SLEEP DISORDERS

This information is not intended to be medical advice. If you feel you may have a sleep related disorder, please seek the advice of medical professionals. This information is intended to be used as an informational guide only.

What Is Sleep Apnea?

This is classified as a disorder of breathing during sleep. Sleep apnea is usually accompanied by loud snoring. Apnea consists of brief periods throughout the night in which you are sleeping and your breathing stops. When you have apneas your body is not receiving enough oxygen during sleep.

There are 2 major types of Sleep Apnea.

Obstructive Sleep Apnea, which is the most common type of sleep apnea, is due to an obstruction, or narrowing of the upper airway, in the throat during sleep. There are pauses in breathing approx. 10 to 60 seconds between loud snores. The causes of this narrowing of the upper airway can be a result of several factors including physical characteristics, excess weight, and alcohol consumption before sleep.
Central Sleep Apnea, occurs when your brain doesn’t send correct signals to the muscles that control your breathing.

With both obstructive and central apnea you will wake up briefly to breathe. This could be happening hundreds of times during the night. Most of the time there is no memory of these brief arousals or awakenings.

Insomnia

Having difficulty falling asleep
No problem falling asleep but difficulty staying asleep
Waking up too early
Sleep State Misperception

What can cause Insomnia?

There are many things can cause insomnia. Insomnia is a complaint. It is not a disorder. You and your doctor need to determine the underlying problem causing your insomnia.Almost any sleep disorder can present itself as insomnia. These may include: circadian disorders, sleep apnea, and restless legs. Ruling out a sleep disorder can be important.

Other factors include: Medications, herbs and caffeine, which can also cause insomnia. The information supplied to you when you pick up your medications from your pharmacy will indicate the possible side effects of your medication, which may include insomnia and sleepiness.

Events going on in ones life can cause insomnia. Usually these episodes are temporary.

Anxiety, can also be responsible, however, if the anxiety is due to a long history of insomnia, the anxiety is probably not the problem and you need to find out what is the underlying cause.

Physical problems such as pain can be an underlying cause. Having a mental disorder such as depression could cause a sleeping disorder. These problems can be treated.

There are three basic types of Insomnia

Transient insomnia – lasting for a few nights
Short-term insomnia – two to four weeks of poor sleep
Chronic insomnia – poor sleep that happens most nights and may last a month or so

Transient and short-term insomnia:

Generally this type of insomnia occurs in people who are temporarily experiencing one or more of the following:

Stress
Noise
Extreme temperature change
Sleep/wake schedule problems such as those due to jet lag or shift work
Medication side effects

Chronic insomnia:

Chronic insomnia is more complex and can result from different factors. These may include any underlying physical or mental disorders. Depression is one of the most common causes of chronic insomnia. Other causes may include arthritis, kidney disease, heart failure, asthma, sleep apnea, restless legs syndrome, Parkinson’s disease, and hyperthyroidism.

Behavioral factors including the misuse of caffeine, alcohol, or other substances; disrupted sleep/wake cycles as may occur with shift work or other nighttime activity schedules; and chronic stress may be the insomnia culprit.

The following behaviors have been shown to perpetuate insomnia in individuals:

Poor sleep hygiene
Worrying about having difficulty sleeping
Excessive amounts of caffeine
Drinking alcohol before bedtime
Smoking cigarettes before bedtime
Excessive napping in the afternoon or evening
Irregular or continually disrupted sleep/wake schedule

Difficulty sleeping is only one of the symptoms. Daytime symptoms include:

Tiredness
Anxiety
Unable to concentrate
Difficulty remembering things
Being irritable

Treatment for transient and short-term insomnia

Transient and short-term insomnia: This type of insomnia may not require treatment since these episodes may last few only a few days at a time. For some people who experience daytime sleepiness and impaired performance may benefit from the use of short-acting sleeping pills, which may improve sleep and next-day alertness. There are always potential side effects associated with the use of any type of sleeping aid. Please consult your physician prior to use.

Treatment for chronic insomnia consists of:

Consulting your physician for diagnosing and treating any medical or psychological problems.
Identifying any personal behaviors that contribute to your insomnia.

Any patient taking sleeping pills should be under the supervision of a physician. Your physician needs to evaluate the effectiveness of any sleep aids and to minimize any side effects associated with the sleep aids.

Behavioral techniques to improve sleep, such as relaxation therapy, sleep restriction therapy, reconditioning, and/or bright light therapy may tried.

Relaxation Therapy. There are specific and effective techniques that can be used to reduce or eliminate anxiety and body tension so that your body can relax and you may obtain restful sleep.

Sleep Restriction. People suffering from insomnia may spend too much time in bed trying to fall asleep. A sleep restriction program may benefit the insomniac by trying only a few hours of sleep during the night then gradually increasing your time period in bed until a more normal night’s sleep is achieved.

