We talked about sleeping sicknesses, their symptoms and their effect on human health with Istanbul University Cerrahpaşa Faculty of Medicine Lecturer Prof. Dr. Derya Karadeniz.
Prof. Dr. Karadeniz, who says that sleep is a process necessary for life, said: “ When we look at the characteristics of sleep, it is different in babyhood, childhood, adolescence period, adulthood and old age. A sickness or disorder in sleep directly effects wakefulness and triggers lots of illnesses. Sleep duration, feeling sleepy, awaking velocity and awaking thresholds so being awake with any external stimulus differ from person to person. This is inborn different as genetically and sleep is like a personal fingerprint.
“Sleep Duration Can Change from Person to Person”
Prof. Dr. Karadeniz, who says normal sleep duration is between 7-8 hours, said: “When we look in general, %80 of the society sleep in normal duration. However, this has got two types as long sleeping and short sleeping. This is again something inborn. A person after 30-40 years shouldn’t tell something like ‘Why am I sleeping for 4-5 hours? Is it insomnia?’ If this situation emerges later on, it can be called insomnia but if it is like this from the childhood, it means this sleeping duration is enough for her/him. While defining sleep, we are talking about a sleep of which the person have enough and wake up as renewed.”
Prof. Dr. Karadeniz, mentioning that human brain has different stages after sleep and in these stages all the systems in the body works differently, said: “ In a normal sleep, the stages of sleep are separated two as NON-REM and REM stages. NON-REM stages also are separated in themselves as superficial and deep. Each of them has a function. For example; NON-REM sleep especially deep NON-REM sleep is a stage that a lot of hormones are secreted, physical regenerations, repair are made and also necessary for immune system. If this stage is destroyed or is slept little, there can be some hormonal disorders. The function of REM stage is regeneration of the functions such as learning, focusing, memory. If REM stage is destroyed, in the next day, there can be irritability, tension, distractibility and even forgetfulness thought as dotage.”
“How Can Sleep Sicknesses be Treated”
Prof. Dr. Karadeniz, implying that sleep sicknesses are not psychiatric diseases, said: “Sleep sicknesses are the diseases that appear as a result of sleep –wakefulness mechanism’s disruption. When we say sleep sicknesses, there are a lot of categories and there are diagnosed sleep sicknesses more than 80. All of these sicknesses have their own standart and diagnosis criteria that valid in worldwide. We know the mechanisms, why they are existed and their treatments. Before all, sleep sicknesses are the diseases that are diagnosed directly and curable. Actually, many of them are chronic so continue for a life time but their treatments continue also for a life time and they response to their treatments.”
Prof. Dr. Karadeniz, talking about the types of sleep sicknesses, said: “When we talk about sleep sicknesses, there are sleep sicknesses that appear as insomnia. We are mentioning about an insomnia emerges as a result of sleep –wakefulness mechanism’s disruption. This contains in itself 8-10 sicknesses. The other category is sleep breathing disorders. There is a sickness that is generally known as sleep apnoea or sleep apnoea syndrome. This is actually one of the sicknesses in the group of sleep breathing disorders. Sleep breathing disorders have 18 sicknesses. Sleep apnoea unawares appears as shortness of breath and respiratory distress and continues with deoxygenation, cardiac dysrhythmia, disorder at heart’s pumping, cerebral bleeding and disorder at brain oxygenation. So we are talking about a group of sicknesses damaging especially heart and brain and the whole body and shortening the life span if not treated and also causing some problems especially heart diseases and diabetes. The other group of sleep sickness is hypersomnia which is shaped by sleeping for long hours in the daytime and not being able to stay awake during the daytime. Another group is movement disorders in sleep like restless legs syndrome. These can be again movement disorders that can’t be recognized by the patient or the one sleeping with the patient but as the result there are some movement problems that drive the sleep away. Again another group is parasomnia known as sleepwalk, sleepwetting, yelling and eating in sleep namely meaning doing all the things that we do while we are awake in sleep without realizing.
