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Common Sleep Disorders

[Sleep Apnea] [Insomnia] [Narcolepsy] [Restless Leg Syndrome]

Sleep Apnea

Sleep Apnea is a disorder of breathing during sleep. Typically it is accompanied by loud snoring. Apnea during sleep consist of brief periods throughout the night in which breathing stops. People with sleep apnea do not get enough oxygen during sleep. There are 2 major types.

Obstructive Sleep Apnea is the most common type and is due to an obstruction in the throat during sleep. Bed partners notice pauses approximately 10 to 60 seconds between loud snores. The narrowing of the upper airway can be a result of several factors including inherent physical characteristics, excess weight, and alcohol consumption before sleep.

Central Sleep Apnea - caused by a delay in the signal form the brain to breath. With both obstructive and central apnea you must wake up briefly to breathe, sometimes hundreds of times during the night. Usually there is no memory of these brief awakenings.

Insomnia

Three basic types of Insomnia

  1. Transient insomnia - lasting for a few nights
  2. Short-term insomnia - two or four weeks of poor sleep
  3. Chronic insomnia - poor sleep that happens most nights and last a month or longer

Transient and short-term insomnia generally occur in people who are temporarily experiencing one or more of the following:

  • stress
  • environmental noise
  • extreme temperatures change in the surrounding environment
  • sleep/wake schedule problems such as those due to jet lag
  • medication side effects

Chronic insomnia is more complex and often results from a combination of factors, including underlying physical or mental disorders. One of the most common causes of chronic insomnia is depression. Other underlying causes include arthritis, kidney disease, heart failure, asthma, sleep apnea, restless legs syndrome, Parkinson's disease, and hyperthyroidism. However, chronic insomnia may also be due to behavioral factors, including the misuse of caffeine, alcohol, or other substances; disrupted sleep/wake cycles as may occur with shift work or other nighttime activity schedules; and chronic stress.

In addition, the following behaviors have been shown to perpetuate insomnia in some people:

  • poor sleep hygiene in general
  • expecting to have difficulty sleeping and worrying about it
  • ingesting excessive amounts of caffeine
  • drinking alcohol before bedtime
  • smoking cigarettes before bedtime
  • excessive napping in the afternoon or evening
  • irregular or continually disrupted sleep/wake schedule

Narcolepsy

Narcolepsy is a chronic disorder affecting the brain where regulation of sleep and wakefulness take place. Narcolepsy can be thought of as an intrusion of dreaming sleep (REM) into the waking state.

Narcoleptics, no matter how much they sleep, continue to experience a irresistible need to sleep. People with narcolepsy can fall asleep while at work, talking, and driving a car for example. These "sleep attacks" can last from 30 seconds to more than 30 minutes. They may also experience periods of cataplexy (loss of muscle tone) ranging from a slight buckling at the knees to a complete, "rag doll" limpness throughout the body.

The prevalence of narcolepsy has been calculated at about 0.03% of the general population. Its onset can occur at any time throughout life, but its peek onset is during the teen years. Narcolepsy has been found to be hereditary along with some environmental factors.

Symptoms

  • Excessive sleepiness.
  • Temporary decrease or loss of muscle control, especially when getting excited.
  • Vivid dream-like images when drifting off to sleep or waking up.
  • Waking up unable to move or talk for a brief time

Restless Legs Syndrome

Restless legs syndrome (RLS) is a sensory disorder causing an almost irresistible urge to move the legs. The urge to move is usually due to unpleasant feelings in the legs that occur when at rest. People with RLS use words such as creeping, crawling, tingling, or burning to describe these feelings. Moving the legs eases the feelings, but only for a while. The unpleasant feelings may also occur in the arms.

Effects of RLS

RLS can make it hard to fall asleep and stay asleep. People with RLS often don't get enough sleep and may feel tired and sleepy during the day. This can make it difficult to:

  • Concentrate, making it harder to learn and remember things
  • Work
  • Carry out other usual daily activities
  • Take part in family and social activities

Not getting enough sleep can also make you feel depressed or have mood swings.

RLS can range from mild to severe, based on:

  • How much discomfort you have in your legs and arms
  • Whether you feel the need to move around
  • How much relief you get from moving around
  • How much sleep disturbance you have
  • How tired or sleepy you are during the day
  • How often you have symptoms
  • How severe your symptoms are on most days
  • How well you carry out daily activities
  • How angry, depressed, sad, anxious, or irritable you feel

Types of RLS

  • Primary RLS is the most common type of RLS. It is also called idiopathic RLS. "Primary" means the cause is not known. Primary RLS, once it starts, usually becomes a lifelong condition. Over time, symptoms tend to get worse and occur more often, especially if they began in childhood or early in adult life. In milder cases, there may be long periods of time with no symptoms, or symptoms may last only for a limited time.
  • Secondary RLS is RLS that is caused by another disease or condition or, sometimes, from taking certain medicines. Symptoms usually go away when the disease or condition improves, or if the medicine is stopped.

Periodic Limb Movement Disorder

Most people with RLS also have a condition called periodic limb movement disorder (PLMD). PLMD is a condition in which a person's legs twitch or jerk uncontrollably about every 10 to 60 seconds. This usually happens during sleep. These movements cause repeated awakenings that disturb or reduce sleep. PLMD usually affects the legs but can also affect the arms.

Outlook

RLS can be unpleasant and uncomfortable. However, there are some simple self-care approaches and lifestyle changes that can help in mild cases. RLS symptoms often improve with medical treatment. Research is ongoing to better understand the causes of RLS and to develop better treatments.

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