Quarter of Americans Report Having Insufficient Sleep

Mon, March 07, 2011

KMUW / Fletcher Powell

According to the Centers for Disease Control and Prevention, more than a quarter of Americans report frequent levels of insufficient sleep.

With Monday marking the beginning of National Sleep Awareness Week, as part of our Sound Mind and Body series, KMUW takes a look at one of the current hot topics in personal health with one man's battle with sleep apnea.

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Tim Daniel had a problem.

He was a vice-president at the Coleman Company—he still is.

He had a beautiful family—he still does.

But something was very wrong.

Daniel: I had gotten to where—this is a little embarrassing—I would fall asleep sometimes even at the dinner table in the evening. We’d have company over and my wife would just have a fit, she’d say, “We’re never having company over here again, it’s so embarrassing, you fall asleep, you’re so rude,” and I couldn’t help it, I just shut down. My body was so tired it was just shutting down.

Daniel thought he was just getting old, just running down. Or maybe that’s what he wanted to believe. Either way, it got to the point that he couldn’t ignore it anymore.

Daniel: My wife had been on my case for years about the fact that I snored, and didn’t sleep well, and gasped for breath every once in a while. And I denied every bit of that. Then I started having leg cramps, and I’m talking about severe leg cramps. I’d feel it in the front of my leg and I’d get up and stretch it and it would go to the back of my leg.

It was these leg cramps that finally pushed him to go to the doctor. He says he tried a million different things to stop the cramps-- spending hours each night just walking around the house, filling his body full of potassium.

Daniel: I ate so many bananas I started to grow a tail.

But as soon as he’d go back to sleep, the cramps would start up again. Daniel says his doctor asked him about his sleep habits, and then insisted on a sleep study. Daniel wasn’t impressed.

Daniel: I was very apprehensive. I thought, number one, I don’t need a sleep study, and how am I gonna sleep over here and just—you just think of the worst… And they wire you, actually, from your head to your feet, they glue them in your hair, and I thought, “How in the world am I gonna sleep like this?”

Daniel did go to sleep, though. Because, he says, he was actually pretty comfortable.

Daniel: Nice carpeted room, set up like a bedroom, with a real bed and a dresser, just like home.

Just like home, aside from all the wires monitoring his brainwaves, his muscles, and his breathing.

Daniel says the plan was to monitor his sleep and then, if necessary, to have him use a machine called a CPAP—that stands for “Continuous Positive Airway Pressure”—that would open up his breathing passages. The concern was that his muscles would relax enough while he was sleeping that his airways would become blocked, stopping his breathing and forcing his body to wake up in order to start breathing again—a condition called “obstructive sleep apnea.” Realistically, Daniel knew this was probably what he was dealing with, and what his wife had been talking about for years.

But even he was surprised about what happened next.

Daniel: Well, it musta been 1:00, she said, “I’m gonna put you on the machine.” I said, “Was I that bad?” She said, “Well, I’ve seen worse.”

Daniel asked the nurse how bad he really was, and she told him to guess how many times he’d woken up in the four hours he’d been asleep.

Daniel: Oh, six or seven.

The nurse corrected him.

Daniel: She said, “Hundreds.”

Hundreds. He woke up hundreds of times in just a few hours, and he didn’t even realize it.

Daniel: I had stopped breathing so many times during the night that the blood oxygen level drops dramatically in your body. And that’s what was causing the cramping in my legs, the muscles weren’t getting the oxygen that they need, and no amount of potassium is gonna help that. That’s what happens when you have sleep apnea.

Heidi LaForge is a doctor with Via Christi, and she says that, as hard as it might seem to believe, it’s actually pretty common that a person would have no real idea he was waking up so many times during the night.

LaForge: Often times, patients aren’t aware when they have an apnic episode at all. So, it’s usually that spouse, that husband or wife that comes to the appointment and says, “they toss and turn non-stop in bed. Back and forth—it just seems like they’re not restful when they sleep. Or they snore like a freight train and then they’re always moving.”

LaForge says it’s important to know that just because a person snores doesn’t mean the person has sleep apnea—what she looks for is what she calls this apnic episode: when the body goes ten seconds without breathing, which sort of forces it into panic mode, causing a person to wake up just enough to gasp for air before falling back asleep. Again, this can happen over and over without even realizing it. Which means a person who thinks she’s getting enough sleep just can’t quite figure out why she’s still tired all day long.

And, when you think about it, being tired all the time isn’t just an inconvenience.

Dr. Heidi LaForge:

LaForge: Sleep should reset a lot of our body functions in terms of our brain’s neurochemical outputs. It has a lot to do with how your thyroid gland functions, it has a lot to do with how your body maintains its normal homeostasis. And if we have a lack of that sleep, our body’s not able to always cope with the stresses on our body that following day. And that’s why you have that increase in blood pressure, your brain has not rested, you have not gone back to that normal physiologic state of rest and wellness.

One of the things LaForge says is common in those with sleep apnea is the inability to control hypertension, even with medication. She says it’s this lack of real rest that keeps the body from balancing itself. What’s worse is that many people then try to compensate for their tiredness by, say, drinking way too much coffee, which can lead to increased hypertension.

In many cases, it’s this strange sort of feedback loop that both causes the apnea and makes it hard to take the necessary steps to treat the underlying cause. Since this obstructive apnea is caused by airways being blocked, it won’t be surprising to learn that the root of the problem is often obesity—too much weight in the neck pushing into the airways when the body is relaxed. But, of course, being tired all day makes it hard to exercise, and not exercising makes it difficult to lose weight.

So how do you break this cycle?

Daniel: Once I discovered that I had sleep apnea and used the CPAP machine, I’ve just got all the energy in the world… when I go to bed I put the machine on, and it’s almost like a sleeping pill—I go to sleep instantly, and when my eyes open in the morning, it’s wake-up. It’s time to go. And it’s none of this “hit a snooze” or anything else, it’s just full of energy whereas before I had none.

Daniel travels for work a lot, and he says that, at first, he thought taking the machine with him would be too much of a hassle:

Daniel: It didn’t take but one trip without it that I realized I don’t wanna be without it. I feel so much better after having that good night’s sleep that a night without it took me several days just to recover.

Besides, he says, it’s not even that much of a burden. The machine is small and not too noisy—he just puts on the breathing mask, turns it on, and falls asleep. And even though there’s some chance Daniel will have to use the CPAP for the rest of his life, the benefits, he says, are immeasurable:

Daniel: I preach this to everyone I see on the street that says anything about a sleep problem because this is something that not only affects your rest, but like I said, affects so many other parts of your body and I think your wellness—your overall health wellness. And this is really nothing to be embarrassed about. It’s a very easy, treatable condition, you don’t have to have any surgery.

And as for wearing a mask to bed every night?

Daniel: I just tell my wife she’s going to bed with a jet pilot or an astronaut every night, so it’s not a really big deal.






Funding for KMUW's Sound Mind & Body series is made possible, in part, by Via Christi Health.