More than 70 million Americans suffer from sleep problems such as trouble falling asleep or waking during the night, according to The National Center on Sleep Disorders. Temporary issues such as a stressful day or too much coffee can disturb sleep. However, research shows that more than half of people with sleep problems actually suffer from a chronic sleep disorder, and may not realize it.
Some of the most common sleep disorders include:
- Sleep apnea
- Periodic limb movements
- Restless leg syndrome
Sleep apnea is a disorder in which a person stops breathing for brief periods (10 seconds or more) during sleep. The most common form of sleep apnea, called obstructive sleep apnea, occurs when muscles in the back of the throat relax during sleep and tissue blocks the airway. The person will either briefly wake up or come out of a deep sleep to re-establish breathing. These episodes can happen a few times or as many as several hundred times each night.
When a person stops breathing, oxygen levels in the blood drop. Over time, this can affect the brain and heart. As a result, sleep apnea has been linked to dangerous health conditions such as heart attacks, high blood pressure and stroke.
Sleep apnea can affect anyone at any age, but it is most common in men and people who are overweight.
Signs & Symptoms
A person sharing your bed will often notice that you are snoring loudly or choking or gasping for breath during sleep. Because sleep apnea severely disrupts normal sleep, excessive daytime sleepiness and fatigue are common symptoms.
Daytime sleepiness can be especially dangerous while driving or operating machinery. Anyone who falls asleep during normal daily activities should be evaluated for sleep apnea or another sleep disorder.
- Continuous positive airway pressure (CPAP). An individual with sleep apnea wears a mask over the nose that softly blows air into the back of the throat. This keeps the airway open so the person is able to breathe normally during sleep.
- Weight loss. Losing weight can often resolve symptoms because it decreases the amount of tissue obstructing the throat.
- Changing positions. In some cases, the sleep apnea only occurs when people sleep certain positions. Sleeping on the side or stomach, or raising the head of the bed on an incline can sometimes reduce symptoms.
- Surgery. Surgery may be considered to address an anatomical cause for an obstructed airway. Tissue may be removed from the back of the throat to make breathing easier during sleep. Correction of a deviated septum may also improve breathing during sleep.
- Oral appliances. A device similar to a mouth guard worn by athletes can re-position the jaw and restrain the tongue during sleep, keeping the airway unobstructed.
Insomnia is the inability to obtain a sufficient amount of sleep to feel rested. It is typically characterized by difficulty falling asleep or staying asleep, and may include early morning awakenings, poor quality sleep or non-refreshing sleep.
Insomnia may be transient (an inability to sleep well over a period of a few nights, but less than 4 weeks); short term (poor sleep on most nights for 4 weeks to 6 months) or chronic (poor sleep on most nights for more than 6 months). Insomnia may start for one reason, and then may persist for an entirely different set of factors.
It may be caused by a variety of conditions including stress; anxiety and depression; underlying medical conditions such as arthritis, gastroesophageal reflux (heartburn) or other painful ailments; poor sleep habits; or a sleep environment that is not conducive to good sleep. Insomnia may also be a side effect of some medications, misuse or overuse of sleeping pills, or use of stimulants such as caffeine or nicotine. Other sleep disorders, such as sleep apnea, periodic limb movements in sleep, or restless legs syndrome, can also cause insomnia.
Insomnia is also common in perimenopausal women, especially when experiencing hot flashes or night sweats.
Signs & Symptoms
A person with insomnia will often feel tired and irritable during the day or have trouble concentrating on work and other activities. Physical symptoms such as headaches and stomachaches can also result from poor sleep.
If you seek treatment for insomnia at the UMCPP Sleep Center, you will first be scheduled for a consultation with one of our board certified sleep medicine specialists.
A comprehensive evaluation is necessary to determine the most likely cause or combination of factors that are contributing to the problem. A thorough medical history, including your current medication regimen, as well as the history of your current sleep complaint will be taken during the consultation.
The sleep specialist will also review your sleep habits including your sleep schedule, sleep environment, and behaviors that you engage in before and during sleep. The sleep specialist may recommend a series of healthy sleep habits known as Sleep Hygiene (link to healthy sleep habits page) instructions. These instructions offer an atmosphere that encourages good sleep.
