Sleep, Sleep Disturbances, and Public Health
By Professor Giora Pillar, MD, PhD
Recent years have shown how important sleep is. Its crucial regulatory function has been demonstrated in wide-ranging areas including: body temperature, glucose metabolism, blood pressure, hunger, body weight, immune system, cognitive function, and mental stability. With sleep deprivation or disturbed sleep, people are at higher risk for cardiovascular diseases, stroke, diabetes, obesity, cancer, accidents, depression and more. Thus, sleeping well, both quantitatively and qualitatively, is of great significance for public health!
As a researcher of the treatment, diagnosis and pathophysiology of sleep-disordered breathing, the two most common sleep disorders in my field are insomnia and obstructive sleep apnea (OSA). While patients with insomnia experience difficulties falling asleep and maintaining sleep, patients with OSA suffer from ineffective sleep. In both cases, the functions of sleep are not fulfilled and patients suffer from medical and mental complications.
The prevalence of insomnia in the general population is estimated between 10-20% and it is substantially more common in women. Insomnia in most cases results from stress, tension and anxiety which prevent people from sleeping well. Accordingly, the best treatment is maintaining good sleep hygiene, relaxation (such as cognitive behavioral therapy, biofeedback, neurofeedback, and mindfulness) and, when indicated, wisely using hypnotic medications.
The prevalence of OSA in the general population is estimated at 7-10% and it is substantially more common in men. The leading cause for OSA in the western world is obesity. When OSA and obesity are coupled together, the two factors form a vicious cycle (see Figure 1 from our group’s publication). By disrupting sleep and reducing the immune system function, my colleagues and I have recently shown that OSA is associated with increased risk of cancer (see Figure 2). When properly treating OSA, usually with continuous positive airway pressure or CPAP, many of the complications are minimized. Therefore, sleep is not a luxury but rather a necessity of life and we must diagnose and treat sleep disturbances to improve quality of life and reduce morbidity.
Photo and graphics courtesy of Professor Giora Pillar.
Professor Giora Pillar is the Head of the Pediatrics Department and the Sleep Clinic at Carmel Medical Center and Clalit Health Services in Haifa and also teaches at the Technion – Israel Institute of Technology, Faculty of Medicine. He was a Fulbright Postdoc fellow at Harvard University in 1998.
Graphic taken from Professor Pillar’s article: https://care.diabetesjournals.org/content/31/Supplement_2/S303
Graphic taken from Professor Pillar’s article: https://www.karger.com/Article/Abstract/486577