When you go to bed, are you one of the lucky people can simply turn off the lights and drift into dreamland? Or are you, like millions of other Americans, struggling to fall asleep? In Part One of this Two-Part exploration into Sleep and it’s effects on Mental Health, Dr. Rajesh Balagani explains why sleep is so important on a biological level to our larger wellbeing, and how a few simple steps can start to curb poor resting habits in practically everybody’s life.
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Rick Hoaglund
Welcome to OnTopic with Empathia! I’m your host, Rick Hoaglund. Today on this show, we’ll meet Dr. Rajesh Balagani. He has over 22 years of diverse experience in medicine. He is a doctor of osteopathic medicine. Dr. Balagani is board certified in critical care medicine, internal medicine, pulmonary disease and sleep medicine. Hello, Dr. Balagani! Thank you for joining us!00;00;36;21 – 00;00;39;18
Dr. Rajesh Balagani
Good, Rick! How are you? Thanks for having me on!00;00;39;21 – 00;01;54;04
Rick Hoaglund
When you go to bed, are you one of the lucky people who turn off the lights and a few minutes later you’re in dreamland? Or do you toss and turn? Look at your cell phone? Have nightmares? Or are your legs restless all night? If you’re at the latter, you may be suffering from a chronic sleep disorder. And you are not alone. According to the Center for Disease Control and Prevention, over 50 million Americans are living with sleep disorders, just like breathing, sleep is essential for our life. All humans sleep, and all animals sleep. It’s an essential biological process that’s not fully understood. But experts do know that sleep restores the body. It helps to consolidate our memories. It’s important for brain development, and it helps us conserve energy. It also regulates our emotions and mood. But sometimes, sleep eludes us. Let’s meet Dr. Balagani! Welcome to our podcast! We’re going to be talking about sleep today. And this is going to seem really elementary, but there has to be sort of a definition of what sleep is. What is your definition of sleep?00;01;54;06 – 00;04;07;13
Dr. Rajesh Balagani
Sleep as opposed to being a passive activity- So there’s a tendency to think that when we’re awake, it’s more of an active phase. And when we’re asleep, it’s more of a passive phase. But I think that sleep is a process by which we go through. And if you think about it from a standpoint of evolution, it must be somewhat important and critical to physiologic parameters because it’s one of the things that’s been preserved over evolution. I mean, one of the things that hasn’t changed dramatically is over the 100,000+ years that we’ve been around or so or more, we still have maintained almost a third of our overall lifetime in this. What we think is ‘less active’ rather than a completely passive phase. And as we catch up to what actually happens in sleep, there’s so many processes that we need that we cannot do if we don’t have this process. So we know that sleep is absolutely instrumental to cognitive function. We know that the flip side of it, the reverse, is that people who do have any degree of lack of sleep on any kind of chronic setting will have a decrease in cognitive functioning. There is a change in hormonal regulation during sleep. There’s cardiovascular things that occurr during sleep, and there was this research where it showed that parts of sleep actually help with brain plasticity. There was this tendency that if you think about the cells in the brain, there’s going to be spaces between the cells, and there’s a tendency to think that actually maybe, there’s some phases where it shrinks a little bit to allow some of the metabolic runoff to be taken out, basically in certain phases of sleep and that allows for more of a improved – you know, you have the cell break down and build up and you have apoptotic changes. And I think sleep helps to regulate some of that. So the most telling thing is the fact that every living creature has to go through it to some degree. And in humans, it’s been preserved despite all the other things we might have lost. We’ve kind of preserved the number of hours and time that we actually put into sleep.00;04;07;15 – 00;04;15;10
Rick Hoaglund
You started to go there with why sleep is important, but it’s- it’s good for both our our mental and physical health. Am I correct about that? Are you saying its…?
00;04;15;12 – 00;05;14;23
Dr. Rajesh Balagani
Yes! I don’t think- I don’t think there’s any single process from a physiologic standpoint that’s not in some way impacted by sleep. We know that blood pressure regulation, heart rate regulation, some of the cardiovascular things noncardiac, respiratory drive and those kind of things change with sleep. Hormonal balance is one of the things we find is that from a simple standpoint, men who experience significant amount of sleep deprivation may have a decrease in testosterone production because testosterone is coupled to a certain amount of sleep. So if you don’t get, I think it’s about three or 4 hours as a minimum, your testosterone production is going to be decreased. And then in children, actually, one of the things that we find is growth hormone production is actually encountered in deep stage of sleep. So if you have children who are not going through a deep stage of sleep, is there a tendency to not have that same kind of growth in that setting? So multiple factors that we encounter as far as the need for sleep itself.
