If you can’t fall asleep or unable to get back to sleep after waking, it doesn’t take a sleep study to determine what the next day at work will be like. If insomnia is a consistent occurrence, going to Northern Westchester Hospital, Phelps Memorial or Westchester Medical Center and getting hooked up to series of electrodes for a study probably is a good place to start.
“Most of the people we see are people concerned that they have sleep apnea,” says Dr. Nicholas Rummo, medical director for The Center for Sleep Medicine at Northern Westchester Hospital. Commonly associated with snoring, it occurs as the airways become obstructed – thus causing a person to frequently awaken from sleep. Aside from the obvious exhaustion the next day will carry, diminished oxygen levels can cause heart problems, and that’s of even greater concern considering that sleep apnea is often associated with being overweight.
“If they are overweight, the best treatment is that they lose weight – by far,” says Dr. Rummo, who is also Northern Westchester’s director of Cardiopulmonary Services. Otherwise, sleep centers prescribe a respiratory device known as a CPAP.
“It’s a mask through which a stream of air is delivered, and the stream of air keeps the airwaves open,” he says.
In less technical terms, it’s almost akin to having your head sticking out of a car window – only the mask creates a tight seal over the nose and mouth. “Most people get used to it,” he says – especially in consideration of a good night’s sleep, he adds.
An alternative to the mask is to surgically remove tissue from the back of the throat. Similar to a tonsillectomy, it has about a 50-50 chance for success. Either way, he says, “It’s a very painful recovery for a few weeks.”
Other manifestations of insomnia include restless leg syndrome, where patients periodically kick, and REM behavior disorder in which people act out their dreams. Both can be treated with medication.
Apart from the physical causes of the condition are those that arise out the cognitive. “Often insomnia is secondary to other issues – most common being emotional issues such as anxiety or depression,” he says. In those cases, patients are referred to a psychiatrist for therapy and possible prescriptions to anti-anxiety medication or anti-depressants.
The Sleep Center also outsources, so to speak, the bad habits that people take to bed with them every night. “We try to get people to have habits that promote good sleep and avoid habits that interfere with good sleep,” he says of the approximately 1000 patients that enlist the hospital for help.
Caffeine and alcohol are both sleep disruptors as is eating late and eating erratically. Of course, it also helps to stay on a consistent sleep schedule and exercising during the day certainly helps promote a deeper sleep.
As for the sleeper who awakes with the starlight and stays that way until the sun shines, getting a full eight hours comes possibly with two strategies. The first few hours of sleep usually satisfies the physical aspect of the process. After that, the emotional issues percolate to point where a person’s REM state is disrupted.
Therefore, it’s recommended that this type of problem is addressed by quieting the mind by taking the time relax prior to getting into bed. If that chance is missed and sleep is interrupted, getting out of bed with the same prescription is a far better way to get back to sleep than just lying in bed worrying about it.
Of course, Ambien has partly taken away the negative connotation of the sleeping pill and with some success. “They can be effective for the most part when used appropriately,” he says, but once people begin to use sleep medicines it often is difficult to come off them, he adds.
Similarly, natural aids such as Melatonin vary in their ability to promote sleep but also succumb to a limitation as to the length of time they will actually be effective. Otherwise, in the end, stopping into a sleep center carries no risk, based on the daytime downtime and the possible outcome. “If there are day time consequences, that’s a reason to seek help,” concludes Dr. Rummo.
Rich Monetti interview of Dr. Nicholas Rummo