2012-07-19 / Other News

Need To Sleep On It? Call The Doc!

By Jonathan Gies

Dr. Mujibur Majumder with some of his staff Dr. Mujibur Majumder with some of his staff If you’re wondering why you spend night after night tossing and turning, or why you wake up in the morning feeling like you haven’t slept a wink, there are plenty of possible explanations.

Eighty-six of them, to be exact.

That’s the number of officially recognized sleep disorders out there. And it’s Dr. Mujibur Majumder’s job to figure out which one of those 86 is keeping you awake at night.

Majumder runs the Metropolitan Center for Sleep Medicine, located at St. Jude Medical Center at 94-13 Flatlands Avenue. A specialist in both sleeping and respiratory disorders, he said that roughly 40 million people in the U.S. are not getting their recommended seven to eight hours of sleep a night— roughly 7.5% of the population.

That’s a lot of tired people.

“Almost everyone, at one time or another, goes through some kind of sleep disorder,” Dr. Majumder said, adding that many people have no idea how lack of shuteye takes a toll on the body. “It’s a major public health problem.”

One of four comfy bedrooms where patients are monitored One of four comfy bedrooms where patients are monitored Indeed, as many are surprised to learn, sleeping problems are strongly linked to some of the most serious health issues, including high blood pressure, heart disease, diabetes, and stroke.

“Sleep is a vital part of normal physiology,” Dr. Majumder said. “There are many hormones secreted in the body during sleep, and a lack of sleep causes chemical imbalances in the brain.”

This is why many sleep-deprived people suffer from concentration problems, fuzzy memory, and depression. A lowered libido can also be a result of these imbalances. Even children are prone to suffer from depression due to lack of sleep, compounding other conditions they may already be dealing with, such as Attention Deficit Disorder.

“Many patients come to us for excessive sleepiness during the day, or lack of sleep at night,” Majumder said. “Fortunately, there are many treatment options.”

Out of 86 disorders — which encompasses everything from insomnia to bedwetting to sleepwalking — the most common is apnea, a condition which causes difficulty breathing during the night. The minute an affected person falls asleep, and their air passage relaxes, the upper airway is partially blocked by either their tongue or their soft palette.

Apnea symptoms range widely — some people may simply experience shallow breathing, while others suffering from periods where breathing stops altogether.

Along with other factors, such as chronic nasal or sinus congestion, apnea is one of the reasons many people snore. Funny as the sound may be (unless you’re the person who has to sleep next to it), snoring is actually an indicator of a serious problem. Snoring is a result of air passage obstruction. When that happens on a nightly basis, it leads to low oxygen levels in the blood, which means there’s less oxygen reaching the vital organs. Over time, this can result in all kinds of health complications.

“If you’re struggling to breathe, it increases stress hormones,” Majumder said. “If the oxygen level keeps going up and down, it will affect the tone of the blood vessels. They’re not relaxing, so they end up getting harder.” Hardened blood vessels are a major risk factor for heart attacks and strokes.

As breathing gets interrupted, apnea often wakes people up at various times during the night, which is annoying enough. But some people aren’t even aware that they’re not getting enough sleep in the first place. No matter how often it may happen, some people never remember having woken up, and don’t understand why they feel sluggish during the day.

For people with insomnia, however, their sluggishness is no mystery at all, as they often spend part or all of the night lying in bed waiting for a sleep that never comes. In addition to depriving the body of what it needs, lack of

Continued on page xx sleep also creates stress, which makes everything worse.

To get to the root of the problem, Dr. Majumder invites patients to spend the night.

Visitors to the center will find four cozy suites, set up like small hotel rooms. New patients are often scheduled for an overnight sleep study. While they spend the night at the center trying to catch some shuteye, a team of technicians is busy monitoring their eye movement, oral flow and nasal flow, chin movement, body/leg movements, heartbeat, oxidation levels, and many other things. Meanwhile the patient — whether they spend the night dreaming or tossing and turning — is also being videotaped, “Big Brother” style.

Charts and tables are soon prepared and shown to Dr. Majumder. Based on the data, he will then prescribe a treatment to be tested out the following night, spent at the center with the same parameters being measured. These treatments include breathing assistance machines, such as the CPAP, which is applied differently depending on the patient’s condition and on what kind of progress is made.

In addition to problems falling or staying asleep, some people have difficulty adjusting their busy lives to make the time to try.

“How many hours at night do you think you sleep?” Majumder asked one patient.

“Four or five,” came the sheepish answer.

“That’s not enough,” he replied, shaking his head.

Dr. Majumder came to the U.S. from Bangladesh in 1990. After training at __________, he went on to practice pulmonology at Brookdale Hospital. Noticing that a significant number of pulmonary patients were suffering from sleep disorders, in 2004 he decided to broaden his expertise and went to Arizona to research and train in sleep medicine. He returned to Brooklyn in 2006 to start the Center for Sleep Medicine, and now divides his time between the Center and Brookdale where he continues to practice pulmonology.

“Everybody that snores, who is overweight, or has high blood pressure, or feels fatigue during the day,” he said, “should be examined by a sleep specialist.”

As Majumder is frank in pointing out, many of these problems — like so many other health issues — are affected by girth. While many sleep troubles are caused by other factors, overweight people are far more susceptible to the problem than most. In fact, Majumder said that if your neck is more than 16 inches in circumference, it can be problematic because it’s just that much more weight pressing down on your air passages overnight. The resulting low oxidation feeds directly into the other problems that come with being overweight, such as diabetes and heart disease.

One patient had been sleeping much better since losing a lot of weight. Dr. Majumder congratulated him, and encouraged him to lose even more. “You’ll feel like a completely new person,” he smiled. “You’ll have so much energy, you won’t know what to do.

“And if you have any problems,” he added, “we are always here.”

The Metropolitan Center for Sleep Medicine is located at St. Jude Medical Center, Suite 205 W, at 94-13 Flatlands Avenue. Call them at (718) 257-

?? 5544.

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