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Various Sleep Disorders are Examined. Aired 2:30-3:00p ET
Aired May 9, 2015 - 14:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
[14:30:35] DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: We all want it. We all need it, and most of us don't get enough of it. Today we're talking about a one thing that impacts everyone no matter where you live or what you do, and that is sleep.
This is "Vital Signs." I'm Dr. Sanjay Gupta.
We spend one third of our lives asleep. That's roughly 25 years of shuteye. Yet sleep is anything by a waste of time. It's a critical component of our health, and it deserves to be taken seriously. When your head hits the pillow your body doesn't shut down. It uses that time to heal tissue and strengthen memory, even grow.
So what happens when you don't or can't get enough sleep? It's a problem for too many of us, and one that affects our every waking hour.
Think about it for a minute. How do you sleep at night? There's so much to learn about how we sleep that impacts how we live. Glenn Keller certainly appreciates the value of sleep. He's a long haul truck driver and his livelihood, his life depends on his ability to be awake.
GLENN KELLER: As a professional driver, being safe and being alert is paramount, and then it's just proof if we get the proper amount of sleep, I realize just how serious a sleep disorder could be.
GUPTA: Glenn and I have actually met before. Three years ago he took part in our Fit Nation challenge. It was around that time that Glenn also discovered he had a sleep disorder, one that he could treat. One of Glenn's routes brought him back through Atlanta. So I hitched a ride to see how he's been doing.
What's up man?
KELLER: Dr. Gupta.
GUPTA: You didn't think you would see me.
KELLER: I didn't think we would ever do it again.
GUPTA: Let's go for a spin.
Do you remember the first time you noticed you had a sleeping problem?
KELLER: I actually noticed, I had gone into the hospital to have surgery on my wrist, and when I came out of surgery there were five doctors standing around my bed, and they were asking me questions, like do you feel dizzy, do you feel lightheaded, do you have shortness of breath? And I did know why they were asking me these questions.
When the doctors checked his blood oxygen levels, they were way below normal. So they recommended a sleep study to find out why. The result was obstructive sleep apnea.
DR. WILLIAM DEMENT, STANFORD SCHOOL OF MEDICINE: Obstructive sleep apnea, for example, afflicts 24 percent of adult males and nine percent of adult females.
GUPTA: Dr. William Dement has been nicknamed the father of sleep science. He began studying sleep in the 1950s when few people realized how much there was to discover. Dr. Dement quickly learned that sleep was complicated, filled with pattern and problems.
DEMENT: I had enough interaction with people with complaints about their sleep. I said let us open a sleep disorders clinic. So we did in the summer of 1970 we opened the world's first, as far as I know, sleep disorders clinic.
GUPTA: Dement's sleep disorders clinic at Stanford University was the first of its kind. From the start the number one problem for his patients was obstructive sleep apnea.
DEMENT: Some called it snoring sickness. And you struggle to breathe for anywhere from a minute to, I don't know, the longest I've ever seen is maybe three or four minutes.
GUPTA: Obstructive sleep apnea occurs when tissues in the back of the throat collapse, blocking the airwaves. It's caused by excess weight, large, tonsils or even just the obstruction of someone's throat. For anywhere from 10 seconds to even a minute or more a person will stop actually breathing, lowering blood oxygen levels and straining the heart. This can happen hundreds of times throughout the night.
UNIDENTIFIED FEMALE: You'll place this on your face. You've done this before.
GUPTA: During his first sleep study Glenn wore a mask connected to machine called the CPAP that monitored his breathing. When he stopped breathing the machine sent pressurized oxygen through his airways, forcing them open.
[14:35:06] So when you woke up in the morning you felt?
KELLER: I felt like a new man.
GUPTA: What Glenn experienced was a night of shuteye that finally included all stages of a sleep cycle. The last stage is called REM, short for rapid eye movements. This is the dream stage of a sleep cycle, and Dr. Dement first discovered it.
DEMENT: The eyeball is like a battery. Putting electrodes around the eyes and you don't have to stare at it. That's how rapid eye movements were actually discovered.
GUPTA: This leads to our first sleep take away. During REM sleep, all muscles in your body except for the eyes and diaphragm are paralyzed. This total relaxation allows the brain and body to rebuild and replenish, essential to our daytime function.
DEMENT: We have a long way to go before the entire human race is well-educated about this issue.
GUPTA: This CDC calls sleep-deprivation a public health epidemic. We're sacrificing sleep in favor of other activities in our busy 24/7 lives.
KELLER: I think it's kind of taken for granted. Sleep health is important enough for everyone to consider it the third pillar in health that goes along with diet and exercise. So a lot of times it's taken for granted. How do we recover, how do we rejuvenate if we're not getting proper sleep and rest?
GUPTA: Glenn got some answers when he got his sleep disorder diagnosed.
KELLER: So this one doesn't have an antenna attached to it.
GUPTA: For the past three years his CPAP machine has been his trusty sidekick both on the road and home. But Glenn wants to go the extra mile. Doctors said if he loses enough weight he might also lose the apnea. So he is stepping up his diet and exercise on a quest to save his sleep.
