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Sleep
Disorders
excessive daytime sleepiness
Definition
Excessive Daytime Sleepiness (EDS) is a condition in which an
individual struggles or is unable to stay awake even after a
good night of sleep. In addition, some individuals
unintentional fall asleep. Individuals with EDS frequently
doze, nap, or fall asleep in situations where they need or
want to be fully awake and alert. However, it is difficult
separating true EDS from generalized fatigued or laziness.
EDS is a
symptom of an underlying medical condition, typically a sleep
disorder such as Narcolepsy, Sleep Apnea and Loud Snoring. The
primary cause of EDS is simply the lack of good sleep at
night. The average adult requires between seven and nine hours
of good sleep in order to be rested properly function during
the day.
Symptoms
Individuals suffering from EDS may be characterized with the
following symptoms:
If you experience these symptoms, avoid alcohol, caffeine,
narcotics, and cold/sleep medicine which may worsen your
condition.
Risk Factors
Medical studies have shown that EDS, whether associated with
any sleep-related disorders, is a significant risk factor for:
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Automobile accidents
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Work-related injuries
INSOMNIA
What Is Insomnia?
Insomnia is the perception or complaint of inadequate or
poor-quality sleep because of one or more of the following:
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Difficulty falling asleep
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Waking
up frequently during the night with difficulty returning to
sleep
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Waking
up too early in the morning
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Unrefreshing sleep
Insomnia is not defined by the number of hours of sleep a
person gets or how long it takes to fall asleep. Individuals
vary normally in their need for, and their satisfaction with,
sleep. Insomnia may cause problems during the day, such as
tiredness, a lack of energy, difficulty concentrating, and
irritability.
Insomnia can be classified as transient (short term),
intermittent (on and off), and chronic (constant). Insomnia
lasting from a single night to a few weeks is referred to as
transient. If episodes of transient insomnia occur from time
to time, the insomnia is said to be intermittent. Insomnia is
considered to be chronic if it occurs on most nights and lasts
a month or more.
What Causes Insomnia?
Certain conditions seem to make individuals more likely to
experience insomnia. Examples of these conditions include:
If other conditions (such as stress, anxiety, a medical
problem, or the use of certain medications) occur along with
the above conditions, insomnia is more likely.
There are many causes of insomnia. Transient and intermittent
insomnia generally occur in people who are temporarily
experiencing one or more of the following:
Chronic insomnia is more complex and often results from a
combination of factors, including underlying physical or
mental disorders. One of the most common causes of chronic
insomnia is depression. Other underlying causes include
arthritis, kidney disease, heart failure, asthma, sleep apnea,
narcolepsy, restless legs syndrome, Parkinson's disease, and
hyperthyroidism. However, chronic insomnia may also be due to
behavioral factors, including the misuse of caffeine, alcohol,
or other substances; disrupted sleep/wake cycles as may occur
with shift work or other nighttime activity schedules; and
chronic stress.
In addition, the following behaviors have been shown to
perpetuate insomnia in some people:
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Expecting to have difficulty sleeping and worrying about it
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Ingesting excessive amounts of caffeine
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Drinking alcohol before bedtime
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Smoking cigarettes before bedtime
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Excessive napping in the afternoon or evening
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Irregular or continually disrupted sleep/wake schedules
These behaviors may prolong existing insomnia, and they can
also be responsible for causing the sleeping problem in the
first place. Stopping these behaviors may eliminate the
insomnia altogether.
narcolepsy
Definition
Narcolepsy is technically defined by Excessive Daytime
Sleepiness (EDS) and sleep attacks, in conjunction with one or
more auxiliary symptoms, which can include Cataplexy,
Hallucination, and Sleep
Paralysis.
Narcolepsy
is a severe disabling neurological disorder of sleep
regulation that affects the control of sleep and wakefulness.
Symptoms
Individuals suffering from Narcolepsy may be characterized
with the following symptoms:
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Excessive Daytime Sleepiness despite a full night’s sleep
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Sudden, uncontrolcenterle sleep attacks lasting minutes to
hours
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Inability to recall details of a task, even though you have
evidence that you completed the task
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Cataplexy
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Hallucination
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Sleep Paralysis
Symptoms of Narcolepsy may appear suddenly or build up over a
period of years. Sleep attacks, ranging from mild sleepiness
to disabling naps, can occur at any time, during any activity.