The treatment of your insomnia will be tailored to address the specific issues identified during the office visit. If insomnia is related to anxiety or depression, or an underlying medical condition, proper treatment of those conditions may lead to better sleep. Your current medication regimen will be evaluated to determine if the medications are contributing to the insomnia.
You may also benefit from treatments such as relaxation therapy, stress management, or cognitive therapy to ease your mind before sleep. Behavioral treatments of insomnia may also be used to change established sleep habits that interfere with sound sleep.
If these non-pharmacological treatments are not effective, prescription sleeping medicine may also be considered to supplement treatment.
Parasomnias are undesired, disruptive events that occur during sleep, such as:
- Nightmares - waking up in a panic after a disturbing dream.
- Night terrors - waking up with an unresponsive look and acting fearful or aggressive.
- Sleepwalking - getting out of bed and walking while still asleep.
- Confusion arousal - waking up confused or disoriented; sometimes called "sleep drunkenness."
Signs & Symptoms
A person suffering from a parasomnia will commonly wake up shouting, crying or speaking incoherently. Injuries to yourself or a bed partner during sleep can also indicate a parasomnia. The person may also avoid going to sleep for fear of experiencing a parasomnic episode.
Your doctor may first explore whether conditions such as depression or anxiety are causing parasomnias and need to be treated.
If a parasomnia is not related to a mental health condition, treatment might involve behavior modification through hypnosis or relaxation techniques. Prescription tranquilizers may also be appropriate.
Prevention is often the best treatment for a parasomnia. Getting a full night of sleep, keeping a regular sleep schedule and avoiding alcohol before going to bed can help prevent parasomnic events. Illegal drugs as well as prescribed medications, including sleeping pills, can trigger parasomnias in some people.
Periodic Limb Movements (PLMs)
Periodic limb movements are the uncontrollable, repetitive flexing of muscles during sleep. The movements most often occur in the lower legs, such as a big toe extending or ankle bending repeatedly, as often as several times a minute. An overnight sleep study may be suggested to determine the degree to which the PLMs are present, and to assess how disruptive they are to sleep.
Signs & Symptoms
The movements can severely disrupt sleep, leaving you feeling tired during the day or feeling poorly rested even after a full night of sleep. In some cases, the movements do not affect the person experiencing them, but impact the sleep of a person in the same bed.
Periodic limb movements do not always require professional treatment, especially if they do not significantly disrupt sleep.
In cases where treatment is necessary, medication including sleeping pills, anti-seizure medications and narcotic painkillers can often help to either limit the movements, or help you to sleep more continuously through the movements.
Restless Leg Syndrome
Restless Leg Syndrome (RLS) is a neurological condition in which a person has a strong urge to move his or her legs. This urge is often accompanied by unusual sensations in the legs such as itching, burning or prickling. These sensations usually go away with leg movement.
Signs & Symptoms
Because symptoms are often worse in the evening and when lying down, RLS can make it hard for you to fall asleep or stay asleep.
RLS is more common in older people, but it can occur at any age. It is also believed to run in families, as the risk of having RLS more than triples when an immediate family member also suffers from it, according to the American Academy of Sleep Medicine.
For mild cases of RLS, taking a hot bath, massaging your legs or using an ice pack or a heating pad may help alleviate your symptoms. Lifestyle changes such as regular exercise, quitting smoking and cutting down on alcohol and caffeine can help improve RLS.
Some people with RLS also find mental relaxation techniques helpful. A number of prescription medications are available to treat RLS.
Narcolepsy causes a person to suffer from excessive sleepiness. At times, a narcoleptic can fall asleep suddenly, even while working, driving or eating.
Signs & Symptoms
A person with narcolepsy may find it impossible to stay awake the entire day or may feel sleepy even after a good night's sleep or a long nap. Also, you are likely to have narcolepsy if you are unable to move right after falling asleep or right after waking up.
Narcolepsy is usually treated with a variety of stimulant medications that help you stay awake during the day. Some narcoleptics also suffer from sudden muscle weakness, known as cataplexy, which is treated with a different class of medications.
Note: The information provided above is for general education purposes and is not intended to constitute medical advice. The information should not be used for diagnosis or treatment, nor should it be used to replace the advice of licensed healthcare professionals. Health concerns or questions should be discussed with your physician. If you have any concerns about your health, please contact your healthcare provider.