Symptoms & Disorders

Most people have trouble falling asleep once in a while.  If you have difficulty sleeping most nights – or if you have any of the following symptoms – you may have a treatable sleep disorder:

• Persistent difficulty falling asleep at night
• Waking often during the night
• Difficulty staying awake and alert during the day
• Trouble concentrating during the day
• Loud snoring
• Choking or gasping for breath while asleep
• Abnormal leg movements during sleep or restlessness of legs at bedtime
• Constant state of fatigue

Persistent difficulty staying asleep, drowsiness during the day and loud snoring often may be due to a sleep disorder. Fortunately, most sleep disorders can be treated easily and effectively. The first step is taking your problem seriously.  Sleep disorders are more than uncomfortable – they can be dangerous and have a real impact on your health.

The following are some of the most common sleep disorders:

Circadian Rhythm Sleep Disorder
Circadian rhythm sleep disorder is a persistent or recurring pattern of sleep disruption due to the daily fluctuation of physiological or behavioral functions that include the sleep/wake state generally tied to the 24-hour daily dark/light cycle.

Insomnia
Insomnia is characterized by repeated difficulty falling asleep or staying asleep, early morning awakenings, and an inadequate quantity of sleep. These complaints often result in some form of daytime impairment.

Narcolepsy
Narcolepsy is a disorder of REM sleep regulation with a tendency for REM sleep to occur at inappropriate times. This results in excessive daytime sleepiness, hallucinations, sleep paralysis and cataplexy (sudden weakening of muscles often precipitated by laughter).  Even though these patients are sleepy, their nighttime sleep may be frequently disrupted.

Obstructive Sleep Apnea (OSA)
OSA is a sleep-related breathing disorder that causes your body to stop breathing during sleep. It is so common that it’s considered a public health problem. Patients develop an upper airway obstruction when airway muscles (esp. the tongue and palate muscles) relax during sleep.  Obesity, an enlarged neck, or a small jaw size can cause a narrowing of the upper airway making it easier for complete airway obstruction to develop during sleep.

Common symptoms include:

• Loud habitual snoring
• Pauses in breathing during sleep or waking up with Choking/gasping sensation
• Poor quality sleep
• Daytime fatigue, memory difficulty, and sleepiness

Other effects of OSA on the body include depression, headaches, excessive nighttime urination, erectile dysfunction, heartburn, high blood pressure, increased risk of heart attack or strokes, worsening of heart failure, and difficulty in controlling blood sugar in diabetics.

Treatments include:

• Weight loss
• Use of Continous Positive Airway Pressure (CPAP)
• Upper airway surgery such as Uvulopalatopharyngoplasty (UPPP)
• Use of oral appliances (mandibular advancement devices) that pull the jaw forward

Parasomnias
Parasomnias are disorders of arousal that occur during entry into sleep, within sleep, or during arousals from sleep, resulting in a wide range of disruptive sleep-related events during the night.

Common symptoms include:

• Sleep walking
• Acting out dreams with sleep terror
• Sleep eating behavior

Some of this behavior may result in injury to the patient or others.

Restless Legs Syndrome (RLS)
RLS is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings. Patients with RLS may experience rhythmic leg jerks during sleep called “Periodic Limb Movement Disorder” (PLMD). These leg movements may result in complaints of insomnia, restless sleep, and poor quality sleep or daytime fatigue/sleepiness.

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