If life has become a constant battle to stay awake, please
seek medical advice as soon as possible.
Cataplexy
Cataplexy is the sudden, temporary loss of muscle tone in the
body. When loss of muscle strength is severe, all the
voluntary muscles in the body are affected, leading to
complete collapse.
During a cataplectic attack, the person is completely awake
and later will have total recall of the entire event. If
episodes last longer than a few minutes, the patient may begin
to hallucinate (distinguishable in occurrence from those
described below). It is extremely rare for cataplexy to occur
independently of narcolepsy. Indeed, Excessive Daytime
Sleepiness and Cataplexy are sufficient for a diagnosis of
narcolepsy.
Hallucination
Hypnogogic Hallucinations occur while falling asleep, and
Hypnopompic Hallucinations upon awakening. These types of
hallucination occur in a small percentage of individuals
suffering from narcolepsy.
These Hallucinations are similar to nightmares, in that they
are typically more intense, and their effects last longer than
mild dreams or daydreams.
Sleep Paralysis
Sleep Paralysis is the inability to move immediately before
falling asleep or upon awakening. This condition also occurs
in a small percentage of individuals suffering from
narcolepsy.
Risk Factors
The following are risk factors associated with Narcolepsy:
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Automobile accident
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Work-related injuries
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Injuries to one-self
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Injuries to people around individuals who suffer from
narcolepsy
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Narcolepsy seems to run in families. 8%-12% of individuals
suffering from narcolepsy also have another family member with
this condition.
Rapid Eye
Movement (REM)
Rapid eye movement (REM) sleep
is the stage of sleep characterized by rapid movements of the
eyes. It was discovered by Nathaniel Kleitman and Eugene
Aserinsky in 1952. During this stage, the summed activity of
the brain's neurons is quite similar to that during waking
hours; for this reason, the phenomenon is often called
paradoxical sleep. Most of the vividly recalled dreams occur
during REM sleep.
REM sleep is so physiologically different from the other
phases of sleep that the others are collectively referred to
as non-REM sleep.
During a night of sleep, a person usually has about four or
five periods of REM sleep, which are quite short at the
beginning of the night and longer at the end. It is common to
wake for a short time at the end of a REM phase. The total
time of REM sleep per night is about 90-120 minutes for an
adult. However, the relative amount of REM sleep varies
considerably with age. A newborn baby spends more than 80% of
total sleep time in REM, while people over 70 years old spend
less than 10%. The average is 20%.
Sleep disorders can occur in REM
sleep if the REM sleep period is not normal. REM sleep can
occur within about 90 minutes, but in those with a sleep onset
REM period, it may be as little as 15-25 minutes. It is
considered a sign of narcolepsy.
Restless leg syndrome (RLS)
Restless Legs Syndrome (RLS) is a neurological disorder in
which patients experience irrepressible sensations in the legs
or arms while sitting or lying still. Terms used to describe
RLS may include creepy, crawly, pulling, tingling, itching, or
gnawing. Often the person with RLS has difficulty being
specific about the sensations in their legs. The sensations
are rarely described as painful. RLS differs from the "pins
and needles" feeling when the blood supply is cut off from a
limb ("My foot fell asleep!"). These uncomfortable feelings
usually begin in the evening and upon arrival to bed, unless
severe, RLS is absent during the morning and early afternoon.
Symptoms are worse or only present when the affected
individual is at rest. The sensations usually disappear or
diminish when the limb is moved. The person with RLS may
experience movements of the toes, feet or legs in the evening
when he/she sits or lies down. For this reason, RLS
individuals are often centereled "nervous" or "fidgety." Because
those with RLS have a constant need to stretch or move their
limbs to get rid of the uncomfortable feelings, sleep is often
disturbed. Those who suffer from RLS can have very severe
insomnia.
Excessive Daytime Sleepiness during the day due to sleep
deprivation can be one result of RLS. Severe RLS also limits
certain activities because of the confinement of traveling in
a car or airplane, sitting through a meeting, or watching a
movie. These individuals find it nearly impossible to sit
without moving for any length of time. Anxiety and depression
are often associated with RLS. Approximately 80 percent of
people with RLS also suffer from Periodic Limb Movement
Disorder (PLMD).
