Sleep Disorders
What you need to know about Sleep Disorders
What is Sleep Apnea?
Sleep apnea is a condition when a person stops breathing repeatedly for short periods of time during sleep. This is most often due to an upper airway obstruction and is termed as obstructive sleep apnea. Two other types of sleep apnea are central apnea and mixed apnea.
All About Sleep Apnea
How Sleep Apnea happens?
Obstructive sleep apnea (OSA) is the most common type of sleep apnea. Primarily, it occurs when the upper airway muscles of the tongue and throat loses their tonicity, causing the airway to narrow or close as you breathe in. This obstruction prevents air from entering the lungs. As a result, the supply of oxygen in the blood is compromised. The oxygen levels in the blood as required by the body can sometimes drop to alarmingly low levels. The brain senses this drop and sends signals to briefly arouse the sufferer (often with a loud snort to gasp for air) so that the airway can reopened for breathing to resume.
What are the characteristics of Sleep Apnea?
Almost all sleep apnea patients are snorers. It is usually characterized by loud snoring or choking sensations that alternate with episodes of breathing pauses (apneic episodes) typically lasting for 10 – 30 seconds. OSA is diagnosed when there are at least 5 apneic events per hour of sleep and 30 events per hour of sleep in severe form.
These frequent interruptions in sleep prevent one from entering into deep restorative sleep and getting the supposed rest that the body and mind needs in order to function in the daytime. For this reason, individuals with sleep apnea are usually accompanied with the following symptoms:
Unrefreshing sleep
Morning headaches
Daytime fatigue
Daytime sleepiness
Slowed thinking and attention deficit
Frequent nocturia
Dry mouth upon awakening
What are the characteristics of Sleep Apnea?
Sleep apnea can be quite common and can occur across all ages and in both genders; although more commonly in men than women, and those who are overweight and middle aged. You are likely to be suffering from sleep apnea if you have the following:
Loud snoring
Nocturnal snorting and gasping
Daytime sleepiness
In women, signs of sleep apnea tends to be more subtle and less likely to be loud snorers, however, risk of sleep apnea worsens during post menopause. On the other hand, unlike adults, children are likely to exhibit behaviour problems during the daytime.
Is Sleep Apnea dangerous?
Sleep apnea is dangerous and can cause serious detrimental effects to one’s health. It is usually a sign of a potentially bigger health concern. In children, sleep apnea impedes growth, cognitive development and behaviour. Early detection of sleep apnea in adults is important to prevent the development of comorbid conditions such as the following conditions:
Diabetes
High blood pressure
Heart attack
Heart failure
Stroke
Narcolepsy
Narcolepsy is a chronic sleep disorder in which the brain loses its ability to regulate the sleep-wake cycle.
Patients with narcolepsy exhibit extreme daytime sleepiness accompanied with uncontrollable sudden episodes of falling asleep (sleep attacks). This condition affects both genders equally and onset typically occurs during teen years (10-20 years old).
Symptoms of Narcolepsy include:
Excessive daytime sleepiness - classic symptoms of narcolepsy, refers to the tendency to fall asleep during any activity even at the most inappropriate times such as during school lessons or work.
Hallucinations - refers to vivid dream-like experiences often unpleasant and associated with fear during falling asleep and/ or awakening.
Sleep paralysis - refers to the inability to move or speak while falling asleep and/or awakening.
Cataplexy - refers to the loss of muscle tone triggered by a strong emotion e.g. excitement or anger.
Excessive Daytime Sleepiness (EDS)
It is common to feel sleepy especially when our body does not receive sufficient rest, and it typically goes away after a good sleep. However, in some cases persistent sleepiness, described as Excessive Daytime Sleepiness, can be serious. It is characterised by the inability to stay alert during the day associated with a lack of energy or extreme fatigue. This affects our daily routine and reduces the ability to function properly e.g. at work, in school and even leisure activities. Patient with EDS may experience the following:
Struggling to stay alert during inactive periods e.g. reading, watching a television program
Having problems focusing or paying attention at work or in class
Feeling sleepy while driving
Frequent napping during the daytime
Have performance related issues at work or school
Most common causes of Excessive Daytime Sleepiness
Sleep deprivation is usually the principal cause. It occurs when one does not get enough sleep, day after day. It can either be described as insufficient duration of sleep, fragmented or interrupted sleep, or a combination of both. EDS occurs as sleep debt accumulates over time. More often than not, other medical conditions in addition to sleep disorders also disrupt the normal sleep architecture thus results in sleep deprivation. Other adverse effects of sleep deprivation also include cognitive functioning, memory and mood disturbance and motor vehicle accidents.
Sleep disorders such as obstructive sleep apnea, restless leg syndrome and chronic illnesses such as heart failure, asthma, cancer, and arthritis (especially those associated with pain) can also result in EDS. These conditions cause sleep fragmentation leading to poor sleep quality.
Narcolepsy – a medical condition in which the brain loses its ability to maintain wakefulness despite a good night sleep.
Insomnia – a condition in which one finds it difficult to fall asleep or maintain sleep when given the opportunity.
Certain medications including asthma or heart medications can also contribute to daytime sleepiness.
Alcohol is a sedating drug which makes one sleepy but unable to achieve restful sleep.
Caffeine and nicotine are both stimulants that stay in your body for prolonged periods and may interrupt your night’s sleep, hence making you sleepy during the day.
Other Sleep Conditions
Restless Leg Syndrome
Restless leg syndrome (RLS) is a condition characterised by an uncontrollable urge to move the legs while at rest. These unpleasant sensations are also associated with pain. They occur mostly during wake times but worsen at bedtime thus interfere with one’s ability to fall asleep. RLS may be a sign of other medical conditions. More than 80% of patients with RLS also experience Periodic Limb Movement (PLM). Untreated RLS can cause daytime sleepiness and fatigue thus leading to decreased productivity and concentration.
Periodic Limb Movement
Periodic limb movement (PLM) is a rhythmic movement disorder that occurs involuntarily only in sleep, characterized by sudden repetitive flexing or jerking of the lower limbs e.g. ankles and knees. PLM occurs mostly in non-REM (rapid eye movement) sleep, each lasting up to 5 secs and occurs in intervals of every 20 to 40 secs and are normally noticed by sleep partner. These movements can cause night awakenings and may be accompanied by sleep arousals. Patients with PLM normally presents with unrefreshing sleep along with daytime sleepiness.
The incidence of PLM increases with age and is associated with anaemia and low iron levels. Periodic leg movements can be monitored by placing electrodes on the tibialis muscle during a sleep study.
Consult your sleep physician
if you suspect you might be suffering from any of the above sleep disorders.
Treatment can relieve your symptoms and prevent more serious consequences.
Please contact us if you would like qualified practitioner recommendations.