U.S. Edition
Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.
The classic pediatric sleep apnea patient is a skinny 6-year-old with chronic congestion and dark circles under his eyes.
We still see many kids in the sleep center who match this profile, but over the past 10 years, a new clinical picture has emerged. Coinciding with the dramatic rise in childhood obesity, there is a clear change in our younger patients.
We now see many overweight children in the sleep clinic who have obstructive sleep apnea that resembles the adult version.
The thin child with OSA does not usually act sleepy in the daytime. On the contrary, they often act hyperactive or inattentive. In fact, their symptoms can mimic attention deficit hyperactivity disorder. FULL POST
This week, a study was presented at the American Stroke Association’s International Stroke Conference that caught my eye. It's a small study that adds further evidence to what most sleep experts already know - that obstructive sleep apnea (OSA) is linked with a high risk of having silent strokes.
OSA is the most common form of sleep apnea, according to the National Institutes of Health. More than 12 million Americans are believed to suffer from this sleep disorder. People with sleep apnea stop breathing for 10 to 20 seconds or longer and this can happen at least 20 to 30 times an hour.
In this new study, researchers at Dresden University in Germany, looked at silent strokes and the prevalence of OSA in 56 patients who had been hospitalized for a major stroke. FULL POST
Patients often come to me with symptoms they describe as "fatigue" or "tiredness." The first task is to tease out exactly what they mean. To a sleep doctor, fatigue and tiredness usually mean the body needs or wants to rest, whereas "sleepiness" suggests that the mind wants to rest.
Patients with any pain syndrome often come in complaining of fatigue or tiredness. Their bodies have trouble falling and staying asleep. Sleep and pain are both ultimately controlled by the central nervous system. Poor sleep and pain form a vicious cycle - uncontrolled pain makes sleep difficult (if not impossible) and, in turn, the resulting poor sleep makes it more difficult to adequately control the pain.
Most physicians know very well that poorly controlled pain will cause difficulty sleeping. But they often don’t think about the patient having a separate sleep disorder that may be fueling the pain. FULL POST
Zach was a life-long teeth grinder.
“It seemed that as soon as his teeth came in, he started grinding," his mother told me.
It was so loud and frequent that Zach was given his own room because his little brother couldn't get any sleep when they shared. For years he had slept at the end of the hall far from his parents’ and his brother’s room, so one suspected that the grinding was getting worse.
When a dentist noticed a progressive worsening of wear on his patient's teeth, he discussed his concerns about a possible underlying sleep disorder with both Zach and his mother. They then came to me. FULL POST
We all know the symptoms. Your eyelids droop and your vision becomes blurry. Your head feels so heavy that you can’t hold it up and so your chin keeps falling toward your chest. You can’t stop yawning. Diagnosis is clear to most of us: You’re sleepy.
I know what it feels like and looks like and so do you. So why do many surveys show that most of us have driven while drowsy and many of us do so on a regular basis?
Well, for one thing, we are not a culture that takes sleep seriously. We think that when our lives become so busy that we don’t see how we can fit everything into a 24-hour day, that we can find extra hours by carving it out of our sleep time. FULL POST
The autumn equinox has come and gone, but many of us here in the Midwest have continued to fool ourselves that it is really just late summer.
But the game is over once we turn the clocks back and we start driving home from work in the dark. The clock change that is mandated by the end of daylight saving time is really the marker for many people that a change in seasons has happened.
For people who live in the Northern Hemisphere, the change in autumn means more hours of darkness and colder weather, which keeps many people indoors. As a result, many feel more depressed and have more sleep disturbance as well as daytime sleepiness and fatigue.
FULL POST
It was a normal follow-up to see how Kurt was adjusting to his CPAP, the continuous positive airway pressure machine prescribed for people with sleep apnea. Not only did he report having a pretty easy time of getting used to sticking some plastic up his nose every night, he said he also felt more rested when he awoke and was more alert throughout the day.
When he began to tell me how happy his wife was, I thought that he was going to say, as many men do, that she was glad that he was no longer snoring or that she was relieved that he no longer stopped breathing during the night. Instead, he grinned as he related how, in the past month, he and his wife had more sex than they had had in the past two years. “Hey doc, if you want men to use this thing, just get the word out that it helps with ED (erectile dysfunction). They’ll be in here begging you for a CPAP.” FULL POST
Her parents were concerned that she had a serious medical or psychological problem, but the only thing that Lori cared about was being able to go to sleepovers without dying of embarrassment.
Lori was 9 years old and was still wetting the bed several times a week. FULL POST
I want to follow up on a piece I wrote two weeks ago about getting kids back on a good sleep schedule.
School was just starting and each year most children need to get out of the summer mode and back to a sleep/wake cycle that allows them to thrive during the school year. Now that most kids and teens are back to school, I would like to address another important topic that I wish educators would give some attention: School start times. FULL POST
It is that time of year again. It is starting to get dark earlier. In some parts of the country, there's a chill in the air at night. And the kids have to go back to school.
For many families, there are some rough days and maybe even weeks ahead as they help their children transition back to a schedule that requires them to get up earlier than they did in the summer.
School-aged children need between 10 and 12 hours of sleep a night. If kids have been going to bed at 10 or 11 p.m. in the summer, it is unlikely that they can suddenly fall asleep at 8 p.m. the night before school starts back. It is best to gradually readjust the bedtime one to two weeks before school starts so that the kids are going to bed 15 minutes earlier every couple of nights until the desired bedtime is reached. FULL POST
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