00;05;14;26 – 00;05;30;21
Rick Hoaglund
So I guess my question is how much sleep do we need? I mean, does it vary on your age? Is it very on your sex or even, I guess, your occupation? I mean, is it an individual thing or is there like a set platform, like you should have X number of hours of sleep a night.
00;05;30;23 – 00;06;31;14
Dr. Rajesh Balagani
Yeah, sleep actually changes with one- the easiest one is age! And we’ve seen that, I mean, newborns probably need about 14, 15 hours of sleep. But there is a dynamic range. I mean, it could be anywhere from 12 to maybe 14, 15 hours. And as you go through, toddlers may need about 12 to 14. Getting into the teenage years, you probably need still about 8 to 10 hours. The least amount of sleep that we think we need or is permissible I would say, is as we get to the more elderly, we still want to be able to get anywhere from 5 to 7, I think is what you want to look at. So then you look at the flip side. Well, is less than 5 hours counted as a disorder, and then if there’s a high range, is there something that a high range of sleep is also not beneficial? So it’s not- it’s almost like Goldilocks, right? I mean, you want you don’t want to get too little sleep because that’s insomnia, but you also don’t want to get excessive sleep. And both sides of the equation actually can be disorders.
00;06;31;17 – 00;06;50;12
Rick Hoaglund
Let’s talk about the disorders really quick. So you’ve said too little sleep. Too much sleep is a disorder. How does the average person know if they have a sleep disorder? How do I know if I’m not- if I haven’t been tested and I haven’t I haven’t even probably discussed this with my doctor. How do I know if I have something going on?
00;06;50;14 – 00;08;29;09
Dr. Rajesh Balagani
There’s multiple different sleep disorders and they fall into different classes, but you can kind of look through each of those individually. But sleep disorders or anything that changes your normal routine of sleep and then leads to symptomology, right? I mean, if someone says, well, I’m not sleeping more than five or six hours, but they have no outward consequences, they’re not even cognitively balanced. Their blood pressure around all their physiologic regulations, all those kind of things are okay, well, maybe that’s the amount of sleep that’s okay for them because you always going to have outliers in the human population! And that’s what we always seem to catered for, the outliers. And one of the things I always find is, you know, most of these things are kind of on that bell shaped curve or causing distribution, right? You’re going to have some people who can probably get away with maybe about 5 hours of sleep, which is on the low end for anyone. And then you’re going to have other people who can’t function until they get to about ten hours of sleep. Neither of them is wrong! But I think that one of the things that is going to be detrimental is actually maybe having a five hour person take a ten hour sleep. But we get too much sleep is, again, not good for you. But at the same time, it’s probably not good for that person who needs ten hours to get down to five. So there is a little bit of that individualistic thing that you have to look for a sleep amount that you need. It’s not that one size fits all, but again, if you look at where is the largest distribution and that goes in, it’s going to be anywhere from that 7 to 9 hours. And that’s why we say you probably need 7 to 9 hours, because it’s easier than saying, well, you’re the guy who only needs five or you’re the guy who needs ten, because how many people are we going to individualize when we look at a population study?
00;08;29;13 – 00;08;45;17
Rick Hoaglund
And you’ve heard of people, some of them very famous people and very smart people in history that did very- I would call them odd sleep habits, let’s just put it that way, where they’re taking very short periods of sleep multiple times during the day. I mean, is that…?
