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Getting Quality Zzzs

Nancy Arcayna
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BRUCE ASATO / BASATO@STARADVERTISER.COM
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Libarios settles in for the night at Sleep Center Hawaii.
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Patient Niki Libarios eyes the sensors he will wear during a night of monitored sleeping at Sleep Center Hawaii's Pearl City office.
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Sleep technician Kim Patterson attaches the sensors to Libarios before he undergoes testing.

Niki Libarios, who is finishing his doctorate in education at the University of Hawaii-Manoa, was continually plagued by headaches, and work on his dissertation and studying for exams kept him up at night.

HOW MANY ZS DO WE NEED?

» Newborns: 12 to 18 hours
» Infants (3 to 11 months): 14 to 15 hours
» Toddlers (1 to 3 years): 12 to 14 hours
» Preschoolers (3 to 5 years): 11 to 13 hours
» School-age children: 10 to 11 hours
» Teens: 8.5 to 9.25 hours
» Adults: 7 to 9 hours

Source: National Sleep Foundation

His doctor suggested he visit Sleep Center Hawaii in Aiea for a thorough evaluation.

At the clinic, Libarios was hooked up to monitors that registered his breathing and sleep levels. A device connected to his throat measured his snoring, chest wires recorded data for an EKG, and other wires on his legs checked for restlessness. Then he settled in for a night’s sleep.

The results of the overnight tests indicated he had nothing worse than a mild case of insomnia. Libarios said it was a relief to find out that his sleeplessness wasn’t caused by more serious health problems.

"Comprehensive exams are done, so hopefully I’ll sleep a lot better now," he said.

Long hours of studying are not the only thing keeping folks up at night. With the Internet, e-mail, television and social media available 24/7 and the fast pace of modern life, many folks leave little time to get some shuteye.

SLEEP CLINICS IN HAWAII

» Pacific Sleep Tech (Aiea, Honolulu and Hilo): 486-1500
» Queen’s Sleep Center: 547-4396
» Sleep Center Hawaii (Pearl City): 456-7378
» The Sleep Lab: (Kaneohe): 234-0033
» Straub Health Services Sleep Disorders Center: 522-4448
» Tripler Army Medical Center Sleep Lab: 433-2778 or 433-6661
» Maui Chest Medicine (Kihei): 874-8774
» Maui Medical Group Sleep Center (Wailuku): 249-8080

(List might not be complete; check the phone book or search online for other clinics.)

Yet sleep is as important to good health as diet and exercise, according to Gabriele Barthlen, a neurologist and board-certified doctor of sleep medicine at the Aiea clinic. "Sleep is one of the pillars of health. People think that they can skimp on sleep to do more important things," she said.

Inadequate sleep affects immune system functions and growth hormones, and can lead people to fall into depression or engage in overeating, resulting in obesity, because they lack energy. Lack of sleep also has been implicated in a large number of traffic accidents.

A growing roster of sleep clinics has opened in Hawaii in recent years as sleep problems have gained more attention.

"Most research on health has focused on the two-thirds of our lives when we are awake, and attention to the third of the time during our lives spent asleep has been neglected. Researchers are now realizing how much of an impact sleep has on our health," said Michelle James, a psychologist at the center.

She said the sleep-deprived often have a harder time dealing with stress. "Fortunately, many of the effects of sleep deprivation improve or are reversible once the individual is able to sleep well again," she said.

COMMON SLEEP DISORDERS

» Sleep apnea: Symptoms can include snoring, excessive daytime sleepiness, fatigue, frequent wakening during the night, waking up with a headache and poor concentration and memory. Sleep apnea is associated with hypertension, obesity, cardiac difficulties, stroke and diabetes.

» Insomnia: Individuals with insomnia have difficulty falling asleep or staying asleep. Individuals with insomnia usually are aware of spending long periods of time in bed not sleeping, worrying or thinking about the day or feeling they can’t "turn their mind off." They also frequently begin "clock watching" to monitor whether they have been sleeping.

» Restless legs: A person who feels restlessness in the legs seeks relief by moving them. This often happens as they are trying to fall asleep.

» Bruxism (teeth grinding): Bruxism can contribute to headaches and is thought to be linked to stress.

Source: Michelle James, Sleep Center Hawaii

COMMON SLEEP problems include insomnia, when a person has trouble falling asleep or staying asleep; teeth grinding; and sleep apnea, whose symptoms include snoring, excessive sleepiness during the day, fatigue, frequent wakening during the night, and waking up with a headache.

Being overweight or obese is the most frequent cause of sleep apnea. Barthlen said Asians also are prone to the condition, perhaps because their smaller facial structures restrict airflow.

The average age of patients at Sleep Center Hawaii is between 25 and 35 years old. Many are in military service nearing retirement.

Tripler Army Medical Center opened its sleep lab last year. "Sleep medicine is an exploding field … ," said Maj. Sean Dooley, a doctor at Tripler.

"We wanted to provide care for our soldiers and veterans within our system. We hope to construct new beds and hire technicians to manage the beds seven days a week. We can’t come close to meeting the demand."

In the meantime, service members continue to be referred to sleep centers on the island.

"It’s not uncommon for soldiers coming back from deployment to experience insomnia and PTSD (post-traumatic stress disorder) symptoms. It’s our role to make sure that no disorder is interrupting their sleep at night," Dooley said.

Combat soldiers often must stay awake at night while on missions, even though their brains want to sleep. Chronic sleep deprivation can lead to irritability and difficulty concentrating, he said.

"Just flying to the mainland and experiencing jet lag can throw off the sleep cycle," Dooley said.

Snoring, a partner noticing that you are not breathing when sleeping or excessive daytime sleepiness are reasons to ask a doctor for an evaluation, he explained.

Patients referred to Sleep Center Hawaii may undergo overnight studies that monitor brain activity, eye movement, respiratory air flow and muscle effort, leg movement, blood-oxygen levels and body position. The data is fed into a computer while the patient sleeps, monitored by clinic technicians. The information is then reviewed and interpreted by a sleep specialist to determine the cause of the sleep disturbance. Treatment recommendations are then sent to the referring physician.

Dooley offered the following tips to avoid insomnia: avoid watching television and reading in bed; don’t drink caffeine after noon; make the bedroom a place for sleeping; avoid stimulating activities late at night; and try to get regular exercise earlier in the day.

"It’s best to maintain the same rise and bed times," he added. "Everyone needs seven hours of sleep on average in order to be a pleasant person."

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