[14:40:27] GUPTA: Heart disease, diabetes, weight gain, even cancer, all risk factors when you can't get enough sleep. For many people lack of sleep isn't a product of their environment or even their habits, but a medical issue. In fact there are over 100 different types of sleep disorders. The most common is insomnia, waking up at night or having trouble falling asleep in the first place. Almost all of us experience some type of insomnia at one point in our lives.
But for more than 10 percent of the population it is a chronic condition. For others, there's the opposite problem. Disorders like narcolepsy and hypersomnia mean you are constantly feeling fatigued and sleepy no matter much sleep you get.
All the conversation about sleep is always how to get more of it. Is there such a thing as too much sleep? You know the feeling, groggy and tired, not fully awake, not fully or ware. We all get this way now and then when we're sleep deprived. For Danielle Hulshizer, it is a constant way of life.
DANIELLE HULSHIZER: Sleep isn't a restful thing for us. You don't wake up feeling energized and ready to go. You wake up still feeling just as tired as you did 12 hours before when you laid down to go to sleep in the first place. GUPTA: For a long time Danielle's constant craving for sleep was
blamed on her busy schedule. As a child she was a competitive figure skater, on the ice early every morning before school.
HULSHIZER: I would be skating from 3:30 in the morning to 7:30, and I'd go to school, and after that cheerleading practice and then homework and then back to the rink for more training. Eventually I would be sleeping at night, but they just figured that I just needed sleep when I could get it.
GUPTA: Danielle was falling asleep frequently and fast, which brings us to our next sleep tidbit. If it takes you less than five minutes to fall asleep at night, you're probably sleep deprived. Ideally, falling asleep should take 10 to 15 minutes.
HULSHIZER: It honestly never occurred to me that there was an issue until moving to Georgia and having all these outside people who didn't know me as a competitive skater tell me there's something wrong.
GUPTA: And 14 years ago Danielle signed up for a sleep study, and she was diagnosed with idiopathic hypersomnia, a sleep disorder where the feeling of sleepiness never wears off even after sleeping all night and taking long naps during the day. It interfered with her education, career, relationships, her entire life.
SCOT HULSHIZER, DANIELLE'S HUSBAND: Living together, there has been times where it's been so bad that in order to get her out of bed in the morning I've literally had to pick her up physically and set her on her feet.
HULSHIZER: I thought that it was never going to get any better and this was my life from here on out. And it was very depressing. Light at the end of the tunnel, honestly it would be meeting Dr. Rye.
GUPTA: Dr. Rye is a neurologist at the Emory Sleep Center in Atlanta, Georgia. Unlike treating traditional narcolepsy, Dr. Rye realized long time hypersomnia treatment would be more than just forcing patients to stay awake, or as he describes it, pushing the gas pedal with the parking brake engaged.
DR. DAVID RYE, NEUROLOGIST, EMORY SLEEP CENTER: We have approved drugs for narcolepsy. We have nothing for idiopathic hypersomnia. Most patients get treated the same way because those are the drugs that, medications that keep a narcoleptic from falling asleep.
GUPTA: After years of research and testing Dr. Rye and his team found that the brain puts itself to sleep but naturally producing an excess chemical that helps us sleep. For hypersomniacs that chemical never clears away, causing the constant fogginess and the urge to sleep.
RYE: People that had evidence of this excessive GABA activity on average was equivalent to the performance of somebody after 30 hours of sleep deprivation or a blood-alcohol concentration of 0.1.
GUPTA: In Danielle's case, the stimulant she was relying on to stay way were wearing off. She was getting desperate. But Dr. Rye discovered one more option, humanozin (ph). It's a drug sometimes used to help bring people out of anesthesia. Two years ago Danielle became only the second person in the United States to get the drug for hypersomnia. Instantly it was a game changer.
[14:45:10] HULSHIZER: Within 15 minutes of placing the tablets under my tongue that wall that I felt like I lived with in my brain my entire life was just gone. It crumbled. And I was able to think clearly and communicate and talk and hold a conversation with somebody without having to look at them. It was incredible. It actually made me feel for the first time like I was alive.
GUPTA: For Glenn Keller, finding how to live with his sleep disorder has been about finding balance. As a professional truck driver he spends more than 250 days of the year on the road driving day and night, all of it while dealing with sleep apnea.
So time for another sleep fact. A region of your brain called the hypothalamus regulates your patterns of sleep and wakefulness, matching them to the 24 hour cycle of day and night called the circadian rhythm. That means your body never truly adjusts to shift work.
Today is a big day in Glenn's quest to find sleep stability. He's back for a follow up test at Fusion Health where he was first diagnosed in 2012.
UNIDENTIFIED FEMALE: This is just getting the oils off your skin.
GUPTA: After losing nearly 100 pounds he's hoping to get his sleep apnea all clear and lose the machine. Glenn will be spending the night in this test room. By midday tomorrow he'll know if he's reached his goal.
