Snoring no laughing matter: Specialists

Prodita Sabarini, The Jakarta Post, Jakarta | Mon, 03/02/2009 2:13 PM | Jakarta

Many Jakartans are unaware of the health and social risks that come with sleeping disorders, seeing insomnia as a regular part of urban life or assuming that snoring as a sign of deep sleep, a sleep specialist says.

Dr. Andreas Prasadja, a sleep physician at the Mitra Kemayoran Sleep Laboratory, pointed out a lack of sleep poses health risks and contributes to the number of traffic accidents in the city.

“We’ve heard about so many traffic accidents being caused by drivers falling asleep at the wheel,” he said Friday at a seminar on sleeping disorders.

Andreas said he hoped to dispel two commonly believed false notions: Sleep as a sign for laziness and snoring was a sign of deep, restful slumber.

He said our urban lifestyle, which hails productivity and runs by the motto “work hard, play hard”, has contributed to people’s sleep problems.

For productivity’s sake people force themselves to work long hours using stimulants which then keep users awake when it was time to rest. Light sleeping is not the only consequence: overuse of stimulants can lead to kidney failure.

He also said exercising just before going to bed can disrupt sleep as well as a brightly lit room, or snuggling up with our digital sidekicks, laptops and cell phones, before snoozing.

He said people should avoid taking stimulants – including caffeine, nicotine, and chocolate – nine hours before going to sleep, replacing them with relaxing drinks such as camomile tea.

He also encouraged people to finish their exercise regimes three hours before going to bed and to stop all work-related activities an hour before.

“When you feel really sleepy, then go to bed. Do not do anything in bed except sleep and have sex,” he said.

Another sleep disorder which is the most common and the most dangerous but also the most ignored is snoring.

“Snoring is not a laughing matter. It’s serious. If untreated it can cause hypertension, heart failure, diabetes or stroke,” he said.

He said that hypersomnia, a condition where people feel excessive daytime sleepiness despite long nighttime sleep might be caused by sleep apnea, a sleep disorder characterized by pauses in breathing during sleep, common among people who snore.

“During sleep the muscles of the body relax, including the soft tissue around the air way in the throat area. These tissues can collapse and obstruct breathing during sleep, causing people to stop breathing until they gasp for air,” he said.

To take in air, sufferers must wake over and over so they are never fully rested and can wind up with chronic, life-threatening consequences of extended sleep deprivation.

The importance of sleep, however, has yet to be fully understood by the public, including doctors, Andreas said.

“In Indonesia doctors diagnosing patients with hypertension or diabetes still rarely ask how well their patient is sleeping at night. In developed countries, that question is one the first questions the doctors ask a patient,” he said.

Lalaine Gedal, a Singapore-based sleep physician, said the prevalence of sleep apnea among 35-year-olds is 20 percent among men, and 5 percent among women. Among the elderly, 60 percent of men have sleep apnea and 40 percent of women.

A patient of Andreas said he had not realized he had been suffering from sleep apnea until he became very tired every day, dozing off during meetings and even while driving.

For those who dread surgical interventions, an effective and noninvasive method for stopping snoring involves a machine. Andreas’ patient now uses a Continuous Positive Airway Pressure device known as a CPAP.

The CPAP includes a mask with air tubes and a fan. It uses air pressure to push the user’s tongue forward and keep the throat open. This allows air to pass through the airway consistently. It reduces snoring and prevents apnea wake-ups.

There are only two sleep specialists in Indonesia, both based in Jakarta. Andreas and Rimawati Tedjasukmana founded Thursday the Indonesian Society of Sleep Medicine, or INA Sleep.

Andreas said he hoped to educate people about sleeping disorders, through the organization.


Hemat Biaya Kesehatan dengan Mengatasi Ngorok

Mengatasi mendengkur sering diremehkan. Apalagi begitu mendengar pemeriksaan dan perawatan yang begitu serius. Tak jarang orang jadi enggan untuk menjalani terapi. Tapi sadarkah Anda akan akibat-akibatnya? Bahkan berbagai penelitian yang dilakukan di negara-negara lain menunjukkan bahwa perawatan mendengkur ternyata justru menghemat biaya kesehatan.

Kebiasaan ngorok jadi berbahaya ketika disertai henti nafas (OSA). OSA berdampak amat luas, selain pada kesehatan, OSA juga berkaitan erat dengan hubungan sosial dan kondisi perekonomian seseorang. Bayangkan beban ekonomi seseorang yang harus berulang kali ke dokter atau dirawat di rumah sakit akibat hipertensi, gangguan jantung, diabetes hingga stroke yang harusnya dapat diperingan jika saja OSA-nya dirawat. Tak heran, jika asuransi di negara-negara maju memilih untuk mengganti semua biaya pemeriksaan dan perawatan OSA.

Penderita OSA, sering kali kita dapati dalam kondisi emosional yang labil hingga rentan untuk terkena depresi(1). Ini dipicu oleh ‘kondisi kurang tidur’ yang dideritanya. Sementara itu, penggunaan CPAP sebagai terapi terbukti memperbaiki status emosional dan gejala-gejala depresi yang terdapat pada penderita OSA(2).

Secara ekonomi, OSA juga amat memberatkan penderitanya. Ini disebabkan oleh berbagai penyakit yang berkaitan dengan OSA, terutama hipertensi dan penyakit-penyakit kardiovaskuler lainnya(3).

Sebuah penelitian menyatakan bahwa penderita OSA, dalam waktu 10 tahun sebelum terdiagnosa, membutuhkan berbagai pelayanan kesehatan hingga dua kali lipat dibanding yang tidak menderita OSA. Sementara, penelitian yang sama juga menunjukkan bahwa penderita OSA mengalami rawat inap di rumah sakit hingga dua kali lebih lama dibanding yang tidak. Akibatnya pasien pun harus mengeluarkan biaya hingga dua kali lipat. Sedangkan, setelah dirawat, pengeluaran untuk perawatan kesehatan berkurang hingga setengahnya(4).

Penelitian lainnya menunjukkan manfaat penggunaan CPAP pada penderita OSA. Dalam dua tahun sebelum perawatan dengan CPAP, pasien OSA memerlukan 413 hari perawatan di RS, selanjutnya ia hanya dirawat 54 hari di RS dalam dua tahun setelah menggunakan CPAP. Sementara pasien yang tidak menggunakan CPAP justru mengalami peningkatan jumlah rawat inap di RS, dari 137 hari sebelum perawatan menjadi 188 hari setelah perawatan(5).


1.  Schröder dan O’Hara, 2005

2.  Schwartz et al, 2007

3.  Smith et al, 2002

4.  Ronald et al, 1999

5.  Peker et al, 1997