For Your Health: Tired? Your sleep may not be what you think

Perhaps you spend a good eight hours in bed every night, yet you feel inexplicably sleepy the next day.

How can this be?

Surely, you should feel refreshed and vibrant after a full night's sleep.

It's possible your sleep isn't the renewing break you think it is. That's because not all sleep is created equal. A good, deep sleep in which your brain cycles through the various sleep states, allowing for the natural progression of brain waves, is what the body needs.

Many people are unaware they have sleep disorders, which compromise their amount or quality of sleep. Because you may not wake fully, as is often the case with sleep apnea, you don't realize your sleep is disrupted. You feel tired the next day and you don't know why.

Fatigue, especially if it affects your life for more than a couple of weeks, can be a symptom of many medical conditions - from a simple virus to a serious illness. Unremitting or crushing fatigue should be assessed by your primary care provider. In some cases, especially if you exhibit additional symptoms of a potential sleep disorder, your doctor may recommend seeing a sleep specialist or having a sleep study.

Sometimes sleep apnea, in which the patient stops breathing repeatedly during sleep, is most evident to the individual's bed partner who notices the common pattern of snoring followed by a short period of silence and then a gasp or snorting sound as the patient resumes breathing. The fragmented sleep that results can cause abnormal daytime sleepiness, problems with memory and attention, high blood pressure, weight gain and headaches.

Fortunately, once identified, sleep apnea, like most other sleep disorders, is treatable. Diagnosis is made after reviewing data collected during an overnight sleep study at a sleep center where the patient's sleep patterns, oxygen levels and body movements are monitored. If a patient exhibits frequent episodes of apnea and meets severe criteria during the sleep study, the sleep technologist may intervene with continuous positive airway pressure (CPAP), adjusting the pressure as needed until the patient is able to breathe continuously while asleep.

A lot of patients are intimidated with the idea of CPAP, but it's not what most people think. A steady flow of air typically comes through a small mask, which is usually tolerated well. For most people, the payoff of finally sleeping well and feeling better is worth it.

For those with mild to moderate sleep apnea, alternate treatment options can be considered, including weight management to reach ideal body weight and oral appliance therapy to advance the mandible during sleep if good dentition is present (in consultation with a dental sleep medicine specialist).

Patients can also benefit from an ENT consultation to assess for structural abnormalities in the upper airway for possible surgical interventions. Patients who have failed PAP therapy or oral appliance therapy can consider the latest treatment called "upper airway stimulation therapy." The best treatment course should be individualized based on the severity and type of sleep problem, individual preference, underlying comorbid medical conditions and insurance coverage.

If you think you may have sleep apnea, excessive daytime sleepiness, restless leg syndrome, insomnia or other types of sleep disturbances, talk with your doctor and consider seeing a sleep specialist, who can perform a comprehensive evaluation and asses the need for a sleep study.

It could be the best night you've had in a long time.

Krishna Mettu, MD, is the medical director for the SSM Health Sleep Center, 3349 American Ave., Suite D, in Jefferson City. The center includes eight bedrooms and a central control room where tests are conducted nightly to diagnose adult and pediatric sleep disorders. More than 10 dedicated and qualified staff members at the Sleep Center are specially trained and registered in sleep disorders. To make an appointment, call 573-556-5525.