Monday 20 November 2017

'My bedtime breathing was so bad, my wife thought I was a goner'

Arthur O'Hara is one of the 100,000 people in Ireland who suffer from a sleep disorder. Liz Kearney reports

Liz Kearney

Each morning, Arthur O'Hara woke up, ate breakfast, and got into his car to drive the short distance from his Leixlip home to his job at Garda headquarters in the Phoenix Park. He'd had the same routine for ages -- but a few years ago, something changed.

Fifty-seven-year-old Arthur, a self-confessed workaholic who'd always prided himself on being able to get by on just a few hours' sleep, would scarcely be out of his estate before being hit by an overwhelming urge to doze off again.

"The tiredness was indescribable. I felt as though I hadn't been asleep at all," he remembers. The exhaustion made him irritable and grouchy. "I couldn't concentrate. My energy levels totally evaporated."

It was his wife Rena who eventually forced him to see a doctor. She'd noticed that while asleep, Arthur would stop breathing altogether and then start again with an almighty jolt.

"That scared the living daylights out of her," says Arthur. "A couple of times she thought I was a goner."

Getting a good night's sleep is something most of us take for granted. But if you're one of the 100,000 people in Ireland with a sleep disorder, you can only dream about catching a few hours of decent shut-eye.

Arthur was eventually diagnosed with sleep apnoea, a common disorder in which the throat muscles relax to the point they close over completely, temporarily obstructing the airway. It can be caused by obesity, drinking or smoking, and it has been linked to strokes and heart problems.

In Arthur's case, his breathing was stopping up to 30 times an hour. It was no surprise that he was exhausted each morning -- he'd barely been asleep.

Sleep apnoea is just one of a range of disorders that can lead to a broken night's sleep. Others include narcolepsy, restless leg syndrome and insomnia, as well as rarer problems such as adult sleepwalking and REM sleep behaviour disorders (see panel).

At the sleep disorder unit at Dublin's Mater Private Hospital, Dr Catherine Crowe and her team of assistants monitor patients' sleeping patterns during an overnight stay at the clinic.

In her office at the Dublin hospital, Catherine pores over the graphs recorded from one young woman who complained of insomnia. Although the patient has woken up 18 times in this particular night, that's not unusual, explains Catherine.

Most of these periods of wakefulness would have been so short -- as she turned over in bed, for instance -- that they would hardly register, although there is one 20-minute window where the patient would have been aware of being awake.

The majority of Catherine's patients suffer, like Arthur, from sleep apnoea. And happily, there is a straightforward treatment for their troubles -- although it isn't a quick fix.

The Continuous Positive Airway Pressure, or CPAP, machine looks like a small clear plastic gas-mask, which fits over the mouth and nose and is joined by a tube to a small plug-in machine. The CPAP regulates the flow of air in and out of the mouth and effectively eliminates the problem.

For patients experiencing other sleep problems, treatment can be more complex. Cognitive behavioural therapy techniques -- which encourage patients to break patterns of anxiety or stress which might be inhibiting their ability to fall asleep -- are widely used and are particularly useful for dealing with chronic insomnia.

With other problems, sleeping pills are occasionally prescribed. "Sleeping tablets can be useful in extreme situations, their short-term use in a crisis situation is no problem," says Catherine.

"Long-term use probably isn't such a good idea, but neither is it good to sleep badly for years."

We all need a good seven hours' shut-eye; eight at the very most. Anything more is excessive, except for young people, who generally need nine hours until they're in their early twenties.

The biggest 'sleep sin' people commit is overindulging in lie-ins at the weekend. This leads to 'social jetlag' -- that familiar Sunday night feeling when you just can't seem to nod off.

"If you get up at 7am every weekday and then at 12 noon at the weekend, that's a five-hour time difference," Catherine points out.

"It's the same as going to New York. So if you've got up late, and then you go to bed at 12am on a Sunday, your body thinks, I'm not ready for sleep. The anchor point of the body clock is what time you get up at."

And yes, that body clock actually exists. It's a cluster of cells in the middle of your brain that controls the sleep/wakefulness cycle, your core body temperature and has a role in hormone regulation. Inherited differences in the make-up of this clock can account for our perception of ourselves as a night owl or as an early bird. We shouldn't fight this instinct, says Catherine.

"If you can, try and go with the flow. If you're a night-time person and you have to begin work at 8am each morning, that's going to be tough."

Today, Arthur O'Hara uses his CPAP machine every night and his quality of life has improved immeasurably. Now retired from the gardai, he runs his own web optimisation business and even finds time to be the chairman of the Irish Sleep Apnoea Trust, a workload he could never have managed in the past.

"I can sleep eight hours a night -- very few people, at my age, can do that. I'd urge anyone who thinks they may have a problem to get medical help -- there are a lot of people who are suffering unnecessarily."

Information and advice on sleep apnoea can be found at the Irish Sleep Apnoea Trust website

Irish Independent

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