00;08;45;24 – 00;11;16;04
Dr. Rajesh Balagani
Yeah, there’s some studies that have showed that people who take short naps, even a 5 to 10 minute, you know, that that catnap kind of thing, they seem to be able to reinvigorate to a degree where their functioning is back to normal. They perform better over the course of the day. I mean, a lot of these are, again, outliers. I mean, I’m glad that you brought up the comment about some very famous people. I mean, you know, you go anywhere from Einstein to Edison, and I think even now I might be misquoting Mark Twain, but I think one of these guys said that sleep was a colossal waste of time. Right. I mean, I think it might have been either Edison or Mark Twain. And then even more contemporary people like Bill Clinton, who said, I sleep for 5 hours. And I think that there are actually like genetics that we’re finding from that. So I think that one of the things that we don’t know about this group of people is there seems to be some genetic protection against detrimental effects of decreasing sleep. So until we get some of those things more resolved, it’s difficult to say that, well, it’s okay for you to get 5 hours because, you know, Bill Clinton did it, you know. So I think that, you know, there are going to be some people that they’re going to be definitely outliers. The interesting thing is how is it that so many of those outliers who only need 5 hours of sleep are these high performance people? I mean, is there some part of the brain and think it’s just, you know, amazingly interesting field looking at that quite a bit now, going back to strictly a nap kind of thing? I mean, one of the things I always talk to my patients about when they say, well, I feel sleepy around 1:00 or 2:00 or anywhere from noon to three. And one of the things that you’ll find there is that the circadian rhythm has a little bit dip. Circadian rhythm is the policy that allows you to be wakeful. Circadian so is within that 24 hours. So there’s a little bit of a dip in that circadian rhythm where it’s less wakefulness and a little bit more sleepiness and your propensity for sleep, how sleepy you feel, kind of almost have a closer relationship where the delta between the sleep propensity and the circadian rhythm is the narrowest around that time frame. And that’s a perfect time frame for someone to take a 30 minute nap and back from again, from evolution, I mean, you still got people who take catnaps in certain countries and that’s still beneficial. So going back to naps, I think that that 30 minute nap that those timings can be useful.
00;11;16;06 – 00;11;39;05
Rick Hoaglund
You alluded a little bit earlier also to phases of sleep. So you know, most people go to bed and they’re- they’re either reading or something and then they go to sleep and I’ll just put that in quotes. What are the phases that they’re going to go through? I mean, there’s obviously some type of deep sleep, and I know that you have probably different terms for this, but what are those phases and how important are they and is there some suggested length on those?
00;11;39;08 – 00;14;40;23
Dr. Rajesh Balagani
We do actually! And stages of sleep, they call it a cycle, the sleep cycle, but it’s definitely not a cycle. It’s almost like a step ladder. And the way that we actually picture it is by brain activity. So we put Wake at the top of that step ladder almost, or that that step because you’ve got the most brain activity there. So you’ve got it, wake, and then you go into what we call N1 or light sleep, which only makes up- normally we think about anywhere from say, 2 to 5% of the night and then you go into N2, which is actually where most of our sleep problems is about 40 to 50%, almost an average, about 45%. That’s where, you know, I’ve always wanted to find out what was the most important thing about N2 sleep, because we tend to spend most of our time there and we find things like K-complexes, which are a kind of brain waveform and those kind of things in that stage where we’re starting to better understand the need for those. It’s almost where K-complexes are thought to be the body’s way of stopping you from waking yourself up. You get these K-complexes, they actually keep your brainwaves from shifting to a wake almost kind of thing. So N2 is kind of that moderate amount of sleep and that makes up 45%. Then you go into what we generally think of as deep sleep, which is N3. There’s a change in brainwaves there. So all of these sleep stages are dictated by different type of brainwaves, and that’s why we can see on a sleep study, when you have a sleep study in a lab, we’re not just looking at someone’s eyes being closed and saying, Oh, he must be asleep. We’re actually looking at the change in brainwaves. And so this is the stage of sleep that we see in deep sleep. This is light sleep. This is REM. So N3, which is deep sleep, makes up about 20, 25%. And then finally, here’s where it gets interesting for that, those steps. So remember, Wake is at the highest because you’ve got the most brain activity. Then it falls down just a little bit for N1, then it falls a little bit further down for N2. And at N3 you’ve got the least brain activity and the most recuperated physical rest. And then suddenly you get into REM, and REM actually goes back up from a brain activity and is just below Wake. So your brain activity in REM is just a little under wakefulness. So you’re actually having significant amount of brain activity. But again, it’s interesting from an evolution standpoint, one of the things that we are not supposed to be able to do in REM is have any movement. I always thought this was interesting and one of my mentors kind of said, Well, yeah, you know, if you’re sitting in a cave and you’re going to REM and you start having all this brain activity and you walk out of your cave and get hit by a sabertooth, that’s probably not good from that standpoint. So I think that it prevents us being able to act out in this sleep stage and have any activity. So you’re actually very active from a brain standpoint, but from a physical standpoint, you are actually paralyzed at that time.
00;14;40;26 – 00;14;48;00
Rick Hoaglund
So if somebody is a sleepwalker and they do this often, does that mean that they’re not potentially getting enough REM sleep?