“Every Sleep Sickness Group Has Its Own Sign”
Prof. Dr. Karadeniz who mentioned about sleep sickness’ reasons, said “Reasons differ according to the sleep sickness’ types. These come from the brain so are not visible to the eye. There is just a disruption in sleep, consequently in treatments we can only fix this disrupted function. Sometimes we do this via medicine, sometimes by adjusting the respiration with the machines along with patient’s using this, diseases can be disappeared.
Prof Dr. also added to her speech “Every sleep sickness group has its own sign. Difficulty in sinking into sleep, difficulty in maintaining the sleep, waking up tired, the need of sleep during the day or dozing off, concentration impairment, loss of attention, forgetfulness, gaining weight regardless of the fact that normal nutrition, weight creep regardless of the fact that various methods, sexual function disorder which is not associated with the age, anger, stress and in consequence depression, sadness, sorrow… These are all the signs of the sleep sicknesses. Sleep sicknesses not only Show themselves in signs that belong to the night, on the contrary sicknesses’ signs belong to the day. At this point, observing and examining the sleep is needed, if suspected sleep survey can be done. Of course this must be done by doctors who experted and was educated in this branch. Because, medically sleep is a branch of science.”
“Sleep Sickness Patient’s Assessment Is a Very Detailed Process”
Prof. Dr. Karadeniz who said individuals cannot determine the sleep sicknesses themselves except from sleepnessness, noted “ Patient can tell about sleeplessness but may not know why he/she is waking up from sleep frequently. We must look into the sleep itself and for this we must apply plenty of techniques. Through at night we are looking and examining all the functions of the body brain to heart, pulse, oxygene, carbondioxide, arm moves, leg moves, eye moves and go on… Also there is some sub-surveys that are used in sleep sickness’ determination. For example, there are surveys that we apply daytime on the patients who doze off during day. This is what we are looking for: Can the patient manage to stay awake in daytime? Of course we have scales for methods that we use on different illnesses like restless legs syndrome or sleepwalking. So, sleep sickness patient’s assessment is a very detailed process. First the patient is listened, probable sleep sicknesses is thought according to the patient’s complaints. Night survey and if needed day survey is applied. One thing that we need to take into the consideration is the possibility of patient’s having more than one sickness-and generally the patient has more than one sickness. We apply a sleep survey according to the patient’s sayings and it leads us to the diagnosis. A very important detail: Sleep survey isn’t standard, it varies according to the patient. So, the methodology of the patient who says that he/she wakes up frequently or snore and yells is different from the methodology of the patient who jumps in sleep.
“Sleep Sicknesses Spoils the Quality Of Life”
Prof. Dr. Karadeniz also utters these: “Everybody has been through this temporarily. For example when you sleep little at night, next day exhaust, tiredness, need for sleep, concentration impairment, tension, forgetfullness show up. In long term, sleep sickness patients can suffer from plenty of diseases. We are talking about diseases like hypertension, obeseness, heart diseases. There is no statistics in our country but we know from the U.S.A. One of the third most common reason in traffic accidents is sleep-disordered breathing and sleep apnoea. Because these people sleep their eyes open and aren’t aware of the fact that they are sleeping. Thus, there is a social dimension also. Of course we can talk about the psychological dimensions, sexual function disorders, tension that shows up depending the sleep sickness, anger even depression. It effects one’s social life as much as it’s private life.”
Karadeniz ends her speech mentioning sleep medically proceeded fastly in our country in parallel to with the world. “It is a pleasing news. The educations of the people who will expert on sleep sicknesses are being given at ‘Turkish Sleep Science Association’ It is being applied as it is in Europe. A doctor must be educated at the centers like Cerrahpasa Faculty of Medicine Sleep Disorders Unit before taking the related exam. Then, joins a course that includes theoretical and practical training. Finally, passing the sleep sicknesses exam and gets the certificate. Sleep survey is a very common application in our country. It seems well but we need to educate the doctors that apply this survey. There are plenty of sleep units in our country, almost in every hospital sleep surveys have been made. But the important thing about this survey is the assessment of it and them being the doctors who educated enough to be able to investigate the survey’s sufficiency.”
Translated by: İrem YAŞAR, Ezgi BITMIŞ
IU Press and Public Relations Department