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Dismissed sleep struggles result in long-term symptoms

Thomas Edison dismissed sleep as a colossal waste of time, and it turns out some men still agree. Yet recent research shows that not getting your Z’s means far more than just being grouchy or scattered during the day.

Obstructive sleep apnea—the cause of repetitive pauses in breathing during sleep, which affects men more commonly than women—can increase the risk of weight gain, cardiovascular disease, diabetes, stroke and other serious health problems.

“So the stakes really are very high,” says Kenneth Plotkin M.D., founder and owner of Sleep Insights Medical Services, which operates sleep centers in Rochester, Buffalo, Syracuse and elsewhere upstate.

Treatment coupled with medical guidance has a very high success rate, which most people do not realize, he says.

Even so, some men minimize their sleep struggles, which can range from insomnia to restless legs syndrome, and live with symptoms for years.

“I think we tend not to go to doctors as often,” says Robert Israel M.D., medical director of the Unity Sleep Disorders Center. “We often have to be prodded …, and I think women are more attuned to their bodies, their senses, their emotions, and are more likely to seek help sooner than a man might. I hate to make generalizations, but I think that’s my observation.”

He adds: “We often see men motivated because their wives or girlfriends kind of mandated that they get this checked out, and women tend to come here on their own more.”

Bravado also prevents men from seeking help.

“Obviously, there’s a certain machismo associated with sleeplessness,” says Donald Greenblatt M.D., director of the Strong Sleep Disorders Center. “You don’t hear men bragging about how much sleep they got.”

Israel agrees: “I think it’s the attitude of the male species: We think we’re more in control and we don’t necessarily need as much sleep, (though) I think that’s a generalization. I’m not sure that’s always true in every man.”

Exactly how much sleep men should get depends on what they need to be active and functioning the next day, Greenblatt says. Albert Einstein supposedly slept 10 to 12 hours a night, while Edison hit the sack for no more than four.

“It’s the same Gaussian—the same bell-shaped—curve that affects everything in our life, where most men end up sleeping between seven and nine hours,” Greenblatt says. “But there are short sleepers and there are long sleepers.

“So if you wake up in the morning without an alarm clock, if you’re not sleepy during the day, if you’re not dozing in meetings, if you’re not losing attention in boring situations, then you’re getting the right amount of sleep for you,” he says.

Recent research suggests that women actually need more sleep than men.

“With ambulatory monitoring and the ease of drawing blood samples now for melatonin and cortisol and doing body temperature, it’s becoming apparent that women have a different … daily body rhythm—circadian rhythm we call it—and that actually women want to get to bed earlier and get up earlier,” Greenblatt says.

The sleep disparity between genders does not rise to the level of an owl-versus-lark scenario, but it often means women are snoozing 15 to 20 minutes more per night, Greenblatt says. Women’s tendency to multitask may trigger the need for more sleep.

“(That) may be part of an explanation as to why women have a longer lifespan than men, because they are getting more restorative sleep,” Greenblatt adds.

Given the sleep difficulties many women encounter during menopause, men “have a little easier row to hoe, because they don’t have quite the same change in their hormone levels during the course of adulthood, although some (men) … do develop low testosterone levels,” Plotkin says.

Studies in which participants endured multiple sleep disturbances that involved horn-blowing or being shaken awake have shown that being woken several times during the night can make people moodier.

“I think this is something we’re all pretty aware of,” Israel says. “But it will also affect the way your insulin works in your body. You’ll become insulin-resistant after even a week of interrupted sleep.”

Weight gain often follows.

Sleep also affects immunity, Israel says. Studies have shown that sleep-deprived individuals who were immunized against influenza did not get the antibody response that the well-rested experienced.

“And so that is something we’ve become aware of just in the last decade,” Israel says.

Groundbreaking research at the University of Rochester Medical Center’s Center for Translational Neuromedicine suggests that sleep also may sweep away toxins responsible for Alzheimer’s disease and other neurological disorders.

Published in the October issue of Science, the study revealed that the brain’s waste-removal workings, dubbed the glymphatic system, are highly active during sleep and operate separately from the lymphatic system’s cellular-cleansing functions. The researchers also observed that the brain’s cells shrink during sleep, permitting waste to be flushed away more effectively.

The study, done on mice, showed that the amount of energy consumed by the brain does not markedly decline during sleep, suggesting that the glymphatic system is hard at work during slumber.

The study, which was supported by the National Institute of Neurological Disorders and Stroke and had co-authors at universities other than UR, holds promise for Alzheimer’s treatment because of the possibility that medical professionals could someday learn how to stimulate or boost the clearing out of toxic proteins in the brain that can lead to the disease.

Sheila Livadas is a Rochester-area freelance writer.

2/7/14 (c) 2014 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or email rbj@rbj.net.

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