Sleep-deprived students seek help

Parasomnias, insomnia and delayed sleep-phase syndrome are the most common sleep disorders among students

Patients at Kingston General Hospital’s sleep laboratory sleep with electrodes attached to their scalp and face in order to track their five stages of sleep.
Patients at Kingston General Hospital’s sleep laboratory sleep with electrodes attached to their scalp and face in order to track their five stages of sleep.

Tara Russell fell asleep in a Pilates class last July.

“I’ll just be doing something and then I’ll fall asleep,” Russell, ArtSci ’13, said. “I’ll be in lecture listening, then fall asleep and miss the entire thing.

“I fell asleep during a calculus exam in high school once and missed the whole thing. That was bad.”

Students whose sleep issues can’t be diagnosed during a daytime appointment with a physician are referred to the Kingston General Hospital (KGH) sleep laboratory.

Russell started seeing doctors at KGH in October.

“It’s gotten worse since I got to university, and the last semester was just ridiculous,” she said. “I couldn’t stay awake for anything, which is why I decided to get help.”

Earlier this month, sleep lab staff attached electrodes to Russell’s scalp and face to help create a polysomnogram, tracking the five stages of sleep. As she slept, two technicians monitored Russell’s breathing, leg movements and eye movements.

“I wasn’t allowed any caffeine,” she said, adding that she has at least two to three cups of coffee a day to try to stay awake. Without any caffeine, technicians could better understand the cause of her problem.

The lab can accommodate up to six patients every night. Each patient gets a private room equipped with video cameras to ensure hospital staff don’t miss any unusual behaviour that could indicate a specific disorder.

Restless leg syndrome is characterized by sensations in the body urging a person to move their limbs. Parasomnias, common among Canadians, include abnormal sleep behaviour like sleep walking or night terrors.

KGH sleep specialists say insomnia is the most common disorder, affecting one third of Canadians over 18 years old.

“I think that these things are so common and sometimes so simple that sometimes a sleep specialist isn’t necessary,” said Dr. Michael Fitzpatrick, medical director at the KGH sleep lab.

Fitzpatrick said people can self-diagnose if they know how to identify the symptoms of a sleep disorder.

“They may be right in saying they can’t sleep at night because they’re taking too much caffeine or working until late at night,” he said. “Very often the patient or the person has good insight into their own problems.”

According to Fitzpatrick, treating a sleep disorder with medication isn’t always effective.

“If you take a sleeping tablet it may be effective for one night or a few nights, but it quickly runs out of steam,” he said.

“Then you’re really stuck because you’re taking the tablets and you can’t get to sleep, but you can’t stop taking the tablet because if you do … it’ll get even worse.”

To prevent this cycle, Fitzpatrick said people need to practice sleep hygiene — reducing activity before sleep, limiting caffeine intake and avoiding TV before bed.

If that doesn’t work, Fitzpatrick recommends meeting with a physician.

“Very often the physician will be able to make good suggestions and help them out, and will get most patients by without a problem,” Fitzpatrick said. “If they’re not successful, then they’ll refer the patient to a sleep specialist.”

A small portion of Fitzpatrick’s patients are students whose busy schedules keep them from getting enough sleep. For some students, resolving sleep issues is as easy as working 10-minute naps into their daily schedule.

“If they sleep for more than half an hour, they get into … so-called ‘slow-wave sleep,’” he said. “That’s going to make them very groggy when they wake up and they have great difficulty getting back to feeling really alert and refreshed again.”

Falling asleep late and waking up early can cause students to develop delayed sleep phase syndrome. The disorder, common in people 17 to 25, can lead to insomnia later in life. Fitzpatrick said students should also limit alcohol and marijuana use if they want to fully benefit from sleep.

Though both substances help the user get to sleep easily, they decrease the amount of Rapid Eye Movement (REM) sleep, putting them at risk of missing any brain development that occurs during sleep.

The fifth stage of sleep is classified as most important because it contains REM sleep — when dreaming occurs due to increased brain activity.

“During that sleep stage, we’re dreaming. We’re paralyzed [and] our eyes are intermittently twitching,” Fitzpatrick said.

Health, Counselling and Disability Services (HCDS) regularly creates accommodation plans to help students diagnosed with sleep disorders.

These cases are defined by disability services as chronic illnesses, a category that registered 86 students in the fall.

Narcolepsy, sleepiness during the day, is a common one among the students that register, disability services advisor Jeannette Parsons said.

“The accommodation for these students is often things like having some extra time on an exam … or a signal to the professor that the student may require an extension on an assignment.”

Students diagnosed with insomnia need more sleep to function the way ordinary students do — qualifying them for disability services support.

“We work with the exams office to schedule certain exams at certain times of the day,” Parsons said. “We also have control over scheduling the exams on certain days so there might be a day in between so that students can have a day to rest between one exam and the other.”

Parsons asks to see documentation from a doctor to verify the student’s problem classifies as debilitating.

“Based on the documentation, we interview the student,” she said. “Based on what their needs are, we develop accommodation for them.”

Russell has yet to appeal to HCDS for accommodations.

“I’d just be happy to find a solution,” she said.

Russell hasn’t been formally diagnosed yet.

— With files from Terra-Ann Arnone

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