Though the exact number of people suffering from sleep disorders in Nepal is not available, the number is increasing across the country, per Dr Shrestha. The most common one is sleep apnoea, a kind of sleep disorder in which breathing stops and resumes while someone is sleeping.
Intake of junk food, sedentary lifestyle, smoking and consumption of alcohol, mental stress are some of the reasons behind sleep disorders, per the health expert. What happens in the lab? Patients’ sleep is monitored in the lab. There is recording of the brain waves, oxygen level in blood, heart rate and breathing of the patients when she or he is sleeping. Eye and leg movements are also recorded during the study to check how the patient’s sleep is. Dr Shrestha said: “During the test, surface electrodes are put on the face and scalp of the patient. The electrical signals generated by the brain during 6-8 hours are recorded and sent to the measuring equipment. An electrocardiogram is used to record electrical activities of the heart.” The hospital conducts electromyography—a procedure to test the electrical activity in muscle for patients who suffer from sleep apnoea. According to a research by New York Medical College and Department of Surgery, Westchester Medical Center, USA, worldwide, 969m people aged 30-69 years may be suffering from OSA with many more people undiagnosed. People with sleep apnoea are treated through the continuous positive airway pressure (CPAP) approach, says Shrestha. This approach involves wearing a mask over the nose of patients or mouth while asleep. The mask directs pressurized air from a small bedside pump to the airway of patients to keep it open during sleep. CPAP eliminates snoring and is most often used to treat snoring associated with obstructive sleep apnoea, per Shrestha. “Through CPAP treatment, patients get snoring treated, have a sound sleep, and do not have drowsiness during the daytime. Blood pressure and diabetes also come under control through this treatment.” Types of sleep A sound sleep makes one feel refreshed and active the next day. Sleep is segmented into two cycles—non-rapid eye movement (non-REM) and rapid eye movement (REM) sleep. Non-REM sleep happens first and includes three stages. During the first stage there is a transition from wakefulness to sleep. The brain slows down, heartbeat, eye movements and breathing slow and body relaxes. In the second stage, one enters light sleep. Eye movements stop, breathing and heart rate become regular, body temperature drops. One becomes less aware of his or her surroundings. In the third stage, muscles are completely relaxed, breathing slows, one progresses into deepest sleep. Dr Shrestha said: “During the REM stage, the body is immobilized and dreams occur. This stage occurs during the morning. REM sleep happens about 90 to 120 minutes. These cycles get disturbed when you snore or are disturbed when you are asleep. People have difficulty going back to sleep again. According to the National Institute of Neurological Disorders and Stroke, during deep-sleep (stage three) and REM, the cells repair and rebuild, and hormones are secreted to promote bone and muscle growth. The body also uses deep sleep to strengthen one’s immunity so that she or he can fight off illness and infection. Disturbance in these stages causes difficulties in sleeping. Dr Shrestha said, “People feel lazy and lethargic and can’t concentrate on their work. There is a feeling of heaviness and a patient wants to sleep during the day time. There is also short-term memory loss.” Long-term health problems such as high cholesterol, raised body weight, heart attack, stroke, paralysis and sudden cardiac arrest can occur when one can’t sleep properly. That’s why the cause for the sleeping disorders should be identified and treated.” The patients are asked to visit the laboratory taking someone along with him or her. They should take a bath in the afternoon before coming to the hospital and carry a night dress with them. They should not wear any kind of hair oil or apply cream on their face. They should sleep after 8 pm in the lab bed. Eight hours of sleep is recorded by a sleep technician. The sleep pattern is then interpreted. Dr Shrestha said: “We advise medical treatment or behavioral changes depending upon the interpretations for a person to have a sound sleep.” “We can subject only one patient to these tests in a day.” The hospital charges Rs 3000 for the service. The test is non-invasive. How long should people sleep? The National Sleep Foundation has recommended sleep durations as follows: 14-17 hours for new-borns, 12-15 hours for infants, 11-14 hours for toddlers, 10-13 hours for preschoolers, 9-11 hours for school-aged children, and 8-10 hours for teenagers. Seven to 9 hours is recommended for young adults and adults, and 7-8 hours of sleep is recommended for older adults. All for a sound sleep The normal sleeping patterns of the people are disturbed. Sleep disturbance causes multiple health problems. When a person snores heavily in his or her sleep there is obstruction of breathing. This affects one’s sleep. Lack of proper sleep degrades one’s work performance and makes one suffer from various health problems. “This lab has been established to help people get medical services for their disturbed sleep and improve health quality.” As per Shrestha, most sleep apnoea patients, who visited the hospital within these four months of launch of the service in the hospital, required treatment through CPAP. Most of the visitors were young people, he adds. The hospital charges Rs 3000 per night for treatment for sleep apnoea through CPAP. For better sleep Don’t take stress Maintain mental peace Create a proper environment. It should be well-ventilated and peaceful. Avoid bright lights in the bedroom Avoid tea, coffee, alcohol and cigarette two hours before sleeping Do some physical exercise Take a bath with lukewarm water before sleeping Treat any medical health condition such as infections Avoid using mobiles and laptops Listen to the music or meditate
