A 2016-2017 Canadian health measures survey found over 6% of respondents had been diagnosed with sleep apnea. Interestingly significant differences in the risk factors and symptoms of sleep apnea were noted between genders, shedding light on how diagnostic accuracy and timing can be improved with greater awareness of the differences between the sexes.
For instance, Canadian obstructive sleep apnea (OSA) male sufferers were more likely to be the loud “window rattling” snorers who can be heard through closed doors as opposed to female OSA sufferers. Canadian female OSA suffers are more likely to suffer from fatigue and insomnia as a result of their OSA and twice as likely to have an elevated BMI as compared to their male OSA counterparts.
Both male and female OSA sufferers reported higher rates of diabetes, hypertension, heart disease and mood disorders than non OSA sufferers, however, female OSA sufferers reported even higher rates of hypertension than their male OSA counterparts. These findings support previous studies that females with OSA are more likely to experience more subtle symptoms that could delay diagnosis, while at the same time suffer greater health consequences if left untreated.(4)
Another 2018 study evaluating over 21,000 Canadians, aged 6-79 years, found that as many as 42% of the adult respondents experienced insomnia symptoms with many suffering with sleep difficulties for well over a year. Older adults, women and those suffering from other health or quality of life setbacks seemed to be the most vulnerable.
Sleep and restfulness are universally associated with positive images of calm, serenity and peacefulness resulting in positive images of next day vitality, enthusiasm and happiness. On the contrary, the sleep deprived individual is typically depicted as one who is cranky, ill-tempered, moody, uninspired and lethargic. Science has provided neurobiological data to back up these images and associations. In fact , mounting evidence shows a strong association between sleep patterns and individual moods and behaviors.(6)
For instance, sleep (or lack thereof) can be a potential trigger or risk factor for both depression and anxiety disorders. Concurrent sleep deprivation can also reduce the overall effectiveness of treatment for mood disorders or increase the likelihood of relapse of symptoms if the sleep complaints are not addressed. Aside from its impact on mood, poor sleep patterns have also been linked with increased likelihood of an individual choosing to participate in risk behaviors ranging from gambling practices, substance abuse, and even reckless driving maneuvers.(7)
Thus mounting evidence suggests that sleep can represent both a personal and public health benefit when it comes to our moods and our actions.
The increase in sleep awareness has also resulted in an economic boom in nonprescription sleep aides and supplements. Most nonprescription sleep aides include one or a combination of the following:
All of the above substances have been associated with inducing sleep, however, in most cases the amount of the active ingredient is not regulated and therefore can vary from brand to brand or even pill to pill. Moreover, even in cases where the supplement does contain the substance as labeled, all of the aforementioned substances can be associated with side effects that can include daytime grogginess, mental slowness and even significant drug reactions. As a result, even greater caution is required when considering use in older individuals.
A recent report from the journal Drugs and Aging (8) based on risk-benefit analysis made the following recommendation for the use of common OTC sleep aides in the elderly population:
Therefore, any of these over-the-counter sleep aides or supplements should not be taken without discussing with your physician. In order to avoid the possible unwanted risk that comes from synthetic sleep supplements, increasing attention is now turning to natural sources of sleep-inducing substances. A small number of well-controlled studies have found sleep promoting benefits from the following foods:
The growing awareness of sleep health has also brought an expanding inventory of consumer tracking devices. Sleep tracking devices now include wearables, sleep apps, portable devices and even smart mattresses to provide real time feedback on the features of your sleep quality. Although research is slowly being reported regarding the agreement and correlation of these device outputs with the more conventional methods to monitor sleep, consumers should remain cautious about making any conclusions about the presence or absence of a sleep disorder based on these devices.
First of all, the reported studies that are well-controlled and independent are usually based on studying a very small number of individuals who are typically young, healthy and without any major sleep or medical conditions at the time of their enrollment in the study. Therefore, the results regarding the reliability of these devices cannot necessarily be applied to older individuals or those with medical or sleep conditions.
With that said, after factoring in the potential limitations that these devices carry, they can still be a useful tool if it helps the individual to be more in tune to their sleep habits and helps promote prioritization of sleep healthy behavior.
The three most common sleep disorders worldwide are insomnia (inability to fall asleep or stay asleep), chronic insufficient sleep, and sleep apnea (breathing difficulty while sleeping, often associated with snoring, gasping or choking while sleeping). Recognize that men and women, as well as adults and children can have different symptoms and consequences for their sleep loss.
Finally, take some time to self-reflect on your sleep habits and overall function and consider the potential link and impact between the two. This may require some self-experimentation in terms of tweaking the various facets to identify your ideal bedtime, wake time and bedroom environment components and how it may factor into your ability to function at “your best” the following day. Consider taking a step back to ponder the following questions:
• Do I routinely allow myself more or less than 7-9 hours of sleep opportunity?
• Do I feel more agitated and irritable with my family, friends, and workmates?
• Do I fall asleep in work meetings, at the dinner table or while watching a movie in the evening with family?
• Do I have more difficulty concentrating and focusing on routine tasks recently i.e., making change, doing simple arithmetic?
• Do I routinely snore loud enough for others to hear me in another room?
• Do I have a new diagnosis of high blood pressure or diabetes?
• Do I have uncontrolled high blood pressure or diabetes?
• Do I nod off while driving an average of once a month ?
If you said yes to any of the above questions, you might want to consider getting a formal sleep evaluation.
Dr. Charlene Gamaldo is the Medical Director of the Johns Hopkins Center for Sleep