SLEEP APNEA
Definition
Millions of people worldwide suffer from Sleep Apnea, a
sleeping disorder that disrupt sleep and makes waking hours
miserable. Sleep Apnea is defined as pause or stoppage of
breathing during sleep. There are three types of Sleep Apnea:
Obstructive, Central and Mixed.
Obstructive Sleep Apnea (OSA)
or Obstructive Sleep Apnea Syndrome (OSAS)
Obstructive Sleep Apnea is the most common. OSA is defined as
pause/stoppage of breathing during sleep caused by repetitive
partial or complete obstruction of the upper airway (throat).
In most cases, the site of the obstruction is the soft palate
extending to the region at the base of the tongue and usually
occurs when the soft tissue at the rear of the throat
collapses and closes during sleep.
Central Sleep Apnea (CSA)
Central Sleep Apnea is the rarest type of sleep apnea. CSA is
defined as pause/stoppage of breathing during sleep caused by
the inability of the brain to send the appropriate signals to
the breathing muscles to initiate respiration. CSA is a
neurological disorder and is very different in cause than OSA
which is a physical in nature.
Mixed Sleep Apnea (MSA)
Mixed Sleep Apnea is a combination of OSA and CSA.
Symptoms
At
night, sleep apneics may:
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Snore,
snort, and gasp for breath, then jerk suddenly, and resume
breathing.
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Perspire heavily during sleep.
During the day, sleep apneics may:
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Experience excessive sleepiness.
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Complain of a lack of restful sleep.
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Awake with a headache.
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Feel confused upon awakening.
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Have high blood pressure.
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Experience impotence.
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Exhibit personality changes.
If you experience these symptoms, avoid alcohol, caffeine,
narcotics, and cold/sleep medicine
which
may worsen your condition.
Risk Factors
The
primary risk factor for OSA is excessive weight gain. The
accumulation of fat on the sides of the upper airway causes it
to become narrow and predisposed to closure when the muscles
relax. Age is another prominent risk factor. Loss of muscle
mass is a common consequence of the aging process. If muscle
mass decreases in the airway, it may be replaced with fat,
leaving the airway narrow and soft. Men have a greater risk
for OSA. Male hormones may also cause structural changes in
the upper airway.
OSA can create physical and emotional drain resulting in a
reduced quality of life. Sufferers may productivity at work,
have strained relationships with loved ones, experience a
decrease in strength and stamina, feel tired and feel
sluggish. At their worst, they are life-threatening. If you
experience any of these symptoms, contact your physician
immediately.
SNORING
Definition
Snoring is the vibration of the soft tissues in the back of
the throat. The noisy sounds occur when there is blockage of
the airflow and the soft part of the airway (i.e. tongue,
tonsils, soft palate and uvula) strike each other and vibrate
during breathing. This is Snoring.
Snoring is the first indicator of possible Obstructive Sleep
Apnea Syndrome (OSAS), a common disorder resulting in improper
breathing during sleep. Loud snoring can be a symptom of a
medical condition and is a characteristic of Sleep Apnea.
Symptoms
Individuals who snore may experience the following symptoms:
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Restless and disturbed sleep.
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Loss of attention span at school and work.
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Tiredness and sleepiness during the day.
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Frequent headaches.
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Irritability and mood swing.
Risk Factors
Is snoring serious? Yes, it is medically and socially serious:
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It can make the snorer an object of ridicule.
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It can cause other to have sleepless nights.
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It can strain relationships with loved ones.
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It disturbs the sleeping pattern and deprives rest.
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Severe snoring can cause health problems.
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It Including Obstructive Sleep Apnea.
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Snoring has been associated with heart problems.
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Hypertension and obesity are common characteristics.
Snoring is not funny and it is not hopeless. There are general
as well as specific treatments for snoring. Your physician can
guide you as to the best course of treatment for you.
Denton Sleep Disorders
Center
3200 Colorado Blvd., Suite
200
Denton, Texas 76210
www.dentonsleepdisorderlab.com
For more information please call
940-381-0971 or fax
940-384-7069
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