WHAT IS SLEEP MEDICINE

Inadequate sleep, affects approximately 70 million Americans. Through research, we know that the lack of sleep has both psychological and physical health affects on patients. Obstructive Sleep Apnea affects approximately 18 million Americans, which translates to about 5% - 10% of the United States population. Although prevalent, sleep disorders are ironically under diagnosed and largely go untreated. Recently, scientific data has propelled the healthcare system to be more proactive about diagnosing and treating patients with sleep disorders. As a sleep medicine center, we have specialized sleep physicians to help further the importance of sleep to one's health. Sleep medicine specialists have the most expertise when it comes to accurately diagnosing and treating both adults and children for many sleep disorders.



SYMPTOMS

Below is a list of prevalent symptoms or complainants seen in patients with sleep disorders. These are only some of the symptoms associated with each disorder. If you or someone you know has one or more of these symptoms you may be a candidate for treatment. Please call us to see our physician.



SLEEP APNEA


• Snoring
• Gasping for air
• Middle of the night awakenings
• Waking up feeling tired
• Dozing off during the day
• Unable to complete tasks because tiredness
• Fatigue
• Problems concentrating
• Erectile dysfunction



INSOMNIA


• Trouble falling asleep
• Trouble staying asleep
• Middle of the night awakenings
• Poor quality sleep
• Mood imbalances
• Fatigue



NARCOLEPSY


• Excessive sleepiness
• Muscle weakness at times
• Falling asleep at inappropriate times
• Hallucinations as you are falling asleep
• Fragmented sleep
• Being briefly paralyzed when you wake up from sleep


RESTLESS LEG SYNDROME


• Uncomfortable sensations in the legs or arms at night when trying to fall asleep
• Irresistible urge to move your legs
• Symptoms worsened with rest and improved with movement
• Trouble falling asleep



CIRCADIAN RHYTHM DISORDERS


• Falling asleep much earlier than the norm
• Falling asleep much later than the norm
• Shift work disorder
• Jet lag



PARASOMNIAS


• Sleep walking
• Sleep talking
• Teeth grinding
• Bed wetting behavior in children
• Nightmares
• Sleep eating
• Acting out dreams
• Falling out of bed




DISEASES

Obstructive sleep apnea (OSA)


Approximately 18 million Americans suffer from OSA and most of these patients remain undiagnosed. Risk factors for OSA include being a male, older age, post-menopausal females, large neck circumference, small airway size and high blood pressure. Most patients complain of habitual snoring or gasping for air in the middle of the night.
OSA occurs when a patient has repetitive episodes of muscles of the throat collapsing causing insufficient air to get into the lungs.

Consequences of OSA include impaired sleep, daytime sleepiness, fatigue, lack of energy, trouble concentrating, as well as, mood and memory impairment. More importantly, we now recognize that OSA leads to higher rates of cardiovascular consequences like heart attacks, strokes, difficult to control blood pressure, diabetes, irregular heart rhythms, elevated pressures in the lungs and erectile dysfunction.
Diagnosis is established with a sleep study, and treatment can improve daytime performance, as well as, reduce the rates of cardiovascular complications.



Insomnia


Insomnia is a condition where patients have trouble initiating or maintaining sleep, or they report poor quality sleep. There are 11 different types of insomnia categories and it can be commonly caused by another sleep disorder, such as obstructive sleep apnea (OSA), circadian rhythm sleep disorders (CRSD) or restless leg syndrome (RLS).

Insomnia is the most common sleep complaint among Americans. It is commonly seen with comorbid psychiatric disorders and the condition becomes chronic if it persists for more than 1 month. Insomnia has been linked to a poor quality of life, and higher rates of cardiovascular disease, including strokes.



Narcolepsy


Is a chronic, but rare neurological condition which usually manifests itself in patients who are 15 to 30 years old. Narcoleptics commonly complain of excessive daytime sleepiness, sleep attacks, episodes of muscle weakness while awake, hallucinations associated with sleep, and a brief inability to move or speak when awakening. It is common to see fragmented sleep with multiple awakenings in the middle of the night.

In narcolepsy, patients may fall asleep abruptly while engaging in social activities. People report an impaired lifestyle because the need for sleep prevents them from carrying out the tasks that they would normally perform throughout the day.

Evaluation for narcolepsy is important because treatment of the condition can significantly improve the patient’s lifestyle. To diagnose narcolepsy patients need to undergo a nighttime sleep study, as well as, a daytime sleep study consistent of multiple naps throughout the day.



Restless Leg Syndrome (RLS)


RLS is seen in approximately 5-10% of the general population. It is a neurologic disorder in which patients describe an uncontrollable urge to move their legs. The condition typically worsens in the evening or when the patient is going to bed, preventing the patient from falling asleep. Patients typically describe pain, discomfort, restlessness or “creepy-crawling” sensations in one or both legs. Some even have the sensation in their arms. The feelings can occur as frequently as every night.

The diagnosis is made based on the clinical history obtained from the patient. Many patients with RLS also have frequent leg movements in the middle of the night while asleep – this condition is called periodic limb movement disorder. Some patients with RLS have deficiencies in iron or other vitamins, which can be determined by performing routine blood tests. Treatment is with medications, and with replacement of iron or vitamins if necessary.



Circadian Rhythm Sleep Disorders (CRSD)


This consists of a group of disorders in which a patient’s internal sleep clock is dysregulated. There are 9 different subtypes of CRSD, which include shift work disorder and jet lag.

Many signals are necessary to help entrain our internal sleep clock including melatonin (our body’s natural hormone that induces sleep), light, exercise, eating and social activities. The diagnosis is established with sleep diaries, as well as, actigraphy – a wrist watch device that helps us track your activity levels and your sleep.

Treatment includes planned sleep schedules, timed bright light therapy and timed melatonin therapy. For jet lag and shift work disorder, we can sometimes also use caffeine, sleep aids and stimulants in addition to the other treatments mentioned above.



Parasomnias


These are a distinct group of disorders which result in undesirable physical events or experiences occurring during sleep. There are 15 different types of parasomnias, and they are classified by which stage of sleep they occur in. Parasomnias such as sleep walking are common in children, but the good news is that most children grow out of these disorders. Adults who suffer from parasomnias usually also suffered from one or more parasomnias as a child.

Parasomnias can be confused for nocturnal seizures and a sleep study is necessary to distinguish the two conditions. Treatment involves environmental precautions and medications.



EDUCATION

For more patient information and education, please visit www.sleepeducation.com.