Last year, I began worrying about my husband’s state of mind.
He has always been absentminded, often misplacing his keys and cellphone or forgetting casual plans we’d made. But then he started having serious memory lapses over important appointments and decisions. When I referred to a particularly charged discussion we’d had a few days earlier about financial and child-rearing issues, he had absolutely no recollection of the talk. None. Zilch.
That’s when I became concerned.
My husband is in his late 40s and the picture of health: Slim, fit and strong, he frequently plays squash, tennis and soccer with considerably younger men. Given his physical health, his extreme forgetfulness didn’t make sense. I feared we might be dealing with something scary, like a brain tumor or early dementia, and suggested he see a neurologist.
After easily passing the neurologist’s cognitive function tests, my husband was given a surprise referral: He was sent to a sleep disorders center for overnight study.
We soon learned that he has moderate sleep apnea, a chronic disorder that causes repeated pauses in breathing during sleep. In fact, my husband stopped breathing 19 times in a single hour during the overnight study. That indicated that his brain wasn’t getting enough oxygen during the night, which meant he was running on empty during the day.
Neither of us had suspected the problem: He wasn’t a habitual snorer; he didn’t have noticeable pauses in his breathing while he slept; and he wasn’t overweight, a major risk factor for the disorder.
If it hadn’t been for that serious lapse in memory, we might never have known.
Sleep apnea affects more than 18 million people in the United States, according to the National Sleep Foundation, a nonprofit organization in Arlington, Va., dedicated to education and research about sleep issues. But it’s not the only reason Americans aren’t getting enough rest.
The Cleveland Clinic has identified 80 sleep disorders affecting 70 million people in the United States. Among the more bizarre: exploding head syndrome (the sleeper feels as if a bomb has gone off in his or her head); REM sleep behavior disorder (the person acts out his or her dreams during sleep); sleep-related eating disorder (the person raids the refrigerator while asleep); and sleep-texting (sending text messages while asleep).
But the most common issues are sleep apnea, insomnia and restless legs syndrome (RLS). Insomnia—which includes difficulty falling asleep, staying asleep, waking too early or simply sleeping poorly—affects 30 percent of adults, according to a 2007 review in the Journal of Clinical Sleep Medicine. RLS, a neurological condition characterized by unpleasant creeping, tugging or pulling sensations in the legs and an irresistible urge to move them, especially while sitting or lying down, affects an estimated 10 percent of the U.S. population.
All three disorders are on the rise, partly because of greater public awareness and partly because of lifestyle factors such as weight gain and poor sleep habits. Yet many people don’t seek help for these problems.
“We are amazingly proficient at ignoring things we can’t see,” says Dr. Helene Emsellem, director of The Center for Sleep & Wake Disorders in Chevy Chase and an associate clinical professor of neurology at George Washington University in Washington, D.C. “People are very good at ignoring snoring or other sleep disturbances, even if our bed partners can’t take it. Our brains protect us from acknowledging what we can’t see, sometimes to our detriment.”
It has long been known that sleep apnea increases a person’s risk of developing hypertension, heart arrhythmias, heart disease and mood disorders; suffering a stroke; or dying prematurely.
“Every time you stop breathing [with sleep apnea], your body says, ‘Oh, no! I’m going to die’—so stress hormones are released and your blood pressure and blood sugar go up, your oxygen level goes down, and your risk of cardiovascular disease and stroke goes up,” says Dr. Konrad W. Bakker, medical director of the Sleep Disorders Center at Shady Grove Adventist Hospital in Rockville.
In May, researchers at the University of Wisconsin found that having severe sleep-disordered breathing (a form of sleep apnea) makes a person’s risk of dying from cancer five times higher than that of someone who doesn’t have the disorder.
Beyond sleep apnea, researchers in recent years have begun to discover just how hazardous insufficient sleep of any kind can be to our health. It can affect memory (as in my husband’s case), learning and critical thinking, math skills and spatial orientation.
“If you take a sleepy person and take away the yawning, you’re left with someone who has trouble focusing and concentrating,” Emsellem says. “We see [attention deficit disorder-like] symptomatology in our population at the sleep center. It’s very difficult to diagnose ADD in anyone who’s sleepy because of the symptom overlap.” This is a particular problem with teenagers, she adds, because they’re so sleep-deprived.
