Prof. Dr. med. Peter Young is one of the most acknowledged experts in the field of sleep medicine in Germany. In this interview, he says why you should not stay in bed if you cannot sleep and that most patients don’t need a sleep laboratory but intensive counseling.
Clinic Compass: Prof. Young, a doctor from Wuhan found out that during the quarantine, 19.9 per cent of 21.44 people calling a hotline were suffering from sleep problems. Did this number increase?
Prof. Dr. Peter Young: Yes, this number increased. The burdens on the people during the pandemics can cause sleep disorders or intensify already existing ones. The environmental stimuli that are normally present in the evening which make you sleepy cease to exist. Additionally, there are restrictions to mobility, thus there are less tiring activities. When someone is infected with the Coronavirus, there are additional questions such as: Am I getting sick? How severe is the illness for me? What are the consequences? There are many factors that lead to sleep deprivation.
Clinic Compass: What can I do if I suffer from a sleep disorder?
Prof. Dr. Peter Young: It is normal that we have trouble sleeping in a psychosocial stress situation. Focusing on one aspect, however, usually results in poor sleep which can be further aggravated. Therefore, the patient should not forcefully try to sleep. It is better to do something different for half an hour than to stay in bed, to read something or go for a walk. It is not a good idea either to go to bed earlier the next evening, as the time you lie in bed awake increases. Lying in bed awake for a long time can cause chronic sleep disorders.
Clinic Compass: Many practical guides about sleep hygiene recommend that you should sleep seven to eight hours. What do you think about that?
Prof. Dr. Peter Young: We at the German Sleep Society (Deutsche Gesellschaft für Schlafforschung und Schlafmedizin) are not very happy about this recommendation. This is because we know that the total sleep time has a very strong genetic component. It is true that most people need between seven and eight hours of sleep. You can recommend this amount of sleep to those people. However, it doesn’t make sense to tell someone who doesn’t sleep long that they have to sleep for seven hours. The same applies to late risers who need 11 hours of sleep. You can’t tell that person that they only need seven hours of sleep. That’s why we recommend that everyone should become aware of their need for sleep and take it seriously.
Clinic Compass: Patients with sleep disorders can spend a night in a sleep laboratory – a patient room in a clinic that electronically monitors the sleep disorder. How do patients get into the sleep laboratory?
Prof. Dr. Peter Young: Ideally, people who have trouble falling asleep or sleeping trough, first visit their family doctor. The doctor looks whether there are any physical conditions that cause the sleep disorder. If the doctor doesn’t find anything, he ideally sends the patient to an expert in the field of sleep medicine. For patients with a sleep disorder, the sleep laboratory isn’t the most important aspect, it is the expert who is experienced with the anamnesis and diagnostic of difficulties to fall asleep or to sleep through the night. Going to a sleep laboratory only makes sense if the expert suspects that the patient suffers from another organic sleep disorder, such as a sleep-related breathing disorder or a limb movement disorder for example. Only 10 percent of all patients suffering from insomnia actually need to go to a sleep laboratory.
Clinic Compass: How is the German sleep medicine positioned compared internationally? Do patients from abroad come to German sleep laboratories for treatment?
Prof. Dr. Peter Young: Probably not that many, we are already happy when we can care for all the German patients. There is a great need and undersupply in sleep medicine. Within Europe, German sleep medicine has a very high reputation. We are the biggest professional association for sleep medicine in Europe with more than 2,000 members. We have our own quality assurance program for the diagnosis of sleep disorders, because the German Sleep Society issues certificates for sleep laboratories if they have the required quality of processes and structures. In addition, we are pioneers in Europe when it comes to the training of experts in sleep medicine.
Clinic Compass: In which other countries is sleep research also an important topic?
Prof. Dr. Peter Young: Sleep research is well developed in the US, France and Italy are good as well, Australia has a good system, too. However, our kind of quality assurance for sleep laboratories is unique in the world.
Prof. Dr. med. Peter Young directs as the department of neurology of the Medical Park Clinic in Bad Feilnbach Reithofpark near Munich as Medical Director and Chief Physician. He is the Head of the German Sleep Society (Deutsche Gesellschaft für Schlafforschung und Schlafmedizin, DGSM).