Laugh and the world laughs with you

[Editor's Note:James Murtagh has practiced 20 years as a Pulmonary Specialist at a major Southeast hospital. Over the past ten years he has become fascinated by the new specialty of Sleep Medicine. He is an author of an upcoming novel on huge human problems arising from sleep apnea.]

Anthony Burgess, author of "A Clockwork Orange," wrote that snorers sleep alone. Today, Burgess could only call the nightmare of sleepy drivers a "real horrorshow," and remind us that " every dogma has its day." Eye-popping studies released by the National Sleep foundation (NSF) this week shows sleep disorders contribute to dozens of major diseases. Half of Americans are so sleepy their work, their relationships and happiness are impaired. Sleep disorders have been found to cause more traffic accidents than alcohol. Sleep disorders are usually overlooked, with devastating consequences. Sleep disorders are like the elephant in the middle of medical living room, ignored, but huge, and not going away anytime soon.

NSF designated March 28 through April 3 as the eighth annual national sleep awareness week. As we prepare to wind our clocks forward for daylight savings on April 3, it is time for patients, doctors and lawmakers to take stock. Neither patients nor doctors can now ignore the sleeping elephant.

Is it an exaggeration to say our society faces a crisis in sleep disorders? The father of modern sleep medicine, Dr. William Dement writes: "Sleep disorders ..have not been adequately addressed by the medical profession; .. the absence of awareness of these problems relating to sleep is so pervasive and the consequences are potentially so dire as to constitute a national emergency". Richard L. Gelula, NSF's chief executive officer states that " sleepiness that permeates our society has serious consequences, and Americans' poor sleep is creating a public health and safety crisis in need of immediate attention,"

Dement links many of national major disasters, including the Exxon Valdez and Challenger can be traced to sleep disorders. Maybe "Mothers against drunk driving" need to change their focus to "Mothers against drunk and sleepy driving." If any disease shows that no man is an island, sleep disorders surely do. The average sleep-apnea-induced truck disaster kills 4.2 persons. Friends cannot allow friends to drive sleepy.

Consider: Sleep apnea is just one of 88 recognized sleep disorders affecting persons of all age groups. Sleep disorders are major, reversible and unrecognized cause of mortality and morbidity:
- More than 40 Million Americans suffer with sleep disorders
- More than 95% of sleep patients are not treated
- Almost all sleep disorders can be treated, with immensely improved quality of life, productivity and life expectancy
- Millions are too sleepy even to have satisfying sex.
- Proper treatment of sleep disorders can result in improved happiness, improved sex life, and loss of weight, and overall improved efficiency and energy.
- Minorities, the poor, the chronically ill, the unemployed and the elderly are at special risk.
- Direct medical costs of sleep disorders account for more than 30 Billion dollars.
- Lost productivity of sleep deprivation costs $50 to 100 billion
- Sleep Apnea is a major cause of many common conditions, such as hypertension, stroke and sudden death.

- Sleep Apnea can be rapidly treated with a simple medical device called CPAP (continuous, positive airway pressure). This device is cheap and now relatively easy to use under proper medical supervision.

- Drowsiness is a major threat to military readiness. DoD has made sleep research a top priority, and has allocated more than $100 million this year to study military aspects of sleep. Research suggests enhanced vigilance will lead to a superior warrior.

Anthony Burgess also wrote, "I didn't think; I experimented." Sleep research is still in its infancy, and vast new research into this undiscovered country needs to be undertaken. Discovery is the answer to the questions that burden the millions of sleepless Americans. Internationally, the surface of the sleep disorder question is just being scratched.

Overweight men are most likely to have sleep apnea, but no one is immune. Genetic factors are being teased out. Any person with a neck larger than 17, such as pro football linebackers or summa wrestler, or any average worker, may be at risk. Sleep disorders are a special difficulty for soldiers. Readjustment on return from duty can also cause sleep difficulties. More facts are being uncovered every day.

Some good news? Treatment of sleep disorders actually saves money. The overall health costs of a patient suffering from sleep disorders can be cut in half by effective treatment of the sleep disorders. Major studies show the savings in heart medications, blood pressure medications, anti-depressants etc more than pays for the cost of treating sleep. The nation can not afford to avoid treating sleep problems.

What can you do? There are seven simple questions your can assess your risk of sleep disorder. Take the simple test at http://www.stanford.edu/~dement/epworth.html. What could be a better use of a few minutes of your time? These few questions can tell you if you need attention from a sleep specialist.

"We are such stuff/ As dreams are made on, and our little life/ Is rounded with a sleep." Shakespeare wrote. How true! As you wind your clock forward, take care to avoid the Clockwork Orange horrorshow of sleep deprivation. Take the the simple screening test. The life you save may be your own, or it may be a loved one.