SLEEP DISORDERS

If you have trouble getting to sleep or sleeping through the night, if you wake up too early or have a hard time waking up at all, or if you are overly tired during the day, you may have one of the following sleep problems.

Circadian Rhythm Disorders

These are disorders that gives you difficulty in sleeping because of how your body is used to a certain time of sleeping. Circadian rhythm disorders include jet lag, adjustments to shift work, delayed sleep phase syndrome (you fall asleep and wake up too late), and advanced sleep phase syndrome (you fall asleep and wake up too early).

Insomnia

Insomnia doesn’t give enough sleep at night because people may have trouble falling asleep or may wake up frequently during the night or early in the morning. It is a problem as long as it affects your daytime activities. Insomnia has many possible causes, including stress, anxiety, depression, poor sleep habits, circadian rhythm disorders (such as jet lag), and taking certain medications.

Snoring

Snore is the noise produced when the air you inhale rattles over the relaxed tissues of the throat. It is a problem because of the noise and it may be a marker of a more srious sleep problem.

Sleep Apnea

Sleep apnea occurs when breathing stops while sleeping due to blocked airway and causes you to wake up. It can cause severe daytime sleepiness. If left untreated, severe sleep apnea may be associated with high blood pressure and the risk of stroke and heart attack.

Pregnancy and Sleep

Women often experience sleepless nights and daytime fatigue in the first and third trimesters of their pregnancy. During the first trimester, frequent trips to the bathroom and morning sickness may disrupt sleep. Later in pregnancy, vivid dreams and physical discomfort may prevent deep sleep. After delivery, the new baby’s care or the mother’s postpartum depression may interrupt sleep.

Narcolepsy

Narcolepsy is a brain disorder that causes excessive daytime sleepiness. Though dramatic and uncontrolled “sleep attacks” have been the best-known feature of narcolepsy, in reality many patients do not have sleep attacks. Instead, they experience constant sleepiness during the day.

Restless Legs Syndrome

In people who have restless legs syndrome, discomfort in the legs and feet peaks during the evening and night. They have delayed sleep onset and cause brief awakening during sleep because they feel an urge to move their legs and feet to get temporary relief. Restless legs syndrome is a common problem among middle-aged and older adults.

Nightmares

Nightmares are frightening dreams that arise during REM sleep caused by stress, anxiety, and some drugs. Often, there is no clear cause.

Night Terrors and Sleepwalking

Both night terrors and sleepwalking arise during NREM sleep and occur most often in children between the ages of 3 and 5 years old. A night terror can be dramatic: Your child may wake up screaming, but unable to explain the fear. Sometimes children who have night terrors remember a frightening image, but often they remember nothing. Night terrors are often more frightening for parents than for their child. Sleepwalkers can perform a range of activities — some potentially dangerous, like leaving the house — while they continue to sleep.

DIAGNOSIS

First, your doctor will give you a checkup and talk with you about what’s going on. He/She’ll ask you questions such as:

• What medical conditions do you have?
• What medications are you taking?
• How stressed are you feeling these days?
• How much alcohol do you drink?
• How much caffeine are you getting?

If you’ve already tried things like allowing enough time for sleep and making your bedroom a good place for rest, your doctor may suggest you go to a sleep lab for more tests. This may take a night or two.

At the sleep lab, you’ll be hooked up to monitors that will track your heart, brain, movements, and breathing patterns as you sleep. A sleep specialist will review the results and tell you what they mean.

RECOMMENDED MEDICATIONS

Your treatment will depend on what type of sleep problem you’re having.

Insomnia

The first thing to try is changing your sleep habits. For instance:

• Go to bed the same time each night and get up at the same time each morning.
• Don’t nap during the day.
• Stop stressful chores or discussions long before you go to bed.
• Relax before bedtime. Try deep breathing, prayer, gentle stretching, meditation, or journaling.
• Keep your bedroom dark, quiet, and cool. Use earplugs or eye shades if needed.
• Can’t sleep? Go into another room and read, or do something relaxing and quiet.
• Avoid caffeine.
• Don’t drink alcohol before bed.
• Quit smoking.

Circadian Rhythm Disorders

These are like jet lag in that your body clock is “off.” Your doctor may suggest bright light treatment.

Snoring

Try these tips:

• Sleep on your side.
• Don’t drink or smoke.
• Avoid sleeping pills and other sedatives.
• If you’re overweight, work on weight loss.
• Get medical treatment for any allergies or nasal blockages you may have.

Sleep Apnea

Losing extra weight may make it better. Also, avoid alcohol and sleeping pills.

Ask your doctor if you need a CPAP machine. (CPAP stands for continuous positive airway pressure.) With CPAP, you wear a mask while you sleep, and it raises the air pressure inside your throat. This keeps your airway more open, so you can sleep better.

For some people, it helps to wear a dental brace that holds the lower jaw forward during sleep.

For others, an implanted device called Inspire is now available. The device, called an upper airway stimulator, delivers mild stimulation to nerves that control airway muscles, keeping them open. There are also several types of surgery available for sleep apnea.

Narcolepsy

People with narcolepsy fall asleep when they don’t want to. Naps can help.

Your doctor may also prescribe medicine to help you stay awake and treat the sudden loss of muscle control when you wake up.

Restless Legs Syndrome

Cutting down on caffeine may help. So can taking a warm bath or relaxing before bed. Hot or cold packs on your legs may provide relief.

Prescription medicines that might help include:

• Horizant (gabapentin enacarbil)
• Klonopin (clonazepam)
• Mirapex (pramipexole)
• Neupro (rotigotine)
• Requip (ropinirole)

These may have side effects, so talk about the pros and cons with your doctor.

Nightmares and Night Terrors

If your child has a nightmare or night terror, comfort them. If they have those dreams often or if they’re severe, tell your child’s doctor.