Rude awakening: Sleep specialists realize many doctors know zilch about sleep

Here’s a question for all my doctor-colleagues: How many of your patients did you refer to another doctor in the past year? Of those, how many were referrals to a sleep specialist?

None? Nada? Could it be that the number of referrals you made to sleep experts is the same amount you know about sleep medicine – that is, zero?

I hope not. Abnormal sleep has been a silent contributor to many lethal illnesses, including intractable hypertension, stroke, and heart attacks. Not making a referral to Sleep Medicine is tantamount to missing out on an opportunity to save a patient’s life.

MIMS sleep medicineAfter a chat with a sleep specialist, I learned a few surprising things about sleep medicine… such as how many doctors don’t know much about it. Check out this screenshot of my MIMS article.

By the way, a patient who snores does not necessarily have obstructive sleep apnea (OSA), and vice versa. If there’s snoring, however, it is a good reason to consult a sleep expert – chances are, OSA is hiding under the covers.


Sleep medicine: Why it should matter to all doctors

Should I blame you if you didn’t know that you could (and should) refer your patients to sleep experts? Probably not. Sleep Medicine is a relatively young field of specialization in our country, with less than 50 sleep specialists in the Philippines to cater to the millions of Filipinos who are suffering from parasomnias and other sleep disorders.

But other than having a horde of doctors who look like zombies from lack of sleep, what is the harm in doctors not prioritizing a good snooze?

“After training, doctors have this notion that they could sacrifice sleep. They then carry that mentality when it comes to their patients,” says Dr. Virginia de los Reyes, president of the Philippine Society of Sleep Medicine, Inc. (PSSMI), during the 2016 World Sleep Day forum at the Lung Center of the Philippines.

World Sleep Day 2016Doctors tell colleagues to wake up during the World Sleep Day forum: We shouldn’t be snoozing on sleep-related health problems.

It’s not just about sleep. It’s also about public safety. When a doctor feels no urge to underscore the importance of a good night’s sleep, his patients stay ignorant and misinformed.

“Think of all the pilots and drivers who feel sleepy,” says Dr. de los Reyes. Then, think of all the people who have entrusted their lives to sleep-deprived pilots, drivers, train engineers, and many others whose profession banks on mental vigilance.

Think of all the lives in danger simply because nobody – not even their own doctors – has bothered to tell them that sleep is of utmost importance, not only to their own well-being but also to the lives of others.


Even physicians misunderstand sleep

“Many doctors think sleep disorders are not urgent,” says Dr. de los Reyes.

Aside from underestimating the urgency and importance of sleep, physicians also misinterpret sleep-related trends and statistics. “Most doctors [have a tendency to] profile patients. They expect patients with obstructive sleep apnea to be obese males.

“However, we’re Asians. Because of our Asian features, we don't need to be overweight to get sleep apnea. If you have a very young patient with hypertension, you usually find that he has sleep apnea if you have the initiative to check.”

Ridiculously enough, sleep specialists often become the butt of jokes, almost all of which are due to ignorance and miseducation.

“There are many basic things that even medical schools overlook [about sleep medicine] that it’s so difficult to change the mindset of these institutions.”

“We say we are sleep experts and they say, ‘So, you’re an expert on sleeping?’”

You might be surprised when you learn about the many other myths still rampant in the medical community. Check out this article I wrote for MIMS on why it’s time for doctors to wake up from their stubborn misconceptions about sleep.


Sleep medicine: definitely not dozing off

Only sleep specialists were invited to attend past sleep forums organized by PSSMI. More recently, doctors from other specialties are being asked to participate.

“The discussion [on sleep] should not be limited to sleep doctors only. In our forums, cardiologists now talk about heart problems related to sleep. Psychiatrists talk about how sleep disorders are related to psychiatric issues. Occupational health experts discuss sleep conditions and work safety.”

Aside from working with different specialists, PSSMI partnered with different brands that specialized in sleep, such as Uratex.

“Each doctor caters to two million patients. It’s obvious that we need help. One thing we do look at for good sleep is the quality of the bed,” says Dr. Keith Romeo Aguilera, PSSMI treasurer.


The art (and science) of sleep

Now that you know the importance of a good night’s sleep, it’s time to find out how one can sleep peacefully and comfortably.

These guidelines on how to choose the perfect mattress might help you and your patients. Everyone should know this because we sleep on our beds daily! “You spend seven hours of the day in bed. That's a huge chunk of your life,” says PSSMI Vice President Dr. Agnes Remulla.

