Sleep ~ Wake Center

Sleep Disorders

There are more than 50 sleep disorders classified by the American Academy of Sleep Medicine (AASM). A sleep disorder impacts a person's daily life severely. More common sleep disorders include insomnia, sleep apnea, narcolepsy and restless leg syndrome.

Symptoms of Sleep Disorders

Common complaints of patients who have a sleep disturbance can include:

  • Excessive daytime sleepiness
  • Chronic daytime fatigue not explained by any other medical condition
  • Difficulty waking up on time
  • Disruptive sleep (snoring, gasping or breath holding)
  • Difficulty initiating or maintaining sleep (insomnia)
  • Falling asleep too early
  • Unwanted behaviors arising out of sleep

Each of these symptoms can be connected by a sleep specialist to a particular disorder. This is why a sleep specialist may want to have you sleep overnight in the facility or may give you equipment to test yourself at home.

Insomnia

When you feel that you cannot fall asleep or stay asleep, it is called insomnia. You may have one or more of these things happen to you while trying to sleep:

  • Difficulty falling asleep
  • Waking up frequently during the night with difficulty returning to sleep
  • Waking up too early in the morning
  • Non-refreshing sleep and daytime fatigue

Insomnia is classified by figuring out how often you experience it. Here is a list of these classifications:

  • Transient or short term insomnia where symptoms may last from a single night to a few weeks
  • Intermittent insomnia where episodes occur from time to time
  • Chronic insomnia where it occurs most nights and lasts for a month or more

There are many different things that can contribute to insomnia. These can include the following:

  • Stress
  • Depression
  • Anxiety
  • Physical illness
  • Irregular schedules
  • Caffeine consumption
  • Circadian rhythm disorders
  • Drugs
  • Pain
  • Post Traumatic Stress Disorder  

Some people also may not realize they are having insomnia, or their sleeping disorder may be something else entirely.

Sleep Apnea

Sleep apnea is a very serious and sometimes life-threatening condition. It occurs in all age groups and both genders and can be divided into two different types:

  1. Central apnea, which happens when the nervous center either does not send signals to breathe or the signals aren’t conducted to the muscles responsible for breathing. Central sleep apnea is not as common as obstructive sleep apnea.
  2. Obstructive apnea (or OSA) happens when the tongue or soft tissues in the back of the throat block the airway. This blockage causes little or no airflow into the lungs and occurs even though your body continues to try to breathe.

There are many factors that lead to sleep apnea. Here is a list of these factors:

  • Family history
  • Physical abnormality in the nose, throat or other parts of the upper airway
  • Body weight
  • Medical/health problems
  • Medication use
  • Alcohol use
  • Age
  • Altitude of your home
  Also, sleep apnea can often happen along with these conditions:  
  • Irregular heartbeat
  • High blood pressure
  • Heart attack
  • Stroke
  • Excessive sleepiness leading to auto accidents
  • Obesity
  • Diabetes

If you have any of the conditions listed above, it is a good idea to pay careful attention to your sleeping patterns. You, working together with your sleep specialist, can determine the best treatment for your sleep apnea. 

Narcolepsy

Narcolepsy is a chronic, neurological sleep disorder with no known cause that involves the body's central nervous system. It is a genetic disorder where a part of the brain called the hypothalamus is not producing enough of the neuropeptide orexin.

The main characteristic of narcolepsy is overwhelming daytime sleepiness, even after adequate nighttime sleep. A person with narcolepsy is likely to become drowsy or to fall asleep at inappropriate times and places, and these sleep attacks may occur with or without warning. They can also occur repeatedly in a single day, the person may be drowsy for long periods of time and they may wake frequently during their nighttime sleep.

Each individual may experience narcolepsy differently, but these are the most common symptoms:

  • Excessive daytime sleepiness (EDS) when an individual has an overwhelming desire to sleep at inappropriate times
  • Cataplexy, which is a sudden loss of muscle control ranging from slight weakness to total collapse
  • Sleep paralysis where the individual is unable to talk or move for about one minute when falling asleep or waking up
  • Hypnagogic hallucinations, which are vivid and often scary dreams and sounds that the individual has when falling asleep

Secondary or other symptoms include:

  • Automatic behavior, where the individual performs routine tasks without being aware that they are doing so and often without memory of it
  • Disrupted nighttime sleep, which can include multiple arousals

An individual may have difficulty coping and can experience these symptoms:

  • Feelings of intense fatigue and continual lack of energy
  • Depression
  • Difficulty concentrating and memorizing
  • Vision problems (focusing)
  • Eating binges
  • Weak limbs
  • Difficulties handling alcohol

Narcolepsy is diagnosed most often by symptoms of EDS or cataplexy. In addition to these symptoms, a specialist will want a complete medical history from you and to conduct a physical examination as well as laboratory tests to confirm the diagnosis. The specialist may use these tests:

  • Overnight polysomnogram (PSG), which is a sleep test to monitor various parameters during an entire night of sleep
  • Multiple Sleep Latency Test (MSLT), which measures sleep onset and how quickly rapid eye movement (REM) sleep occurs
  • Genetic blood test, which is used to test for a genetic mutation often found in people who have a predisposition to narcolepsy

Treatments for narcolepsy can include the following methods:

  • Medications: excessive daytime sleepiness and cataplexy are treated separately, with central nervous system stimulants usually prescribed for EDS and antidepressants for cataplexy.
  • Nap therapy: two or three short naps during the day may help control sleepiness and maintain alertness.
  • Proper diet
  • Regular exercise
  • Behavioral therapy

The goal of narcolepsy treatment is for the patient to remain as alert as possible during the day and not have any recurring episodes of cataplexy, while using a minimal amount of medication. You and your specialist will determine the best possible method or combination of methods to treat your disorder.

Restless Leg Syndrome

People can experience restless leg syndrome (RLS) in different ways; however, all patients describe very unpleasant "creepy-crawly" (or even painful) sensations that occur in the legs when they are sitting or lying still, especially at bedtime. Although it affects mostly the legs, RLS can also affect the arms. It is not related to emotional or psychological disorders.

Restless leg syndrome, which appears most often in the calves of the legs, can be temporarily relieved by stretching or moving the limb where you are experiencing the sensation. But, the constant need to stretch or move the limbs to relieve the sensations can keep a person from falling asleep. Because of this, a person with RLS might be very tired during the day and unable to work or perform tasks well. Their social activities may be affected due to the excessive fatigue. RLS may also impact how long they can sit still at the movies, at a concert, in business meetings or travel by plane or car. Five to 10 people of every one hundred experience RLS at some point in their lives. Restless leg syndrome is more common in older individuals but may occur at any age. It can be severe during pregnancy, especially the last six months. RLS may come and go without any obvious cause over the course of a person's life. 

The cause of RLS is not known but there are some related conditions. About 30 percent of restless legs cases appear to be hereditary. Other related situations might include the following:

  • Iron deficiency anemia
  • Antidepressants
  • Nerve problems
  • Disorders of the kidneys
  • Alcoholism
  • Vitamin or mineral deficiencies
  • Consumption of caffeine
  • Fatigue
  • Sleep deprivation

A visit with a sleep specialist can help determine if you have restless leg syndrome. Here are also home remedies that have worked for some people:

  • Hot bathes
  • Massages 
  • Pain relievers 
  • Ice or hot packs
Depending on the severity of RLS, your sleep specialist may prescribe medications to help.

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