Insomnia is characterized by difficulty initiating or maintaining sleep. People suffering from insomnia will usually experience some or all of the following symptoms:
- Difficulty falling asleep, inability to relax the mind enough for sleep to take over.
- Restless sleep and/or waking up often during the night and having trouble going back to sleep.
- Not feeling rested or refreshed from a night’s rest.
- Waking up too early in the morning.
- Daytime problems with fatigue, sleepiness, moodiness, lack of focus, clumsiness or accidents while at work or driving.
Insomnia can vary in duration and frequency and may either be short-term (acute insomnia) or long-term (chronic insomnia). It can also be intermittent, with extended periods of time where a person experiences no sleep problems. Acute insomnia may last from one night to a few weeks. Experiencing insomnia consistently at least three nights a week for thirty days or more would be considered chronic insomnia.
Insomnia is often treated with a combination of sedative hypnotics (sleeping pills) and a behavioral program called cognitive behavioral therapy. If you think you have acute or chronic insomnia, talk to your health care provider, and ask to be referred to our sleep center for special tests.
Interrupting a person’s breathing during sleep is considered a serious sleep disorder. Untreated, sleep apnea may stop breathing repeatedly during a person’s sleep as often as hundreds of times during the night.
Of the two types of sleep apnea, obstructive and central, obstructive sleep apnea (OSA) is the more common of the two. OSA is caused by a blockage of the airway, causing a temporary cessation of breathing, usually as a result of soft tissue in the rear of the throat collapsing during sleep. These brief obstructions result in many sleep interruptions each hour, drastically affecting the quality of sleep. Since these interruptions are rarely remembered, sleep apnea sufferers are often unaware of the cause of their symptoms. OSA may cause daytime drowsiness, increased irritability or depression, decreased concentration, reduced work productivity and even frequent accidents or mishaps, including serious traffic accidents. Loud, consistent snoring is a hallmark of obstructive sleep apnea as well.
During central sleep apnea, the airway remains clear and unblocked. The brain, however, fails to signal the muscles to breathe properly due to instability in the respiratory control center. It is called central sleep apnea because it results from a failure in the function and communication of the central nervous system.
Due to the debilitating effects of this disorder, if you believe you, a friend or family members suffers from these symptoms, consult your primary physician, or schedule a consultation with Mountain View Sleep Lab.
Restless leg syndrome (RLS) is characterized by tingling, pulling, creeping, or painful sensations in the legs at night. This sensation is brought on by resting such as lying down in bed, sitting for prolonged periods such as while driving or at a theater. The aching may also be accompanied by periodic limb movements that may continue for minutes or hours. RLS typically occurs in the evening, making it difficult to fall asleep.
Snoring happens when you are unable to move air freely through your nose and mouth during sleep. Many factors, such as the anatomy of your mouth and sinuses, alcohol consumption, allergies, a cold, and your weight can lead to snoring. It is normally caused by a narrowing of your airway, resulting from poor sleep posture or abnormalities of the soft tissues in your throat. A narrow airway gets in the way of smooth breathing and creates the sound of snoring.
As you progress from light to deep sleep, the muscles in the roof of your mouth (soft palate), tongue, and throat relax. The tissues in your throat can relax enough that they partially block your airway and vibrate. And, the more narrowed your airway, the more force required to flow air. This increases tissue vibration and consequently raises the volume of snoring.
Common causes of snoring:
- Your Age. As you reach middle age and beyond, your throat becomes narrower, and the muscle tone in your throat decreases.
- Your mouth anatomy. Men usually have narrower air passages than women and are more likely to snore. A low, thick, soft palate can narrow your airway or an elongated uvula obstruction may cause increased vibrations.
- Alcohol consumption. Snoring also can be brought on by consuming too much alcohol before bedtime. Alcohol relaxes throat muscles and decreases your natural defenses against airway obstruction.
- Being overweight or out of shape. Excess fatty tissue and poor muscle tone contribute to snoring.
- Nasal and sinus problems. Blocked airways such as deviated septum make inhalation difficult and create a vacuum in the throat, leading to snoring.
- Sleep apnea. Snoring also may be associated with obstructive sleep apnea. In this serious condition, your throat tissues partially or completely block your airway, preventing you from breathing. Sleep apnea often is characterized by loud snoring followed by periods of silence when breathing stops or nearly stops. Eventually, this reduction or pause in breathing may signal you to wake up, and you may awaken with a loud snort or gasping sound. You may sleep lightly due to disrupted sleep. This pattern of breathing pauses may be repeated many times during the night.
- Sleep posture. Sleeping flat on your back causes the flesh of your throat to relax and block the airway.
