TALLINN - Most people would consider someone who stops breathing for four-and-a-half minutes while sleeping a corpse. But not Mart Kull - to him such nocturnal abnormalities just represent patients in need of a good widening of a deviated septum or a quick tightening of an oversized tongue.
Kull is an otolaryngologist - a doctor who specializes in physical afflictions of the ears, nose and throat. A self-described "surgery enthusiast," Kull has been helping patients with sleeping disorders get through the night for the past 12 years via his leadership of Tartu University Hospital's Sleep Center.
"Our Sleep Center specializes in obstructive sleep abnormalities - not psychological problems," he says. "These are mainly people who snore, as well as people who have respiratory difficulties - people who don't breath for several minutes while they are sleeping."
The Sleep Center's record for sleeping without breathing is a whopping four minutes and 24 seconds. As far as the highest number of times a patient stops breathing - the center has monitored a patient who ceased breathing during 478 distinct periods in one night.
"It's mainly an anatomical condition," he says of his clients. "Their breathing spaces are so narrow they obstruct breathing patterns," he says. "They can be corrected though - with surgical methods."
Along with the 57 employees of the Sleep Center, Kull evaluates and proposes surgeries for patients usually by operating on narrow nasal cavity walls to make them bigger.
Over the next few weeks, however, patients are in for a special treat. The Sleep Center will begin providing patients with overly large tongues - a common condition in snorers - an opportunity to receive tongue-reduction plastic surgery.
For this kind of surgery, a needle is first inserted in the tongue and then used to create an electronic tightening of the muscles, which in turn reduces the tongue's mass.
It's the first time the new procedure will be used in Estonia, as well as the other Baltic states, and it stands as a new chapter in the 12-year history of the Sleep Center.
When Dr. Kull first took over from his predecessors in 1992, however, they were doing a few hundred cases a year. In 2003, they had close to 8,500.
So why the surge in surgery?
"The most useful way of advertising our services is through personal contacts," says Kull. "Patients who are cured go to their friends and colleagues and say how we helped them."
The center also advertizes via TV, radio and Internet, and due to its high success rate it has received little bad press over the years - the kind, Kull notes, can easily destroy any clinic's reputation.
"Every year our numbers are rising. The patients are happy, so the awareness of the clinic is also increasing," he says.
The spike in interest has created a waiting list, with patients often waiting several months - depending on who lives where - for surgery, evaluation time included. Patients are monitored in special "sleeping rooms" to determine what kinds of procedures they require.
While Kull explains that only 30 percent - 35 percent of the clinic's patients are snorers, they are usually males over 40 who suffer from abnormalities that drive either them or their wives crazy.
"We can't explain why it's men, but oddly the same conditions exist in male animals," he says.
Also, contrary to the cultural idea of snoring as being an innocuous sleeping condition, doctors warn that chronic snoring can lead to cardial problems and high blood pressure. Kull even goes so far as to pin Estonia's low birth rate on sleeping abnormalities, as well as other factors.
It may seem a stretch, but sleeping is even a topic that Kull and His Holiness the Dalai Lama discussed at great length when the Dalai Lama visited Estonia in 2001.
"I also told the Dalai Lama about how we treat children with breathing abnormalities and their success rate," he says, noting that sleeping conditions disappear within two days following surgery.
The special distinction of being one of Estonia's most recognized surgeons comes with a downside for the center's leader, who says he tries to fit his family life into his busy schedule. Still, he's happy to report none of them have required his services.
"They haven't started snoring," he says. "Not yet."
Dreamy factoids...
1. One-third of our lives is spent sleeping.
2. In your lifetime, you spend about six years of it dreaming. That is more than 2,100 days spent in a different world.
3. Dreams have been here as long as mankind. Back in Roman times, significant dreams were submitted to the Senate for analysis and interpretation.
4. Everybody dreams. Simply because you do not remember your dream does not mean that you did not dream.
5. Dreams are indispensable. A lack of dream activity can mean protein deficiency or a personality disorder.
6. We dream on average one or two hours every night. And we often even have four-seven dreams in one night.
7. Blind people do dream. Whether visual images will appear in their dream depends on whether they where blind at birth or became blind later in life. But vision is not the only sense that constitutes a dream. Sounds, tactility and smell become hypersensitive for the blind and their dreams are based on these senses.
8. Five minutes after the end of the dream half the content is forgotten. After 10 minutes 90 percent is lost.
9. The word dream stems from the Middle English word, dreme, which means "joy" and "music."
10. Men tend to dream more about other men, while women dream equally about men and women.
11. Studies have shown that our brain waves are more active when we are dreaming than when we are awake.
12. Dreamers who are awakened right after REM sleep, are able to recall their dreams more vividly than those who slept through the night until morning.
13. Physiologically speaking, researchers found that during dreaming REM sleep, males experience erections and females experience increased vaginal blood flow - no matter what the content of the dream. In fact, "wet dreams" may not necessarily coincide with overtly sexual dream content.
