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Identifying the Source of Sleep Issues
The Sleep Disorders Centers can assist with diagnosis and treatment of many sleep-related conditions. Among the most common are sleep apnea, narcolepsy, insomnia, restless leg disorder and shift work sleep disorders.
Sleep apnea is the most common sleep disorder. Sleep apnea is usually caused by an obstruction or narrowing of air passages. People with sleep apnea stop breathing repeatedly throughout the night, sometimes hundreds of times. The person's sleep is repeatedly interrupted, but he often does not recall awakening. It can cause fatigue, personality changes, morning headaches, hypertension, impotence, irregular heart rhythm and even death. Because it occurs during sleep, this condition can go undetected by the patient. Often a spouse will notice the warning signs, which include:
Pauses in breathing that can last to 90 seconds
Loud, snoring, snorting or gasping for breath
Restless sleep or sudden body movements when breathing resumes
Sleep apnea is typically diagnosed using a sleep study. Treatment options for sleep apnea varies according to the symptoms and severity of the problem.
Machines that deliver air through the nose during sleep including CPAP & BiPAP
Oral mouthpieces to open the airway
Surgical or radiofrequency techniques to reduce tissue in the airway
Narcolepsy is a neurological disorder which causes irresistible sleep attacks. While the disorder affects each person differently, symptoms can include:
Sudden attacks of sleep during the day
Excessive daytime sleepiness
Muscular weakness
Hallucinations
Attacks of rapid eye movement (REM)
Performing tasks without consciously thinking & then unable to recall details
Diagnosed with nighttime sleep studies and nap studies
Treated with carefully administered stimulants to prevent sleep attacks
Educational support
Most adults have experienced insomnia or sleeplessness at one time or another in their lives. An estimated 30-50% of the general population are affected by insomnia, and 10% have chronic insomnia.
Insomnia is a symptom, not a stand-alone diagnosis or a disease. By definition, insomnia is "difficulty initiating or maintaining sleep, or both," and it may be due to inadequate quality or quantity of sleep. Insomnia is not defined by a specific number of hours of sleep that one gets, since individuals vary widely in their sleep needs and practices. Although most of us know what insomnia is and how we feel and perform after one or more sleepless nights, few seek medical advice.
Insomnia affects all age groups. Among adults, insomnia affects women more often than men. The incidence tends to increase with age. Stress most commonly triggers short-term or acute insomnia. If you do not address your insomnia, however, it may develop into chronic insomnia.
Insomnia is generally classified based on the duration of the problem. Not everyone agrees on one definition, but generally:
Transient insomnia: Symptoms lasting less than one week
Short-term insomnia: Symptoms between one & three weeks
Chronic insomnia: Lasting longer than three weeks
In addition to a physical exam, medical history and blood tests, your doctor may ask you to keep a journal tracking your sleep as well as intake of caffeine and alcohol as part of investigating the root cause your insomnia. Many people remain unaware of the behavioral and medical options available to treat insomnia.
Diagnosis: A sleep study may be recommended to rule out other sleep disorders.
Treatment can include improving sleep hygiene.
Cognitive behavioral therapy may be recommended
Sleep restriction therapy sets a specific time to spend in bed.
Stimulus control therapy can assist with creating a regular sleep-wake cycle.
Prescription medications can be used with other therapies, often short-term.
Benefits & side effects of medications should be carefully considered.
Restless leg syndrome is a sleep disorder characterized by leg discomfort during sleep, which is only relieved by frequent movements of the legs. The disorder consists of sensations in the lower legs that make the person uncomfortable unless the legs are moved. The sensations usually occur shortly after going to bed but may also occur during the daytime. The abnormal sensations occasionally occur in the upper leg, the feet, or the arms, in addition to the lower leg. There is an irresistible urge to walk or move the legs to relieve the discomfort, resulting in periodic episodes of leg movements during early sleep stages. Symptoms, which may last for an hour or longer and may be worse during stress or emotionally upsetting periods, can include:
Abnormal sensation in the legs, occasionally, feet, thighs, arms
Creeping sensations or discomfort, not pain, not cramps
Discomfort relieved by movement of the legs may occur during the day
Discomfort may be worse when lying down
Irresistible urge to move the legs
Persistent leg movements during sleep hours
Sleeping difficulty
Restless leg syndrome is diagnosed through evaluation by a physician. Blood tests may be used to rule out other conditions that could cause your symptoms such as low iron levels and kidney failure. RLS is generally a lifelong condition for which there is no cure. However, treatments are available to ease symptoms.
Iron supplements if iron levels are low
Anti-seizure medications
Medication to increase dopamine in the brain
Lifestyle changes may offer relief for mild to moderate symptoms.
Avoiding or reducing alcohol, nicotine & caffeine
Maintaining regular sleep pattern
Regular moderate exercise, stretching
Massaging the legs or taking warm baths
Applying heating pad or ice pack to legs
Special foot wrap designed for restless leg syndrome
Vibration pads applied to the back of the legs
Shift work sleep disorders affect people who frequently rotate shifts or work at night. Schedules for these people go against the body’s natural Circadian rhythm, and individuals have difficulty adjusting to the different sleep and wake schedules. These disorders consist of a constant or recurrent pattern of sleep interruption that results in insomnia or excessive sleepiness. This disorder is common in people who work non-traditional hours, usually between 10 p.m. and 6 a.m.
Shift work sleep disorders can cause increased accidents, increased work-related errors, increased sick leave, increased irritability and mood problems. Symptoms include:
Insomnia
Excessive sleepiness
Lack of energy
Difficulty concentrating
Headaches
Shift workers must be willing to make sleep a priority. People who work shifts other than a 9 a.m. to 5 p.m. routine might have to prepare for sleep even though it might be daylight outside. Ask friends and family to help.
Prioritize sleep hygiene
Decrease night shifts worked in a row to allow for sleep deprivation recovery
If possible, limit third shifts to five or less a week, with days off in between
If you work a 12-hour shift, you should limit work to four shifts in a row
Avoid extended work hours, prolonged shifts and excessive overtime
Make sure you have time to sleep and join in family and social activities
Avoid long commutes, which can take time away from sleeping
Avoid frequently rotating shifts
Get enough sleep on your days off
Caffeine & medications like modafinil are options but adequate sleep is best
If you need to sleep during the day, these steps can help you get the best sleep possible. You may need help from your family and friends to create a sleep-friendly environment.
Minimize exposure to light to avoid activating the body’s daytime clock
Go to sleep as soon as possible after work; get 7 to 8 hours of sleep every day
Create a regular sleep schedule; stick to it even on weekends & holidays
Have family members wear headphones to listen to music or watch TV during your sleep time
Ask your family to avoid vacuuming & other noisy activities during your sleep time
Use a "Do Not Disturb" sign to discourage knocking or ringing the doorbell
Sleep hygiene encompasses habits and soothing environments that help promote sleep. Good sleep hygiene can be part of a healthy lifestyle as well a treatment for sleep disorders.
Keep the bedroom quiet, cool & relaxing
Dim your lights & avoid screens before bedtime
Create a regular sleep schedule; stick to it even on weekends & holidays
Avoid watching TV, scrolling on your phone in bed
Move work & personal tasks like paying bills out of the bedroom
Avoid heavy meals close to bedtime
Avoid alcohol & nicotine; alcohol decreases the quality of your sleep
Create bedtime rituals like quiet meditation, a soothing bath or gentle stretches
Try an eye mask, blackout curtains, a white noise machine or earplugs