Here’s to better sleep and better mornings. None of us don’t want to look like zombies, that’s for sure.

Because celebrations are healthy (or are they?)

Last week, I was a little crazier than usual.

I wanted to go to Jamba Juice to buy a fruit shake with a caffeine booster. I was coughing like a dog and I had ten deadlines – I knew I needed something natural yet chemically spiked (yep, loved ‘em paradoxes) to get me through the day. It was raining but, the hero that Stanley Chi was, he volunteered to go get my drink for me.

After thirty minutes, he was back. I heard his footsteps, then a splashing sound followed by a really succinct series of cusswords.

It dawned on me that he just dropped it. He dropped whatever it was that he bought for me, the magic juice supposed to make me feel well enough to work.

I didn’t know what came over me but I exploded like a bomb long overdue for detonation.

I screamed. I cried. I threw a major fit.


I’m a doctor, I don’t practice, and it’s okay

Is it your first time to visit my blog? Welcome! My name is Stef and I’m a doctor.

I studied medicine, graduated with Latin honors from the University of Santo Tomas, and passed the physicians’ board exams. No, I don’t currently practice medicine. Yes, I used to.

I now write for a living. You’re probably thinking, “What a waste! You studied medicine for nothing! And you’re an honor graduate, to boot! Que horror!

non-practicing doctorIt’s such a common sentiment among doctors who chose nonclinical careers that it should be on a shirt. (Thanks to my fellow doctor-writer, Aidz, for this idea.)

I bet you’re clucking your tongue and shaking your head like some telenovela villain, too, and I don’t blame you. Here, let me share with you a common scenario in my ten-or-so years of life as a writer:

New Acquaintance: Oh, so you’re a doctor? What’s your specialization? (smiles broadly)
Me: I didn’t specialize. (smiles)
New Acquaintance: (raises brow) Ah. Where do you practice, then?
Me: I don’t practice anymore. I’m a writer now.
New Acquaintance: (frowns) Really? Sayang naman ang pinag-aralan mo.

At that point of the conversation, a really nasty part of me is generally tempted to say, “Considering what you think of writers and how shortsighted you obviously are, mas sayang ang pinag-aralan mo.”

Digital dementia: If you're reading this, then you're at risk

Can you stand not watching TV or using your phone the entire day? No? Yeah, I thought so. Unfortunately, this addiction to everything digital that we all seem to be afflicted with might be making us dumber.

Dr Gary Small[2]Dr. Gary Small, who received a letter from the president in this photo, came to the Philippines to spread the word about brain aging and digital dementia.

They say we all have to use our gadgets less than we do – it’s allegedly good for our health. Although that’s good advice if you want to preserve your brain function, do we really have to be tech-averse just to stay sharp?


8 Brain tips to fight digital dementia

If you can’t stay away from gadgets (I know I can’t), here are a few suggestions based on Dr. Small’s pointers on how to prevent brain aging.

Brain tip no. 1:

Acknowledge your role in preventing brain aging

Some people think, “Hey, I’m getting old – being forgetful is natural.”

Well, ain’t that defeatist?

Dr.-Gary-Small2“Two-thirds of risk factors for brain aging are non-genetic and a lot of it is under our control,” says Dr. Gary Small, director of UCLA Longevity Center. “We have to get the message out there that 50 percent of dementia worldwide is attributable to these factors.”

So, basically, fighting brain aging starts in your mind.


Brain tip no. 2:

Don’t rely on your phone to remember everything

Glutathione lozenges and skin lightening: the (white) elephant in the room

Question: Do you want to whiten your skin? Are you unhappy with your beautiful, brown skin, the kind that every freckled, burns-rather-than-tans Westerner probably envies?

Pardon the judgment apparent in my second question (and the rather tacky pun that is the title of this article). As someone who has once used sunblock in highschool – not for sun protection, but for skin lightening “after just four weeks” – I shouldn't thumb my nose at anyone who wants fairer skin.

Thiocell glutathioneBe honest: Would you buy these glutathione lozenges if they could whiten your skin?

I've grown to accept – no, love – my skin. The more I understood why I wanted my complexion to be fairer in the past, the more I realized it wasn't white skin that I wanted. I wanted acceptance, something that I knew had to start with me.

I realized a few things about our skin preferences and a glutathione preparation by Brady Pharma, Inc. that I wanted to share with you. You might want to read this carefully, especially if you're stubborn about wanting fairer skin.

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