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How To Evaluate and Treat Sleep Disorders
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Business New Haven
11/11/2002
By: BNH
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Many people take sleep for granted until that odd night when the sandman doesn't come. Some 100 million people in the U.S. regularly fail to get a full, restful night's sleep. The American Sleep Disorders Association (ASDA) estimates that at least 84 sleep disorders can harm personal health and endanger public safety because people are exhausted on the job and behind the wheel.
Most people with sleep-related disorders don't realize that they aren't sleeping through the night. They go to bed and get up with no recollection of how they slept. The ASDA estimates that at least 84 sleep disorders can harm personal health and endanger public safety because people are exhausted on the job and behind the wheel.
Common symptoms include: excessive daytime sleepiness, falling asleep at inappropriate times, intermittent snoring with "breath holding" terminated by snorts, restless sleep, choking or coughing, disheveled bed covers, nocturia, headaches and impotence.
Sleep disorders include:
Sleep apnea is the temporary cessation of breathing due either to obstruction of the airway caused by relaxation of the muscles of the soft palate or to failure of the diaphragm and chest muscles. The loud snoring or snorting characteristic of sleep apnea is caused by the person waking and gasping for air.
Insomnia is trouble falling asleep or staying asleep.
Restless Legs Syndrome is an unpleasant restlessness in the legs and sometimes the arms due to an achy, throbbing, tingling, pins-and-needles, pulling or "creepy crawly" sensation. Restless Legs Syndrome may be associated with abnormal leg movements while awake and with Periodic Limb Movement Disorder during sleep.
Circadian Rhythm Sleep Disorders are changes in the normal "sleep-wake" cycle (such as jet lag or shift work) that may lead to fatigue, sleepiness, insomnia, irritability or gastrointestinal distress.
Narcolepsy is excessive drowsiness with a tendency to sleep at inappropriate times.
Parasomnias are abnormal sleep-related physical events (sleep walking, sleep talking, sleep terrors, nocturnal leg cramps and movement disorders) that disrupt sleep and sometimes cause injury to those involved.
What causes sleep disorders?
Some common causes include: upper airway obstructions, paralysis of the diaphragm, systemic hypertension, cardiac arrhythmia, myocardial infarction, lung disease, depression, tension and anxiety, asthma, stroke and neuromuscular disorders.
Treatment
Most sleep disorders can be treated through lifestyle changes, medication, good sleep habits, continuous positive airway pressure (CPAP, pronounced SEE-pap) therapy, oral appliances to open airways, surgery or a combination of methods.
The key to successful treatment is proper diagnosis. A sleep study is often recommended to help sleep specialists determine effective treatment.
A sleep study is a recording of a person's brain and body activity during the sleep state. Brain waves, muscle and eye movements, breathing, snoring, heart rate and leg movements are recorded using an instrument called a polysomnograph.
During a sleep study, a technician will ask about the person's sleep history and explain the test. After changing into pajamas or other comfortable clothing, the patient is connected to the polysomnograph with small metal discs, called electrodes, attached to thin, lightweight wires called transducers. The electrodes are applied to the ears, forehead, chin, head, legs, nostrils, mouth and chest with an adhesive. Flexible elastic belts are then placed around the rib cage and abdomen to measure breathing. A clip on the index finger or earlobe monitors the level of oxygen in the blood and the heart rate. The application of these devices doesn't hurt. The wires are loosely gathered behind the head so the patient can change positions while sleeping.
Closed-circuit television monitors the patient's sleep for position changes, leg twitches and breathing patterns. The videotape also can help patients see their sleep behavior for themselves.
When the study is over, patients leave and resume their daily routines in the morning. A detailed written report with findings and treatment recommendations is sent to the referring physician within a few days following the completed evaluation.
Insomnia - the inability to fall asleep or stay asleep - affects 1 out of every 3 adults in the U.S. Insomnia, however, is a treatable condition. The staff at the Insomnia Treatment Program can work with clients to identify and deal with those factors that cause their insomnia and help them sleep better.
Past treatment has relied on the use of sleeping pills. While they may be effective for a short time, sleeping pills tend not to be effective for a longer period and have negative side effects. Today there are non-drug techniques that are very effective in treating people with chronic insomnia.
Behavioral interventions or techniques include: decreasing the anxiety associated with going to sleep, developing conditioned responses to falling asleep in bed and decreasing daily stress to promote restful sleep.
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