep disorders during the recent Covid pandemic. Fear of the disease and its consequences, stress of health of near ones and loss of job are enough to disturb sleep. Sleep is closely related to emotions. The following tips may be helpful:
Support our body clock and daily rhythms. These are biological, social and environmental time keepers. These include exposure to light, meal times, interaction with people and others. We may lose these cues if we are indoor for long time.
Remedial measures-
1. Get up around the same time every day.
2. Get bright light into your eyes within few minutes of getting up. Also get light during the day.
3. Have breakfast, lunch and dinner around the same time everyday.
4. Exercise can be done at home. Avoid being sedentary for long hours. Do not exercise too close to bedtime.
5. Make a short contact with friends, just a hello at the same time in morning.
6. Have good illumination during the day, dim lights in late evening for quieter activities.
7. Block blue light from electronic devices 1-2 hours before bedtime.
8. Consumption of warm milk at bedtime may be helpful
9. Do not plan the next day while going to sleep.
10. Keep mind calm. Avoid recalling episodes which can cause anxiety.
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