00;14;48;02 – 00;15;23;00
Dr. Rajesh Balagani
Actually sleepwalking, usually it happens – it can happen in REM. It’s called REM behavior disorder. So, you know, right off the bat, you can tell that that’s not normal because we don’t want people walking in REM! But usually sleepwalking can also happen in deep sleep. And if you wake someone up from that setting, they have no idea what’s going on. Because remember, at those times there is a decrease in brain activity so that that person waking up from that stage of sleep has no physiologically – they may have a increase in heart rate all of a sudden, like when you wake them up, but they have no idea what’s going on at that point.
00;15;23;03 – 00;15;43;06
Rick Hoaglund
And sometimes sleepwalking and other sleep activities are induced by medication. And I know we’re not going to really talk about medication in this half hour, but tell me a tiny bit about- is that a problem? Is that, I mean, is it common? Is it rare? Because you hear stories about people that drive when they’ve been on certain sleep medications and that type of thing?
00;15;43;08 – 00;17;21;12
Dr. Rajesh Balagani
Right. I think that zolpidem, which is Ambien, I think, you know, unfortunately did get some of that press from the increase in power, some use or increase in sleepwalking, sleep eating, all those kind of activities and especially some of the higher doses. But as far as the sleepwalking, any of these types of insomnia, obviously they are detrimental in the setting that it leads to a sleep disruption, right? I mean, if someone’s walking and then they have to be moved back to the bed, those kind of things, it can limit their sleep itself, especially if they awaken during that state. It can be, you know, in most times the sleepwalking is more of the dangerous activity aspect. Right? And one of the things that we try and limit from a sleepwalking standpoint is anything that they can injure themselves with because again, they don’t know what they’re doing. They may trip over things that are in their way. They may fall down a flight of steps. If they’re driving, they’re not fully cognitively aware of what they’re doing. So I think some of those things are more from a standpoint of limiting any kind of dangers that they may pose to themselves when they have this activity. As far as common, I think it’s common in children and it seems to be one of these things that they do grow out of. It may be a function of a evolving brain almost. You will have some genetics and familial aspects to sleepwalking. A lot of my patients will say that. Well, I think that part of this was that, you know, my mom used to do this or my dad used to do this, and I’ve done this too. And that might carry on to a little bit of a later age. But we do try and find ways of extinguishing that behavior if we do find it.
00;17;21;15 – 00;17;47;11
Rick Hoaglund
So we talked a little about the importance of multiple hours of uninterrupted sleep. What about people? I mean, you have a natural sleep rhythm. You know, it gets dark. You go to sleep for- for many people. What about people that either are having a disruption in that maybe they’re shift workers, maybe they’re people that are going to a lot of travel. How can they set their bodies again? Is there a way- is there a way to do that?
00;17;47;13 – 00;20;32;23
Dr. Rajesh Balagani
Yeah, from a shift work standpoint, that’s interesting because it’s more of a very much of a chronic thing, right? I mean, you know, if you’re doing shifts, a lot of times this is something that you’ve done over the years at long stretches as opposed to, you know, potentially jetlag, which is, you know, probably a much shorter period of time. But I think that, you know, shift work itself is probably not beneficial. I got to say, from a human makeup, one of the things being is that the change in sleep, one, as a night person, you never get the same amount of sleep as you would during the day, basically. So it’s never going to replace nighttime sleep. And then the second thing is that some of the hormones that are in the neurotransmitters that are released at night, the most important one sometimes being melatonin, is not produced the same way in someone who has daytime sleep as it does night time sleep. Melatonin is produced in the dark. You need the dark for it. And I don’t know if you can create that same kind of setting where as working at night and sleeping during the day, you get the same thing. The reason I bring up melatonin is that because it’s also a very powerful antioxidant. You wonder if because you’re not getting the same amount, are you, then more prone to certain inflammatory things? There’s been some studies looking at even shift work and cancer risk with everything else being equalized and nothing else being that there is a increase in cancer, which tells you that there’s got to be some role for some of these hormones changes that maybe are not there if you’re sleeping at night, but if you’re awake or during the night, even if you sleep during the day, it’s just not a natural set up. How do we counteract that? Well, you know, I think that you can always take exogenous melatonin during the day and see if that lessens said. That might be one thing. And you have to kind of recreate that same type of sleep setting. It’s got to be a dark room. It’s got to be quiet. A lot of times what happens with shift work is that because you’re the only you know, that that person might be the only one in the family that’s going through the night? You know, do night shifts. It’s tough not to say take care of their kids during the course of the day, even if they’re supposed to be sleeping. So but they really have to say, I’ve got to maintain this as my you know, my normal ritual. And I think it takes that away from, you know, just family and, you know, gatherings and stuff like that, because you’re not able to do the same thing if you’re trying to maintain that type of shift change.
