Sleepless In Ocala


Go back to bed, try again, but still, sleep won’t come. 
Or if it does, you just seem to finally fall asleep when the alarm clock goes off. More exhausted than when you went to bed, you get up and stagger drowsily through your day.


Sound familiar? If it makes you feel any better, albeit still sleepy, you’ve got plenty of company. According to the National Institutes of Health, 50 million Americans suffer from some form of chronic sleep disorder and another 20 million deal with occasional sleep problems. Of adults, 75 percent experience daytime sleepiness. All of this sleepiness is not healthy and can be downright dangerous, even deadly. Research has proven there is a definite connection between sleep disorders and serious medical conditions, including heart disease, diabetes, stroke, hypertension and depression. And according to National Highway Traffic Safety Administration statistics, sleepy drivers cause more than 100,000 motor vehicle crashes and claim more than 1,500 lives a year.


And while people will go to a doctor for all types of reasons, not being able to sleep is rarely at the top of their list. But considering the quality of life implications, maybe it should be. In fact, sleep medicine is an ever-growing specialty field for many doctors. Dr. Hany Falestiny of Ocala Pulmonary Associates, P.A. & Sleep Center is board certified in sleep disorders by the Academy of Sleep Medicine, and Dr. Lance Kim of FNC Sleep Center is board certified in sleep disorders by the American Board of Psychiatry & Neurology. Dr. Falestiny and Dr. Kim recently took the time to talk with Ocala Style about our sleep-challenged lives and what we can do to get a good night’s rest.

OS: How important is getting a good night’s sleep to overall health?


Falestiny:Chronic lack of a good night’s sleep can lead to decreased performance and alertness, memory and cognitive impairment, stress on relationships, occupational injury and overall poor quality of life. If left untreated, sleep deprivation can cause serious health risks, such as cardiovascular disease and obesity.


Kim:There is a very close relationship between sleep disorders and medical and neurological conditions. A sleep disorder acts as a catalyst, fuel to the fire, to medical conditions like diabetes and cardiovascular issues; to neurological conditions such as chronic headaches, neuromuscular disorders, depression and even attention deficit disorders.

OS: What are the most common sleep disorders that you treat?


Falestiny: The most common referral to our practice is complaints of excessive daytime sleepiness and fatigue, most commonly caused by obstructive sleep apnea. In obstructive sleep apnea, the breathing airways become obstructed and prevent the flow of air. There is also central sleep apnea, where the brain doesn’t send the signal to the respiratory muscles. Sleep apnea disrupts sleep by causing repeated awakenings and pauses in breathing during the night. A physical exam may reveal a long and wide soft palate, a large swollen uvula, large tonsils and/or excess tissues in airway walls. Excessive weight often plays a major role in obstructive apnea.


Kim: The No. 1 reason people come to my center is because of insomnia, which can include difficulty falling asleep, frequent wakening, waking up too early and not being able to go back to sleep and waking up feeling unrested. There are many causes for insomnia, including lifestyle factors such as stress, diet and exercise. And, of course, sleep apnea as well.

OS: When should people seek professional help for sleeping problems?


Falestiny: Patients shouldn’t hesitate to talk with their physician as early as possible when they suspect they have a sleeping problem. Common problems connected to a sleeping disorder include loud snoring, gasping, restless sleep, daytime sleepiness, fatigue, headaches, blurred vision, leg swelling, shortness of breath, irritability and memory problems.


Kim: You should get professional help when you can’t fall asleep, don’t wake up refreshed and suffer from daytime drowsiness on a regular basis. Also, if you have a medical condition like high blood pressure, diabetes or have had a stroke and you take two or more medications, there’s a good chance you suffer from sleep apnea, so it would be a good idea to see a sleep specialist.

OS: How are sleep disorders like obstructive sleep apnea and insomnia diagnosed?


Falestiny: After a consultation and complete physical, the patient will undergo a one-night sleep study in a special bedroom at the sleep center. The patient is fitted with several leads to measure air flow, oxygen saturation, heart rate, brain waves, respiratory efforts and more. This provides a baseline measurement. If sleep apnea is diagnosed, the patient will need to come in for a second night for a CPAP/BiPAP titration.


Kim: The sleep study results oftentimes really surprise people. We can monitor how long it takes them to fall asleep, how long they stay asleep and how often they wake up. They think they’re only waking up a few times a night, but then we show them it’s more like a hundred times a night. Now they can understand why they’re so tired and sleepy.

OS: How are sleep disorders like obstructive sleep apena and insomnia treated by a sleep specialist?


Falestiny: Once a patient has been definitely diagnosed with obstructive sleep apnea, he or she is prescribed and fitted with either a CPAP or a BiPAP breathing machine that they wear all night, every night. A CPAP gives continuous positive airway pressure to keep the upper airways from collapsing. A BiPAP provides two levels of air pressure with the highest on inhalation and lowest on exhalation. Some people are not comfortable with the continuous high air pressure of a CPAP and can handle a BiPAP better. A BiPAP is also used to support ventilation at night in morbidly obese patients, those with severe lung disease or those suffering from neuromuscular disorders. Both the CPAP and BiPAP include the machine itself, hosing and a mask or nasal pillow to deliver air pressure. How long a patient needs a CPAP or BiPAP depends on each individual case.


Kim: For insomnia without sleep apnea, the treatment protocol is usually a combination of medication and lifestyle changes. But any kind of sleep medication should only be taken under strict supervision by your physician and only for a short time. It’s too easy to become addicted to sleeping pills, and then you have another problem to deal with. There is no quick fix to a sleeping disorder. Instead, think of it as a long-term investment in your health. Lifestyle changes include a strict adherence to a nightly sleep schedule; keeping daytime and nighttime activities separate; reserving the bedroom only for sleeping (and sex); limiting Internet and TV time in the evening; creating a comfortable, relaxing bedroom environment; eating a good balanced diet; and getting adequate daily exercise. And, most importantly, learn to respect sleep for the critical role it plays in your well-being.

Be sure to pick up a copy of the November issue of Ocala Style, or check out the virtual issue online to read about a myriad facts and figures on insomnia.

Posted in Ocala Style Features

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