If asked “Are you sleeping every night?”, you’d most probably say “Yes”. But if asked, “Are you satisfied with your sleep?”, your likely answer is “No”. Unfortunately, that’s what the Philips Sleep Survey, conducted by the Nielsen Co. in December, found: 93% of Indians are sleep deprived, getting less than 8 hours of sleep per day; 87% think lack of sleep is affecting their health; 11% took leave from work because of it; 58% felt their job suffered, with 11% actually falling asleep at work.
Philips Healthcare plans to establish 130 sleep labs across the country this year. Most larger urban hospitals have sleep labs which can identify what causes the lack of shut-eye but people shy away from these labs because “the sleep study test is a little expensive and people don’t know what to expect from it. In fact many people don’t consider snoring as a disorder and hence seek no treatment for it,” says Manvir Bhatia, chairperson, sleep medicine, and senior consultant, department of neurology, Sir Ganga Ram Hospital, New Delhi. According to her, 5-6% of Indian males above 40 suffer from sleep apnoea, and the numbers for those who snore are higher.
— Seema Chowdhry
I always imagined a sleep lab to be something you see in a sci-fi movie—a closed pod, multiple monitors and wires that strap you to the pod. However, the sleep-study equipment that I was hooked to at the Neurology and Sleep Centre, Hauz Khas Enclave, New Delhi, fit in a laptop-sized bag.
There are usually two ways a sleep study can be conducted. You can opt to have the study conducted at your home or spend a night at a hospital in a sleep lab which has a well-defined area with monitoring stations attached.
For a trial, I was allowed to participate in an hour-long version—the Nap Test, which is not useful for patients with severe sleep-related disorders.
“Where a person wants his sleep study conducted depends on the person and on the doctor. If you are finicky about being able to sleep only in your bed, a technician can be sent to your home with the sleep-study apparatus. But if your symptoms are severe, it is best to check into a hospital for the night,” explains Dr Manvir Bhatia. She says she conducts about 25-30 sleep studies per month at three centres—her clinic at Hauz Khas Enclave, Sir Ganga Ram Hospital and Sama Nursing Home, all in New Delhi.
A sleep study is best conducted overnight, over 6-7 hours. “We usually conduct extensive interviews before where we ask the patient about their work schedule, personal history, family ailments, any mental health problems, etc. Based on these factors we decide whether a sleep study is best conducted at the hospital or at home,” says Dr Bhatia.
The Nap Test usually takes 45 minutes to 1 hour to prepare for any sleep study (short or long version) at a hospital or a centre. The technician has to fix as many as 13 electrodes on the body, starting with six on the face, two on the top of the head, one on either side of the neck, one near the waist, one on each leg below the knee, plus a sensor to measure breathing (a pipe is taped to the nostrils).
The points where the electrodes are stuck are first smeared with a sticky gel. The electrodes are kept in place by fixing a white plaster over them. Multicoloured wires attached to electrodes stuck on my body were connected to a 4-inch box apparatus strapped on to my chest. “In this study we are examining as many as 14 channels, including your brain activity, eye movements, muscle movements, heart rate and rhythm, blood oxygen levels, breathing patterns, but at home usually only seven channels are monitored,” Dr Bhatia informs me. “Cardio-respiratory activity and brain activity are not included in home-based sleep study.”
I was sure that with so many wires and a box strapped to my chest, it would be tough to get 40 winks at 4pm, but the technician assured me I could move around freely without worrying about the wires getting dislodged. Even if a wire gets dislodged, there is a technician at hand.
I was asked to lie on a bed and then hooked to a laptop which recorded the results. It took 10 minutes of restless shifting before I dozed off for about 20 minutes. Later, I was told that I shifted my entire body three times in those 20 minutes, and moved only my legs three times. My sleep study showed that I had reached a relaxed sleep state (there are three states and I managed to get to level two in 20 minutes), which was a good sign. “The air flow was good, oxygen saturation above 98%, heart rate regular, no snoring, hence, no blocked air passages,” explained Dr Bhatia, looking at the squiggles that indicated my sleep patterns— and gave me a clean bill of health.
The study is usually conducted once and costs Rs7,000-8,000. People who have breathing difficulties or excessive snoring while sleeping have to go in for an advanced study using CPAP (continuous positive airway pressure). It costs Rs12,000-15,000 if the device is used.
EYES WIDE OPEN
— Kavita Devgan
Doctors warn that lack of sleep affects quality of life and productivity drastically. “You can be drowsy during the day, think less clearly, your concentration span drops, and you may become irritable and angry at the smallest of provocations,” says Dr R.K. Mani, Artemis Health Institute, Gurgaon. “It may also lead to...decreased immunity, hormonal imbalances, colds, depression, diabetes, high blood pressure, obesity, strokes, heart disease, cancer and more.” Just as the potential problems are many, so are the causes of sleeplessness. “There are more than 70 types of sleep disorders,” says Dr Manvir Bhatia.
Click here to read about some common types of sleep disorders and how to treat them.