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Snoring

Snoring affects approximately 45% of the adult population and can be an indicator of a serious breathing problems. Generally, men tend to snore more often than pre-menstrual women. Unless they have enlarged tonsils or adenoids, children generally do not snore.

Causes:

1. Weak muscle tone in the throat and tongue

2. Residual effects from the use of alcohol and sleeping pills which causes the muscles to relax which results in snoring

3. Obstructed nasal passages

4. A long soft palate and uvula narrows the passage way from the nose to the throat which can flutter during relaxed breathing and cause snoring

5. Deviated septum refers to a malformation in the wall that separates the nostrils

Treatments:

1. Maintain regular exercise routine

2. Avoid the use of sleeping pills and antihistamines prior to bedtime

3. Avoid intake of alcoholic beverages within 3 hours of bedtime

4. Avoid eating heavy meals 3 hours before bedtime

5. Sleep on the side position rather than in a supine position in order to prevent turning. Sew a pocket with a tennis ball in the back of your pajamas

6. If snoring disturbs an individual and or family member, consult a health care professional as the snoring may be an indicator of obstructive sleep apnea

Sleep Apnea

Apnea, which means “want of breath” in Greek, is a sleep disorder that can last as long as 10 seconds or longer, per episode. Those with severe cases of apnea may stop breathing hundreds of times during their sleep.

Symptoms:

1. Loud, habitual snoring and/or snorting

2. Witnessed pauses in breathing during sleep

3. Daytime sleepiness

4. Gasping/choking during sleep

5. Non-refreshing sleep

6. Frequent napping

7. Frequent awakenings

Types:

1. Obstructive sleep apnea (OSA) is both the most often seen and most severe type of sleep apnea. For those individuals with OSA, the muscles of the soft palate and uvula become too relaxed and block the airway, causing cessation of breathing to occur typically lasting from ten to sixty seconds. As the pressure to breath increases, the chest and diaphragm muscles are forced to work harder and sleep is interrupted. This interruption activates the throat muscles and forces the individual to breathe. Every time breathing stops, oxygen in the blood falls, causing the heart to work harder which raises the blood pressure. Overweight men are usually the most prone to OSA.
    

2. Central sleep apnea is one particular type of sleep apnea where the diaphragm and the chest muscles used for breathing stop working altogether although the airway may remain open. When the blood oxygen levels fall, a signal is sent to the brain to awaken the person and breathing is then resumed. This type of sleep apnea becomes more commonplace with age and becomes more frequent in those with congestive heart failure or neurological disorders.

Treatment:

• Continuous Positive Airway (CPAP) – This is a highly effective therapy in which a mask is worn throughout the night and provides a specific pressure that allows the person to breathe and sleep normally throughout the night.

• Dental Appliances

• Positional Tricks

• Surgery

Narcolepsy

Narcolepsy, a relatively uncommon sleep disorder that involves the body’s central nervous systems and characterized by attacks of sleep, affects approximately 1 in 2,000 of the general population. Narcoleptics are liable to fall asleep at inappropriate times and places. Daytime sleep attacks may occur without warning and can occur repeatedly throughout the day. Night time sleep may be fragmented with frequent arousals. While there is not yet a cure, recent technology and pharmacological advances have allowed narcoleptics to live relatively normal lives.

Symptoms:

1. Excessive daytime sleepiness

2. Sudden loss of muscle control (Cataplexy)

3. Low concentration

4. Vivid dream-like experiences while dozing or falling asleep or waking up (Hypnagogic Hallucinations)

5. Temporary inability to talk or move when falling asleep or waking up (Sleep Paralysis)

6. Occupational/school problems

Treatments:

1. Medication including use of stimulants and anti-depressants

2. Changes in behavior to encourage good night time sleep

3. Scheduling short naps (10 to 15 minutes) two to three times per day to help control excessive daytime sleepiness
   
    

Restless Legs Syndrome (RLS)

Restless legs syndrome is a “creepy, crawly” perception in the legs when they are still, especially at bedtime. Stretching or moving the legs provides relief to the sensation. The constant need to stretch or move the legs to rid of the uncomfortable sensations often prevents the person from fallings asleep and results in daytime sleepiness. Five to ten percent of the general population experience RLS symptoms during some point in their lives. While RLS can occur at any age it is more prevalent in the elderly population. Approximately 30% of RLS cases have a hereditary case.

