Patients

Cardiovascular Problems // Diabetes/Heartburn // Eating Disorders // Menopause //
Anxieties // Muscle and Respiratory Problems // Snoring // Sleep Apnea // Restless Legs Syndrome // Narcolepsy // Parasomnias

The following section will give you an overview of common sleep disorders. For information specifically about sleep apnea, please click here. Sleep is an essential part of everyone's life and a necessary component of good health. While individual requirements vary, everyone needs a good night's sleep to rest and recharge both their physical and mental states. Unfortunately, for millions of Americans, getting a good night's sleep is an elusive goal.

How Can Illness Lead to Sleep Disorders?

- Cardiovascular Problems
- Diabetes/Heartburn
- Eating Disorders
- Menopause
- Anxieties
- Muscle and Respiratory Problems

Virtually everyone suffers from the inability to sleep well at night – insomnia – at some time or another. The causes may emanate from any number of factors: stress, lifestyle, eating habits, schedule conflicts or illness. Other than being a nuisance, an occasional bout with insomnia is not cause for alarm. However, if insomnia becomes a persistent problem, there may be underlying medical conditions which should be professionally addressed.

Many conditions directly contribute to sleep loss including cardiovascular disease, diabetes, eating disorders, heartburn, kidney or liver disease, menopause, mental illness, musculoskeletal or neurological disorders, and respiratory or thyroid problems.

Cardiovascular Problems back to top

Those suffering from cardiovascular problems such as COPD, CHF, Hypertension, Stroke, or MI, may find themselves snoring or gasping for breath at night.  This may be due to Sleep Apnea or Upper Airway Resistence Syndrome.  These disorders can also manifest themselves during the day as moderate to severe sleepiness or poor cognitive functions.

Diabetes/Heartburn back to top

Diabetes can contribute to irregular sleep patterns. Those with unstable sugar levels are often plagued at night by excess urination, diarrhea or profuse sweating. Many otherwise normal people experience heartburn at night. The cause is often simply a matter of gravity — when they lie down, acid leaves the stomach and backs up into the esophagus often causing the person to awaken.  Other causes such as a hiatal hernia can cause reflux as well.

Eating Disorders back to top

Those experiencing eating disorders such as anorexia or bulimia often find themselves awake at night. Anorexics are often unable to drift into deep sleep. For bulimics, the proverbial "raid on the refrigerator" can become a compulsive pattern of behavior, with potentially dangerous repercussions.

Menopause back to top

Women experiencing menopause often have fragmentation of sleep, and consequently find themselves exhausted during the day. They may also awaken during the night after having experienced nocturnal hot flashes.

Anxieties back to top

Individuals with anxiety disorders almost always experience some form of sleep disturbance; so much so that the inability to get adequate sleep can sometimes develop into an anxiety all its own (called "conditioned insomnia"). People suffering from depression often experience insomnia and wake up early. Schizophrenics rarely get a healthy dose of deep sleep.

Muscle and Respiratory Problems back to top

Disorders of the muscoskeletal system are notorious sleep quality robbers. Arthritis and fibromyalgia can prevent an individual from finding a body position conducive to sleep. Likewise, neurological disorders such as Alzheimer's, epilepsy, Parkinson's disease and certain severe headache episodes can significantly disrupt sleep patterns. Individuals suffering from asthma or other respiratory problems often awaken abruptly due to an attack and can find it difficult or impossible to get back to sleep for fear of suffering another.

Can Medications Affect Sleep? back to top

As complex as the above medical conditions can be, medications intended to soothe and alleviate their symptoms can sometimes prove to have detrimental side effects of their own — especially when it comes to promoting or negating sleep.
 
Medications conducive to sleep: back to top

Antidepressants
Antihistamines
Clonidine (used in hypertensive patients)
Medications not conducive to sleep:
Amphetamines
Antiarrhythmics (used to regulate heartbeat)
Antidepressants
Beta blockers (used to control high blood pressure/angina)
Caffeine
Corticosteroids (used to suppress inflammation)
Diuretics
Nicotine patches
Theophyline (used to treat asthma)
Thyroid hormones

What Other Sleep Disorders Exist? back to top

- Snoring
- Sleep Apnea
- Restless Legs Syndrome
- Narcolepsy
- Parasomnias

As we have noted, many illnesses can influence how we sleep. In addition, there are sleep disorders which can be prime indicators of an illness or that are illnesses in and of themselves. These can range from mild nuisances to life-threatening attacks. They include snoring, sleep apnea, restless legs syndrome, periodic limb movements, narcolepsy and a host of behaviors known as parasomnias.

