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CNN SATURDAY MORNING NEWS

"Weekend House Call": Sleep, or Lack of It, Impacts Health

Aired April 3, 2004 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


CATHERINE CALLAWAY, ANCHOR: Hello everyone. I'm Catherine Callaway with the headlines.
First in Spain, train service is running again on a high-speed rail line in Spain where a bomb was found yesterday. Authorities say the 26-pound bomb contains the same material used in the Madrid bombing last month.

And in Iraq a gunman shoots and kills the police chief and his driver just south of Baghdad. Police sources say the assailant was wearing an Iraqi police uniform.

In Tyler, Texas, closing arguments in the trial of a mother who confessed to killing two of her sons with a rock. She says that God told her to do it and is pleading insanity. The boys were 8 and 6 years old. The woman's 15-month-old son survived that attack.

Stay with us everyone. WEEKEND HOUSE CALL with Dr. Sanjay Gupta begins right now.

DR. SANJAY GUPTA, HOST: Good morning. Welcome to WEEKEND HOUSE CALL.

Today we're talking to sleep, or really the lack of it. As our clocks spring forward this weekend, we lose an hour of that precious dreamtime. And as a new study points out, it's an hour we and our children can't afford to miss.

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): For Gwyn Hicks, juggling 3-year-old Maggie and 6-year-old Hunter with work, means sleep gets sacrificed. She says she usually only gets between five and six hours a night, often interrupted by the kids.

GWYN HICKS, MOTHER: I really could probably fall asleep, or at least I think, I could fall asleep pretty much anywhere any time.

FEIG: But for many Americans like Gwyn, that could be doing more than just making you tired. Research shows it can actually increase your risk of certain diseases, like diabetes, hypertension, heart disease and even obesity.

DR. THOMAS RUSSO, NORTH VIRGINIA SLEEP DIAGNOSIS CENTER: When you don't sleep well, you may have a diminished metabolism, and therefore you don't burn the calories that perhaps someone with a good eight hours of sleep may do.

FEIG: It's not just adults getting too little rest. A new study from the National Sleep Foundation says increasingly, children also aren't sleeping enough.

Toddlers need about 12-14 hours of sleep a day; preschoolers, 11 to 13 hours; and school age children, 10-11 hours. But on average, the study says kids sleep about 30 minutes to an hour a night less.

It might not sound like much, but it adds up and can mean problems with attention and schoolwork.

Experts say getting to bed and up at the same time every day, limiting caffeine and keeping TVs out of the bedroom can all help you get some extra Z's.

In Washington, I'm Christy Feig.

(END VIDEOTAPE)

GUPTA: About 50 percent adults in the U.S. are sleep deprived. And it turns out we're sleeping than ever before: about one to 1.5 hours less per night than we did 100 years ago. I guess that can really add up.

In fact, the National Institutes of Health held the first ever sleep conference this week to talk about how sleep has become a public health concern.

So here to help us work through this, hopefully help you, as well, at home get a little bit more shut-eye, Dr. Joyce Walsleben. She's the director of the New York University Sleep Disorder Center and author of a book as well, "A Woman's Guide to Sleep."

Welcome.

JOYCE WALSLEBEN, DIRECTOR, NEW YORK UNIVERSITY SLEEP DISORDER CENTER: Thank you.

GUPTA: Are women and men different with regards to sleep?

WALSLEBEN: Well, actually they are. Women have more trouble sleeping for a variety of social reasons, as well as physical.

GUPTA: This conference sounds pretty interesting, this sleep conference. I mean, a whole conference just dedicated to helping everyone get more shut-eye. Anything sort of strike you about that?

WALSLEBEN: It was an exciting time, because it's the first time I think that we're all under one roof, trying to move the sleep science from the bench to the public, and the recognition that the public is really quite sleepy.

SANJAY: It's interesting, you know, because there is a lot of science -- sort of scientific basis to sleep. Obviously for the people at home it's how many hours a night am I getting. But you know, there's a lot of science that goes into that. And we're going to work through some of that today, hopefully.

Lots of questions. You're not surprised by that. You probably get them all the time in your profession. Lots of e-mails coming in on this particular topic.

Let's see if we can get to some, OK?

WALSLEBEN: OK.

