Sleep Disorders

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    What is a sleeping disorder?

    A sleep disorder is a condition in which sleep is either inadequate, of poor quality (thus leaving a person unrefreshed), causing sleep at odd hours or is associated with unusual behaviors during sleep. Occasionally people may think that they sleep well during the night but are sleepy during the day. Daytime sleepiness in the context of adequate nighttime sleep may also be a manifestation of a sleep disorder. 


     

    When should I seek help for a suspected sleep disorder?

    If your night sleep is disturbed and your daytime performance is impaired for longer than one month it would be appropriate to consult your physician. 


     

    What are some of the common sleep disorders?

    Insomnia
    Disturbed nocturnal sleep characterized by difficulty falling asleep, and/or staying asleep, frequent awakenings, unrefreshing sleep

    Obstructive Sleep Apnea Syndrome
    Characterized by recurrent episodes of either cessation of breathing or decrease in breathing during sleep. This condition is usually associated with snoring and excessive daytime sleepiness.

    Periodic Limb Movement Disorder of Sleep
    Recurrent episodes of leg kicks/twitches which may be associated with arousal. This condition can present with either insomnia or excessive daytime sleepiness.

    Restless Legs Syndrome
    Sensation of discomfort in the legs or arms which occurs during rest and is relieved with movement. This condition can be associated with insomnia.

    Parasomnias
    Conditions that occur during the night and which take the form of unusual behaviors during sleep. Parasomnias can occur in different sleep stages. Some of the parasomnias include sleepwalking, night terrors, confusional arousals, bedwetting, acting out of dreams (REM Sleep Behavior Disorder), nightmares, teeth grinding and head banging or nocturnal eating (when you awake to find remnants of food or food containers and do not remember eating during the night).

    Circadian Rhythm Disorders
    These are conditions that present as abnormal timing of sleep. They include jet lag, delayed sleep phase syndrome, advanced sleep phase syndrome and non-24 hour sleep wake cycle.

    Narcolepsy
    This condition presents with severe sleepiness and consists of sleep attacks, episodes of muscle weakness which occur during wakefulness and episodes of loss of muscle tone and/or hallucinations which can occur when dozing off or waking up. 


     

    Initial Evaluation

    This usually includes a complete history and physical examination to help your doctor to better understand the sleep problem. Laboratory evaluation in the form of blood work may also be a part of the initial evaluation.

    Sleep Study (Nocturnal polysomnogram)
    This is a non-invasive test that monitors sleep and is done overnight. During a sleep study, various physiological variables including brain waves (EEG), eye movements (EOG), muscle tone (EMG), heart rate (ECG), airflow, breathing effort, and oxygen saturation are recorded. Assessing all of these variables enables your doctor to accurately diagnose certain sleep disorders such as Sleep Apnea, Periodic Limb Disorder of Sleep and various parasomnias.

    Daytime testing (Multiple Sleep Latency Test)
    This is a non-invasive test that is done during the day and following the night study. During the test, 4 to 5 naps are taken at regularly scheduled times during the day to help assess the level of sleepiness.

    Treatment
    Each of these sleep disorders can be treated. Treatment is individualized and depends on the type of sleep disorder the individual has. 


     

    Other Resources

     

    For additional information, please call (631) 444-4000.