Published: 00:01, 20 November 2018
| Updated: 14:32, 19 February 2020
Thousands of people across Kent are suffering from chronic sleeping problems, which could have potentially dangerous consequences.
Nearly 8,000 patients are being treated at a specialist sleep clinic at William Harvey Hospital in Ashford, which currently has a two-month waiting list due to growing demand.
But experts fear the figures could just be the tip of the iceberg as most people with sleep apenea - the most common condition they diagnose - don't even know they have it.
The disorder happens when a person involuntary stops breathing for a split second repeatedly during the night, due the narrowing of muscles in the airway, starving the brain of oxygen and stopping the body from being able to properly rejuvenate.
In a moderate case that happens more than 30 times a hour, but Dr Bandipalyam Prathibha, who heads the sleep clinic, has treated cases where people were waking up 100 times an hour.
"The body recognises it as a form of stress so it produces a whole lot of adrenalin - it's almost as if you have gone on the treadmill, even though you are supposed to be asleep," she said.
"So what happens is even though a person has slept for eight or even 10 hours the brain never gets the quality or amount of deep sleep or dream sleep required to feel refreshed.
"So the sufferer feels extremely tired during the day."
Dr Prathibha says the importance of sleep, which accounts for a third of our lives, is often underestimated.
"If you don't have refreshing sleep then you're not able to perform during the day," she told KentOnline.
"Sleep deprivation was used as a form of torture - and probably still is in some countries - and it just shows how much it can interfere with your daytime activities."
One of the problems with sleep apnea is the consequences of having the disorder - such as rising blood sugar levels, an irregular heart rate, and high blood pressure - means GPs can end up treating that rather than the underlying cause.
"Most people attribute it to getting old or working long hours, but over a period of time what happens is chronic sleep deprivation starts having an effect on their memory recall," says Dr Prathibha.
"It's very subtle, something that would take them a few minutes would take five minutes to do.
"A lot of them get diagnosed with depression and other illnesses, but unless we actually study how they breathe and how they sleep we wouldn't know they had sleep apnea."
The consequences of sleep apnea can be life-changing in some cases, with studies showing the reaction time of sufferers behind the wheel can be slower than drink drivers.
"Sleep deprivation can have a major affect on the way people function both in the workplace and at home," said Dr Prathibha.
"The DVLA have now made it a legal requirement that people with sleep apnea inform them of their diagnosis.
"The impact on having undiagnosed sleep apnea on the person and on society as a whole and on the roads is huge."
"Sleep deprivation can have a major affect on the way people function both in the workplace and at home"
People with the condition and other sleeping problems, especially insomnia, can often turn to alcohol to try and help them sleep.
"There's no doubt most people think if you drink a little bit you're going to fall asleep easy, which is true," says Dr Prathibha.
"But it fragments sleep even more and relaxes the muscles so sleep apnea is a lot worse when people have a drink."
If left untreated, sleep apnea can also led to heart and lung problems and issues with the body's endocrine organs such as the pancreas.
People classified as obese are more at risk of getting the condition and in some cases it can be genetic if a person is born with a narrow airway.
However, Dr Prathibha says lifestyle can also make a difference, particularly if a person is putting on weight, frequently drinking alcohol, or smoking.
The sleep clinic takes in patients from the whole of east Kent as well as referrals from Maidstone, and Tunbridge Wells and operates from Ashford, Canterbury and Margate.
Its preferred treatment for sleep apnea involves the suffer wearing a CPAP (continuous positive airway pressure) mask while sleeping.
It works by increasing air pressure in the patient's throat so their airway doesn't collapse when they breathe in.
However, due to the intrusive nature of the mask, its success depends on how the patient takes to it, with up to 15% of people choosing to stop using it.
Another option is wearing a device similar to a gum shield that keeps the jaw open enough, while some private clinics offer patients laser surgery to remove excess tissue in the throat.
It is not just the sleep clinic which has been impacted by growing sleeping disorders.
Dr Julian Spinks, a GP in Strood and vice-chairman of Kent Local Medical Committee, said: "We're definitely starting to see more people coming forward.
"There's always been a problem for many years as people get older with insomnia.