00;20;32;26 – 00;20;52;24
Rick Hoaglund
How do I know if I have a sleep disorder? I mean, I’m just the average guy at home. And what are the symptoms I should look out for to say, hey, maybe I have a sleep disorder and then prior to going to a doctor, are there things that I should do to try to see if I can I won’t say cure this, but get control of this myself?
00;20;52;26 – 00;22;49;00
Dr. Rajesh Balagani
Yeah. So remember, we were kind of I had mentioned that there’s going to be multiple different sleep disorders. So, you know, let’s kind of look at that. So one one type of sleep disorder is either excessive sleep or a decrease in sleep, so hypersomnia. So sleeping more than what you would be expected to need or insomnia sleeping less than that aspect. The second disorders class of sleep disorders would be snoring and respiratory kind of things that are related to sleep. So sleep apnea, snoring itself, those kind of things fall into that. There’s going to be these parasominoas as we talk about the different things such as REM behavior disorder or sleepwalking sleep talking, those fall into that parasomnia group. There’s going to be movement disorders. We- we see people with restless leg or actually restless leg and or periodic limb movements, which are a type of leg movement that occurs in sleep. So you’ve got different kindj. Then you’ve got the circadian rhythm phase, which is some people like to sleep late into the day and they can’t sleep till late at night. And some people like to sleep at late, early during the day and wake up early during their morning. So those are circadian rhythm disorders and they all have different consequences and level of consequences. And I think that one of the ways that someone would know if they have it is- if there had been a change in their either their sleep amount or their sleep at night itself, are they having one of these things going on? As if that point you told them that they’re much more restless and they’re kicking. So it could be between, you know, someone’s bed and telling them or someone waking up in the morning with less energy. They are feeling more fatigued, having to nap more often. And those kind of things that tell them that maybe there’s something else going on.
00;22;49;03 – 00;23;06;03
Rick Hoaglund
If I have a short night of sleep because my sleep has been interrupted, whether that’s, you know, work or noises or whatever, it gets interrupted. But I, I am very tired the next day and I sleep a couple of extra hours. Is that good or is that bad?
00;23;06;05 – 00;24;18;13
Dr. Rajesh Balagani
That’s just happening naturally. I think that your body’s trying to make up. I mean, one of the things that we find always very interesting is that when we sometimes look at sleep studies, some patients who got, say, significant sleep apnea, you know, you will have this person with terrible sleep apnea who on their initial diagnostic study will have very little REM. They’ll keep having these disruptions and then we’ll put them on CPAP. And one of the things that’s the most interesting is almost that one of the things that we use when we dictate studies is that you see this REM rebound where you go from having that to a 20%, which is normal to having 45% REM because you’ve had so much sleep disruption in during those years or months or whatever leading into this that your body suddenly just says, Oh, thank you, and then just has this beautiful amount of REM. And so you can tell that if you having, you know, if you’ve lost some sleep the night before for a couple of nights maybe, you know, sleep study on someone you see that they’re catching up on certain things. So doing this on here and there is probably okay, if that happens more often, then, you know, do we really catch up? I mean, you’re playing catch up every couple of days if you’re missing out on sleep.
00;24;18;15 – 00;24;23;20
Rick Hoaglund
How about as a parent, how do you know if your child is suffering from this?
00;24;23;22 – 00;25;28;11
Dr. Rajesh Balagani
Yeah, no, I think that childhood sleep disorder is one of the first things that, you know, we talk about the power of is. And again, it’s a safety issue. A lot of times, you know, if they’re having these issues of, you know, getting out of bed and tripping over something or they’re in a different room, those kind of things. And then we do see some degree of sleep apnea, which is linked to enlarged tonsils and things like that. I think that the way that children manifest a lot of sleep disorders is one performance of school performance in sports and those kind of things. And it’s somewhat different from the adult setting is that they’re not- So they may be sleepy, but they’re also hyperactive in some way. They’re almost acting out because they haven’t slept well. So. So if you see that your child is has a change in their behavior, they’re not participating as much in the activities or you being told that they’re falling asleep during class, those kind of things. I mean, those are probably telling things to look out for at that point.
