Sleep Disorders

Sleep is a pillar of health and is as important as good diet and regular exercise to maintaining a healthy lifestyle.

How are you sleeping?

Practicing good sleep hygiene can make a big impact on the quality and quantity of sleep achieved. If practicing good sleep hygiene still leaves you feeling tired during the day, it's time to speak with your doctor about your sleep. Unfortunately, millions of Americans are poor sleepers. In fact, there are more than 80 known sleep disorders, most of which remain undiagnosed in those affected. The good news is that sleep disorders can be diagnosed accurately and treated effectively.

Are you having sleep issues?

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Speaking with your physician is the first step to getting a better night's sleep. Your physician can evaluate your sleep health, medical history, and symptoms to determine if a sleep study is right for you.

What is Sleep Apnea?

Sleep apnea is a common condition that causes your breathing to stop for a few seconds to minutes.

This is a significant, potentially life-threatening condition that requires prompt diagnosis and treatment. People with sleep apnea typically snore loudly. Under normal circumstances, snoring is no more than an inconvenience and is not life-threatening. However, it can be the main symptom of sleep apnea. For a person with sleep apnea, breathing stops from ten seconds to more than a minute at a time, and these attacks can occur from five to more than one hundred times an hour during sleep.

Sleep apnea can lead to high blood pressure, stroke, heart attack and/or abnormal heart rhythms. It may also impact your memory.

There are two types of sleep apnea, Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA).

What are the consequences of sleep apnea?

Untreated sleep apnea may cause high blood pressure, stroke, heart attack, and abnormal heart rhythms. The National Commission on Sleep Disorders estimates that 38,000 people die each year because of the untreated cardiovascular complications of sleep apnea.

What are the next steps?

After meeting with a physician, you will have a sleep clinic appointment. Your physician will either order an overnight sleep study at a sleep center or possibly a Home Sleep Apnea Test.

Obstructive Sleep Apnea

Obstructive Sleep Apnea occurs when muscles of the soft palate (airway) and throat relax during sleep, obstructing the airway and making breathing difficult and noisy (snoring). Eventually the airway walls collapse blocking airflow. Breathing then pauses or stops (apnea).

Paused breathing can result in a drop of blood oxygen levels. Since oxygen is the fuel for the cardiovascular system, this stresses the heart and puts the sleeper at a greater risk for heart attack or stroke.

Central Sleep Apnea

Central Sleep Apnea occurs when the brain fails to tell the lungs to breathe during sleep. As this signal is lost, the lungs do not take in the oxygen that your body needs. This condition is less common than OSA. This is associated with heart failure, certain medications, or central nervous system diseases such as stroke.

Other Sleep Disorders

Insomnia

Insomnia occurs when you have trouble falling asleep or staying asleep. Anyone can have insomnia, but it is more common and more frequent in older adults, women, and people under stress.

Some medical and mental health problems, such as other sleep disorders, can also cause or worsen the frequency of insomnia. Medications, both prescription and over-the-counter, can be taken to treat insomnia. However, many sleeping pills are not meant to be used long term and have side effects. You should speak to your healthcare provider about any sleeping pills you have been prescribed or purchased over the counter. If you think you have insomnia, talk to your healthcare provider.

Restless Leg Symdrome

Restless Legs Syndrome or RLS is best described as having an overwhelming urge to move your legs. You may also feel burning or itching inside your legs.

Typically, these discomforts are relieved by walking around. Patients with RLS will complain that these symptoms are worse at night. The urge to move your legs at night may go unnoticed; however, it can disrupt your sleep. Low levels of iron in your blood, diabetes and some medications have been linked to RLS. Women are twice as likely to have RLS as men. If you think you have RLS, talk to your health care provider.

Periodic Limb Movement Disorder

Periodic Limb Movement Disorder (PLMD) is a sleep disorder involving the uncontrollable movements of limbs—usually feet and legs, but sometimes the arms too. However, PLMD movements occur during sleep, and sufferers aren’t always aware that they have it. It can still cause daytime fatigue and sleepiness because of its disruptive nature.

