Sleep Conditions We Treat
Millions of Americans suffer from the effects of sleep apnea. When patients with this disorder sleep, the muscles of their throat and neck relax, which allows soft tissue to block the airway. Snoring results if the airway is only partially blocked, but when the airway obstructs completely, the person temporarily stops breathing. Doctors refer to this cessation of breathing as apnea. Since this serious condition occurs at night, physicians use the term sleep apnea.
Once a person stops breathing, he or she wakes up briefly and then falls back asleep. This cycle of respiratory cessation and arousal repeats itself over and over. Some people with the most severe cases can stop breathing up to an alarming 150 times in a single night. This recurrent pattern disrupts the normal sleep cycle, and individuals with sleep apnea never feel fully rested. Consequently, patients with this illness fall asleep frequently during the day. In extreme cases, patients can doze off during the course of a conversation or even behind the wheel of a car while driving. Some sufferers also experience extreme fatigue and difficulty staying awake at work, which can result in the ultimate loss of their jobs.
Doctors screen patients for sleep apnea by observing their physical appearance and asking a few simple questions. Since the condition occurs more commonly in the obese population, heavy individuals heighten physiciansÔøω index of suspicion. Professionals delve further by asking about the telltale signs of frequent napping during the day, excessive daytime sleepiness, and snoring at night. In addition people with sleep apnea sometimes complain of waking up with severe headaches.
If you describe symptoms typical for sleep apnea, your doctor may order an overnight sleep study. During this procedure, a technician observes the sleep of a patient in a laboratory that is equipped with a comfortable bed and surroundings similar to a hotel room. Instruments monitor the oxygen level over the course of the night along with the chest wall movements, airflow from the nose, leg movements, brain wave patterns and an electrocardiogram. With the detection of patterned breathing cessation, the laboratory will diagnose sleep apnea.
Upon the confirmation of sleep apnea, your doctor will probably recommend sleeping with a special mask called CPAP along with weight loss. The CPAP (continuous positive airway pressure) blows a small amount of air through the nose into the back of the throat. This pressure keeps the airway open and prevents the airway from occluding. A dramatic and overall improvement in well-being is usually reported by individuals with the use of CPAP. In rare cases, this mask might not help patients and physicians may recommend surgical procedures to remove the excess tissue in the throat and soft palate.
Narcolepsy is a rare disorder. Sudden and abrupt falling asleep without warning characterizes this condition. Sufferers perform their normal and usual daily tasks that may include driving, operating equipment, and talking on the phone among other activities, only to drop off to an unexpected sleep. Patients with narcolepsy also suffer from an associated cluster of symptoms including sleep paralysis and cataplexy. Cataplexy is the sudden loss of muscle tone following an emotional response such as laughing. Sleep paralysis describes the sensation of being alert associated with a complete inability to move. This usually occurs just prior to arousal in the morning.
Physicians specializing in sleep disorders, use a multiple sleep latency test to diagnose narcolepsy. Patients go to the lab for the procedure after a full nights sleep. Individuals with this disorder will fall asleep in the correct environment despite being well rested. In addition, the EEG pattern and eye movements of patients with narcolepsy demonstrate a tendency to fall immediately into the rapid eye movement (REM) phase of sleep. This distinguishes them from normal individuals who gradually progress from the early stages of sleep to REM sleep.
After diagnosis, physicians treat the disorder with medications. The two most frequently prescribed medications are Ritalin and Provigil. These medicines keep patients awake during the day and prevent the sudden, unexplained sleep attacks typical in narcolepsy.
Insomnia is the inability to fall asleep at night. Patients toss and turn frequently, sleep only for brief periods, and have a sense of overwhelming tiredness during the day. Doctors treat insomnia effectively using a combination of behavioral therapies and medications. Physicians usually recommend adjusting the patientÔøωs schedule to retire at the same time each night and wake up at the same time every morning. Behavioral modifications also include using oneÔøωs bed only for sleeping and not reading or watching television in bed during daytime hours. When behavioral modifications alone fail to rectify the problem, most experts prescribe non-addicting sleeping aides such as Trazadone or Ambien.
Restless leg syndrome
Restless leg syndrome describes a poorly understood condition in which patients kick and thrash their legs repeatedly during the night. This constant movement disrupts the patientÔøωs sleep and results in repeated awakenings during the night. These recurrent awakenings in turn lead to sleepiness during the day. Physicians diagnose this syndrome using an overnight sleep study (polysomnography). Once a diagnosis of restless leg syndrome is established, physicians prescribe medications such as Klonipin, Sinemet or Requip for treatment. These medications usually alleviate the symptoms of kicking during the night and sleepiness during the day.
Parasomnias are abnormal behaviors during sleep. Sleepwalking and night terrors are the most well known parasomnias. Once again, physicians use overnight sleep studies (polysomnography) to diagnose these disorders. If an overnight sleep study demonstrates a parasomnia, physicians prescribe medications and behavioral therapies to treat the problem.