GUPTA: The first one comes from Maria in Chicago, who writes, "I am a snorer. My boyfriend sleeps in the other bedroom at times." That's interesting. "I've gained weight, and it's getting worse and louder! Help! Could I have a deviated septum?" is her question. "Is there anything we can do?"

And we often laugh about snoring, but it can be a real problem for people. I mean, it starts interfering with your life.

WALSLEBEN: Half of the public snores, and it isn't funny, really.

She may have a deviated septum. It could be anything between the nose and the lung that is compromising that airway and making a sound. And the important part is, it's a symptom of something going wrong, and she should check it out.

GUPTA: So who do you go see for something like that?

WALSLEBEN: She could start with her own physician, certainly, or an ear, nose, and throat person.

The likelihood is that, if it is a very deviated septum, it might be the problem. But the likelihood is it isn't the whole problem. Her weight could certainly be the problem.

GUPTA: And sometimes the snoring can cause weight gain, as well. You and I were talking, so we're going to talk a little bit more about that, as well.

WALSLEBEN: OK.

GUPTA: Let's go to another question. This is an interesting one, as well, from John from Washington, who wants to know "What about taking short power naps during the day?" Guilty, John. Me, too. "Do they interfere with the quality or duration of getting a full night of sleep?"

What about those power naps? Because I always think, "All right. I'll get a couple hours in and sort of catch up." Does that work?

WALSLEBEN: It has to work, because sleep is sleep. However, a power nap should be short, maybe under 20 minutes.

And you really have to worry about the time you wake up, because there may be a little inertia, a little sleep drag as you're waking up. But they can lifesavers, particularly if you're sleep deprived and you're about to hit the road and drive. A power nap before driving will give you some more alertness for an hour.

GUPTA: I feel like if I sleep 20 minutes, I actually -- if I try to wake up, I'm even more tired.

WALSLEBEN: That's the problem. So you may be very sleep deprived. We may diagnosing you.

So there's that little bit of inertia after that nap. And you just have to be aware of it. Sometimes taking a cup of coffee before, if you're not a standards coffee drinker, before the nap will help, because by the time you're finished with the nap, the coffee is taking over. It gives you an extra boost.

GUPTA: Better sleeping through medication, as it turns out.

WALSLEBEN: I'm a big proponent of that.

GUPTA: Just to add something onto that, as well. People always say, "You know what? I'll sleep in on the weekend. I'll sleep an extra couple hours." Can you make up for sleep debt?

WALSLEBEN: Not really hour per hour, but the debt is really important, and it is an accumulating type. So if you lose an hour every night, Monday to Friday, by Friday night you're five hours in the hole.

Could you sleep in and make it up? No. But you might feel better. The problem is you get your rhythm out of sync, and so going to bed Sunday night is very difficult. And you start the week in a hole. So it's a good idea to stay on regular time.

GUPTA: You know, this is one of the most fascinating topics we talk about, sleep. I mean, every time we talk about this topic people always writing in.

We're going to take a lot more of your questions, as well.

Millions of Americans suffer from insomnia. If counting sheep isn't working for you, stay tuned.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: If you can't get to sleep or can't get back to sleep, you may have insomnia. We'll show you how to stay in dreamland.

Plus what about sleep aids? Are some better than others?

First take our "Daily Dose" quiz: "True or false, people need less sleep as they grow older?" The answer when we come back.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP) UNIDENTIFIED FEMALE: Checking the "Daily Dose" quiz. We asked, "True or false, people need less sleep as they grow older."

The answer is false. Our sleep needs don't change with age, but our ability to get into the deep restful stages of sleep does decrease as we get older.

(END VIDEO CLIP)

GUPTA: And welcome back.

We're talking with sleep expert Dr. Joyce Walsleben. She's director of the Sleep Disorder Center at NYU School of Medicine. Also wrote a book about women and sleep, a very interesting book.

We went around looking for some sleepy people. Not hard to find, as it turns out. And here's a question from Atlanta.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: Most adults, you're lucky if you can get six hours of sleep in any given night. So I'd just be interested to know if the eight-hour rule is still good or if there's something else that we should be applying.

(END VIDEO CLIP)

GUPTA: So you hear about this eight-hour rule. Does the eight- hour rule still apply? And where did that come from in the first place?

