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Dr. Michael J. Breus

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The Sleep Problems You May Not Know You Have

Posted: 08/11/11 09:28 AM ET

Unfortunately, this news makes a lot of sense to me: Sleep problems are extremely common, yet they go dramatically under-reported by patients and under-diagnosed by physicians. In addition, people with sleep problems are significantly more likely to require health-care treatment, including hospitalization, according to findings from an analysis of sleep data from the National Health and Nutrition Examination Survey (NHANES), a national survey that is conducted annually and covers a range of health and nutrition topics.

The data used in this recent analysis represents the first time the survey has included questions specifically addressing sleep. The results shed important light on just how common problems with sleep are -- and just how many are going undiagnosed and untreated.

Slightly more than 2,000 men and women participated in the sleep portion of the survey. The respondents had an average age of 46, and they all rated their own health as either "excellent," "good" or "very good." Among this group, nearly everyone -- 99 percent -- reported at least one sleep complaint. And many people reported multiple difficulties: the average number of sleep complaints per respondent was 4.2. The survey analysis also revealed:


  • 54 percent of respondents don't feel they are getting enough sleep

  • 45 percent said they snore

  • 45 percent suffer from excessive daytime sleepiness

  • 37 percent have trouble falling asleep

  • 12 percent experience some form of gasping or apnea while sleeping


Here's where the numbers get even more troubling. Of those 99 percent who responded that they struggled with a sleep problem, only 24 percent had told their doctors about their difficulty with sleep. This leads directly to the next problem revealed by this survey: sleep problems are dramatically under-diagnosed.  Researchers found that:

  • 1 percent of respondents had been diagnosed with insomnia, yet 37 percent had possible insomnia

  • 4.6 percent had received a sleep apnea diagnosis, but 33 percent had possible sleep apnea


We know that living with a sleep disorder can have serious consequences for your health. So it's not surprising that the survey analysis also found that people with sleep problems were significantly more likely to require a doctor's visit of some type than those who slept without difficulty. Among those with sleep problems:

  • 85 percent made some type of medical visit in the past year, compared to 59 percent of those without sleep complaints

  • 16 percent were hospitalized in the past year, compared to 8 percent of problem-free sleepers

  • 20 percent required at least one mental health checkup, compared to 5 percent of those without sleep problems

  • 14 percent missed at least six or more days of work, compared to 7 percent of those who slept without difficulty

  • Those who slept fewer than five hours or more than nine hours had the highest rates of reliance on health care.

  • People with sleep problems were more likely to suffer from an array of chronic diseases, including cancer, cardiovascular problems, depression and diabetes.


These numbers are pretty staggering. For health-care professionals, the message is clear: Make sleep a priority! Assessing sleep habits -- and looking for possible problems with sleep -- should be as essential to a patient's exam as measuring blood pressure. I know there are many health providers who already give sleep issues the attention they deserve. With so many sleep disorders going undiagnosed, however, it's clear that sleep is often getting left off the examination table.

The responsibility belongs not just to health care professionals. Your health -- and your sleep -- is in your hands. Here are some steps you can take to make sure your sleep is getting the attention it deserves:

Don't ignore the snore. The first step in protecting and improving the quality of your sleep is to be attentive to your symptoms. Snoring, daytime tiredness, fatigue, irritability, lack of focus: these are all signs of sleep deficiencies that are often brushed aside.

Talk to your doctor. This one is a no-brainer. If you've noticed any signs or symptoms of disordered sleep, take your concerns to your physician. We all must be our own biggest health advocate. If you feel your sleep concerns are not being taken seriously, be persistent and, if necessary, seek out a health care provider who will.

Commit to a sleep routine. Sleep is a critical factor in your mental and physical health, along with diet and exercise. Create a sleep schedule that you can stick to -- and that allows you to sleep 6-8 hours per night.

Kids count, too. Sleep problems are not exclusive to adults. Sleep difficulties can start even in very young children -- and so can the consequences to their health. Helping your children develop strong sleep habits will help protect their health now and in the long-term.

Doctors and patients: let's get the sleep conversation started.

Sweet Dreams,

Michael J. Breus, PhD 
The Sleep Doctor™ 
www.thesleepdoctor.com


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