Complications of sleep disorders and impact on quality of life

C. Michael Gibson, MD: Many doctors follow me on Twitter. I asked, “How many people have you had or know who have had accidents related to sleep disorders?” This applies to all healthcare workers. Surprisingly, about 20% said they knew someone who had fallen asleep while driving or had been in a crash. Nate, talk about insomnia and complications from sleep disorders.

Nathaniel F. Watson, MD: That’s a big problem. If you can’t maintain a normal level of alertness throughout the day, it affects your social, work, or other functioning. Approximately 7,000 to 8,000 people die each year in the United States from falling asleep. This is a big problem and underrated. Whenever you’re in an accident where no workarounds have been taken (usually one in which he drifts off the road with one vehicle), chances are you’re dealing with a falling asleep accident. Poor performance at work or school. You mentioned the risk of accidents, depression, anxiety and substance abuse. This is more often seen in patients with insomnia and sleep disorders. It also increases the risk and severity of cardiovascular disease. Sleep is just as important as diet and exercise to your overall health and well-being. We’ve been yelling it from the rooftops for years to get people to think about diet and exercise as long as they’re maximally healthy.

C. Michael Gibson, MD: Ashgan, I’ve heard about really dangerous things like crashes, but what about the quality of life associated with insomnia and sleep disturbances? How are they related?

Ashgan A. Elsinawi, DO: I see that problem come up frequently in my practice. Nate hinted at this a bit when he mentioned his job and school performance. Many students, especially college and graduate students, come to see me at my office. A very intelligent genius comes to see me and I’m having a hard time staying awake in class, during Zoom meetings, and staying focused on my studies after 11pm. They have highly irregular sleep schedules that affect their quality of life and school performance.

Another thing I’ve noticed is that when people have undiagnosed, untreated, or inadequately treated long-term sleep disorders, they resort to drinking alcohol more often than necessary. The thing is, they use it as a crutch and as a sleep aid. Many will turn to marijuana. It’s becoming legal almost everywhere, but some of these people have no guidance behind it. Based on what they have reported to me and what they have disclosed to me, there is not the slightest bit of alarming oversight or guidance. I will try to put it back. Unfortunately, one of the complications of chronic sleep disorders is that they crave treatment.

C. Michael Gibson, MD: As cardiologists and carers of patients after heart attacks, they have a lot of PTSD [post-traumatic stress disorder] After an episode in the intensive care unit or coronary care unit. It’s very disturbing.they have many sleep problems after myocardial infarction [myocardial infarction]It is associated with shortness of breath and having to sleep on pillows. This is a major problem in our cardiology practice. How many hours of sleep do we need each night? Can we sleep too much?

Nathaniel F. Watson, MD: that’s a great question. A few years ago, I was leading a task force evaluating the optimal amount of sleep to stay healthy. We explored all different aspects of human physiology, including immunology, cardiovascular health, mental health, cancer, and pain, and explored all aspects of human disease. We began to evaluate how different sleep durations affect the epidemiology of these and these different diseases. One thing that is very clear is that short sleep is definitely bad for you. Definitely less than 6 hours, and sometimes even less than 7 hours. The important thing to remember is that if someone self-reports his 7 hours of sleep, they are reporting hours in bed, but probably less sleep than that. is. Most of the studies that looked at this were based on self-reported sleep duration.There is a fairly strong evidence for short sleep, but for long sleep there is no evidence that extended sleep in animals adversely affects animal function. In fact, once an animal is full, it can no longer be kept asleep.

Although there are no animal model data demonstrating that prolonged sleep is bad, there is some epidemiological evidence suggesting that ≥9 hours of sleep is associated with cardiovascular disease, diabetes, and mortality. This probably means several things. First, sick people have a sedentary lifestyle and may self-report more sleep. Of course, that is always the challenge of epidemiological research, which is the notion of causality. Therefore, we are looking at animal model studies to see if there is a causal link. My feeling is that you don’t get much sleep. In fact, there are situations in which longer sleep is perfectly normal, such as recovery from illness or early life. There is an ongoing debate in the field of sleep medicine, but my feeling is that sleep deprivation is definitely bad for you. I decided to recommend more sleep.

C. Michael Gibson, MD: As a doctor, I was sleep deprived for nearly 40 years. I stopped getting her calls two years ago and it has never made me feel better. It changed my life because I think I was hungry when I was tired and exhausted. What is your occupation? You eat and you gain some weight. Then you get obstructive sleep apnea and feel sleepy. These are all temporary, but many of them start with sleep. That’s why I was interested in all these interactivity discussions. Thank you for this provocative segment.

Transcript edited for clarity