WALSLEBEN: It very much does apply. There's controversy about it today, as you may well know, but it applies because our performance is optimized when we sleep actually about eight hours and 15 minutes. However...

GUPTA: I need that extra 15 minutes.

WALSLEBEN: ... as close as we can get, for the most part. I mean, it's always an individual variance. But for the most part, we should be aiming at eight hours on a very consistent basis to optimally perform and be safe.

GUPTA: How about kids?

WALSLEBEN: Kids really need a lot more. And certainly during their adolescent years, it's been shown they need a good ten hours or more. And they seldom get it. We're always pushing. School start times are too early.

GUPTA: Right.

WALSLEBEN: and then work and activities after school. It's very, very tough for them.

GUPTA: And you know better than anybody else how widely studied this particular topic is. In fact, according to the recent polls, the majority of adults experience difficulty sleeping at least a few nights a week. The most common cause is insomnia.

Now if you have trouble getting or staying asleep, or if you're waking up in the middle of the night and can't fall back asleep, these could be signs you have insomnia.

Another tip-off, if you wake up too early, before you're rested.

Let's get to another e-mail now. Lots of e-mails coming in. Amazing. Tammy in Georgia writing, "I have no trouble falling asleep. The problem is that I wake up almost every two hours to the minute. Oftentimes, I grab a cookie or milk and go right back to sleep easily, only to wake up again exactly two hours later. What can I do to stop this?"

She's on the two-hour rule here, instead of the eight-hour.

WALSLEBEN: Very simple. She's perfectly normal. We all wake up every hour and a half to two hours. The problem is don't look at the clock. Get rid of it. Cover it over. Don't open your eyes. Roll over and just say, "This is fine. It's normal."

And you will soon break that habit, and it is a habit.

GUPTA: It's a little bit obsessive compulsive to have to look at the clock every couple of hours.

WALSLEBEN: It's a tough habit to break.

GUPTA: I do that, that's why I say that.

WALSLEBEN: But get it out, and you'll sleep right through and you'll be much better off for it.

GUPTA: Covering the clock is a good piece of advice. Another e- mail coming in, Dan from Chicago wanted to know, "I've always been an insomniac. A few years back, I tried Ambien, which was great at first but not after extended usage. My doctor prescribed Clonidine, which is actually a high blood pressure medication. What is known about Clonidine being prescribed for a sleeping disorder, and is there anything else out there for long-term help?"

What about that?

WALSLEBEN: There is -- the issue of -- Clonidine is used, particularly in children. However, the concern over sleep medications is that you use them properly.

There are a number of new ones on the market coming out, at least in the pipeline, that have been studied over long periods, up to a year and more, and seem to be safe without developing tolerance.

So I think it's a sensible thing for people to think about them and use them properly. GUPTA: Talking about medications very quick, you and I were talking on the break, Provigil, a medication that actually keeps you vigilant. A kind of -- a very unique name, exciting name.

WALSLEBEN: Right.

GUPTA: What about that? Do you believe in that?

WALSLEBEN: I think it's wonderful for, again, appropriate use. It was first marketed for narcolepsy, which is a sleep disorder. But it's now been FDA approved for that sleepiness that happens on shift work: sleep disorder, for instance. Or people who do have sleep apnea and are still sleepy.

I personally think we're much better off keeping our patients and our public safe and alert, but there's no thought that Provigil is going to replace sleep. So I think that's an important piece.

GUPTA: It's interesting. Pilots are using that.

WALSLEBEN: Sure.

GUPTA: People who do need alert using medications like this.

Take a listen to another question now from Atlanta.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Those herbal ones, names which I can't remember right now. They're called Sleep Easy or Sleep Aid or, you know, Relaxation or something like that, whether or not they actually are, you know, safe.

(END VIDEO CLIP)

GUPTA: And, you know, interesting topic, talking about herbs. More people than ever are looking to natural supplements for their own health. So what's your opinion of these sort of herbal sleep aids?

WALSLEBEN: In this country, my concern is we don't know for sure what's in that bottle. So in thought, in Germany Valerian has been very well studied and shown over time to be useful and that's about it.

So I'd prefer that folks will go to their physician, get a prescription for a short acting, very nicely succinctly hitting sleep medication, and they're much better off for it.

