Sleep Disorders

Conditions experienced by patients with sleep disorders include difficulties with falling asleep or staying asleep at night or problems staying awake in the daytime. Most sleep disorders can be helped, but effective treatment depends on a thorough evaluation, accurate diagnosis, and the most up-to-date therapy.

Snoring and Sleep Apnea– Many people who snore have a sleep disorder called obstructive sleep apnea (OSA). OSA results from the breathing passage in the back of the throat falling shut during sleep, causing repeated episodes of struggling for breath. Most people with sleep apnea snore loudly but are otherwise not aware of any sleep or breathing problem. Family members however, may observe the person struggling to breathe or stop breathing during sleep. Sleep apnea is also a major cause of daytime sleepiness.

Excessive Sleepiness – There are many causes of excessive sleepiness. One of them, a brain disorder called narcolepsy, also may cause sudden episodes of muscle weakness prompted by strong emotion (cataplexy), dreaming while awake, or awakening with the sensation of total paralysis. Narcolepsy is caused by an abnormality in the way the brain controls wakefulness and sleep, and is treated with a variety of medications. Other causes of excessive sleepiness include sleep apnea (above), circadium rhythm disorders (see below) and insufficient sleep.

Difficulty Falling Asleep – Individuals with insomnia have difficulty falling asleep or staying asleep. While almost everyone may suffer from insomnia during episodes of stress (school exams, bereavements, etc.), chronic insomnia may be an indication of significant conditions such as restless legs syndrome, depression, anxiety, poor sleep habits or sleeping schedule problems. Many of these conditions may be treated with behavior modification techniques or medication.

Sleep Walking – Sleep walking, sleep talking, nightmares, night terrors, teeth grinding, rocking, groaning, bedwetting and other undesirable behaviors during sleep are called parasomnias. Because they are events associated with being asleep. Some are relatively harmless, while others may be symptoms of serious medical conditions, disrupt sleep or put the patient into dangerous situations. Sleep apnea or restless legs may trigger parasomnias.

Circadian Rhythm Disorders – These disruptions of the body’s internal clock are most common in individuals doing shiftwork or after multi-time zone air travel, and can cause both sleepiness and insomnia at inappropriate times. Adolescents and young adults often suffer from a circadian rhythm disorder called delayed sleep phase syndrome, which causes them to have difficulty falling asleep at a normal time at night and difficulty awakening in time for school or work in the morning. Circadian rhythm disorders can respond to bright light therapy and behavior modification.

Sleep Apnea – Sleep apnea is a condition of abnormal breathing during sleep, usually caused by an obstruction of the throat that develops during sleep. Most patients snore loudly but are not aware of the problem. Sleep apnea causes daytime fatigue, sleepiness, impaired work performance and, in extreme cases, heart disease. Factors which my contribute to the condition are obesity, large tonsils, use of alcohol or sedative and nasal obstruction.

Insomnia – Some patients have difficulty falling asleep, staying asleep or wake up early in the morning not feeling refreshed. If chronic, insomnia may be an indication of a significant condition such as depression, anxiety or breathing problems. Many insomniac conditions can be treated with behavior modification techniques.

Narcolepsy – This condition causes profound sleepiness punctuated by sleep attacks, episodes of muscle weakness, vivid dreams and automatic behavior. This cause is abnormal control of rapid eye movement, (REM) sleep state which intrudes into waking activities.

Parasomnias – Sleepwalking, sleep talking, nightmares, night terrors, teeth grinding and other complex behaviors during sleep are examples of parasomnias. Some are relatively harmless, while others may be symptoms of serous medical conditions. (See Sleep Walking)