By Dr Lim Poh Hin

“Microsleep” is a short sleep that cannot be controlled and often occurs for a period of between one and 30 seconds while driving. But there are also cases where a person falls asleep unconsciously while doing other activities such as operating dangerous machinery.

Statistics in Malaysia show that one of the main causes of road accidents is due to driver negligence which can occur as a result of microsleep. Uncertain sleep patterns, excessive fatigue may be the cause of this. Therefore, what is the best step that a person should do to avoid the occurrence of microsleep. Does microsleep occur because the nervous system of a person’s body does not function normally?

Why is it important for us to need “sleep”?

Sleep is an important component, but unfortunately it is often neglected. Sleep is important because it allows the body to go through the repair process for the next day. Adequate sleep can also help prevent excess weight gain and heart disease, and is important for overall health.

What are the causes of microsleep?

Microsleep happens when you don’t get quality and sufficient sleep. Here is a guide to the amount of sleep time you need, according to age:

Baby

4 months to 12 months – 12 to 16 hours per 24 hours, including naps

Children 1 to 2 years – 11 to 14 hours per 24 hours, including naps

3 to 5 years – 10 to 13 hours per 24 hours, including naps

6 to 12 years – 9 to 12 hours per 24 hours

Teenagers

13 to 18 years – 8 to 10 hours per 24 hours

Adults

7 hours or more every night

For children, getting the recommended amount of sleep regularly is associated with better health, including better attention, behaviour, learning and memory, ability to regulate emotions, quality of life and mental and physical health.

Besides age, other factors can affect how many hours of sleep you need. For example:

• Quality of sleep

If your sleep is frequently interrupted, you are not getting quality sleep. The quality of your sleep is just as important as the quantity.

• Pregnancy

Changes in hormone levels and physical discomfort can result in poor sleep quality.

• Aging

Older adults need the same amount of sleep as younger adults. However, as you get older, your sleep patterns may change. Older adults tend to sleep restlessly, take longer to fall asleep and stay asleep for shorter periods of time than younger adults. Older adults also tend to wake up several times during the night.

For adults, sleeping less than seven hours per night on a regular basis has been linked to poor health, including weight gain, having a body mass index of 30 or higher, diabetes, high blood pressure, heart disease, stroke and depression.

Does poor quality and quantity of sleep contribute to microsleep?

Lack of sleep in terms of quality and quantity causes the brain to “demand” the sleep at other times throughout the day, resulting in microsleep. Even so, there are several diseases that can cause poor quality sleep, one of which is “sleep apnea”. Some individuals will feel that they have had enough sleep, but in fact they have woken up multiple times during the night due to improper breathing. When we sleep, our brain base will help us breathe automatically. But for some individuals, they will experience “obstructive sleep apnea” which is when the tongue falls back and closes the breathing space causing oxygen levels to drop and carbon dioxide to rise. When this happens, the brain will signal the brain.

Among the serious comorbidities caused by sleep apnea are stroke, diabetes, heart disease and also the potential to get cancer. These health conditions can all be fatal, and they are all related to obstructive sleep apnea.

• Diabetes

The relationship between diabetes and sleep apnea has long been identified. According to studies, the majority of type 2 diabetes patients also suffer from obstructive sleep apnea.

• Heart failure

As stated by the studies above, cardiovascular disease (i.e., the heart) is so closely related to common sleep apnea comorbidities that it is among the most frequently mentioned when discussing the health risks of sleep-disordered breathing. Sleep apnea is often observed in patients with heart failure, sleep apnea patients often have increased blood pressure.

• Stroke

Obstructive sleep apnea is very common in patients with transient ischemic attack and stroke.

• Cancer

Although the evidence for an association is not as strong as for other comorbidities, a study published last year in the American Journal of Respiratory and Critical Care Medicine has linked snoring and sleep-disordered breathing to an increased risk of cancer. Studies have found that mild or moderate snoring also increases the risk of dying from cancer.

• Obesity

All of these conditions are more at risk if you are obese. Individuals with obstructive sleep apnea have a high risk of sudden cardiovascular death.

Is the lack of quality and quantity of sleep the only cause of microsleep?

In addition to not getting enough sleep, an individual is also likely to have an “absence seizure” which is a short and sudden seizure. It is more likely to happen to children than adults. A person experiencing an absence seizure may look like he’s staring blankly into space for a few seconds and return to normal within seconds.

What treatments or tools are used to help sleep better to avoid microsleep?

For someone who wants to know if he has sleep apnea, he will be fitted with a detection tool such as polysonography on the body along with EEG (electroencephalogram), ECG (electrocardiogram) and oxygen. After that, the individual will be observed under expert care throughout the night. The purpose of installing this device is for sleep patterns including sleep time and wake time. If the results show a decrease in oxygen levels, the individual may have sleep apnea. If the results of this polysonogram show signs of “absence seizure”, this means that the sleep disorder is not caused by sleep apnea. There are also individuals who experience a condition where they always want to sleep, which is called Narcolepsy.

Narcolepsy is a rare long-term brain condition that causes a person to suddenly fall asleep at inappropriate times. These people need to get a doctor’s prescription to take the drug “modafinil”.

--BERNAMA

Dr Lim Poh Hin is a neurologist at KPJ Ampang Puteri Specialist Hospital.