Narcolepsy is a neurological disorder that affects the control of sleep and wakefulness. People with narcolepsy experience excessive daytime lethargy and intermittent, uncontrollable episodes of falling asleep. These sudden sleep attacks may occur during any activity at any time of the day during mid-sentence, while at work, or possibly behind the wheel of a car. Other symptoms of narcolepsy include the sudden loss of muscle tone while awake when surprised or upset, vivid hallucinations as they fall asleep, and sleep paralysis, a condition where normal paralysis of large muscles during REM sleep fails to end upon waking.
Narcolepsy usually begins between the ages of 15 and 25. However, it can become apparent at any age and appears to run in families.
Symptoms and diagnosis:
Since the symptoms of narcolepsy can be found in several other conditions, including obstructive sleep apnea (OSA), accurate diagnosis is critical. Many researchers now believe that narcolepsy is caused by the lack of receptors for the neurotransmitter hypocretin, which regulates the sleeping and waking states. If you believe you or someone you know suffers from narcolepsy, talk to your health care provider, and ask to be referred to our sleep center for special tests.
Sleepwalking is mostly common in children and tends to occur within an hour or two of falling asleep and may last on average between 5 and 15 minutes. While the child’s brainwaves are in those of a deep sleep, the sleepwalker moves as though awake. The sleepwalker usually has no recollection of the event the next morning.
Sleepwalking occurs in more than 10% of children, however, most will outgrow it. It also appears to be genetics. Sleepwalking episodes may be triggered by fever or some medications, unpredictable sleep schedules, sleep deprivation, and stress.
The child’s safety during these episodes is the primary concern. Parents should ensure that doors and windows are locked and that no obstructions could cause a fall or other injuries. When a child is sleepwalking, gently guide the child back into bed. Don’t try to awaken them.
CPAP is considered the best sleep apnea treatment. However, CPAP is not the only sleep apnea treatment. There are three other options to treat sleep apnea. Depending on the individual's anatomy, and unique set of conditions, one of these other options may prove to be optimal.
Continuous positive airway pressure therapy (CPAP) requires the use of a machine to help a person breathe more easily during sleep suffering from obstructive sleep apnea (OSA). A CPAP machine creates increased (positive) air pressure in your throat preventing your airway from collapsing while breathing during sleep. The use of a CPAP will likely help your bed partner sleep better, as well.
Typically once you begin the use of a CPAP, it will be every night. A CPAP machine will normally be one of the following types:
- A mask that covers your nose and mouth.
- A mask that covers your nose only: nasal continuous positive airway pressure, or NCPAP.
- Prongs that fit into your nose.
There are a few types of surgeries for the treatment of sleep apnea. The most popular is Uvulopalatopharyngoplasty (UPPP). A UPPP procedure involves the surgical trimming (shortening) of the uvula dangling in the back of your throat and the floppy tissue on either side of it. After removing this excess floppy tissue the airway is able to move air freely with less chance of collapsing. If UPPP is successful there normally is no need for a CPAP machine, and the need to carry it with you at all times. Unfortunately, UPPP has a success rate of only 30% to 50% and often it is not effective enough to cure severe cases of sleep apnea.
Oral appliance therapy involves the use of a dentist who specializes in oral appliance therapy for sleep apnea, taking impressions of your teeth, and custom fitting a plastic device that fits tightly on the upper and lower teeth. This device “juts” the lower jaw forward during sleep. By pulling the jaw forward, the tongue is moved forward and is pulled away from the back of the throat, opening the airway and decreasing the probability of airway collapse.
They are convenient, easy to travel with, and do not require the use of an electrical receptacle. Unfortunately oral appliance therapy is limited in how far it can pull the jaw forward before leading to temporomandibular joint problems (jaw joint). Therefore it is only considered effective for mild to moderate cases of sleep apnea.
Medical management primarily consists of three techniques: weight loss, avoiding certain medications, sedatives, avoidance of alcohol prior to sleeping or as a sleep aid, and positional therapy (sleeping on your side or with the head of bed elevated). Depending on the root cause and the severity of OSA symptoms, medical management may not have a significant enough impact on sleep apnea to be a reliable treatment option.
- Weight loss or management is a healthy thing to do, in general. Alone, it often does not have enough impact on sleep apnea to be a reliable treatment option. For some very overweight patients with only mild sleep apnea, significant weight loss may be enough. However, someone with severe sleep apnea whoich is only moderately overweight, weight loss alone may not be a viable sleep apnea treatment.
- Alcohol and sedating medications can aggravate make sleep apnea worse. However, it is rarely the sole cause of sleep apnea.
- Positional therapy can be helpful for some patients, but in general moderate to severe cases of sleep apnea do not respond.