Monday, October 29, 2007

Recognizing Serious Sleep Disorders

SOMETIMES one’s symptoms may indicate a serious sleep disorder. Chronic insomnia, which lasts more than a month, is often related to more serious problems, including depression. Chronic insomnia may also be a symptom of a serious physical ailment.

Sleep Apnea

Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. These episodes, called apneas (literally, "without breath"), each last long enough so one or more breaths are missed, and occur repeatedly throughout sleep. When apnea alternates with periods of rapid, heavy breathing (hyperapnea), they may be due to lack of oxygen in the brain, accumulation of acid in the blood, increased pressure on the brain stem, or heart failure. Apnea may be associated with such harmful conditions as irregularities in heartbeat, high blood pressure, and decreased contractile force of the heart muscle.

Central apnea occurs when the brain’s respiratory control center doesn’t give the command to breathe regularly. With obstructive sleep apnea, the upper airway at the back of the throat actually closes, blocking air movement. Mixed apnea is a combination of the two and is the most common diagnosis. The victim of any type of apnea can end up in virtually the same condition as someone who stayed up all night, every night!

Those with sleep apnea may live dangerous lives, for they can blank out while on the job or at the wheel of their automobile. They may suffer from high blood pressure, an enlarged heart, and an increased risk of stroke or heart failure.

There are several treatments—all best supervised by a medical sleep specialist. The most effective nonsurgical treatment for obstructive sleep apnea is the use of a device to create continuous positive airway pressure. The patient wears a mask over his nose at night, and a pressure regulator (custom-set by a physician) delivers just the amount of air needed to prevent apnea. If this does not rectify the condition, there are several surgical approaches, including using laser or radio-frequency waves to remove excess tissue from the throat.

Narcolepsy

The main characteristic of narcolepsy is overwhelming excessive daytime sleepiness (EDS), even after adequate night time sleep. A person with narcolepsy is likely to become drowsy or to fall asleep, often at inappropriate times and places. Daytime naps may occur without warning and may be physically irresistible. These naps can occur several times a day. They are typically refreshing, but only for a few hours. Drowsiness may persist for prolonged periods of time. In addition, night-time sleep may be fragmented with frequent awakenings.

Symptoms usually appear in adolescence and the disorder afflicts men and women equally. The cause of narcolepsy is unknown, although genetics may play a role. Some research suggests that narcolepsy may be a type of autoimmune disease, in which the body attacks some part of itself.

In addition to sleep attacks, about 80 percent of narcolepsy cases are accompanied by cataplexy, a loss of muscle control that causes the person to collapse, often following a sudden surge of emotion, such as laughter or rage. More than 60 percent of narcoleptics experience sleep paralysis, an inability to move for one or two minutes even though fully conscious, which can induce an intense feeling of fear. Narcoleptics may also experience hypnagogic hallucinations, usually vivid, emotionally charged, and unpleasant visions, which occur at the onset of sleep or upon awakening.

Narcolepsy typically starts between the ages of 10 and 30. Sufferers sometimes develop what is called automatic behavior, wherein they appear to behave normally but do not remember the passing of extended periods of time. The tragedy of this disease is that it often goes undiagnosed for years, while the victim is viewed as lazy, mentally slow, or peculiar. It is presently considered incurable, but symptoms can be treated with medication and adjustments in life-style—with varying degrees of success.

Other Sleep Disorders

Two other disorders, sometimes appearing in combination with each other, directly affect the limbs, resulting in chronic insomnia. One is periodic limb movement disorder, in which the legs, and sometimes the arms, jerk and twitch during sleep.

A separate disorder is restless legs syndrome, in which sensations deep within the leg muscles and knees cause a powerful urge to move, thus preventing the sufferer from falling asleep. While this condition is sometimes associated with lack of exercise or poor circulation, some cases appear to be related to caffeine intake. Alcohol consumption is also known to aggravate the condition at times.

Bruxism is a disorder characterized by grinding or clenching the teeth during sleep. If it occurs regularly, it can cause abnormal wear of the teeth and extreme jaw discomfort, resulting in serious insomnia. Depending upon the degree of the problem, treatments vary from oral surgery to wearing a mouth guard at night.

This limited look at just a few of the many sleep-related disorders illustrates that it can be dangerous to ignore them. Treatment may be simple or complex, but it is often essential. If you or a loved one suffers from chronic insomnia or shows signs of any serious sleep disorder, it may be wise to get professional help soon. Even if treatment does not totally eliminate the problems, it may significantly reduce the risks involved and make the situation easier for all to endure.

*Erratic, heavy apnea snoring is not to be confused with the occasional light, rhythmic snoring of many sleepers—the major detriment of which is that others in the same bedroom are kept awake.

(909 word count)

Related post:
How much sleep do we need?
Sleep debt and Sleep disorder


No comments:

Post a Comment