Nagpur Today spoke to Dr Ashok Arbat, noted pulmonologist and Managing Director, KRIMS Hospital. Dr. Arbat is also the President if Vidarbha Chest Association. Following are excerpts from the interaction.
Meghna: What are the most common causes of sleep disorders that you see every day?
Dr. Arbat: Sleep disorders are most common among obese people. People with a big tongue, nasal obstructions, big tonsils, a big neck or a small lower jaw or those who sneeze often have a slight difficulty in breathing when they sleep. These are all snoring- related problems, which are common among obese people. Around 30 to 35 percent of Indian people snore while sleeping, 5 percent of which suffer from sleep disorders. It is common in adults and the elderly, though some children suffer from this as well. When you snore, the noise disturbs your breathing and restricts oxygen flow in your body, which adversely affects your sleep architecture.
Meghna: Why is sleep important?
Dr. Arbat: When you have a sound sleep at night, you feel mentally and physically fresh next morning. If you lack sleep, you will lack the ability to think clearly, and you won’t feel fresh. Normal sleep produces some hormones which are very important for our well- being. When you don’t sleep properly, you don’t get proper oxygenation. Carbon Dioxide and other gases might get accumulated in the body. There are many adverse consequences to this, on your heart and kidney. Lack of sleep impedes your memory, and, over the years, may cause hypertension, diabetes, kidney problems, gastric ulcers or even a stroke. Your judgement of situations is also affected, which leads to accidents. Vehicular accidents are seven times more common among snorers.
Snoring leads to disturbance in the architecture of sleep. People also stop breathing often at night, because they snore- this is called Apnea, which leads to fragmented sleep throughout the night. These are the two main negative consequences of snoring. These lead to many problems during the day, and are most common in obese people, people with diabetes or kidney problems or people who are hypertensive.
Meghna: Could you explain the basics of the architecture of sleep?
Dr. Arbat: Sleep occurs in stages. When we go off to sleep, after a while we reach stage 1, which is called Non- REM sleep. We then go to stage 2, then stage 3, then stage 4. We then come back to stage 2 nad proceed to stage 3 after which we drift into REM sleep, i.e. Rapid Eye Movement sleep. Both Non- REM and REM sleep are important for you to think clearly and be physically fresh. When you snore or don’t breathe properly, this architecture gets disturbed.
Meghna: Is Excessive Daytime Sleepiness (EDS) a cause or result of lack of sleep?
Dr. Arbat: It is a result of excessive snoring. It is common to see politicians or executives who work late hours sleep during meetings in the day. EDS hampers your work, and your thinking and decision- making abilities. It makes you more accident- prone, whether you are driving or operating machinery indoors.
Meghna: In recent times, is Internet addiction and caffeine consumption a growing cause of lack of sleep?
Dr. Arbat: We always advise our patients not to take caffeine or tea before going to sleep, because it keeps them alert and they are unlikely to fall asleep quickly. Regular smokers, those who chew tobacco and those who consume alcohol are more likely to snore during sleep. We don’t snore during the day, because we have complete control over our muscles then. At night, however, our body relaxes and we don’t have that control over our respiratory muscles and the muscles of the pharynx. If these muscles relax too much, they collapse and that leads to snoring.
Meghna: What are the common ways of treating sleep disorders, other than sleeping pills?
Dr. Arbat: Sleeping pills are not a solution; they often aggravate the problem. Unlike what most people assume, the sleep that results from sleeping pills is an abnormal form of sleep. One must go to an expert to figure the root cause of lack of sleep. The cause normally lies in the patient’s history and bad habits, which must be addressed.
– Meghna Majumdar