IT SEEMS like the most natural thing to do - sleep; but for thousands of South Africans suffering from sleep disorders bedtime offers everything but that.
According to the South African Society of Sleep Medicine (SASSM): “Sleep is actually made up of two separate and distinctly different states: ‘non-rapid eye movement sleep (NREM sleep) and ‘rapid eye movement sleep’ (REM sleep) or dreaming sleep.”
Dr Karine Scheuermaier, head of the Sleep Laboratory at the Wits School of Physiology, said: “There are many kinds of sleep disorders that we are becoming more and more aware of.
"Known sleep disorders include people who suffer from sleep apnoea in which there are breaks or pauses in a person’s breathing during sleep,” she said.
A research student in Scheuermaier’s faculty conducted a study in 2013, in which 200 people were participants.
“We did the study in Soweto, with people mainly around their fifties and
mainly female and asked them basic questions
around their sleeping patterns. The study revealed that 30% of them had symptoms of sleep apnoea - which means that if we put them in our lab for tests, 80% would probably test positive for sleep apnoea.”
According to Scheuermaier, it is “completely under-diagnosed” in the country and there are almost no facilities in the public sector to detect or screen for it.
The treatment is as “simple” as using a continuous positive airway pressure device in which a mask is worn over the nose during sleep to help push air through the upper airway to allow normal breathing.
“And while sleep disorder screening isn’t prioritised in the public health-care budget, it could make big savings in the health system.
"We know that sleep has a correlation to hypertension as well as obesity.
"Sleep apnoea is also an independent factor of mortality because some people do just stop breathing in their sleep”, she said.
With the increase in non-communicable diseases across the world, Scheuermaier said it was critical the country also focus on treatment of sleep disorders.
Sleep plays a role in adding to obesity and cardiac disease by regulating two hormones, leptin and ghrelin, which influence the energy balance of the body as well as appetite levels.
“People with sleep apnoea often feel hungrier and tend to snack a lot - yet if you sleep well, you have less of those midnight cravings. If you sleep well, you also lose weight better and have the energy to do exercise. The other thing we know, is that people with sleep apnoea tend to develop Type 2 diabetes,” Scheuermaier said.
A more commonly known sleep disorder, insomnia, affects about 30-40% of adults within any given year about with about 10-15% indicating it as chronic and/or severe, according to SASSM.
And often, insomnia and mental disorders such as depression correlate.
According to Scheuermaier, causes of insomnia can be broken
down into the “3 Ps” - namely: predisposing (having genetic relation), precipitating (caused by stress, death, divorce, etc) and perpetuating factors such as having bad habits and needing a night ritual to have normal sleep.
“Chronic insomnia is a state of hyper arousal for most people affecting the sympathetic nervous system that governs your fight-or-flight response, as well as your para-sympathetic nervous system governing the rest and digest response. How we treat chronic insomnia is complex as it involves a combination of medical and cognitive behavioural therapy to condition people not to stress about sleep and remember that sleep is natural," she said.
Scheuermaier said it was important for people to learn about sleep hygiene, particularly now that people go to bed still using their cellphones.
“We have a natural biological wake clock; if you get very bright light very early in the morning, it resets your body clock.
"Artificial light has a very acute effect - particularly cellphone light. You feel more alert while scrolling through a phone, almost like taking caffeine.
“Cellphones are full of blue light and the cells connected to our retina are very sensitive to blue light. And while some phones have a setting for the night, even the lowest brightness setting on a phone is still very bright because we look at cellphones around 20cm from our faces”.
She also advised against taking stimulants such as caffeine in coffee and teas and alcohol.