Patient Education

Sleep Disorders

Good night, sleep tight…four little words that conjure up visions of counting sheep and childhood sweet dreams.

But for many, getting a good night’s sleep is a dream in itself: the National Sleep Foundation estimates that 63 percent of Americans are sleep deprived, and 70 million Americans suffer from sleep disorders.

Sleep disorders cause more than just sleepiness – a lack of restorative rest can cause accidents on the job and on the road; affect your relationships, health, and mental prowess; and make you feel generally "disconnected" to the world around you.

Symptoms

Getting a good night's sleep is essential for feeling refreshed and alert during the day. Did you know that the average adult needs eight hours of uninterrupted sleep every night in order to maintain optimal mental and physical health? Many sleep disorders go undiagnosed, however, ignoring the underlying causes, or covering the symptoms with over-the-counter sleep aids usually makes the problem worse.

And untreated sleep disorders can even be hazardous to your health - a British study released in September 2007 found that people who do not get enough sleep are twice as likely to die of heart disease. Luckily, through proper testing, diagnosis and care, sleep disorders can be managed and overcome.

Particular behaviors during normal daytime activities are telltale signs of sleep deprivation. If you are experiencing one or more of the following symptoms during the day, you may not be getting enough restful sleep at night, and you may even have a sleep disorder.

Do you . . .

feel irritable or sleepy during the day?
have difficulty staying awake when sitting still, such as when watching television or reading?
fall asleep sometimes while driving?
have difficulty paying attention or concentrating at work, school, or home?
perform below your potential in work, school, or sports?
often get told by others that you look tired?
have difficulty with your memory?
react slowly?
have emotional outbursts?
feel like taking a nap almost every day?
require caffeinated beverages to keep yourself going?

Each type of sleep disorder has its own particular symptoms, but all result in some of the above signs of sleep deprivation.

Common Sleep Disorders

While insomnia is the best-known sleep disorder, over 100 types of sleep disorders actually exist. In order to get a proper diagnosis, it’s important to understand the symptoms and causes of the most common forms of sleep problems – insomnia, sleep apnea, RLS, and narcolepsy.

Insomnia

Insomnia is a significant lack of high-quality sleep. It can be short-term or chronic. Insomnia may be caused by stress, a change in time zones or sleep schedule, poor bedtime habits, or an underlying medical or psychiatric condition.

Symptoms include:

Difficulty falling asleep despite being tired
Requiring sleeping pills or alcohol to fall asleep
Awakening frequently during the night or lying awake in the middle of the night
Awakening too early in the morning despite not feeling refreshed
Daytime drowsiness, fatigue, and irritability

In most cases, insomnia can be helped by improving bedtime habits, relieving stress, and relaxation exercises. However, certain medications may be prescribed by your doctor if these alternative treatments do not have the desired effect.

Sleep Apnea

Sleep apnea is a common disorder that can be very serious, and even life-threatening. In sleep apnea, your breathing stops or gets very shallow while you are sleeping. Each pause in breathing typically lasts 10 to 20 seconds or more. These pauses can occur 20 to 30 times or more an hour.

The most common type of sleep apnea is obstructive sleep apnea. During sleep, enough air cannot flow into your lungs through your mouth and nose, even though you try to breathe. When this happens, the amount of oxygen in your blood may drop. Normal breaths then start again with a loud snort or choking sound.

Symptoms can be quite scary - frequent waking episodes at night, usually accompanied by a feeling of "choking" or gasping for air. Significant others or roommates of those with sleep apnea often report hearing gasping, gagging, or choking sounds from their partners. The severity of this disorder makes treatment essential. Treatment may include behavioral changes, physical and mechanical devices, and in some cases, surgery.

Restless Legs Syndrome (RLS) and Periodic Limb Movements in Sleep (PLMS)

Restless legs syndrome (RLS) is a sensory disorder causing an almost irresistible urge to move the legs. The urge to move the legs is usually due to uncomfortable, tingly, or creeping sensations that occur when at rest. Movement eases the feelings, but only for a while.

RLS is not necessarily confined to your sleep time. Symptoms most often occur when you are relaxed or lying down. You may also notice small, jerky movements of the toes, feet, and legs as you are trying to fall asleep.

Periodic Limb Movement Disorder (PLMD) is a related condition involving involuntary, rhythmic limb movements, either while asleep or when awake. While most people who have Restless Legs Syndrome also have PLMD, only some people with PLMD also have RLS. Because of the discomfort the symptoms cause, RLS can make it difficult falling (and staying) asleep. Alternative therapies, lifestyle changes, and even nutritional supplements have proven helpful for RLS and PLMD sufferers.

Narcolepsy

Narcolepsy is a disorder that causes a person to have difficulty staying awake. Narcolepsy can cause a person to suddenly fall asleep during the day.
These "sleep attacks" occur even after getting enough sleep at night. The unusual sleep pattern that people with narcolepsy have can affect their schooling, work, and social life.
Falling asleep during activities like walking, driving, cooking, or talking can have dangerous results, both professionally and personally.

