Dreamcatchers

Sleep deprivation leads to exhaustion, feeling overwhelmed and difficulties living a normal life. And what if this goes on for months or even years? If night after night, no amount of sheep counting or drinking Valerina infusions help to fall asleep? Clinique La Prairie has a solution to help people get their sleep and their life back.

It was was like being born again, grateful patients said to Dr. Olivier Staneczek, sleep specialist at Clinique La Prairie, located in the picturesque Montreux area. This «rebirth» is the result of a collective work by a team of professionals who put the pieces together, analyzing the patient’s sleep, detecting and then eliminating the elements that were detrimental to it.

– Dr. Staneczek, how did you come up with the idea of a program to improve sleep?

About 30% of people in our country suffer from sleep disorders. In China, for example, the problem affects 41% of the population. In Russia too, many people have sleep-related problems. As I am qualified not only as a pulmonologist but also as an expert in sleep-medecine, I have seen a lot of patients on this issue. This program emerged based on my 15 years of experience in this field.

– What are the things that prevent a person from sleeping?

– There are 15 to 20 common reasons. Most often, insomnia is caused by psychological problems: changes in social life, death of a loved one, anxiety because of the relationship with ones partner… This is the reason why we have a psychiatrist on our team.

– How does the treatment begin?

– First, the patient fills out our questionnaire, then the first sleep study is done – a kind of screening test. We give the patient a device that allows us to monitor their sleep remotely. The next day, we already have a clear idea that can be used as the basis for our preliminary conclusions. We also check whether the patient’s metabolism is in order, since many sleep disorders are associated with thyroid gland dysfunctions or anemia due to iron deficiency or vitamin deficiency in the body. Other problems can affect sleep as well, such as urological disorders, for instance…

We have to pay attention to all factors that can hinder healthy sleep. We know that many people have the harmful habit of looking at their Smart-Phone screens before bedtime ore even in bed. This is a serious problem, because Smart-Phones emit ultraviolet light which gives our brain the signal: «It’s morning», even though just a moment before the brain received the information that, on the contrary, it is night. The brain gets confused and it is unable to sleep any more. This is especially damaging for children. We really shouldn’t check things on our smartphone after eight in the evening. It is much better to read a book! They may seem trivial, but these things are often the root of the problem. For this reason, we can’t neglect any detail and we analyze all the circumstances that may affect the patient, as this is the only way to achieve success.

Two days after the start of the survey, I get the opinions of our neurologist, otolaryngologist and other specialists. And only after that huge amount of preliminary work has been done, can we prescribe a treatment. I personally read the entire night polysomnography produced by the computer, each of the 5-minute cycles.

– What else leads to sleep disorders?

– We often diagnose a respiratory problem that leads to sleep disorders, and this is snoring. At first, the person snores in their sleep, and then the snoring turns into an intermittent «khhhh» sound, and then to less frequent «kh, kh, kh» … ’This is called «sleep apnea» and it often affects people who are overweight. Breathing becomes intermittent and they can suffocate because the airway is closed. Sleep apnea syndrome is the most typical sleep disorder. ’This problem becomes evident in the very first night of our study. We then find out if snoring is the only problem or if the patient is also short of breath.

Quite a common syndrome is periodic limb movements during sleep (when people move their legs every 6-10 seconds). This is also one of the things that hinder a person from entering a deep sleep. When a few brain cells work and send impulses, the brain and other cells cannot fully relax. But this syndrome should not be confused with restless leg-syndrome which occur during waking hours.

In the case of somnambulism, the person affected can leave their bed and move in the apartment – all this without waking up. These people are very surprised when told about it. This is why we always try to communicate with the patient’s family members, as we can learn a lot of interesting things from them.

– What methods are used to monitor patients in their sleep?

– We use a special device. ДThe sensors are mounted on the belt and on the chest and another, the oxygen sensor, is on the patient’s finger (it monitors breathing). An additional sensor and a microphone are set up near the mouth. So if the patient has a stuffy nose, and he or she breathes through the mouth, I will know about it. I will also know whether he or she wakes up at night, and whether their blood pressure rises when they are asleep…

– What may cause blood pressure to rise at night?

– For example, if a patient has sleep apnea and he or she feels suffocated, it can increase their blood pressure, and not only at night. The body is experiencing incredible stress, which is a huge burden for the blood vessels. One scientific study done more than 10 years ago revealed, after 12 years of follow-up, that the risk of heart attacks and strokes in an elderly population was 4-5%, while among people suffering from sleep apnea it was about 30% – a much higher risk, you’ll agree. Sleep apnea also contributes to the development of diabetes. Did you know that the blood sugar of diabetics surges when they are stressed? Those who spend all night being stressed are more often affected by diabetes than others.

– What are other problems related to sleep disorders ?

– One problem is driving. The reaction time of a person who doesn’t sleep well at night is considerably slower. A very interesting scientific study done in Lyon showed that the reaction time among the general population is 0.9 seconds, whilst among those suffering from sleep apnea it is 1.5-1.8 seconds. This can be the cause of road accidents. In England, for example, someone involved in an accident has to undergo tests to check the quality of their sleep, so that doctors can confirm whether he or she suffers from slow reactions.

