2,000 suffer from sleep disorders in Marbella

Sleeping like a baby has become a distant memory for many.  Nearly 2,000 people arrive at Costa del Sol Hospital annually complaining of sleeping disorders. For them, the arms of Morpheus is an elusive ‘dream’, and in most cases that disorder has a name: apnoea.

‘Over 90 percent of the people we see in the Costa del Sol Hospital have breathing disorders during sleep’, respiratory physician José Joaquín Cebrián said. It is a problem that increases 10 percent every year according to figures, in fact, since the Hospital started its Sleep Unit seven years ago.

‘We started doing some 200 studies per year and in 2009 we made 870. We could do more, but our technical teams are a little short’, Cebrián says.

‘The clearest symptoms of this disease include snoring, but also other respiratory pauses during sleep, and mainly, the daytime sleepiness and fatigue are’, the expert explains. He adds that multiple factors lie behind the disease. However, if one were to produce an ID to identify these patients, being overweight would be the main feature.

It affects 4% of men and 2% of women and is defined as an airway obstruction that prevents one from maintaining a deep sleep. ‘The treatment is simple’, Cebrián says. ‘We most often prescribe sleeping with a machine called CEPAP.” Costa del Sol has installed 1500 CEPAP machines in patients’ homes.

Treating this illness is not a trivial matter: “It is unusual for a patient’s drowsiness to occur during periods of inactivity, but there is a severe form, in which one can even can fall asleep while driving’, the doctor says. ‘In fact, the risk of accidents among people who have this disease and are not in treatment is two to three times higher’, he concludes.

In the Carlos Haya Hospital Complex in Málaga, two units have coordinated treatment of sleep disturbances. The Neurophysiology Unit is responsible for determining the type and degree of neuronal disorders in patients through sleep studies. In 2009, nearly 900 people passed through the Sleep Unit of this department, which is part of the Civil Hospital’s Department of Maternal and Child Health. One fact that these studies have revealed is that these problems do not only affect the old. There are in fact many children who are affected.

The Unit for Management of Respiratory Diseases treats patients who suffer from sleep apnoea. ‘We serve about 3,400 people who cannot sleep because of apnoea, although we know that there are many patients who are undiagnosed’, Dr. Jose Luis de la Cruz Rios, head of the department, said. ‘The audible symptom is snoring, which in itself is not a disease, but it is dangerous if accompanied by respiratory arrest. The result is a bad dream and a break in the sleep cycle that harms the sufferer’s performance the next day, causing fatigue, irritability, social and labor problems, and can even cause depression’, the specialist said.

In addition to apnoea, many other causes lie behind insomnia. In the western world, one third of the population has trouble sleeping, and Málaga province is no exception. About 478,000 Malagueños have some type of sleep disturbance, to which must be added the 20,000 more who cannot sleep a wink at night due to the noise they endure in their homes. In total, for half a million people, every night is a living nightmare. This is 24% more than a decade ago, due to increased population.

Bad sleeping habits are winning the game in the big cities. Stress, poor diet, too much dinner before bedtime, alcohol and drugs, watching TV late all take time away from sleep. All these factors, which experts call ‘poor sleep hygiene’, adversely affect healthy people and can lead to other medical conditions, worsening the health of society as a whole.

‘Sleep is one of the great pillars of health, and we are not aware of how fragile the balance is’, Francisco Javier Puertas, president of the Spanish Society of Sleep (SES), said.

The International Classification of Sleep Disorders recognizes more than fifty diseases, which are divided into three main groups, says Dr. Henry Bauzano, Chief of Neurophysiology at Carlos Haya Hospital. The first major segment includes sufferers called ‘dyssomnias’. ‘This includes more common conditions such as insomnia, sleep apnoea, restless leg syndrome or narcolepsy’, Bauzano said.

The categories are not watertight, however, and problems may have a cascading effect, with one condition leading to others. ‘Sleep apnoea can lead to narcolepsy, hypersomnia, and on and on’, the expert said.

The most common ailment for sufferers is insomnia, according to Puertas. Some 10% of the population suffer from it, and it is considered chronic when a person needs more than 45 minutes to fall asleep three times a week and for more than three months. According to the National Statistics Institute (INE), 20% of the population claims to have trouble falling asleep, the percentage being higher among older people.

Dyssomnia results from external factors such as noise pollution, allergies, or ingestion of alcohol or drugs. It also results from internal factors,  commonly disorders in circadian rhythm, the normal cycle of sleeping and waking. The category also includes temporary disruptions, the best known of these being the transoceanic syndrome, commonly known as jet lag.

This category includes one more that can cause long term problems in circadian rhythms, leading to other physical, psychological and social issues: the enforced sleeplessness of night workers. ‘It is proven that many people working on night shifts, 25% of workers, have difficulty adapting to society as whole, and among them, there are increasing cases of divorce, traffic accidents, depression or gastrointestinal conditions’, Puertas stated.

Another category is parasomnias. These are less common disorders associated with medical or psychiatric processes. They are also the most spectacular. Confusional awakening, or sleepwalking, also known as sonambulation, occurs in 4% of pre-pubertal children. ‘Night terrors’ occur mainly in infants, who cry suddenly, sweat or hyperventilate, but without waking. Experts say these disorders occur during REM sleep. Muscles are not inhibited during deep sleep, and sufferers move as if they are in a dream-reality. Symptoms include nocturnal enuresis, or bed-wetting, and bruxism or clenching of teeth.

Humans spend one third of life sleeping, and failing to get proper rest can cause irreparable consequences. Growth hormones are released in REM sleep, De la Cruz Ríos says. ‘Why we need eight hours of sleep a day is a mystery, but the need for sleep is even stronger than hunger’, Bauzano says.