Sleep Disorders

Sleep plays an important role in our lives and has a strong impact on the quality of our lives. With proper sleep, we wake up feeling refreshed, rejuvenated, and ready to perform the activities of our daily lives.

Quantity and quality are important in getting a good night’s sleep. We need to allow ourselves enough time to cycle through the stages of that are necessary for muscle repair, memory consolidation and hormone release that regulates growth and appetite.

Without proper sleep, we wake up less prepared to make decisions, concentrate, and perform daily activities. Poor quality sleep can result in health problems and the increased risk of accidents.

Treatments for sleep disorders include behavioral training, weight loss, the avoidance of sedative drugs and smoking, surgical and medical interventions, and the use of therapeutic appliances such as continuous and bi-level positive pressure devices.

If you suspect you have a sleep disorder, discuss your symptoms with your health care provider to establish a plan for diagnosis and treatment.

Sleep Apnea

Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. Traditionally, there were three classifications of sleep apnea: Obstructive Sleep Apnea, Central Sleep Apnea, and Mixed Sleep Apnea. Recently, there has been an emergence of a fourth classification of sleep apnea: Complex Sleep Apnea.

Central sleep apnea is a result of the absence of breathing effort; in obstructive sleep apnea, a physical block of the airway occurs despite a continuing effort to breathe. In its mixed form, there is an initial central component that transitions into an obstructive component. Complex Sleep Apnea is a condition in which central apnea occurs as a result of treating obstructive apnea with positive pressure therapy.

Obstructive Sleep Apnea (OSA) is the most common form of sleep apnea, and it is estimated that 1 in 5 American adults suffer at least a mild form of this sleep disorder. Signs and symptoms of OSA include snoring, gasping and choking during sleep, and non-refreshing sleep. Obstructive hypopneas, a diminishment of airflow due to a partial block of the airway, are a form of sleep apnea.

If left untreated, OSA can cause high blood pressure and other cardiovascular diseases, memory problems, weight gain, impotence, and headaches. In addition, untreated OSA can increase the risk of heart attack, stoke, and work-related and motor vehicle accidents.

Upper Airway Resistance Syndrome

Upper Airway Resistance Syndrome (UARS), a term coined in 1993 by Dr. Guilleminault at Stanford University, is a condition in which chronic daytime sleepiness is caused by the increased effort of breathing and the nighttime arousals that occur as a result of snoring and the increased effort. In UARS, breathing does not actually cease or significantly diminish as in sleep apnea, but the build-up of internal pressure caused by UARS can be very disruptive to sleep.

Periodic Limb Movement Disorder

Periodic Limb Movement Disorder PLMD) is similar, yet distinct from, Restless Leg Syndrome (RLS). Both can be referred to as nocturnal myoclonus, describing frequent and /or involuntary muscle spasms, and both are treated similarly.

While RLS affects people generally while at rest, PLMD affects those suffering this disorder while asleep. PLMD is characterized by limb movements ranging from shallow, continual movements of the ankles and feet, to wild, flailing movements of the arms and legs. Abdominal and facial movements can be a result of PLMD as well, but, generally, the legs are most affected. Movements typically occur for 0.5 seconds or greater, with intervals of five to 90 seconds.

Narcolepsy

The primary characteristic of narcolepsy is irresistible, excessive daytime sleepiness despite adequate nighttime sleep. A person with narcolepsy is likely to become drowsy and fall asleep, often at inappropriate times and locations. Drowsiness may be persistent, and nighttime sleep is often disrupted with frequent arousals and awakenings.

Other symptoms of narcolepsy, which may not always occur, are cataplexy, sleep paralysis, hynogogic hallucinations, and automatic behavior. Cataplexy is a loss of muscle function ranging from mild weakness, facial drooping, buckling knees, to full collapse. Cataplexy can be triggered at times of sudden, high emotional reactions such as laughter, anger, surprise and fear. Sleep paralysis is a temporary inability to talk or move upon awakening, lasting from seconds up to several minutes. Hypnogogic hallucinations are vivid, sometimes frightening, dream-like experiences while drowsy, and automatic behavior refers to awake-like activity while asleep, with no recall of the episodes.

The cause of narcolepsy is still unknown, but researchers have discovered genetic conditions that may increase an individual’s risk of having the disorder. Specifically, variations in HLA genes may predispose an individual to narcolepsy.

Bruxism

The most common form of bruxism is clenching and/or grinding of the teeth. This activity can often occur during sleep, and can occasionally be disruptive to sleep. Bruxism can cause chips in the teeth, wearing down of the biting surfaces, and cracks in teeth.