- Sleep apnea is estimated to be prevalent in about 5% of the adult population. It is characterized by partial or complete obstruction of the upper airway with continued respiratory effort. As an individual sleeps, one’s upper airway may collapse, leading to interruptions in breathing known as apneas. As these continue throughout the night, one has to wake up repeatedly to breathe normally. These “micro-arousals” from sleep lead to a non-restful sleep period and sleepiness during the day. The typical symptoms of sleep apnea are excessive daytime sleepiness, loud snoring, and having apneas that are witnessed by a bed partner. Obesity is a predisposing risk factor. Sleep apnea itself is a risk factor for uncontrollable hypertension, heart attack, and stroke. It is treated by using a positive pressure breathing apparatuses that work as a “pneumatic stent” to prevent the airway from collapsing.
- Insomnia is a highly complex sleep disorder that can manifest as excessive sleepiness. Insomnia is very often secondary to other medical issues, other sleep disorders, or most commonly, stress and anxiety. Obtaining a thorough medical history, including a discussion of stress and anxiety, is essential in the proper diagnosis and treatment of insomnia.
- Restless leg syndrome can prevent sleep, and therefore result in sleepiness during the day. It is characterized by an urge or desire to move or kick legs while trying to fall asleep. People who have this syndrome often need to get up and walk around to relieve this sensation. It can be treated with a variety of medications. Interestingly, iron deficiency can sometimes cause RLS and supplementation with iron in these people can often alleviate the symptoms.
- Narcolepsy is a disorder of inappropriate intrusion of sleep into being awake. It is typically diagnosed in individuals in their 20’s. The popular misconception of narcolepsy is somewhat misleading. Most people with narcolepsy have an unshakeable desire to sleep and often doze off in inappropriate settings. However, most people do not simply collapse on the street, asleep – as popular depictions of narcolepsy suggest. Narcolepsy is often accompanied by symptoms of sleep paralysis, a sensation of being paralyzed after waking up for about a minute, hallucinations when falling asleep or waking up, and cataplexy. Cataplexy is a unique symptom of narcolepsy where individuals lose muscle tone when they are surprised. It is somewhat rare, but is diagnostic of narcolepsy
The treatment of sleep disorders can markedly improve a patient’s quality of life as well as reduce cerebrovascular and cardiovascular risk.
A referral to a sleep specialist is highly recommended to evaluate for these disorders.
A polysomnogram is usually necessary to diagnose sleep disorders. The sleep lab is part of the hospital, but is an outpatient procedure during which we watch you sleep for the night. There are electrodes attached to the head, next to the eyes, on the chin, and both legs. There are also heart leads, a pulse oximeter, and a belt around the chest and abdomen to measure work of breathing. Despite how it sounds, most patients fall asleep normally.
This post is provided courtesy of Dr Matthew J. Davis, Fellowship Trained Sleep Neurologist.