Dr. Zsuzsanna Vida, one of Hungary’s best-known somnologists, talks to the Budapest Business Journal about sleep disorders and its treatment.
BBJ: What are the most common forms of sleep disturbance and their causes?
Zs.V.: Talking about sleep disturbance, usually both the doctor and the patient are thinking about insomnia. In reality, we can talk about more symptoms and illnesses behind them. Behind sleep disturbance there is usually stress, burdening events, irregular sleeping habits, and a changing work schedule. It can be the follow-up symptom to illnesses (psychiatric, neurological, etc.), and medication can cause it as well. The group of primary sleeping illnesses is especially important, if sleep disturbance is caused by the body’s ill operation during sleep. One of the most well-known ones is sleep apnea, with the main symptoms, such as snoring, mostly disturbing the relaxation of the bedmate. Sleep-related movement irregularities must also be mentioned, especially restless legs syndrome (prevalent in 5-15% of cases).
You should seek professional help if insomnia is present more than four days a week, causing significant disturbances to daytime activities (weariness, sleepiness, worsening mental performance). Also seek help when the time taken to fall asleep reaches 30 minutes (onset insomnia, found in 20% of cases), if sleep is interrupted by at least three conscious awakenings (maintenance insomnia, 60-70%), or for awakening insomnia, when you wake at least an hour before usual (10%).
BBJ: Are there warning signs before the onset of sleep disorders?
Zs.V.: There is nobody who has never slept poorly at least a few times during his or her lifetime, because of stress, exams, or other issues. However, among a large portion of the population, this occurs regularly. Sleep disturbance (insomnia) affects one-third of the population, even by the most careful estimates (some studies have found 65-66% are affected).
BBJ: What are the most common misconceptions?
Zs.V.: Everybody knows that too little sleep leads to weariness or exhaustion, but oversleeping and the need for too much sleep generally fails to sound an alarm. However, the ability to “sleep anytime, anywhere” is not a sign of physical and mental health. Sleepiness, weariness during the day, and need for more than eight hours of sleep indicates a lack of quality sleep. The reason is often a sleep disorder, in most cases sleep apnea. This illness and the accompanying loud snoring does not only ruin the sleep quality and relaxation of the sleeping partner, but can be the cause of several, possibly life-threatening issues: increasing the likelihood of hypertonia, diabetes, preventing weight loss, weakening the immune system, and increasing the risk of stroke and heart attacks.
We tend to blame sleep issues on everyday stress, and ignore them. Those affected usually try homemade remedies and then turn to the easiest solution: sleeping pills. They only seek help if their problem is longstanding, and they have tried a number of medications, are exhausted and want immediate solutions.
However, the basic principle for treating sleep disturbances is to seek and treat the source of the problem. This often involves cardiological, endocrinological, exams and the like after the detailed recording of the anamnesis and sleep laboratory or home sleep exams.
BBJ: What long-term solutions would you suggest?
Zs.V.: For every symptom related to sleep, the primary task is finding the cause and treating it. The examination is undertaken by a somnology expert, who refers the patient towards another expert if needed. If the main symptom is snoring, the examination has to start towards sleep apnea, with sleep diagnosis mandatory in this case. The diagnosis can be done in the patient’s own home, with mobile equipment. The data collected through the night is evaluated by the somnologist, who proposes a treatment. Those who receive a diagnosis of sleep apnea will need equipment facilitating breathing, a CPAP machine, which can successfully treat symptoms.