Friday, March 30, 2007

Drowsy Driving

According to the National Sleep Foundation, drowsy driving causes over 100,000 motor vehicle accidents, 71,000 injuries, and 1550 deaths each year. Common causes of drowsy driving include chronic sleep deprivation and untreated sleep disorders, such as obstructive sleep apnea.

A commercial driver’s extended hours of operation can create a scenario of continuous sleep deprivation. Difficulties in adjusting to varying shifts and rotating work schedules can compound the problem. The average adult needs 7 to 9 hours of sleep each day, and it is important to allow for sufficient sleep time. For those who have trouble adjusting to unusual work hours or rotating shifts, medication and/or bright light therapy are sometimes helpful.

Obstructive sleep apnea is present in 2-4% of the middle-aged population. It is more common in commercial drivers due to the high rate of obesity in this population. Obstructive sleep apnea is a disorder in which apneas (breathing pauses) occur during sleep. It is normal for the tissues of the upper airway to be somewhat collapsible during sleep, but in obstructive sleep apnea this tendency is exaggerated. Common symptoms of obstructive sleep apnea include loud snoring, daytime sleepiness, memory/concentration difficulties, and erectile dysfunction. The most common treatment for obstructive sleep apnea is continuous positive airway pressure (CPAP), in which pressurized air is delivered through a nasal mask to the upper airways. The pressurized air acts as a pneumatic splint for the upper airways. Other treatments for obstructive sleep apnea include dental appliances and ENT surgery.

Driving while sleepy is a serious problem, especially for commercial drivers. Any commercial driver with snoring or daytime sleepiness should be evaluated by a sleep specialist to ensure their, and the public’s, safety while driving.

Thursday, March 29, 2007

Why do we Sleep?

Sleep is not an optional enterprise. All mammals do it. So do birds, reptiles, and even fruit flies. Rats deprived of sleep apparently die faster than those deprived of food. Sleep deprivation is a ruthlessly effective means of torture, as the new movie The Lives of Others shows in a stomach-turning scene. Yet the bedrock question—what purpose does sleep serve for us and the rest of the animal kingdom—remains oddly unsettled.

no one knows exactly what the underlying need is.

This Slate article discusses the theory that sleep plays a role in memory consolidation.

Ambien is going Generic Soon

Patients suffering from insomnia may soon sleep better for less thanks to the pending expiration of patents on a number of widely used prescription drugs. This year alone, 10 brand-name medications with revenue exceeding $8.1 billion are expected to lose patent exclusivity, including the widely prescribed sleep medication Ambien (zolpidem tartrate).
Ambien CR is being pushed due to the impending patent expiration of Ambien. Ambien works great for patients who have trouble falling asleep at the beginning of the night, but Ambien CR is better for patients with middle-of-the-night awakenings.

Sunday, March 11, 2007

Separate Bedrooms

The New York Times reports that many couples sleep in separate bedrooms, often due to either snoring or restless sleep:
According to the National Sleep Foundation in Washington, 75 percent of adults frequently either wake in the night or snore — and many have taken to separate beds just for those reasons. In a report issued Tuesday, the foundation found that more than half the women surveyed, ages 18 to 64, said they slept well only a few nights a week; 43 percent believed their lack of sleep interfered with the next day’s activities.
Stephanie Coontz, director of public education for the Council of Contemporary Families in Chicago, said many couples she interviewed were “confident enough that they have a nice marriage, but they don’t particularly like sleeping in the same room.”
“I don’t think it says anything about their sex lives,” Ms. Coontz said.

Saturday, March 03, 2007

New Sleep Medicine Board Examinations

It's time to register for the sleep medicine examinations. Pretty much everyone with sleep experience is elgible during the "grandfathering" period. For internists/pulmonologists, you can find out more info here. The early registration period is March 1 to May 1 2007. Here is the site for psychiatrists/neurologists. Here is the site for ENT physicians. This is the site for pediatricians.


Family practitioners are out of luck for now; their board is not yet sponsoring the new examination.
The cost of the exam for those whose primary board is the American Board of Internal Medicine is $1575. The application was very easy- took me about 2 minutes online, and it will take me about another minute to fax my sleep board certification certificate (from the old certifying organization) to the American Board of Internal Medicine.
The American Academy of Sleep Medicine site has frequent updates about the board exams.