In addition to respiratory causes of sleep disorders, our complete analysis often reveals hidden depression that prevents people from sleeping. They typically fall asleep quickly but at 3 or 4 o’clock in the morning they wake up and start thinking about something, and from this moment onward they are unable to get back to sleep.

– Yes, we all know people beset by such problems…

– A hidden depression is most probably present in such cases. A psychiatrist will give their recommendations and may prescribe medication. The decision is made jointly with the patient and other specialists. They all communicate with each other to put the pieces of the puzzle together. For me, this is a very interesting process. Some people suffer from sleep disorders for many years and have seen many specialists. But if we don’t have the complete picture, no solution can be found.

– When these patients come to you, they are probably exhausted from their condition?

– That’s true, and they are also disappointed and frustrated because no one has been able to help them so far. I recently had a patient from the US, a very educated and intelligent person. He said: «The best doctors in New York City only spent 8-10 minutes examining me, no one has ever paid as much time to my insomnia as you.» We dedicated a lot of time to this patient and we found a solution. After two months of therapy he stopped taking his cocktail of sleeping pills, and the only medication he’s taking is a drug to combat hidden depression. He sleeps very well now and he doesn’t have those constant memory lapses that are a typical side effect of sleeping pills. He is on top of the world, as if he were born again.

– During treatment, your patients spend time doing various interesting things, such as cooking. Do you pay special attention to leisure activities?

– Of course, because our philosophy is that we need to teach people to discover new aspects of life. So we offer cooking classes, host a variety of workshops, for instance, in massage or aesthetics.

– Is it possible to overcome the disease completely, so that there is no need for a second visit to the clinic?

– It is possible in case of respiratory problems, such as sleep apnea. Not so long ago, we had exactly that type of patient. We asked her to choose whether she wanted to sleep with a special mask, or if she’d rather have a jaw splint installed. She chose the latter option, and in less than 48 hours she had a jaw splint to take home. The jaw splint was made by the dental technician who comes to our clinic to consult patients.

– Do you use medication in your program?

– Yes, but please keep in mind that each case of sleep disorder requires an individual approach. The program includes two relaxation sessions with a psychotherapist. We work on all spheres of human life, from nutrition to the way the patient deals with stress. If a patient has a mental problem, we can even try hypnosis. We find the right buttons and push them.

– What is the lengthiest case of insomnia that you recall from your practice?

– One of my patients had been suffering from sleep disorders for over 20 years. He had read many books, and many things he had been doing were right. What was wrong was the combination of methods used. We corrected that. The result was stunning, the kind of success that motivates me to do my job.

– Who are your youngest patients?

– One of them is a girl aged 18, who is treated as an outpatient, and there is also a young man from the United Arab Emirates who comes to us with his parents, he is 19.

– How many hours does a person need for a healthy sleep? Some people say women need 8-10 hours, while five hours is enough for men.

– There are no clear rules or differences between men and women. Some people need more sleep, others need less. We must listen to our bodies. For me personally, 6.5 hours is enough. Whatever you do, you cannot change your genetic predisposition. It is believed that with age people sleep less and less. But this is not the case. The fact is that some retired people have a nap in the afternoon, so their night sleep is reduced. But the total time spent sleeping remains the same.

– What about getting up early and going to bed not too late? Does this have a positive effect in terms of healthy sleep?

– It also depends on one’s genes. There are people who feel great with this routine. For others, though, it is better go to bed late and wake up late.

– Many people consume alcohol before bedtime to sleep better. What do you think about it?

– It’s alright to have, say, a glass of wine at 7 pm. But if you drink whiskey at 11 pm, it is not good for the body. Alcohol is one of the worst hypnotic drugs you can imagine. Three and a half hours after drinking, it begins to act as a stimulant. The person wakes up and cannot go to sleep again. Alcohol increases sleep apnea. So drinking before going to sleep is counterproductive. A very different thing is phytotherapy. I use a lot of phyto-therapeutic products that are very effective.

Olivier Staneczek

An FMH Chest Physician and founder of Clinique La Prairie’s Stop Smoking programme, Dr Olivier Staneczek draws on such disciplines as Therapeutic Patient Education to bring about lasting change in patients’ behaviour. A graduate of the University of Ulm, Germany, he was previously chief resident at the University Hospital of the Canton of Vaud (CHUV) in Lausanne and at Rolle Hospital, Switzerland. He completed his postgraduate training at the hospitals of Chablais and Rolle as well as the University Hospitals of Geneva (HUG) and Lausanne (CHUV). He also holds a Specialist Diploma in Respiratory Rehabiliation from the Universities of Lausanne and Geneva, an Inter-university Diploma (DIU) in Sleep Disorders from the Universities of Grenoble and Lyon, France, and a qualification in breaking nicotine addiction from the University of Geneva. Dr Olivier Staneczek joined Clinique La Prairie in September 2007.