The Atlanta Journal-Constitution
Having trouble sleeping? You’re not alone
70% of adults say they don’t get enough sleep at least once a month.
If you’re among the millions of Americans who’ve struggled to fall asleep at night, like Uri Chan, you’ve probably realized by now that sleeplessness can be more than a nuisance.
For most of the past month, Chan has awakened at 3 a.m. or some ungodly hour only to find it impossible to shut her mind off and fall asleep again.
Chan, a resident of Brookhaven, attributed the problem to anxiety, but she longed for a solution.
So when Say-so, an Atlanta conversational salon, recently announced that Atlanta native and sleep medicine specialist Dr. Scott Leibowitz would be their guest at an upcoming Zoom meeting, the 67-year-old travel agent saw it as a godsend.
Chan immediately signed on. So did Sal and Katherine Brill of Johns Creek, joining more than 30 others for the virtual gathering.
According to Dr. Leibowitz, some 70% of adults report not getting enough sleep at least one night a month and 11% report insufficient sleep every night. What’s more, 20% of the U.S. population suffers from excessive sleepiness for one reason or another.
Indeed sleep disorders are extremely common in these United States.
“Large epidemiological studies have found that 10% of the population suffer from chronic insomnia,” Leibowitz said.
And while he isn’t able to drill down to metro Atlanta, he said, it wouldn’t surprise him if the metro area and Georgia’s “sleep dysfunction aren’t on par with the rest of the country, which is to say, it’s fairly rampant.”
“If you look at the demographics of our city, as compared to other major metropolitan cities,
I would expect that we would compare equally,” Leibowitz said in an email exchange after the online meeting. “The only caveat to that would be looking at the average body mass index of those in Atlanta, as compared to other cities.”
Because obesity is a significant risk factor for obstructive sleep apnea, and Atlanta ranks 74th (out of 100) for overweight and obese adults in the most populated cities (of note, Augusta was ranked 4th), he said this would be the only predictor of prevalence of sleep disorders that might differentiate one city from another in this regard.
To get a better grasp of the problem, consider that an esti
mated 1 in 2 individuals in a general primary care office at any time has had at least a night of disrupted sleep in the past week, and it has been estimated 30% to 40% of adults report symptoms of insomnia at some point in the year.
Obstructive sleep apnea, the most common sleep-related breathing disorder, affects an estimated 20% of the U.S. adult population and it has been estimated that 70% of these individuals remain undiagnosed.
For years, Sal Brill, 80, was among the uncounted. He slept like a baby, albeit very, very loudly.
Even when his Army buddies and then his wife, Katherine, complained his snoring was keeping them awake, Brill greeted each day rested and feeling good.
Katherine Brill said her husband’s snoring was so bad, that she rarely got a wink, fearing he might stop breathing.
“I’d sit and count to 10,” she said.
Then six years ago during a routine check-up, Sal Brill’s internist suggested he see a cardiologist. That doctor suggested he see a sleep doctor.
After a couple of nights in a sleep clinic, Brill was diagnosed with obstructive sleep apnea and fitted with a Continuous Positive Airway Pressure machine, also known as a CPAP, a small air pump device attached to a face mask that fits over the nose and mouth to keep breathing passages open.
Among his patients, Leibowitz said the most common complaints he hears in order of frequency are snoring like Brill, prolonged middle of the night awakenings like Chan, daytime sleepiness and difficulty falling asleep.
Whatever the issue, it is the “waking up” that oftentimes leads to a prolonged awakening. If they didn’t wake up, they wouldn’t be awake worrying.
If you aren’t getting enough sleep, however, there is cause for concern, Leibowitz said. Insufficient sleep has not only been associated with metabolic dysfunction like diabetes and obesity but high blood pressure and overall cardiovascular risk, depression, anxiety, and cognitive problems.
“There are enormous economic implications of insufficient sleep, in terms of work productivity, tardiness and absenteeism as well as medical expenditures,” Leibowitz said.
Until the past few years, Leibowitz said that most doctors did not inquire about someone’s sleep unless the patient specifically complained because medical education was “entirely deficient” regarding sleep disorders.
“Primary doctors are extensively trained in the management of chronic illnesses like hypertension, diabetes, heart disease, but get little to no training in sleep disorders,” Leibowitz said.
And while it is still wholly deficient, he said it is getting a little better. “Sleep problems are becoming part of primary care physicians’ general intake of patients’ health similar to diet, exercise and smoking status.”
Asked for his best tips to get a good night’s sleep, Leibowitz said these are his top four:
■ Go to bed when you are sleepy. Contrary to popular belief, going later will almost always confer a better night’s sleep.
■ Try to maintain a consistent daily wake time throughout the week and weekend.
■ The old adage that the bed should be reserved for sleep and sex is an accurate one. If you watch TV in bed, the association with sleep is lost.
■ If you wake up in the middle of the night, give yourself 30 minutes to fall back to sleep. If you don’t, get out of bed and read until you get sleepy.
At the end of the Say-so Zoom meeting, Chan was determined to get on Leibowitz’s patient list. Meanwhile, at the Brill home, nights are quiet again, even when Sal opts not to use his CPAP machine. They say that’s thanks to Leibowitz.
“He seems to be fine now,” Katherine Brill said of her husband. “I’m sleeping easier because he’s sleeping easier.”