Reconditioning. Reconditioning is a treatment that reprograms you to associate the bed and bedtime with sleep. For example, not using their beds for any other activities other than for sleep and sex . i.e. no eating, reading, watching t.v., or working in your bed. With this the person is advised to go to bed only when they are sleepy. If you are unable to fall asleep, you should get up and stay up until you are feeling sleepy, and then return to bed. When trying this process, you should avoid taking naps and go to bed and wake up at the same time each day. With this exercise your body will be conditioned to associate the bed and bedtime with sleep.

Bright Light. Try resetting your internal clock by waking up the same time every morning and allowing as much bright light into your bedroom in the morning as possible. If you are having trouble staying awake in the evening, make it as bright in your home as possible.

Sleep State Misperception: Sleep state misperception is where a person will sleep most of the night but believe that they did not sleep at all.

Narcolepsy:

Narcolepsy is a disorder that affects the brain. This is where regulation of sleep and wakefulness takes place. Narcolepsy can be thought of as an intrusion of dreaming sleep (REM) into the waking state.

Narcoleptics continue to experience an irresistible need to sleep no matter how much sleep they get. People with narcolepsy can fall asleep at any given time. This may happen while at work, talking, or driving a car. This sleep can last from 30 seconds to more than 30 minutes. Narcoleptics can may experience periods of cataplexy which is the loss of muscle tone. This can range from a slight buckling at the knees to a complete, limpness throughout the body.

The onset of narcolepsy can occur at any time throughout your life, but generally occurs during your teen years. Narcolepsy has been found to be hereditary along with some environmental factors.

Symptoms may include:

Excessive sleepiness.
Temporary decrease or loss of muscle control, especially when getting excited.
Vivid dream-like images when drifting off to sleep or waking up.
Waking up unable to move or talk for a brief time.

Simple Test for Narcolepsy:

Do you feel like you could sleep for days and still wake up sleepy?
Do you ever collapse or feel weak when laughing?
Do you ever collapse or feel weak when angry?
Are you afraid you may fall asleep while driving?
Are you afraid you may fall asleep while doing activities such as taking a bath or swimming?
Did one any one in your family have the “sleeping sickness”?

Sleepwalking:

Sleepwalking is a behavior that is initiated during slow wave sleep and results in walking during sleep.

Symptoms of Sleepwalking: The walking or moving about that occurs while asleep. The onset typically occurs in prepubertal children.

Is Sleepwalking common: About 18% of the population are prone to sleepwalking. This is more common in children.. Boys are more likely to sleepwalk than girls.

What can be done about sleepwalking?

Being overtired can trigger sleepwalking, so try to get plenty of rest
Try a relation method, stress can also trigger an episode of sleepwalking
Seek medical attention so you and your physician can assess the degree of this disorder and determine the best way to treat it.

What are Sleep Terrors?

Sleep Terrors are characterized by a sudden arousal from slow wave sleep with a piercing scream or cry, accompanied by intense fear

What are the symptoms of Sleep Terrors?

A sudden episode of intense terror during sleep
These episodes usually occur within the first third of the night
Partial or total amnesia occurs for these events

Restless legs syndrome (RLS):

This is a disorder that affects the legs. This is a uncomfortable feeling in the legs. Most people refer to it as a crawling, tingling or prickling sensation. This can usually be relieved by moving or stimulating your legs. Medications of dopa agonist such as Requip or Mirapex may be beneficial.

These symptoms usually occur

When riding in a car
While watching TV
While reading
While sitting inactive
Lying in bed

These techniques may provide temporary relief of symptoms

Walking around
Taking a hot shower
Rubbing the areas affected

Periodic Limb Movements

A variation of RLS (Restless Leg Syndrome) is Periodic Limb Movements in Sleep (PLMS). PLMS are leg movements or jerks, which typically occur every 20 to 40 seconds during sleep. These PLMS may cause your sleep or you bed partners to be disrupted. Due to these disruptions, you may experience excessive daytime sleepiness.

Test for Restless Legs

Do your legs ache prior to bed time or when getting up?
Does your bed partner complain that you are kicking them at night?

Take the steps you need to research your sleeping problems. Sleep deprivation can be hazardous to your health. We live in a hurried society so that contribute to your sleep problem, but it could also be to a sleep disorder.

Don’t get caught up in the Sleep Dept game. Sleep Dept is when you do not get the sleep you need, you begin to build up a sleep debt. If you are losing one hour of sleep a day during the week, by Friday you have a 5- hour sleep debt. We try to make up for this by sleeping in on days we don’t have to work. This can make for a dangerous situation if a person driving has a sleep dept, especially if they have alcohol on top of it.

How much sleep does a person need? Usually enough sleep to feel alert. Typically the average person requires 7 to 9 hours of sleep to feel at their best.

If you feel that you may have a sleep disorder, please see you physician and discuss this matter with them. Then follow through with what recommendations your physician suggests.