Sleep is essential to good health. As one of my professors once stated, "If a person can eat, poop, pee and SLEEP well, he is well!". Of course, he added something else not suitable for polite company!

Difficulty with sleep or insomnia, as it is termed, is a significant health issue. Every year, 30 to 40 % of us report some difficulty in falling asleep, staying asleep or waking up too early. One in ten of us have long term problems with sleep. We generally sleep about 6 to 8 hours per day. Children sleep more while the elderly sleep less.

Being unable to sleep, regardless of the cause has significant consequences or complications. Amongst these are Hypertension, Stroke, Diabetes and early death. In addition to these, 10-15% of Motor vehicle accidents are due to sleepiness or fatigue.

Nearly 100 thousand deaths occur in US hospitals every year due to medical errors with sleep deprivation being an important factor.

As the world moves towards more of a 24/7 economy, the problems of sleep will only increase.

Women tend to have sleep issues more than men.

Sleep deprivation results from a number of broad causes.

First is a disruption of the circadian rhythm or normal sleep-wake cycle as in night shift work or travel to different time zones.

Second is psychological problems like Depression, anxiety and schizophrenia.

Third are medical problems that may be neurological or general. Neurological problems include stroke, Parkinson disease and Dementia. The general medical problems include Asthma and Reflux Disease.

The fourth group involve the effects of medications including hormones, blood pressure and Asthma medications. It should be added that excessive coffee, smoking and drinking can lead to problems with sleep.

Finally, there are sleep problems like Obstructive Sleep Apnea, Central Sleep Apnea and Narcolepsy or daytime somnolence.

Overweight people are particularly at risk for obstructive sleep apnea.

There are 2 main investigations after a physician does not find an obvious cause.

These are polysomnography and multiple sleep latency test. These are done at special facilities. Before these , a patient may be asked to fill a questionnaire or keep a diary. Partners are very helpful witnesses and often prompt the patient to seek care.

The treatment involves the underlying causes,medications, C-PAP or surgery. Sometimes, changing sleep habits or eating habits make a big difference. The take home is that sleeplessness is a major health problem that should be discussed with your doctor. If your partner snores and ceases breathing , encourage them to seek help.

Stay healthy and SLEEP well.

Arthur K