Symptoms include:

Intermittent, uncontrollable episodes of falling asleep during the daytime
Excessive daytime sleepiness
Sudden, short-lived loss of muscle control during emotional situations (cataplexy)

As narcolepsy involves the nervous system, treatment requires a combination of medication, behavioral treatments, and counseling.

Diagnosis

Self-diagnosis

To determine if you have a sleep disorder, first pay attention to your sleep habits and daily routine. Whether you are trying to help yourself or planning to visit a doctor, it is helpful to record your sleep habits. Your sleep history will help you and your doctor find the cause of your sleep problems.

Keeping a sleep diary can help you identify lifestyle factors related to sleep disorders, and make it easier to discuss your daily patterns if you do decide to see a doctor or sleep specialist. A sleep diary should record all sleep-related information, including:

time you went to bed and woke up (total sleep hours)
quality of your sleep - times that you were awake during the night and what you did (e.g., stayed in bed with eyes closed, or got up, had a glass of milk, and meditated)
types and amount of food, liquids, caffeine, or alcohol you consumed before bed, and times of consumption
feelings and moods before bed – happiness, sadness, stress, anxiety
drugs or medications taken, amounts taken, and times of consumption

A sleep partner can add observations to your sleep diary as well. The details can be important, and a sleep diary might reveal that your pre-bedtime behavior is thwarting your chance for a good night’s sleep. For example, a two-week sleep diary might reveal that you don’t sleep well if you have had more than two alcoholic drinks before bedtime, or that you have more trouble falling asleep on days when you haven’t exercised.

Seeing a doctor

You can address most common sleep problems through lifestyle changes and improved sleep hygiene but it is important to see your doctor or a sleep specialist for a diagnosis if your sleep does not improve. A doctor who specializes in sleep problems is most skilled in diagnosing and treating sleep disorders. Sometimes sleep specialists work out of a sleep center; others are independent.

Medical professionals diagnose sleep disorders based on a number of factors including your description of symptoms, your age and gender, and your psychological and medical history. Along with your sleep diary and the answers to a sleep questionnaire, your doctor should interview you to figure out the cause of your sleeping problems. The doctor will want to rule out possible medical conditions and may want you to make behavioral and environmental changes as first steps of your treatment. In addition, your doctor may recommend any number of common tests used to diagnose sleep disorders.

The information above was obtained from the following Web site.

Get a Good Night’s Sleep

Like eating well and being physically active, getting a good night’s sleep is vital to your well-being. Here are 13 tips to help you:

   1. Stick to a sleep schedule. Go to bed and wake up at the same time each day—even on the weekends.

   2. Exercise is great but not too late in the day. Avoid exercising closer than 5 or 6 hours before bedtime.

   3. Avoid caffeine and nicotine. The stimulating effects of caffeine in coffee, colas, teas, and chocolate can take as long as 8 hours to wear off fully. Nicotine is also a stimulant.

   4. Avoid alcoholic drinks before bed. A "nightcap" might help you get to sleep, but alcohol keeps you in the lighter stages of sleep. You also tend to wake up in the middle of the night when the sedating effects have worn off.

   5. Avoid large meals and beverages late at night. A large meal can cause indigestion that interferes with sleep. Drinking too many fluids at night can cause you to awaken frequently to urinate.

   6. Avoid medicines that delay or disrupt your sleep, if possible. Some commonly prescribed heart, blood pressure, or asthma medications, as well as some over-the-counter and herbal remedies for coughs, colds, or allergies, can disrupt sleep patterns.

   7. Don’t take naps after 3 p.m. Naps can boost your brain power, but late afternoon naps can make it harder to fall asleep at night. Also, keep naps to under an hour.

   8. Relax before bed. Take time to unwind. A relaxing activity, such as reading or listening to music, should be part of your bedtime ritual.

   9. Take a hot bath before bed. The drop in body temperature after the bath may help you feel sleepy, and the bath can help relax you.

10. Have a good sleeping environment. Get rid of anything that might distract you from sleep, such as noises, bright lights, an uncomfortable bed, or a TV or computer in the bedroom. Also, keeping the temperature in your bedroom on the cool side can help you sleep better.

11. Have the right sunlight exposure. Daylight is key to regulating daily sleep patterns. Try to get outside in natural sunlight for at least 30 minutes each day.

12. Don’t lie in bed awake. If you find yourself still awake after staying in bed for more than 20 minutes, get up and do some relaxing activity until you feel sleepy. The anxiety of not being able to sleep can make it harder to fall asleep.

13. See a doctor if you continue to have trouble sleeping. If you consistently find yourself feeling tired or not well rested during the day despite spending enough time in bed at night, you may have a sleep disorder. Your family doctor or a sleep specialist should be able to help you.

The information above was obtained from the following Web site.