You are getting sleepy ... (Photo courtesy iStock)
Sleep is a crucial component to healthy living, says the director of the University of Maryland Sleep Disorders Center.

For decades, Dr. Steven M. Scharf worked as a pulmonary disease and critical care specialist at medical institutions in the New York and Boston areas, as well as in Israel. But during the past 16 years, he has dedicated his professional life to one particular medical pursuit — sleep.

“For me, there’s a lot more satisfaction in the sleep field,” says Dr. Scharf, founding medical director of the University of Maryland Sleep Disorders Center. “If you help someone who’s dealing with insomnia, what a difference you can make in their life. It’s like night and day. Their quality of life is so much better.”

Located at the University of Maryland Medical Center Midtown Campus, the center is a comprehensive program designed for the diagnosis and treatment of sleep disorders.

An estimated 40 million Americans suffer from chronic disorders of sleep and wakefulness. The center offers a team of multi-disciplinary specialists to help diagnose and treat a wide range of disorders, from insomnia and sleep apnea to snoring and narcolepsy.

Dr. Scharf
Dr. Steven M. Scharf with a patient. (Handout photo)

Dr. Scharf, a professor at the University of Maryland School of Medicine, says the center conducts between 1,200 and 1,500 sleep studies annually and sees approximately 600 to 700 patients monthly.

“There’s no one-size-fits-all,” he says, noting that the center has a 60 percent success rate. “Everyone is different.”

A native of Nanuet, N.Y., Dr. Scharf received his medical degree from the Johns Hopkins University School of Medicine and his doctorate in environmental medicine from the JHU School of Public Health.

Jmore recently spoke with Dr. Scharf about sleep disorders and their impact on general health.

How’d you get interested in sleep?

A million years ago when dinosaurs roamed the Earth and I was doing my pulmonary fellowship, we were asked to see a patient who was in respiratory failure for no obvious reason. We examined her and found that her tongue was huge. My mentor said, ‘I wonder if it’s sleep apnea. Find out what we should do.’ So I read up and told him all about sleep apnea. I said, ‘You’ve got to do a sleep study.’ Things in this field were still very new, so we watched this lady at night and she had horrible sleep apnea.

This spurred my interest in sleep disorders. It was a hobby of mine, and I joined the Sleep Disorders Center at Long Island Jewish Medical [Center]. In 2002, what was once a hobby became my full-time job when I was invited to come here and create a sleep center.

Why is sleep so crucial?

I don’t know [laughs]. No one really knows why we sleep, but if you don’t, you die. I take in my car every 3,000 miles to be serviced, and then it drives. But our bodies can’t wait that long. We need a tuneup every night. We know that toxins are washed out of our brains during sleep, and there’s a reconstitution of memories and rebuilding of proteins and damaged muscles. We know it’s vital, but the reason [for sleep] is we don’t really know.

Does our society yet understand the need for good sleep habits?   

Sleep deprivation in our modern society is extremely prevalent. We have TVs, cell phones and computers with enough light in their LCD screens to turn off our nighttime hormones. So our sleep today is bad and getting worse. People need tremendous discipline to sleep.

Forty percent of the population has insomnia at any given time, but 8 to 10 percent of men and 10 to 12 percent of women have chronic insomnia. It’s very common, and people’s sleep habits are really crummy.

Define insomnia.

It’s the difficulty of initiating and maintaining sleep. If you wake up at 4 in the morning and are perfectly fine and starting your day, you may just be a short sleeper. Some people do fine with five hours of sleep and don’t have a problem. But that’s rare.

What do you recommend to eliminate insomnia?

First of all, fix a bedtime and fix a time to rise. It should always be within an hour or two each day. Second, 20 to 30 minutes before bedtime, all computers, cell phones and TVs should be off. Three, do a little downer activity — some light reading, a bath or shower, maybe a light snack (no caffeine), listen to soft music, relaxation exercises — always at the same time each night. Also, your bedroom should always be dark, cool and quiet. Your bedroom should be for sleeping and sex — that’s it!

How does stress impact sleeplessness?

If you have an underlying mental health issue or stress, depression or anxiety, you might have what I call “the chatty brain.” But there are behavioral things you can do to reduce that, like relaxation or breathing exercises or yoga. Chronic insomnia can be treated with cognitive behavioral therapy, while acute insomnia can be treated with sleeping pills. We’re not a pills-pushing clinic, so we tend to take a behavioral approach. But pills are like a tool — you use them when you need to.

Are we more stressed out than previous generations?

There’s a lot more stuff going on at night than there used to be. It used to be that when the sun went down, you were done. Now we have so much, more than [previous generations] did. Everything today is available 24/7, so we have to discipline ourselves.

How many hours of sleep do we need each night?

It varies and depends on the person. Different people have different sleep needs. Five to nine hours is normal, but seven to 7½ is the average. But there’s a lot of chronic sleep deprivation out there and that reduces your ability to read, concentrate and reason. You can’t just make it up by sleeping in late one day on the weekend.

