Neuroscience
Sleep Disorders
Overview
Types
Insomnia
Narcolepsy
Sleep Apnea & Snoring
Restless Leg Syndrome (RSL)
Other
Overview
Sleep disorders and sleep deprivation affect the careers
and social activities of sufferers, and also put the sufferer
at risk in certain situations, such as driving. It is estimated
that $16 billion in medical costs can be traced to sleep disorders
each year, not counting the considerable indirect costs due
to lost productivity.
Causes, incidence, and risk factors
Sleep disorders are on the rise in America, affecting an
estimated 40 million people. The medical community has described
more than 80 sleep disorders, and most of these conditions
can be managed once they are diagnosed. The most common disorders
include insomnia, sleep apnea, restless legs syndrome, and
narcolepsy.
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Specific sleep disorders
Insomnia
People suffering from insomnia have trouble falling or staying
asleep. Insomnia can be caused by psychological conditions
(like chronic depression or temporary stress), environmental
conditions (such as noise), or physiological conditions (like
pain or chronic breathing disorders).
Insomnia can also be caused by a change in the sleep-wake
rhythm (such as shift work) or by the misuse or overuse of
sleeping pills.
Treatment for chronic insomnia includes first treating any
underlying conditions or health problems that are causing
the insomnia. If insomnia continues, your health care provider
may suggest behavioral therapy.
Behavioral approaches help you to change behaviors that may
worsen insomnia and to learn new behaviors to promote sleep.
Techniques such as relaxation exercise, sleep restriction
therapy, and reconditioning may be useful.
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Narcolepsy
People who feel excessively sleepy during the day, or who
feel muscular weakness when they are angry, surprised, or
amused, may have narcolepsy. Narcoleptics sometimes have terrifying
dreams or hallucinations just as they fall asleep. This disorder
often emerges in young adulthood and is a life-long medical
problem.
Narcolepsy affects an estimated 250,000 Americans. The disorder
(or at least a predisposition to it) is usually hereditary,
but it occasionally is linked to brain damage from a head
injury or neurological disease.
Once narcolepsy is diagnosed, stimulants, antidepressants,
or other drugs can help control the symptoms and prevent the
embarrassing and dangerous effects of falling asleep at improper
times. Naps at certain times of the day also may reduce the
excessive daytime sleepiness.
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Sleep apnea and snoring
Heavy snoring can be a symptom of a serious sleep disorder
called sleep apnea. People with sleep apnea stop breathing
again and again during sleep. These apneic episodes may last
10 to 90 seconds and can occur hundreds of times each night.
An estimated 18 million Americans have sleep apnea.
Several treatments are available. Mild sleep apnea frequently
can be overcome through weight loss or by preventing the person
from sleeping on his or her back. Other people may need special
devices or surgery to correct the obstruction. People with
sleep apnea should never take sedatives or sleeping pills,
which can prevent them from awakening enough to breathe.
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Restless legs syndrome/periodic limb
movements
Restless legs syndrome (RLS), a familial disorder causing
unpleasant crawling, prickling, or tingling sensations in
the legs and feet and an urge to move them for relief, is
emerging as one of the most common sleep disorders, especially
among older people. This disorder, which affects as many as
12 million Americans, leads to constant leg movement during
the day and insomnia at night. Severe RLS is most common in
elderly people, though symptoms may develop at any age. In
some cases, it may be linked to other conditions such as anemia,
pregnancy, or diabetes.
Many RLS patients also have a disorder known as periodic
limb movement disorder or PLMD, which causes repetitive jerking
movements of the limbs, especially the legs. These movements
occur every 20 to 40 seconds and cause repeated awakening
and severely fragmented sleep. In one study, RLS and PLMD
accounted for a third of the insomnia seen in patients older
than age 60.
RLS and PLMD often can be relieved by drugs that affect
the neurotransmitter dopamine, suggesting that dopamine abnormalities
underlie these disorders’ symptoms. Learning how these
disorders occur may lead to better therapies in the future.
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Other Disorders
Nightmares and night terrors
Though they often disappear after adolescence, nightmares
may occur at any age. This may be a sign of a serious disorder.
Sleep evaluation is used to determine whether a physiological
or biological condition triggers the episodes.
Sleepwalking and sleeptalking
These disorders are common in childhood but can occur in
any age group. Sleep evaluation is helpful to determine whether
the troublesome behavior is benign or a sign of sleep-related
epilepsy or other problems.
Breathing problems
When patients have chronic breathing problems or lung disease,
their symptoms often worsen during sleep. Complete evaluation
of such respiratory diseases requires measuring blood oxygenation
during sleep.
New hope
Our understanding of sleep disorders has increased considerably
in recent years. Now more than ever, patients can benefit
from advanced diagnostic tools and treatment options so they
can address their disorder and reclaim their quality of life.
Learn more about Saint
Mary’s Sleep Disorders Program
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