00;25;28;14 – 00;25;42;07
Rick Hoaglund
So if I want to get a good night’s sleep, how do I prep myself? How do I do everything I possibly can to I want to ensure that you make it possible to have a good night’s sleep? What would you what would you tell someone?
00;25;42;09 – 00;28;35;17
Dr. Rajesh Balagani
Yeah, I mean, again, go back to I think that very few of us in this day and age are lucky enough to have that great we where your mind is completely relaxed. So one of the things I tell people is, just like anything else, it takes practice. You want to set a you want to set yourself a schedule. I think that’s important. So stick to a wake time, a sleep time. So if you stick to that, I think that it helps your brain because it’s not that it doesn’t keep on having to change that fundamental night of sleep. So if you say, I’m going to sleep 8 hours, okay, that’s fine. So you want to set yourself a sleep time and you want to be able to set yourself a wake time. So remember also that adage that too much is not good any better for you. So you don’t want to say, well, if I got 8 hours of sleep then 10 must be better. So set that time period. Make sure that you do all the things that you can to, uh, to heighten that. No electronics. We say that no electronics for about at least about 30 to 1 hour before bedtime. And that’s- part of that is most of the electronics now, even though they’re trying to cater to this, actually have blue light spectrum applied. And one of the things that blue light spectrum light does is it actually blocks melatonin production. And if we think that melatonin production is useful from a sleep standpoint, then not having it is going to be detrimental. So I think that the electronic part of it, not only is it just engages your mind, but also takes away that takes away from losing it from the blue light. Make sure you’re comfortable. I think that any discomfort, one of the things that you always have to make sure is outlying things or underlying things, pain control. Unfortunately, you know, a lot of people do suffer from joint and back pains and those kind of things. And they can- they can have a huge impact on sleep itself, unfortunately. And the best you can really do is kind of, y’know, try and lessen that as much as you can safely. And then lastly, I think that temperature control, one of the things I find, you know, in- I don’t know again now if we’re going to find more and more data on this, is that I think if you’re- if your core temperature is lower, you’re able to sleep better. Now you get I mean, there are ways of reducing core temperature. Please don’t try to do that. They’re not fun things or anything you ought to be trying. But lower core temperature actually helps to regulate sleep better. So I think that being in a very warm room from a temperature standpoint probably lessens the chance of sleeping well. Some people feel like they do sleep better with warmer, but usually the body’s regulation is that as you cool down that’s when you kind of- that melatonin peaks and your core temperature kind of almost go hand in hand at that point. So things you can do – better schedule! That’s the most important thing!
00;28;35;19 – 00;28;44;23
Rick Hoaglund
Anything you’d like to add? Any advice to people that that are having sleep issues, Any warnings for people?
00;28;44;25 – 00;30;13;28
Dr. Rajesh Balagani
Yeah, I think that the most difficult thing that’s going to be that you have to change is your you’ve got to change your mind for, say, sleep. I think that we all we carry all our problems of the day or the events of the day into our night. And I think what happens to the brain at that point is it almost feels that you’re in some sense of wakefulness. So I think that, you know, the lucky few of us who are able to kind of distance ourselves from the events of the day so that that sleep time becomes kind of a very, you know, very protected time is great, but so don’t take anything that’s happened during the course of the day with you if you can, you know, if you can let go of it. And, you know, we try all different types of tricks with our patients. You know, if you’ve got a lot of things that are on your mind, please write it down in a- in a diary or somewhere else, you know, well before you sleep don’t. So you feel like you’ve already accounted for it and you’re not taking it out with you. Because I find it that anxiety that comes with some of those things is that probably the number one cause for some degree of insomnia and insomnia is probably the most common sleep disorder that there is out there. I mean, I think more so than, you know, much more than sleep apnea and those kind of things. I think we have more people who say they’re not able to sleep sufficiently then any other complaint that they’ll have.
00;30;14;00 – 00;30;56;19
Rick Hoaglund
And there are economic costs caused by sleep deprivation. These costs are primarily from reduced productivity, absenteeism, health care costs and accidents and injuries. Dr. Balagani, thank you for joining us today and sharing with our listeners. Next time on OnTopic, we’ll continue with Dr. Balagani. We’ll talk about the treatment of sleep disorders. To hear that episode and other episodes of OnTopic with Empathia, visit our web site, www.Empathia.com. Follow us on social media @Empathia and subscribe to OnTopic with Empathia to hear new episodes as soon as they go live. I’m Rick Hoaglund – thanks for listening to OnTopic with Empathia!