Snoring back to top

Most of us are subjected to snoring — either we do it ourselves or we experience it through a bed partner, family member or other person in close proximity to our place of rest. Snoring results from loose tissue in the throat or windpipe which vibrates as we breathe in air. Often, lax muscles or oversized or enlarged organs in the throat area such as tongue, tonsils, adenoids or the uvula are the culprits. REMEMBER; ALL PATIENTS WHO HAVE SLEEP APNEA SNORE, BUT NOT ALL PATIENTS THAT SNORE HAVE SLEEP APNEA.

Sleep Apnea back to top

Typically, snoring is no more than an inconvenience and is not life-threatening. However, it can be a prime symptom of a potentially lethal condition known as Obstructive Sleep Apnea (OSA) — a condition in which the air passage in the throat becomes blocked. It is estimated that as many as 18 million Americans suffer from sleep apnea, yet up to 95% of these cases go undiagnosed and untreated. Although it is most common in overweight men, both adults and children of either gender can be affected no matter what the weight.  And the problem could be anatomical.

For a person with sleep apnea, breathing stops from 10 to 60 seconds at a time, and these attacks can occur from 5 to over 100 times an hour during sleep. As a result, oxygen levels in the bloodstream fall, which in turn may lead to high blood pressure, stroke, heart attack and/or abnormal heart rhythms.

Fortunately, there are treatments for sleep apnea which range from the use of drugs, to oxygen ventilation therapy, to surgery, in certain cases.

For more details on sleep apnea, click here. 
 
Restless Legs Syndrome back to top

It is not unusual for us to shift positions as we sleep. In fact, we do it very often during the course of the night whether we realize it or not. It is also not unusual for our muscles to twitch as we sleep. However, some individuals suffer from a neurological condition known as restless legs syndrome (RLS) — an incessant "crawling" sensation felt in the calves of the legs which can only be relieved by moving them. As discomforting as RLS can be during the day, it can be insufferable at night — forcing the person to get out of bed numerous times to move about and all but depriving them of meaningful sleep. A similar condition known as periodic limb movement disorder (PLMD) only occurs at night. Individuals with PLMD are often unaware they have the condition since muscles in the leg contract involuntarily throughout the night, partially awakening them. Unfortunately, neither RLS nor PLMD give up their secrets easily and there is currently no single test to confirm their presence in an individual. Certain drugs have been shown to alleviate the conditions to a degree.  Both conditions show a decrease in the normal iron level in the body.

Narcolepsy back to top

Perhaps one of the most famous and disturbing sleep disorders is narcolepsy — the condition where a seemingly fully alert person suddenly and without warning becomes drowsy and falls asleep. It is not an uncommon condition, occuring in about one in 1,000 people, and it strikes both men and women of all races. It is believed that persons with narcolepsy suffer from the abnormal onset of REM sleep. Rather than progressing through a series of sleep stages, they involuntarily fall into dream sleep at any time. Narcolepsy may appear in several forms: sleep attacks, cataplexy, paralysis, hallucinations or fragmented night time sleep. In a sleep attack, a person may suddenly fall asleep during the course of their normal daytime activities. They can even begin to speak appropriate to their dream sequence.

Presently, Narcolepsy is a life long illness and we can only treat the symptoms that occur..

Parasomnias back to top

There are still other sleep disorders which are called parasomnias — conditions where a person carries out complex behaviors but is not aware of these behaviors. These include somnambulism (sleepwalking), somniloquy (sleeptalking), nocturnal eating disorders, bedwetting, REM behavior disorder (acting out of dreams), night terrors and panic attacks. Some of these conditions can be benign, others can be highly injurious to the individual. All should be discussed with a physician if there is concern.

What Can You Do if You Suspect a Sleep Problem? back to top

Many sleep problems can be viably addressed. Depending on the extent and severity of the condition, therapies, drugs, surgery or other regimens can markedly improve a patient's well-being. Simply adjusting habits detrimental to sleep may be all that is needed. In other cases, counseling or support groups may prove beneficial. Professional testing can be conducted overnight or during the day in special sleep laboratories. In cases where mild insomnia is indicated, a variety of treatments including sleep restriction, reconditioning, relaxation techniques, drugs or light therapy may achieve significant results. If a more severe condition is diagnosed, other therapies and treatments are available. The key is arriving at a proper diagnosis in a timely, consistent and comprehensive manner.

For information specifically about sleep apnea, please click here.