Our speaker at the final Lunch and Learn program for 2023 was Dr. Kirk Watkins, MD and sleep specialist in charge of the Sleep Center at St. George Regional Hospital. Dr. Watkins spoke to various questions and comments posed by the attendees and the first topic addressed was the pervasive problem - Insomnia. We were surprised to be told that insomnia is a learned behavior which can be unlearned. After experiencing either a negative or positive life event, we may suffer sleep loss, which is then perpetuated because wakeful sleep patterns have been formed. Dr. Watkins suggested that if unable to sleep within thirty minutes of going to bed, we should get up and engage in some quiet, relaxing activity, free of lights or screen time. Various sleep aids and suggestions for curing insomnia are commonly touted in the media, but the most effective treatment is cognitive therapy conducted by a certified sleep psychologist. There are educational phone Apps dealing with the subject, which may be downloaded, with one of the best having been developed by the VA. It is free and titled, "Insomnia Coach." Other strategies which may promote better sleep are wearing ear plugs, listening to white noise, meditating, and using red bulbs in nights lights because our wake centers are not sensitive to red light.

We explored the diagnosis of restless leg syndrome, which can result in irregular sleep patterns and is known to have a genetic component as its cause. Dr Watkins shared that recent and important findings show RLS might actually be a brain iron deficiency syndrome because those affected have been found to be deficient in the glutamate receptors responsible for extracting iron from the blood in the brain.

We also discussed the use of over-the-counter medications for sleep:

• Benadryl - antihistamine, longer-lasting sedation resulting in next day sleepiness and its anti-cholinergic properties may make possible dementia worse over time.
• Allegra - safest as only antihistamine that is non-sedating and not anti-cholinergic
• Melatonin - OTC unsafe over long term and studies show actual dose may be considerably stronger than that shown on label. Medical grade melatonin by prescription can be therapeutic.

We all know about the condition of sleep apnea, and while even babies and toddlers can be diagnosed as having the problem, it is imperative at any age to investigate any suspected lack of proper oxygenation during sleep because it could be a matter of life or death - high blood pressure, strokes and heart issues. Currently, most sleep studies are conducted as home tests. If treatment is indicated, there are various styles of masks from which you may choose or an oral appliance may be effective in certain circumstances. Available also, at significant cost and requiring intervention, is an implantable nerve stimulating device, Inspire.

If you would like to listen to the audio from Dr. Watkins' presentation, it can be found here.