Narcolepsy

Narcolepsy symptoms typically emerge in patients between the ages of 10 and 20. The most common symptom of narcolepsy is excessive daytime sleepiness.

This is a common symptom in other sleep disorders, which makes sleep testing even more important in these cases. Cataplexy, intense dream-like hallucinations while falling asleep, and sleep paralysis are other symptoms of narcolepsy. Narcolepsy can run in your family, but most cases are not genetically related. Typically, medication is used to treat narcolepsy along with lifestyle changes. If you think you have narcolepsy, talk with your health care provider.

What to expect when having a sleep study

A sleep study is similar to an EEG study.

Many signals are recorded throughout the night including brain waves, respiration, oxygen levels, and limb movements. The electrodes are resting on the skin attached by a medical adhesive and tape. These tests begin at night and last through the morning, as would a normal night of sleep.

Home sleep apnea testing may be ordered to look for obstructive sleep apnea. This is a simplified version of an in lab sleep study. Respiratory patterns, oxygen levels, and airflow are recorded. If OSA is found, treatment can begin. If the testing does not show OSA but your physician feels strongly that you have OSA, a more detailed test is performed in the sleep lab.

Treatment Options

Weight Loss

Weight loss helps decrease the severity of sleep apnea. Even losing a little weight makes a big difference.

Continuous Positive Airway Pressure (CPAP)

Most common treatment option
Pressurized air goes through the nose to keep the airway open
Oxygen and carbon dioxide levels return to normal
Sleep is deeper and more restorative
Many mask options are available

Bi-level Therapy (BPAP)

Similar to CPAP except two pressures are set – one for inspiration (inhaling), one for expiration (exhaling).
Some patients with lung disease do better with this device than CPAP.
Masks are identical to CPAP masks.

Oral Appliances

These devices enlarge the airway by pulling the jaw forward. They are effective for mild-to-moderate OSA and generally well-tolerated.

Surgery

Surgery is the most effective treatment for snoring, but is not as effective in treatment for sleep apnea in adults. There are many types of surgery available.

Home Sleep Testing

What should you expect and know about your in-home sleep apnea test?

In-Lab Sleep Testing

What can you expect when you're having an in-lab sleep test?

A good night’s sleep starts with good sleep hygiene

The following are suggested tips to help you get the rest you need:

Go to bed at the same time each night and get up at a similar time each morning. This strengthens the biological rhythm that controls the sleep-wake cycle. If bedtimes vary significantly on work-nights versus nights off, then the body’s rhythms are disrupted, much like jet lag. People need an average of eight hours of sleep per night.
Go to bed only when you are sleepy.
If you cannot fall asleep, or awaken for more than 15 to 20 minutes during the night, get up and do something relaxing in another room. The bedroom should only be associated with sleep or sex.
Do not use the quiet time once the lights are off to rehash the day or plan the next day’s activities. Develop a worry time for these thoughts prior to bedtime.
The bedroom should be dark (never try to fall asleep with the lights or TV on) and quiet. Draperies, including black-out curtains will help darken the room. Drapes and carpets also serve as sound absorbers.
Cool rooms are better for sleeping than warm rooms.
A light snack before bedtime may help you sleep, but avoid heavy meals late in the evening.
Avoid alcohol in the late evening, this aggravates snoring, obstructive sleep apnea, and causes disturbed sleep during the latter part of the night. No one feels refreshed after drinking too much the night before.
Avoid using sleeping pills for more than one or two nights per month. Avoid them totally if you have obstructive sleep apnea.
Eliminate all caffeine after lunch time. It may not keep you from falling asleep, but it keeps you from obtaining deep sleep and staying asleep.
Do not nap for more than 30 minutes during the day. Longer naps disrupt the body’s ability to stay asleep at night.
Regular exercise helps promote deep sleep, but avoid heavy exercise in the evenings, or it may make it harder to fall asleep. Avoid vigorous exercise after 7 p.m.

Additional Resources

Browse the links below for more information on sleep disorders and sleep education.