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21 September 2017Last updated
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Healthy body

Why you may have trouble sleeping

We sent one reader to The London Sleep Centre Dubai to get to the bottom of her sleep woes

Aquarius
29 Jan 2017 | 04:30 pm

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Whether it’s because of stress, hormones, crying children, bad sleep habits or anything else, lack of sleep is tantamount to torture and can impact your life and wellbeing on every level. Claire Malcolm, from the UK, says she has been suffering with sleep issues for a couple of years. After a consultation and sleep test at The London Sleep Centre Dubai, she now understands why...

What sleep issues do you suffer from?

I’ve had an occasional, yet recurring, bout of insomnia for the last couple of years, which, for the past six months, has escalated from the odd night to monthly, prolonged periods of up to a week.

I drop off to sleep easily enough but then wake up an hour or so later and am usually wide awake for up to five hours before finally dropping off again just before dawn.

As a writer, this kills my concentration, attention to detail and overall creativity. Plus I generally feel lethargic and lackluster, which is emotionally draining.

Have you tried to treat it before?

Finding a cure for my insomnia has become something of an obsession – from attempting old wives’ tale remedies, such as taking a hot foot-bath before bed to draw the blood from the brain, to cranking up the air-conditioning; popping melatonin tablets and chugging down endless cups of chamomile tea.

I’ve digitally detoxed, tried to kick my Netflix-in-bed habit, learned deep breathing techniques and started doing daily workouts at 6.30am in the hope of establishing a 10pm bedtime routine.

Having a regular bedtime and the early exercise regime definitely helps ensure a decent night’s sleep on normal weeks, but when the extended insomnia jet-lag kicks in, nothing works.

What happened at the consultation?

First I had to complete an extremely detailed 15-page questionnaire, which covered everything from general health and wellness to my emotional state-of-mind, sleeping position, work-life balance and family history.

Then I had an appointment with Dr Irshaad Ebrahim, consultant neuropsychiatrist and medical director at The London Sleep Centre Dubai, to talk through my symptoms. Based on the fact that I snore and other in for from my Q&A, the doctor’s initial feedback was that I most likely have some degree of sleep apnea (A disorder in which there are breaks or pauses in a person’s breathing during sleep).

He felt this could be what was interrupting my sleep pattern, rather than classic insomnia, and recommended an overnight sleep assessment. This sleep ‘test’ is done at home and is designed to monitor your sleep pattern.

A technician came to my apartment to wire me up – literally from head to toe - with sensors to record my heart rate, brain waves, snoring, body position and leg movements.

It wasn’t the most comfortable – or attractive - bedtime look, with sensors glued to my scalp, a nasal cannula and motion detectors stuck to my legs, and I had to be somewhat careful turning over in bed or using the bathroom. It was also a little challenging dropping off to sleep... or so I thought.

What were your results?

The resulting 11-page sleep assessment report provided an hour-by-hour analysis of my night’s sleep, and confirmed that I have mild Obstructive Sleep Apnea.

On the night in question, I had an average of 15 sleep interruptions (hypopneas) per hour, caused by a reduction of airflow into the airways of around 50 per cent. Most embarrassingly, I snored for 61 per cent of my total sleep time!

One of the most interesting findings was the fact I slept for a lot longer than I originally thought. The results showed that even with all the wires and associated paraphernalia, I initially went to sleep in less than seven minutes and my overall sleep pattern was pretty normal.

Dr Irshaad explained that my insomnia has evolved from the sleep apnea, which is a reverse conditioning of the brain whereby interrupted sleep, known as ‘confused arousal’ instead feels like no sleep.

What did they suggest for treatment?

Sleep apnea can be managed, but not cured, with three available treatment options. A machine, a dental device and surgery.

According to Dr Irshaad, the ‘gold standard’ solution is a Continuous Positive Airway Pressure (CPAP) machine. It comprises of an air pump and face mask, either covering just the nostrils or the nose and mouth. The dental device option holds the jaw straight and keeps the tongue forward; they are individually moulded in the US for each client. The surgery, says Dr Irshaad, is the least successful, unless there is a clear craniofacial abnormality.

How has your sleep been since then?

I tried the CPAP machine for a week and had a positive experience overall as the results of my follow-up consultation showed. My sleep apnea more or less disappeared and I slept through the night.

As I have a slight overbite, and come from a family of snorers, the next step is to have a craniofacial CT scan to see if surgery is a viable option for me, and also to look at a dental device, which could be an even less intrusive option.

What was the biggest lesson?

I was completely surprised and, if I’m honest, a little shocked, to be diagnosed with Obstructive Sleep Apnea (OSA) rather than insomnia. According to Dr Irshaad, one in 10 adults are believed to suffer from it, and that’s a conservative estimate.

The long-term health implications are pretty frightening with OSA being a major catalyst for Type 2 Diabetes, as ongoing sleep interruptions directly affect our insulin resistance as well as the production of the appetite-controlling hormones leptin and ghrelin, which impact weight management.

Other chronic health issues associated with sleep disorders include obvious ones such as depression and hypertension.

Would you recommend it to others?

It’s a no-brainer if your sleep pattern is so disrupted that you feel unable to function normally. Kate, the sleep service manager and lead technologist at The London Sleep Centre, says that for insomnia sufferers, just finding out the results of their sleep assessment and being able to see exactly how much sleep they are getting can be a real mental and emotional boost, even if there are issues that need to be addressed.

It’s not cheap, but can you really put a price on a good night’s sleep when considering the effect on your daily life and wellbeing? It’s also worth checking with your health insurance provider if this is covered.

Prices start at Dh1,500 for a consultation. The clinic also offers a comprehensive dental sleep medicine assessment and treatment package for various sleep-related issues, which includes the CT scan, digital scan, mouth moulds and bespoke dental device – prices start at Dh5,050. Visit londonsleepcentre.ae for details.

Photo by iStock

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