KELLER: Wow. And all these are leading to me somewhere.
UNIDENTIFIED FEMALE: Yes. Now we're ready for the big moment. So we're going to start with your baseline study.
GUPTA: For an entire night his sleep is monitored. All of those wires on his head and chest are sending back critical information on the way he sleeps, when he dreams, and most importantly in his case, his sleep apnea is still obstructing his airways and interrupting his sleep.
Seeing Glenn do all this has inspired me to take a closer look at my own sleep health. So I'm going to see what we can all learn from some serious shut eye.
[14:50:47] GUPTA: My friend and Fit Nation partner Glenn Keller is on a journey to repair his sleep and improve his health. A long distance trucker unable to get a decent night's sleep, he's hoping his latest sleep study can get him back on the road to rest.
All this talk about sleep got me thinking about my own sleeping habits. Look, I'm busy. I got three kids. I work at the hospital. I work at CNN. I travel a lot. Just how bad are my sleeping habits? I've decided to come to Emory Sleep Center here in Atlanta to try to figure out. Maybe we can all learn something.
I've done overnight sleep studies before, but this time I'll be doing a daytime one. If I can fall asleep at 2:00 in the afternoon, that's going to tell the doctors a lot.
It seems like having all these wires on would make it hard to sleep.
UNIDENTIFIED FEMALE: Some patients say that.
GUPTA: After the wires, there's one more step before I can take my nap. It's a 10 minute electronic test that measures reaction time and concentrate.
Finally, nap time. It's a little tricky to get comfortable at first. It's a lot of wires. But not long after the lights are out, so am I.
UNIDENTIFIED FEMALE: This is his eyes moving here.
GUPTA: From a room down the hall Angela monitors my brain and heart. I get a 15 minute power nap, and then it's time to take the test again. Here's another sleep tip -- even a nap of just six minutes can improve memory. Would a nap of 15 minutes improve my reaction time? Dr. David Rye is back for a chat about my results and some healthy sleep advice.
RYE: Interestingly enough here we in the afternoon, and you fell asleep pretty quickly.
RYE: Compared to normal people, you feel asleep in about four minutes.
RYE: Which is pretty quick. And you weren't just sort of rolling eye movements, you actually went into stage two sleep. So it was unequivocal sleep.
GUPTA: People always talk about good sleep hygiene. Is that a term you use as well?
RYE: We use it in the clinic, good sleep hygiene, keep a regular schedule, try to get to bed at the same time, get up early, get exposure to the sun. Don't go to bed with your iPhone.
GUPTA: Is there an ideal map length?
RYE: Probably 20, 30, 40 minutes, no more than 40 minutes.
GUPTA: Another sleep fact, this time for sleep hygiene -- 60 to 67 degrees Fahrenheit is the best room temperature for quality sleep. Combing all those factors will hopefully help you get a better night sleep.
Moment of truth. Just how valuable was this power nap?
RYE: So what this is showing is a little bit before you took your nap your reaction time was 216 milliseconds, the median, which is excellent. This is like fighter pilot range, OK. Now what did the nap do. You went from 216 to 200. So you're median improved by almost 10 percent.
GUPTA: That's impressive.
RYE: In terms of your speed.
GUPTA: The 15 minutes of stage two sleep in the middle of my day seem to have an impact.
GUPTA: I have my results, and now it's Glenn's turn. It's mid- morning the day after his sleep study. He's back to find out if his weight loss of nearly 100 pounds has been enough to diminish or even end his sleep apnea and lose the CPAP machine.
UNIDENTIFIED MALE: We have your sleep study results from last night, and we have a few things to talk about. The short answer is that yes, there continues to be obstructive sleep apnea, and we recommend continued usage with the pap therapy device. There is an improvement, so there's good news that has accompanied the weight loss.
KELLER: Although there is a need to continue the CPAP, it's still good news because I know how important as a driver that I get good sleep care.
[14:55:11] GUPTA: Even though the results weren't exactly what he'd hoped, Glenn's positive attitude still shines through. It's something I've seen in him time after time, and it is key to any healthy lifestyle change.
GUPTA: When they told you that you needed a machine, Glenn, was that hard news? Did you see that as a defeat for you?
KELLER: Actually, it wasn't, because I was wanting to get that. I was wanting to be treated, and especially after I got the level of sleep I got. Where's that machine? Give it here.
KELLER: I welcomed it with open arms.
GUPTA: What's the goal ultimately? Do you want to get off of it?
KELLER: Ultimately I want to get off of it. If it is in fact associated with the weight, I will get off of it.
GUPTA: As Glenn and I both learned in our sleep studies, it's time to start taking sleep seriously. Wearable technology and our smart phones are one way to start tracking how much and how well we sleep. And remember, sleep just as important as your diet and exercise. In fact, if you only have one free hour in day and you've got to choose between a nap or exercise, pick the nap. Give yourself that chance to heal, and your body will thank you for it.
For "Vital Signs," I'm Dr. Sanjay Gupta.