What about all of the trends and fads out there promoting better sleep?

The mattress companies like to tell you how being comfortable [promotes enhanced sleep]. It makes sense, but we don’t really know. Aerobic exercise makes sense, but not late at night. Food supplements like herbal medicine promise sleep, but the data is not that great. Some over-the-counter sleeping pills contain antihistamines like Benadryl, and that makes people sleepy. There’s no good data on valerian root, but it contains a substance resembling valium-class medicine.

What about melatonin?

Melatonin is what I call, “Our natural hormone of the dark” [laughs]. When the sun goes down, melatonin is released in the brain and signals it to go into nighttime mode. When the sun comes up, melatonin secretion stops and that signals the brain that it is day. We do offer patients melatonin in certain situations. But does it do any good? It’s not been shown to be a substitute for a sleeping pill.

How do you feel about caffeine?

In some people, it can last from six to 12 hours, so we advise no caffeine beverages after 2 p.m. I also advise one to three cups, or there’s a carry-over. Of course for shift workers, it’s different.

Alcohol?

The initial effect of alcohol — I’m talking about a nightcap here, not a glass of wine with dinner — is that it makes you sleepy. But it can also make sleep apnea worse, and it can become a stimulant for waking up when alcohol levels in the blood fall. A lot of people wake up at 2 in the morning [when drinking alcohol], so it’s not highly advised.

How do you feel about pets in the bed?

Many people experience stress reduction and great solace from pets, but we encourage everyone to make sure the doggie or the kitty is not sleeping with you. It could be a stimulant for waking up. We encourage animals to sleep in their own areas. They can be trained that’s where to sleep.

Counting sheep?

Counting sheep is actually a reasonable exercise because it’s an attention diverter. It turns your chatty brain off. We have other attention diverters as well, but if counting sheep works for you, have a ball.

Your perspective on naps?

If we’re talking about an ordinary situation, we tend to be at our sleepiest from 3 to 5 a.m. Our secondary downer time is 3 to 5 in the late afternoon. It’s our biological clock. That’s why many cultures evolved a siesta. But if you take two- to four-hour naps in the afternoon, you won’t sleep at night. An afternoon nap shouldn’t be more than 45 minutes, maybe an hour.

Talk about sleep apnea.

It’s the most common reason for referrals to sleep disorder centers. As obesity has increased in our society, sleep apnea has increased as well, although half of the people with sleep apnea are actually not obese.

The word apnea means not breathing. The airway closes off behind the tongue or nose, and the brain says, “I ain’t getting any air.” It puts a strain on the heart, and if this happens every night, it’s a major risk factor for things like heart attacks, strokes, type 2 diabetes, Sudden Death [Syndrome], cancer.

What about snoring?

Forty percent of people snore. There’s cyclical snoring, which doesn’t mean sleep apnea, and then there’s non-cyclical snoring, which you see with sleep apnea. That’s when you have snoring every few breaths. We’ve seen many men who are pulled in kicking and screaming by their poor, long-suffering wives [due to excessive snoring].

Does the medical community at large understand the complexity and seriousness of sleep disorders?

Most medical schools only give two to four hours of sleep education to their students. You spend a third of your life asleep and there are 62 sleep diagnoses, yet the amount of education of sleep disorders is sorely lacking. We need a major oversight institution to mandate it.

This is a sore spot for those of us in the sleep community. We’re getting a lot of referrals, and we’re not considered exotic or on the periphery anymore. Sleep apnea gave [sleep disorders] a big boost for awareness. But we’re still trying to educate people out there.

So how do you personally sleep at night?

I do pretty well. I’ve always been a good sleeper. Of course, everyone has their good and bad nights.

And business at the center is good?

Yes, we’re very busy, thank God. We’re talking about expanding the center because the need is so great.

For information about the University of Maryland Sleep Disorders Center, call 410-706-4771 or visit umms.org/midtown/health-services/sleep-disorders.

You May Also Like
What Exactly is Ketamine and Is It Effective?
vials and needle

A pair of local social workers discuss the pros and cons of ketamine-assisted psychotherapy.

Baltimorean Dr. Ruth Gottesman Donates $1 Billion to Einstein College of Medicine
Albert Einstein College of Medicine

The gift -- which will be tuition-free for the indefinite future -- is intended to attract a range of students to the medical school in New York.

Evexia’s Kerryann Gross Works with Patients for Long-term Success
Kerryann Gross

If weight loss and wellness are on your list of New Year's resolutions, Kerryann Gross, owner of Evexia Weight Loss and Wellness Clinic, may have the answer.

Sinai Employee Ira Ackerman Retires After 45 Years at Hospital, Becomes Professional ‘Tinkerer’
Ira Ackerman

A Northwest Baltimore native and resident, Ira Ackerman has invented a game called Gridiron Golf that incorporates the rules of football for scoring with miniature golf.