GUPTA: But you always add, as well, that medication is obviously not a first line of therapy if you're having sleep problems.

WALSLEBEN: I personally do add that. I use it as a crutch, in a sense, when I work with patients to change their behavior. And in the long run, behavioral changes tend to hold longer and work better.

GUPTA: Covering up that alarm clock, I'm going to do that. I promise you.

WALSLEBEN: It works. It works.

GUPTA: And coming up, we're going to talk about snoring. Can that be putting your health at risk?

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: It can be annoying and keep your partner awake, but snoring can also be a sign of something more serious, sleep apnea. We'll give you the latest tests and treatments after the break.

And later, we find out some pointers for ensuring a good night's sleep. Stay tuned.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

GUPTA: Welcome back to WEEKEND HOUSE CALL.

If you're one of the millions of sleep deprived Americans, the National Sleep Foundation has some tips to help you.

Holly Firfer runs them down.

(BEGIN VIDEOTAPE)

HOLLY FIRFER, CNN CORRESPONDENT (voice-over): First off, forget it's Saturday. We all look to the weekend as a time to catch up on sleep. But sleep experts say it's important to keep your body clock on the same time.

So no more lazy weekend mornings. You should get up at the same time every day.

If you need a few extra hours of shuteye, you can take a nap, but only if it's for an hour or less and 3 p.m. Otherwise you run the risk of having trouble falling asleep at night.

While you're awake, expose yourself to as much daylight as possible. A 45-minute daily walk outdoors is recommended.

No caffeine between four and six hours before you go to bed and no more than two alcoholic drinks per day. Some suggest no drinks up to four hours before bedtime.

Exercising after a long day can relieve stress but it revs you up, so sleep docs say doing so too close to bedtime can keep you awake, as can the stimulant effects of nicotine, so no smoking either.

Use your bedroom for sleep and sex. Do not use it as an office, a place to read or watch TV.

And if you have trouble sleeping, or wake up in the middle of the night, leave the bedroom and go read or listen to relaxing music. Go back to bed when you're sleepy and whatever you do, don't look at the clock. This will just stress you out and keep you up.

Holly Firfer, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: And we're talking with sleep expert Dr. Joyce Walsleben.

Let's get to another e-mail here. Lots of e-mails coming in on this, one of our most popular topics. Matt from Florida writing, "I have difficult unwinding after work most nights, which in turn affects my sleep. How does one go about unwinding and getting ready for bed?"

Is there a process to this?

WALSLEBEN: There should be a process.

GUPTA: As opposed to just collapsing on the bed like a lot of people do.

WALSLEBEN: The process should be in some way to separate the day from the night. Even if you have to build something, your bedroom should be dark, comfortable, quiet and that's it. No television, no book reading in the bedroom.

You can wind down earlier in the day, which is really more important, by actually using a worry book, which sounds silly. But you write down issues for 15 minutes on one side of the page and solutions for 15 minutes on the other page, put it away and then train yourself to do it every day at the same time. Then you can get some of those thoughts out of your mind that race through at night.

GUPTA: A lot of people read in bed. You don't recommend it?

WALSLEBEN: I don't like to change things if they're working well, but the idea is if you're having difficulty sleeping, get everything out of the bedroom except sleep.

GUPTA: Good sleep hygiene. Really good advice there.

You know, but sometimes sleep problems can be more serious. If you have a more serious problem, experts recommend you see a doctor. If you're feeling sleepy during the day despite getting enough sleep, if you snore loudly or stop breathing at night, and if you're violent during your sleep or being kept awake by restless legs.

Millions of Americans suffer from sleeping problems. According to recent polls, insomnia is the most common, followed by sleep apnea and restless leg syndrome.

Sleep apnea, incidentally, is characterized by loud snoring or choking and gasping during your sleep, sleepiness during the day and headaches or dry throat in the mornings, as well.

What are the risks of not getting treated for sleep apnea? Lots of questions coming in about this. Lots of e-mails, as well. This one is from Doug in Massachusetts, who writes, "I was diagnoses with obstructive sleep apnea in 2000 and have been using my CPAP machine ever since. My doctor discouraged surgical solutions due to their limited success rate and suggested that I wait because much new research was underway. What are the newest surgical procedures and advances in treatment available?" He'd love to lose the machine is what he's saying, the CPAP machine.

