Dr. Kirtly Jones: November is National Sleep Comfort Month. This is Dr. Kirtly Jones from Obstetrics and Gynecology at University of Utah Health Care. And today we're talking in our sleep on The Scope.
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Dr. Kirtly Jones: The health news has been increasingly focused on the importance of sleep and sleep quality and comfort in many aspects of overall health. But how do we know what we do when we sleep. How do sleep doctors figure that out?
Today in the Scope Radio studio I'll be talking to Dr. Chris Jones who is a neurologist and a sleep medicine specialist who has been the Director of the University of Utah Sleep Wake Center for 25 years. Welcome Dr. Jones.
Dr. Chris Jones: Thank you.
Dr. Kirtly Jones: Before we start, Dr. Jones, do you have any conflicts of interest or disclosures for our listening audience?
Dr. Chris Jones: Yes, I am married to the person who is interrogating, I mean, asking me questions today.
Dr. Kirtly Jones: So given that you are my sleep partner, I'm going to call you Chris.
Dr. Chris Jones: All right.
Dr. Kirtly Jones: Okay. How does talking to the bed partner, your bed partner, let you know about sleep quality and comfort?
Dr. Chris Jones: Even remembering what happened when you're drowsy is extremely difficult, and usually just doesn't even get recorded into long-term memory, much less what happens when you're in unconscious sleep.
Dr. Kirtly Jones: So things can happen when you're sleeping that might actually disrupt your sleep quality, but you don't know about it, right?
Dr. Chris Jones: That's correct. Most of the sleep fragmentation at night does not result in a complete awakening that you could remember. Sleep medicine clinicians routinely invite the bed partner to the patient's clinical visit. We see bed partners who say, "You stop breathing in your sleep, you're gasping for air. And in the daytime you're tired, apathetic and irritable and short with the kids, then you're short with me, and you need to see a sleep medicine doctor."
Dr. Kirtly Jones: So what are the pitfalls in talking to your bed partner about sleep?
Dr. Chris Jones: One of the most common pitfalls we see clinically is the "nagging."
Dr. Kirtly Jones: And just because I'm a woman's health specialist, what gender is that nagger usually?
Dr. Chris Jones: Our rule of thumb clinically is that we get much more information from a female bed partner about her partner's sleep than we do from male bed partners. Often times it is the wife who brings the patient kicking and screaming into the Sleep Clinic.
Dr. Kirtly Jones: Well let's talk about sleep apnea.
Dr. Chris Jones: Sleep breathing problems, especially of the obstructive type, which is associated with snoring, interrupts sleep sometimes as much as once per minute, leaving people not just physically tired, but cognitively tired the next day and emotionally tired. So the most reliable sleep deprivation symptoms we have in human beings are irritability, and apathy.
Dr. Kirtly Jones: Okay, you aren't ready for this, but I know you can do it. You're going to give us an example of what sleep apnea sounds like on the air.
Dr. Chris Jones: It sounds like this...
Dr. Kirtly Jones: Thank you. Okay, so if your partner sounds like that you should talk to him about it.
Dr. Chris Jones: You definitely should talk with him in a supportive... and there is published literature, including some by University Health Care Sleep Researchers, on styles of interacting with your bed partner about stuff that happens when they're in unconscious sleep; and it's the supportive style is usually, not surprisingly, the best.
Dr. Kirtly Jones: So you're sleeping with someone who is twitching and twitching, and you can't go to sleep because they keep twitching. Can you tell us a little bit about restless legs?
Dr. Chris Jones: Restless leg syndrome is very common on the order of 5% to 10% in northern European populations. It is more common in women than in men, and when women get pregnant it is even still more common. Restless legs is known by the patient with it to be present because it happens while they are still awake, before they fall asleep. Usually there is no argument from the restless legs patient whether they have a sleep disorder or not. They are actually actively complaining about it. They don't like it.
Dr. Kirtly Jones: So you don't have to talk with your bed partner, because you know you've got it, and it may affect your bed partner, because they're trying to sleep while you're moving around.
Dr. Chris Jones: It's always difficult to see where you are when you're in the middle of an emotional storm of irritability and apathy every day. And so it's a good idea in terms of the relationship to ask your bed partner, do you think I'm more irritable or apathetic, or short with the kids, because I'm not really sure I've noticed that. And that's just normal for a lot of people, that they don't. So this could be very helpful feedback for them, that boy, they really need to look into this.
Dr. Kirtly Jones: So the conversation could start with, do you think I'm more irritable or apathetic, or cranky with the kids, because I wonder if my sleep is okay.
Dr. Chris Jones: Exactly, yeah.
Dr. Kirtly Jones: Okay. Well let's talk about sleep talking and walking. Do people know if they sleep talk and walk?
Dr. Chris Jones: Some people who completely wake up during the sleep walking or sleep talking, including yours truly, do know that they do it. But the vast majority, again, are not completely awake. They half awake, half asleep during the sleep walking, sleep talking, and so they have no conscious memory of it at all. And they need to be told the next morning, you were talking to me about your bank account, or you were punching me, or you were running in bed, or you got up and wandered around the bedroom a couple of times, and then you went back to sleep. What's going on with you?
Dr. Kirtly Jones: And aside the fact that it's disruptive and kind of threatening, perhaps, sometimes it's just funny to the bed partner. Are there any consequences to the person who is sleep talking or walking? Are there any health consequences to that?
Dr. Chris Jones: Usually if the sleep walker, sleep talker, does not leave the bed and is just talking or moving in the bed, it's not dangerous. But there is always the risk of falls, especially going down stairs and especially as we become, how shall I say, more mature in age.
Dr. Kirtly Jones: Right.
Dr. Chris Jones: And if the sleep walking sleep talking takes a more violent form, then it could be dangerous to the bed partner.
Dr. Kirtly Jones: Yes. Well let's talk a little bit about sleep eating. I'm sure I do that, because that would be the only condition, only situation in which that half of the chocolate chip cookie would go away. But let's talk about sleep eating. Does that really exist?
Dr. Chris Jones: It does, and in fact almost anything you can do awake has been reported asleep, so sleep sex, sleep driving, sleep unlocking doors, sleep walking, sleep talking, you name it. And it's been reasonably well described.
Dr. Kirtly Jones: Let's go to the really hard stuff, which is bed negotiation; so covers, room temperature, ambient light. How do we negotiate that with our bed partner?
Dr. Chris Jones: That's a real sit-down conversation.
Dr. Kirtly Jones: Sleepers might be different in terms of how warm they like to be. Women in mid-life with hot flushes might be struggling with throwing covers off and on. Light sleepers may be bothered by noise, who wants the dog in the bed, who wants the kids in the bed, who wants to eat in bed, and all of those are part of a negotiation.
Dr. Chris Jones: I recommend it be done in all seriousness. I would urge the partner who is missing out on sleep to have the upper hand, because the consequences for driving safety, job performance, and emotional function the next day are actually very serious. This is not a trivial conversation, and you have to be honest with your bed partner about what you need to sleep.
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