Symptoms:

1. A strong urge to move the legs, often accompanied by uncomfortable sensations in the legs

2. Worsening of the discomfort when lying down or during other forms of inactivity

3. Experiencing the most discomfort at night and during the latter part of the day

Treatments:

1. Home remedies including application of hot bath, ice packs, leg message and regular exercise

2. Medication, including pain relievers, Benzodiazepines (such as Valium, Halcion, Restoril and Klonopin) and L-Dopa drugs that enhance a brain chemical known as dopamine

3. In certain cases Vitamin E and supplemental Calcium
   
    

Periodic Limb Movement Disorder (PLMD)

Periodic Limb Movement disorder (PLMD) refers to involuntary movements of the legs and arms during sleep. These movements cause arousals and sleep disturbances. PLMD are observed mostly in those over 50 years of age and are rarely in those under 30. PLMD are more common in people who have kidney disease or narcolepsy. Individuals with PLMD may also experience Restless Legs Syndrome (RLS).

Symptoms:

1. Repetitive movements, most typically in the lower limbs, that occur every 20-40 seconds

2. Brief muscle twitches, jerking movements or an upward flexing of the feet during sleep

Treatments:

1. Many people sleep through PLMD and are unaware of the symptom in such case treatment is unnecessary

2. Following the guidelines for a good night’s sleep will help those disturbed by PLMD

3. While certain drugs have been reported to reduce PLMD, the effectiveness of these drugs remain unproven

4. Treatment is only necessary when PLMD is accompanied by Restless Legs Syndrome (RLS) insomnia or daytime fatigue
    

Insomnia

The inability to fall asleep or remain asleep is known as insomnia. Chronic insomnia occurs when this conditions lasts for weeks, months or even years. Insomnia may be related to worry, anxiety, depression, medical/psychiatric problems, or substance abuse. Insomnia is a symptom and in order to treat it, the physicians must find the cause. Most insomnia sufferers sleep better once they obtain the appropriate evaluation and treatment.

Types:

1. Transient insomnia is the inability to sleep over a period of a few nights. Stress or excitement usually causes this type of insomnia. For instance an anxious bride may be unable to sleep the night before the wedding or an athlete may experience some transient insomnia the night before the big sports event
    

2. Short-term insomnia is caused by periods of high stress at work, school, or daily life and results in two to three weeks of poor sleep. After the stressful period is over, sleep usually returns to normal
    

3. Chronic insomnia is characterized by poor sleep most or every night. Most chronic is cause by physical ailment such as breathing disorders and muscle activity

Treatments:

1. Sleeping pills, taken for a limited time usually no more than 3 weeks, can help in certain cases in treating short term and chronic insomnia

2. Good sleep habits
    

Parasomnias

Parasomnia refers to a variety of disruptive sleep-related events that disrupt one’s sleep and can lead to injury or disturbance of oneself or others in the bed or house. Parasomnia often be effectively diagnosed and treated.

Parasomnia include:

• Sleepwalking – Sleepwalking appears to be a temporary sleep mechanism malfunctions which occurs during deeper stages of sleep and tends to be hereditary. Sleepwalking affects mostly children. Sleepwalkers do not recall their nocturnal walk the next day.
   

• Sleep talking – Sleep talking is generally harmless and usually temporary, brought on by illness or stress. The sleeper has no memory of sleep talking. Sleep talking can sometimes be associated with sleep apnea or sleep terrors.
   

• Sleep terrors – Sleep terrors are more common in children and typically and typically do not continue into adulthood. Sleep terrors are marked by a sudden awakening with physical behaviors associated with intense fear and last about 15 minutes, after which the person goes back to sleep.
   

• REM movement disorder – In this type of a disorder, the paralysis that occurs normally during REM sleep is incomplete or absent, allowing the sleeper to act out their dreams. This type of disorder is most common in men and can lead to violent behavior or injuries. Medication is usually very effective in treating this disorder.

Copyright © 2007 Advanced Sleep Medical Centre - All rights reserved.