"The big change I see is a lot of people who are middle age or younger coming in saying they have very poor sleep that's starting to affect their daytime behaviour.
"We are moving towards a 24-hour society.
"What that means is the rhythm of life we had where in the daytime you were awake and night you went to sleep is disappearing.
"Artificial light means are ability to stay up is extended and there is good evidence that some LED lights can actually inhibit sleep and make it more difficult to get off.
"The fact people are missing a night's sleep is a much bigger problem than you might initially imagine" - Dr Julian Spinks
"We also see that when people are using things like mobile phones and tablets which tend to have a bright bluish light."
Dr Spinks said people's jobs can also have an impact on the quality of their sleep.
"The zero hours contact workforce these days have difficulties because they can't get into a routine," he said.
"Not getting enough sleep is a danger beyond just feeling tired.
"It has an impact on things like your memory, your ability to concentrate on tasks, it makes people depressed, it causes things like weight gain and an increased risk of serious diseases, including diabetes and heart disease.
"When you put all of that together it means that the fact people are missing a night's sleep is a much bigger problem than you might initially imagine."
Dr Spinks warned medication was not a proper solution to sleeping problems.
"Sleeping tablets have a brief effect where they are helpful but after that they are often counter-productive both because they can become addictive and also because you have poorer quality sleep."
He advised people with sleeping problems to try the following steps:
"I do feel modern life is not really conducive to having good quality sleep, it does impact on people's ability to have a good routine and often as we become more stressed out by the pressures of work it makes it much more difficult to allow yourself to drop off to sleep," added Dr Spinks.
"Ultimately if we don't take some action to improve people's life quality we will get a generation of people who have poorer sleep and that increases the risk of both psychological and physical illness.
"The NHS inevitably has to pick up the tab when there's an increase of any sort of illness, including insomnia, and of course that is diverting money away from other illnesses and because it means people get more physical illnesses that has an even greater impact on the NHS."
Dr Spinks says older people often think they have insomnia because they tend to need less sleep at night.
"The big clue is if they are sleepy during the day they probably aren't getting enough at night, but if they are wide awake all day then the likelihood is their night time sleep is sufficient and they don’t need to push it further," he said.
Another sleep expert seeing more patients is Katie Palmer, an infant sleep consultant based near Sevenoaks.
Expert explains to KMTV why sleep changes as we get older
She sees an average of three families a week with children ranging from six-months-old to five years.
The most common problem she deals with is sleep onset association disorder, where a child has an inability to fall asleep without some kind of help.
The mum-of-three, who has 22 years experience in the field and carries out home visits in Kent, Surrey, Sussex and London, says such problems are often caused by a lack of education about sleep.
“As a society we don’t put enough importance on the need for sleep because it is just as important as eating well and exercising well," she said.
“If you haven’t had a good night’s sleep you don’t really want to get up and have any exercise, you are much more likely to eat rubbishy stuff.
“A very tired young child will really struggle with their emotions because they’re tired, they get frustrated, they might have more temper tantrums, it can affect their development because they’re too tired to be making those neurological connections and figuring things out.
“It can affect their appetite so they are off their food."
Mrs Palmer says research shows good quality sleep is important for children - around 11 hours a night up to the age of five or six - to be able to consolidate and retain memories, particularly around periods of study, and also to help their immune system.
“By putting a bigger importance on this you are giving your child the best chance possible to thrive," she said.
Mrs Palmer is also concerned about the impact of technology on sleep.
“Modern technology is part of our everyday lives, with various channels for children on TV, and IPads and IPhones and Kindles, and although we do need to accept they are part of our life now it is finding the time and place for them," she said.
“A lot of them emit a blue light and that can block your body from releasing melatonin, which is the hormone that makes you sleepy.
“So if your child is watching TV too close to bedtime or if you have an older child who is not reading a book but is reading it off an electronic book reader and then they switch it off and go to bed then the chances are that’s delayed the onset of sleep so they’re going to find it hard to get to sleep.
"Don’t use technology an hour before going to bed."
Up to 175 people in Kent have had their driving licences revoked after being diagnosed with a sleep-related health problem.