WALSLEBEN: I'm sure. The machine works beautifully, but not everyone loves it.

GUPTA: What is a CPAP machine?

WALSLEBEN: A CPAP machine is an air blower, an air pump, about one horsepower. Pumps the pressure of air to the nostrils through an interface. And it goes down your airway, holds your airway open like a pneumatic splint.

All it is, is a crutch. But it's wonderful, painless and works beautifully if you can tolerate it. And clearly, some people can't tolerate it.

GUPTA: You were talking about sleep apnea a little bit earlier on. Weight and sleep apnea, what's the relationship?

WALSLEBEN: They're well linked. If you are obese and snoring and sleepy in the daytime, those are really the signs that you probably do have sleep apnea.

If you could lose weight, it would probably help a great deal. In fact in the old days, before we had CPAP, that's how we used to treat it with weight loss or tracheostomy.

GUPTA: So if someone has it right now, is watching and is using that machine and is unhappy with it, like our last e-mail, are there any surgical options or any other options for them?

WALSLEBEN: There are surgical options and dental options. So first I would advise someone if they're having trouble with the CPAP to get back to their clinic and let them get some help.

But for the right people, surgery can do a nice job. It's just trying to find that right person, or a dental appliance, which also will work for mild to moderate sleep apnea.

GUPTA: Good advice. And as we said, another disorder we've been talking about, as well, something called restless leg syndrome. Makes you feel like rubbing or moving your legs, usually all night and when you try to go to sleep, as well.

Questions coming in on this. Sharon from Illinois wanting to know, "Can you speak about restless leg syndrome and periodic limb movement?"

We sure can, Sharon. This is something that the doctor and I have been talking about. Are those disorders treatable? WALSLEBEN: They are treatable. There are medications. Usually dopaminergic aganus (ph) will work. Or an anti-epileptic medication in low dose will help people get through the night.

However, one other thing that's interesting. The newer research is showing that it may be a drop in iron.

GUPTA: Really?

WALSLEBEN: So that in the brain there may not be enough iron. Hard to find. However, the interesting thing is if you're running even a low-normal iron level in your blood, it might be worth trying some supplements, under your doctor's care, to see if that makes a difference.

GUPTA: An iron supplement or something. You can buy those iron supplements over-the-counter.

WALSLEBEN: But, again, I would share it with your physician before running out to the drug store.

GUPTA: Interesting. Good piece of information. New information there, as well.

A lot more coming up still. Stay tuned for more WEEKEND HOUSE CALL.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: From jet lag to insomnia, we'll give you some web sites for more information on getting those Z's.

Plus, are you up for another quiz? That's just a click away.

But first, check out some of this week's medical headlines, in today's "For Your Health."

UNIDENTIFIED FEMALE: Could artificial blood help save an accident victim's life? It might. The testing for the blood substitute is controversial.

Often patients who need the artificial blood the most are unconscious and cannot give their consent to try the product, something which worries patient's rights advocates, who say patient should give their consent before treatment.

Also C reactor protein blood tests may not be as useful at predicting heart disease as investigators once thought. A study published in the "New England Journal of Medicine" suggests the tests had very little predictive power to standard tests for heart disease.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

GUPTA: If you want to research on your own, click on www.sleepfoundation.org. That's the web site for the National Sleep Foundation. There you're going to find information about sleep disorders. Plus you can print out a diary to keep track of your own sleep problems.

Another great resource is the American Academy of Sleep Medicine at www.aasmnet.org. Move your cursor to patient resources and take a sleep quiz. Or click on find a sleep center to see a few specialists in your area.

It's been a great show. Thanks so much for joining us.

WALSLEBEN: I'm so pleased.

GUPTA: Final word for our viewers?

WALSLEBEN: I'd love it if everybody makes sleep a priority, instead of the last think they thing about for themselves and their family. We'd all be better off.

GUPTA: Lots of good advice. Thanks so much.

WALSLEBEN: Thank you.

GUPTA: We are out of time. Make sure to join CNN.com this week to find out what our next topic is going to be. And keep those e- mails coming, as well to HouseCall@CNN.com. Remember, this is the place where you can ask the medical experts all of your questions.

Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned for more news now on CNN.

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