Raise a sleepy hand if you suffer from irritability, difficulty concentrating or impairments in judgment, motivation and motor skills. Anyone who’s ever gone a night without sleep has experienced the consequences.Sleep, explains Dr. Nancy Foldvary-Schaefer, director of Cleveland Clinic Sleep Disorders Center, isn’t the deathlike state so many imagine. Studies have shown metabolic waste products are cleared from mice’s brains at a faster rate during sleep than wakefulness.
“There’s a lot of research going on now suggesting that sleep -— good sleep — impacts how brain synapses work,” Foldvary-Schaefer adds, “and how memory gets transferred from short-term to long-term.”
The vital role sleep plays in brain health is particularly evident in those with neurological diseases. One of the most powerful examples comes from an observational study on treating epilepsy patients with obstructive sleep apnea, a common disorder in which the throat muscles intermittently relax during sleep, resulting in repetitive episodes of complete or partial upper airway blockage.
Foldvary-Schaefer and her team found that 63% of epilepsy patients treated with continuous positive airway pressure therapy that keeps the airway open had a reduction in seizures of 50% or more.
“Treating sleep apnea stabilizes sleep, allows people to get into deeper stages of sleep and abolishes the oxygen desaturations associated with apnea,” she explains. “Seizure control seems to improve.”
Studies on treating sleep apnea in stroke patients have yielded similar results.
Foldvary-Schaefer hopes to conduct research on the benefits sleep therapy could provide to those with other neurological diseases. Her team’s analysis of more than 19,000 records of adult initial outpatient visits to the clinic’s Neurological Institute from March 2015 to October 2016 revealed more than one-third were at high risk for obstructive sleep apnea. And 25% reported significant symptoms of insomnia, a sleep disorder often linked to depression and other psychiatric disorders.
But particularly when talking about neurodegenerative diseases, some afflictions suggest that the sleep disorder predates the cognitive decline. Examples include REM sleep behavior disorder, an affliction in which sufferers physically act out dreams that tend to be violent and injurious, and Parkinson’s disease.
Unfortunately, Foldvary-Schaefer says most people don’t discuss sleep issues with their physicians. She estimates, for example, that obstructive sleep apnea remains undiagnosed in 80 to 90% of Americans who have it. Symptoms are snoring, tiredness, fatigue or daytime sleepiness, high blood pressure and, of course, actual observed apnea.
“People who have two or more of those four [symptoms] are considered at high risk for obstructive sleep apnea and at least should be talking to their doctor about it,” she says.
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