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What is sleep medicine? Role of Sleep Physicians in clinical practice

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Australian Polyclinic Breathing and Sleep Centre is in CCA Phase 5, DHA, Lahore. We perform overnight oximetry and sleep studies (polysomnogram) along with different breathing tests.

Sleep medicine is sub-speciality of medicine which deals with different types of sleep related disorders. Sleep physicians undertake further training after they obtained the fellowship in pulmonology, general medicine, neurology, or ENT usually. Sleep medicine is usually combined with pulmonology given there is a lot of overlap with breathing disorders.

What is included in sleep medicine?

  1. Snoring
  2. Obstructive sleep apnoea (OSA)
  3. Central sleep apnoea
  4. Circadian sleep disorders, including shift work and non-24-hour sleep-wake rhythm
  5. Hypersomnia (increased sleepiness)
  6. Insomnia (difficulty falling asleep)
  7. Narcolepsy
  8. Night-time leg cramps
  9. Nightmare disorder
  10. Parasomnias
  11. REM sleep behaviour disorder
  12. Restless legs syndrome
  13. Sleep terrors
  14. Sleepwalking (somnambulism)
  15. Bruxism (teeth grinding)

Snoring is very common problem which affects up to 40% of population. It may or may not be associated with sleep apnoea.

Sleep Apnoea:

Patients with sleep apnoea stops their breathing during sleep frequently leading to reduction in oxygen saturation, hyperactive state during sleep and increased sleepiness and tiredness during the day.

It is of two main types, obstructive and restrictive. In obstructive sleep apnoea (OSA), patients are usually obese, and they stop their breathing as the throat closes during sleep. In central sleep apnoea, issue lies in their brain which won’t send a signal to breathe when patients are asleep.

OSA is one of the most common sleep disorders which affect up to 10-15% population. It is associated with increased risk of hypertension, diabetes, heart disease and strokes. Patientswith loud snoring and choking during sleep and daytime increased sleepiness should be checked by sleep physicians and may need sleep study depending upon their symptoms.

Circadian rhythm issues:

There is a biological clock in our brain which measure the sleep-wake cycle very precisely. There are many factors which affect its functioning. People may suffer from issues regarding their sleep and awake time. It is common in shift workers and youth, if they spend too much time on social media, delaying their sleep.

Insomnia:

It is a condition in which a person finds difficulty falling or maintaining sleep.

Narcolepsy:

Patients with narcolepsy suffer from sudden onset of sleep without warning. They may fall to ground if they were standing at that time and increase the risk of physical and occupational injuries.

Night cramps:

Night cramps are not uncommon problem affecting women more and they find difficult to sleep due to cramps.

Restless leg syndrome and periodic leg movement disorder:

It is a condition in which patients find great urge to move their legs when they go to bed for sleep and during sleep. It affects not only their sleep but also of their partners.

There are many other rare sleep disorders which presents to either sleep physicians, or neurologists.

Sleep study or polysomnography:

It is a common test performed in patients with sleep issues. It measures their sleep efficiency, effects on their breathing and heart and leg movements. It can be done in the lab or at home.

CPAP/BiPAP:

This is a common therapy used in patients with sleep apnoea. Positive airway pressure is provided by a machine which is attached to nose or/and mouth of the patients whilst they are asleep. It prevents their airway collapsing and can provide an artificial breath too if required.

If you or your spouse or partner suffers from any sleep related issues, you should consult us or any other sleep physician for proper diagnosis and management of these disorders, to reduce the risk of heart attacks and stroke.

Australian Polyclinic,

CCA Phase 5 DHA, Lahore

0311 057 3333

Dr G Sarwar Chaudhry

MBBS (King Edward Medical College)

Fellow Royal Australasian College of Physicians (FRACP Australia)

Fellow American College of Chest Physicians (FCCP)

Conjoint Lecturer, University of Newcastle, NSW, Australia

Consultant Pulmonologist and Sleep Physician

Consultant General Physician www.australianpolyclinic.com

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