Sleep Disorders, Syndromes, and Treatment

There are over 70 different sleep disorders that are generally characteristic of lack of sleep (ex insomnia), disturbed sleep (ex sleep apnea), or excessive sleep (ex narcolepsy). The average adult needs 7-8 hours of sleep per night, and as people age, it is estimated that about 50% of adults over 65 have some sort of sleep disorder, even if very mild. The most common types of sleep disorders and syndromes are covered below.

Insomnia is essentially the inability to fall asleep. It often causes a person to worry about not getting enough sleep and commonly results in disruption of daily life. Insomnia can be a result of one's diet, emotional situation, stress, or possibly an affecting disease.

Narcolepsy is a disorder that causes people to fall asleep at various points throughout the day without control. Also, it causes an abnormal sleep pattern in which narcoleptics do not cycle through the normal sleep stages but enter REM (rapid-eye-movement) sleep prematurely. Narcolepsy is typically genetic and therefore inherited, but it may be related to an alternative neurological condition.

Restless legs syndrome (RLS) is a sleep syndrome in which a person has an uncomfortable or unpleasant sensation in their legs while lying down, causing people to have an irresistible urge to move their legs. Restless legs syndrome usually gets worse as a personal relaxes or settles down, and can lead to severe daytime sleepiness and fatigue. People with restless legs syndrome also often have the related periodic limb movement disorder (PLM) which causes restlessness, trouble falling asleep, trouble staying asleep, and extreme sleepiness after waking up.

Sleep apnea literally refers to when a person stops breathing throughout the night, as a result of a partial (obstructive hypopnea) or full (obstructive apnea) blockage of the airway. Sleep apnea affects 30 million people in the United States.

 

Treatment

While a wide variety of treatment options exist for various sleep disorders, most common treatment of sleep disorders includes medications, a CPAP machine, or surgical treatment, depending on the actual disorder(s) at hand.

For disorders affecting REM sleep behavior or restless legs syndrome/periodic limb movement disorder, drugs are typically prescribed that will assist the body in getting the most natural sleep with the goal of minimizing or eliminating the affect of the disorder. Such drugs are often very successful in returning a person's restorative sleep - some +90% of those treated feel relief.

Disorders such as narcolepsy often require a more adaptive solution, as other symptoms often are present in addition to narcolepsy - such as cataplexy (intermittent muscle-weakness), hypnogogic hallucinations (hallucinations while falling asleep or waking), sleep paralysis, or automatic behavior. These problems are usually treated with a combination of behavioral treatments and medication to reach the source of the problem.

Obstructive sleep apnea, caused by a chronic respiratory disease or an obstructed airway, is often heavily related to obesity/weight gain, age, high blood pressure, snoring, the use of alcohol and/or tobacco. Some simple solutions to treat sleep apnea include losing weight, stop use of alcohol/tobacco/sedatives, sleeping on your side and staying on a regular sleep schedule. Professional medical treatments for sleep apnea include CPAP (Continuous Positive Airway Pressure), surgery, and dental appliances, the most common of which is CPAP which will be covered below. Surgery for sleep apnea aims to increase the size of the airway to allow more airflow, thus reducing sleep apnea. The benefit of this is that it is more of a one-time solution that a continuous remedy, such as CPAP or the dental appliance, which is an oral divide that aligns the jaw to improve the flow of air. Most commonly, CPAP is administered and used by the patient on a nightly basis, details of which may be found below.

 

 

 

 

Continuous positive airway pressure (CPAP) is the most common treatment for sleep apnea, though it is long-term. CPAP involves wearing a mask over the nose and/or mouth during sleep, in which air is blown through the nasal passages and into the airway with a certain determined & prescribed degree of pressure. This pressure, which is specifically determined during the 2nd or titration sleep study, keep the airway open during sleep and helps to greatly improve the quality of sleep.

S7 CPAP Machine, by ResMed
ComfortGel CPAP Mask, by Respironics