Recognizing Serious Sleep Disorders

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Reprinted from the February 8, 2004 Awake Magazine.

Sometimes one’s symptoms may indicate a serious sleep disorder.  Chronic insomnia, which lasts more than a month, is often related to more serious problems, including depression.  Chronic insomnia may also be a symptom of a serious physical ailment. 

Sleep Apnea

Mario suffered from excessive daytime sleepiness.  When he drove the family car, his wife had to watch him carefully, as he tended to lapse into momentary blackouts, which he rarely recalled.  He snored loudly and irregularly every night and at times violently jerked himself awake, gasping for breath. (Erratic, heavy snoring is not to be confused with the occasional light, rhythmic snoring of many sleepers—the major detriment of which is that others in the same bedroom are kept awake.)

Mario had the classic symptoms of sleep apnea.  Apnea literally means “no breath.”  An episode of sleep apnea may last anywhere from ten seconds to two or three minutes.  The victim often thrashes around gasping for air and then falls asleep again, only to repeat the apnea hundreds of times per night.  There are three types of apnea. 

Central apnea occurs when the brain’s respiratory control center doesn’t give the command to breathe regularly.  With obstructive sleep apnea, the upper airway at the back of the throat actually closes, blocking air movement.  Mixed apnea is a combination of the two and is the most common diagnosis.  The victim of any type of apnea can end up in virtually the same condition as someone who stayed up all night, every night!

Those with sleep apnea may live dangerous lives, for they can blank out while on the job or at the wheel of their automobile.  They may suffer from high blood pressure, an enlarged heart, and an increased risk of stroke or heart failure.  Dr. William Dement of Stanford University estimates that 38,000 Americans die each year from the cardiovascular consequences of sleep apnea. 

While most common in obese men over 40 years old, sleep apnea can occur at any age, even in young children.  There are several treatments—all best supervised by a medical sleep specialist.  The most effective nonsurgical treatment for obstructive sleep apnea is the use of a device to create continuous positive airway pressure.  The patient wears a mask over his nose at night, and a pressure regulator (custom set by a physician) delivers just the amount of air needed to prevent apnea.  If this does not rectify the condition, there are several surgical approaches, including using laser or radio-frequency waves to remove excess tissue from the throat.

Narcolepsy

Another sleep disorder requiring medical attention is narcolepsy—a neurological condition that causes excessive daytime sleepiness.  Buck, for example, was constantly drowsy.  He would fall asleep abruptly, even during important meetings.  He started holding keys in his hand so that when this happened, the noise they made hitting the floor would wake him.  Then he developed cataplexy—a condition causing him to become weak in the knees and collapse whenever he became excited.  Next came symptoms of sleep paralysis as well as occasional hallucinations just before he fell asleep.

Narcolepsy typically starts between the ages of 10 and 30.  Sufferers sometimes develop what is called automatic behavior, wherein they appear to behave normally but do not remember the passing of extended periods of time.  The tragedy of this disease is that it often goes undiagnosed for years, while the victim is viewed as lazy, mentally slow, or peculiar.  It is presently considered incurable, but symptoms can be treated with medication and adjustments in life-style—with varying degrees of success. 

Other Sleep Disorders

Two other disorders, sometimes appearing in combination with each other, directly affect the limbs, resulting in chronic insomnia.  One is periodic limb movement disorder, in which the legs, and sometimes the arms, jerk and twitch during sleep.  Consider Michael.  Tests showed that episodes of periodic leg movements awakened him some 350 times each night!

A separate disorder is restless legs syndrome, in which sensations deep within the leg muscles and knees cause a powerful urge to move, thus preventing the sufferer from falling asleep.  While this condition is sometimes associated with lack of exercise or poor circulation, some cases appear to be related to caffeine intake.  Alcohol consumption is also known to aggravate the condition at times.

Bruxism is a disorder characterized by grinding or clenching the teeth during sleep.  If it occurs regularly, it can cause abnormal wear of the teeth and extreme jaw discomfort, resulting in serious insomnia.  Depending upon the degree of the problem, treatments vary from oral surgery to wearing a mouth guard at night. 

This limited look at just a few of the many sleep-related disorders illustrated that it can be dangerous to ignore them.  Treatment may be simple or complex, but it is often essential.  If you or a loved one suffers from chronic insomnia or shows signs of any serious sleep disorder, it may be wise to get professional help soon.  Even if treatment does not totally eliminate the problems, it may significantly reduce the risks involved and make the situation easier for all to endure.

Reprinted from the February 8, 2004 Awake Magazine. 



Additional information may be found at the following web site:

MySleepCenter.com's Encyclopedia Of Sleep

http://encyclopedia.mysleepcenter.com/

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