Published: March 01, 2008 10:14 pm      

Life and Death and Sleep: National Sleep Awareness Week

Health Matters column

PALESTINE — Thomas was two weeks old when his mother went into the nursery and found him dead in his crib. His death was ruled to be Sudden Infant Death Syndrome. Could it be that Dr. Spock had it wrong? Perhaps. Could it be that Thomas would still be alive if his crib had been in his parents' bedroom instead of being isolated down the hall? Perhaps.

Tom, a robust, outwardly healthy, 39-year-old was courting death by a stroke or heart attack. Neither of these conditions killed him. He fell asleep in the wrong place at the wrong time.

Tommie Anne, a 48-year-old music also was courting death by a stroke or heart attack. She can, however, reasonably expect to live another 36 years or so.

It all has to do with sleep, an extraordinarily important component of daily living and long life. Adequate sleep is critical for physical growth and development, for learning, for short and long term memory maintenance, for sexual differentiation, and, of course, for physical rest and recovery. Any prolonged activity, behavior, or life style that interferes with good sleep hygiene can be just as dangerous as attempting to out run a speeding train at a railroad crossing.

So what is good sleep hygiene? The human organism needs about eight hours of sleep each night. It has been reported that 63 percent of adults in the US do not get the requisite eight hours. The clear majority of folks in this country is at risk for poor health, hazardous behavior, and suboptimal performance at home and at work.

The sleep experience is normally divided into five distinct periods or episodes over an eight hour span. In this dynamic process, there are five stages of sleep in each episode, more or less:

Stage I sleep is characterized as having a very active brain, easily aroused, and awareness of what caused the arousal.

Stage II sleep occupies the greatest amount of time during the night. The brain is still quit active allowing us to turn over, scratch, kick, slobber, vocalize, and so forth. Arousal is much more difficult, and normally the individual is not aware of what caused the arousal.

Stages III and IV are referred to as delta sleep, the stages where rest and recovery occurs. The brain is relatively quiet with great looping brain waves, characterized by an infusion of the growth hormones into the blood stream. It is difficult to arouse a person in delta sleep. These stages are most pronounced in infants, children, and adolescents, the period of greatest growth in life.

Dream or Rapid Eye Movement sleep is a fascinating sleep stage. It is characterized as a very active brain in a paralyzed body. Muscle paralysis, caused by the sex hormones, is probably a factor in preventing us from acting out our dreams. Since, in my case, paralysis is caused by testosterone, secondary sex characteristics like my beard, muscle architecture, and voice identify me as a male throughout life. REM periods increase during the night, generally at the expense of delta sleep. It has been well established that REM sleep is absolutely essential for learning as well as for short and long-term memory retention.

Biological anthropologists are fairly uniform in recommending that infants co-sleep with their parents. Perhaps this has to do with the continuum of sound, first experienced in the womb, that should be carried over into development after they are born. In my experience, SIDS is not a phenomenon found in noisy, well-lighted hospital nurseries!

Tom, a successful big-rig driver, had a couple of problems. His wife was sleeping in the guest bedroom because of his raucous snoring, his thrashing around in bed, and scary periods for her when he stopped breathing. Tom had been twice scheduled for sleep studies. He rescheduled the first one and totally ignored the second one.

In any event, Tom was on the interstate about an hour out from his terminal. He was cruising down the boring, open road at about 80 miles an hour when he dozed off. He died instantly, one of those 1,500-plus yearly fatalities caused by drowsy drivers. Oh, yes, they also cause 71,000 injuries at a cost of $12.5 billion a year.

Tommie Anne's physician encouraged her to have a sleep study after she complained of severe headaches each morning and a growing problem of staying awake in class. She was discovered to have obstructive sleep apnea and was successfully treated. For Tommie Anne, life goes on...

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For more information regarding the Sleep Disorder Center at Palestine Regional Rehabilitation Hospital, please call 903-731-5264.

Robert Weilacher, RRT, FAARC, was a pediatric and neonatal respiratory therapist for a number of years at Baylor Medical Center, Dallas. He opened the first sleep disorders center in Anderson County in January 1991 at Memorial Hospital, now Palestine Regional Rehabilitation Hospital.