Why Do We Sleep?

sleeping boyIn the field of sleep medicine one would always ask “Why do we sleep?” And “If we don’t sleep, what would happen?” Well, we don’t have the answer to the first question yet, although there is a lot of research trying to find the answer. Regarding the second question personal experience tells us that if we don’t sleep one night, we suffer the consequences the next day; one feels sleepy, fatigued, irritable, tired, unmotivated, etc. Each one of us can generate a long list of symptoms that we are all familiar with. So why do we feel that way or why do we sleep so we can avoid the symptoms of sleep deprivation?

Research on rodents has shown that if rats are forced to stay awake long enough they will eventually die, usually in a matter of weeks. The same fatal ending does not happen to humans because the human brain will manage to get brief periods of sleep despite attempted continuous wakefulness. This observation clearly tells us that sleep is very important to our health. Many theories were put forth to explain the above phenomenon including: the need for restoration, adaptation, growth, memory? But the simple answer is we just don’t know exactly why we need to sleep.

Like every other field in medicine there is a limit to what we know and we continue to study sleep hoping that one day we will have the answer. Meanwhile it is good to keep in mind what Thomas Dekker said: “Sleep is the golden chain that binds health and our bodies together”.

A Trip to A Sleep Specialist Can Save Your Life

an apple a dayAs with any typical day for a sleep clinic, a patient was referred to me to evaluate her for insomnia. After my extensive evaluation of her, I listened to her carotid arteries and heard bruit. “Bruit” is a noisy blood flow suggestive of narrowing of an artery. I asked her if her carotid artery was known to be narrowed or “clogged up”. She said, “No.” So I urged her to make an appointment with her primary care physician right away for further evaluation. He ordered an ultrasound of the carotid arteries which also suggested that she has carotid artery stenosis (which means narrow blood vessel). An angiogram was performed later, being the ultimate test for the assessment of this condition. The angiogram confirmed the presence of severe Carotid Artery Stenosis. The standard treatment for severe stenosis is surgery.

So this patient who went to see a sleep doctor ended up having carotid surgery. She went ahead with the surgery and afterwards called to thank me for making the diagnosis before she had  symptoms or complications from Carotid Artery Stenosis. The initial symptom could have led to a transient ischemic attack or stroke. I have not seen her in a long time because her insomnia did not require further intervention. But her trip to see me saved her from a possible disabling stroke or even death.

I learned a lot from this event. One lesson in particular is that a physician should look out for the health of his or her patient even if it is something unrelated to one’s specialty.