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Understanding and Treating Sleep Disorders

Do you have trouble sleeping? If so, you're among about 40 million Americans who suffer each year from some sort of chronic, long-term sleep disorder, and another 20 million people who suffer occasional sleeping problems. According to the National Institute of Neurological Disorders and Stroke, about half of all adults over the age of 65 have some sort of sleep disorder, though it is not clear if this is a normal part of aging or a result of medications that older people commonly use.

The amount of sleep that a person needs to function normally depends on several factors such as age. Infants sleep most of the day - about 16 hours; teenagers need about 9 hours a day, while adults need about 7 to 8 hours a day on average. Even though elderly adults need just as much sleep as young adults, as people age, they usually sleep for shorter amounts of time and they tend to spend less of their sleep time in the deep sleep stages. The good news is that most sleep disorders can be managed once they are properly diagnosed.

Sleep and Your Body

It is not clear exactly why the body needs sleep, although not getting enough sleep can have severe detrimental effects on a person's health. Studies have shown that sleep is essential for the normal functioning of the body's immune system and ability to fight disease and sickness. It is essential for the normal functioning of the nervous system and a person's ability to function both physically and mentally. It is essential for learning, and it essential for normal and healthy cell growth.

Falling asleep and waking up are governed by various chemical changes in the brain and blood. Thus foods and medicines that affect the balance of these various chemicals also affect how easily we can fall asleep and how well we sleep. Caffeine, for example, can cause insomnia (the lack of sleep). Antidepressants, smoking, and alcohol can cause a loss of REM (rapid eye movement) sleep, the dream phase of sleep. Smoking and alcohol can also cause a loss of deep sleep. Both REM and deep sleep are essential parts of the normal sleep cycle.

Types of Sleep Disorders

There are more than 70 different sleep disorders that are generally classified into one of three categories:

  • insomnia
  • sleep apnea
  • narcolepsy

Insominia

Insomnia is the most common sleep disorder. It occurs more often among women and the elderly. Some general symptoms of insominia are:

  • difficulty falling asleep
  • waking up frequently during the night with difficulty returning to sleep
  • waking up too early in the morning
  • unrefreshing sleep

Insomnia affects about a third of the older population in the United States. Nocturnal sleep difficulties can result in excessive daytime sleepiness, attention and memory problems, depressed mood, and lowered quality of life.

The following behaviors have been shown to perpetuate insomina in some people:

  • 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 schedules

Sometimes intermittent insomnia may not require treatment since episodes last only a few days at a time. However, for some people who experience daytime sleepiness and impaired performance as a a result, the use of short-acting sleeping bills pay improve sleep and next-day alertness. As with all drugs there are potential side effects. The use of over-the-counter sleep medicines is usally the recommended treatment for insomnia.

Sleep Apnea

Sleep apnea is a common disorder that can be very serious. In sleep apnea, your breathing stops or gets very shallow while you are sleeping. Each pause typically lasts 10-20 seconds or more. These pauses can occur 20 to 30 times or more an hour.

Most people don't know they have sleep apnea. They don't know that they are having problems breathing while they are sleeping. A family member and/or bed partner may notice the signs of sleep apnea first. Untreated sleep apnea can increase the chance of having high blood pressure and even a heart attack or stroke. Untreated sleep apnea can also increase the risk of diabetes and the risk for work-related accidents and driving accidents.

Adults most likely to have sleep apnea:

  • Snore loudly
  • Are overweight
  • Have high blood pressure
  • Have decreased size of the airways in their nose, throat, or mouth. This can be caused by the shape of these structures or by medical conditions causing congestion in these areas, such as hay fever or other allergies.
  • Have a family history of sleep apnea.

The most common type of sleep apnea is obstructive sleep apnea. During sleep, enough air cannot flow into your lungs through your mouth and nose even though you try to breathe. When this happens, the amount of oxygen in your blood may drop. Normal breaths then start again with a loud snort or choking sound. People with sleep apnea often have loud snoring.

Treatment for Sleep Apnea is aimed at restoring regular nighttime breathing and relieving symptoms such as very loud snoring and daytime sleepiness.

If you have mild sleep apnea, some changes in daily activities or habits may be all that are needed:

  • Avoid alcohol, smoking, and medications that make you sleepy. They will make it harder for your throat to stay open while you sleep.
  • Lose weight if you are overweight. Even a little weight loss can improve your symptoms.
  • Sleep on your side instead of your back. Sleeping on your side may help keep your throat open.

People with moderate or severe sleep apnea will need to make these changes as well and may need additional treatments or surgery. If you suspect that you are suffering from Sleep Apnea, you should contact your doctor to find out treatment options.

Narcolepsy

Narcolepsy is a chronic sleep disorder with no known cause. The main characteristic of narcolepsy is excessive and overwhelming daytime sleepiness, even after adequate nighttime sleep. Daytime sleep attacks may occur with or without warning and may be irresistible. Drowsiness may persist for prolonged periods of time. In addition, nighttime sleep may be fragmented with frequent wakenings.

Although it is estimated that narcolepsy afflicts as many as 200,000 Americans, fewer than 50,000 are diagnosed. It is as widespread as Parkinson's disease or multiple sclerosis and more prevalent than cystic fibrosis, but it is less well known. Narcolepsy is often mistaken for depression, epilepsy, or the side effects of medications.

Narcolepsy can occur in both men and women at any age, although its symptoms are usually first noticed in teenagers or young adults. There is strong evidence that narcolepsy may run in families; 8 to 12 percent of people with narcolepsy have a close relative with the disease.

You should be checked for narcolepsy if:

  • you often feel excessively and overwhelmingly sleepy during the day, even after having had a full night's sleep;
  • you fall asleep when you do not intend to, such as while having dinner, talking, driving, or working;
  • you collapse suddenly or your neck muscles feel too weak to hold up your head when you laugh or become angry, surprised, or shocked;
  • you find yourself briefly unable to talk or move while falling asleep or waking up.

Although there is no cure for narcolepsy, treatment options are available to help reduce the various symptoms. Treatment is individualized depending on the severity of the symptoms, and it may take weeks or months for an optimal regimen to be worked out.

Ongoing communication among the physician, the person with narcolepsy, and family members about the response to treatment is necessary to achieve and maintain the best control.


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