This can take the form of an adequate amount of time in bed but loss of sleep time, as seen in sleep apnea (loud snoring, followed by cessation of breathing multiple times throughout the night.) or by narcolepsy (falling asleep briefly many times during the day, sometimes accompanied by cataplexy which is sudden loss of muscle strength brought on by a strong emotional stimulus such as anger, laughter, or fear.)

Another sleep disorder that directly affects nighttime sleep is periodic limb movements of sleep or PLMS (repeated jerking of the limbs, usually the legs during sleep) or Restless Leg Syndrome (RLS). Others have problems falling asleep, staying asleep, or both. This comprises the large category of insomnia.

Other problems evaluated at the Center include sleep walking, grinding of teeth (Bruxism), night terrors, agitation and/or confusional states during sleep (REM behavior disorder) and problems associated with changing shift work or difficulties adjusting to a “normal” day/night schedule (Chronobiologic Disorders).
The key is getting the diagnosis. It is crucial that a patient see a sleep specialist who can determine what is wrong and suggest help for the patient. You would be amazed how a person’s quality of life improves once he or she receives treatment.

Information on Obstructive Sleep Apnea in Adults

It has been estimated that two out of three adult men snore some or all of the time during nocturnal sleep. Following menopause, almost that number of women snore. Of 100 people who snore, approximately one third do not have sleep apnea; one third have mild to moderate sleep apnea; and one third have severe sleep apnea. All people who have sleep apnea snore, but not all people who snore have sleep apnea. Snoring indicates that the airway is not fully open. The distinctive sound of snoring comes from efforts to force air through a narrowed passageway in the throat.

The typical patient with sleep apnea is an overweight middle-aged man who habitually exhibits loud snoring throughout the night. These patients cannot breathe properly in a recumbent position because their upper airway either collapses under its own weight or the tongue and uvula (the small tissue that hangs on the soft palate in the back of the throat) close over the back of the throat causing air to be blocked. The person literally chokes himself or herself at the level of the upper airway.

To break the blockage, the body chooses breathing over sleep, and the person undergoes a brief awakening—usually without awareness—to allow the muscles of the throat to contract and open the passage. This pattern can occur from 5 to more than 100 times per hour. During the time the patient is not breathing, his or her oxygen level falls and carbon dioxide builds up. Because of this constant interruption of sleep, the patient becomes chronically sleep deprived. This deprivation leads directly to daytime sleepiness, which can be severe.

Other consequences of untreated sleep apnea are high blood pressure, heart failure, heart attack, and stroke. Chronic sleep deprivation leads to impaired concentration, poor memory, and a significant increase in automobile accidents and fatalities. Continued weight gain can make the apnea worse over a long period of time. Ingestion of any sedative or tranquilizer including alcohol can turn mild apnea into severe apnea in one night.

One does not need to be overweight, middle aged, or a man to have sleep apnea. Persons with enlarged tonsils, posterior displaced jaws, or masses in the throat can experience the same signs and symptoms that the typical patient described above can exhibit.

Snoring loudly every night calls for a visit to your physician or referral to a sleep specialist connected with a sleep laboratory where overnight studies are performed to evaluate and treat sleep apnea.

Warning signs include:

  • Snoring so loud that it rivals a jackhammer and can be heard in other rooms of the house.
  • Abnormal pattern of snoring with long relative periods of silence followed by resumption of snoring with loud gasps or snorts.
  • Awakening each morning with a headache and/or a dry mouth.
  • Daytime sleepiness with problems concentrating or experiencing poor short-term memory.
  • Sexual dysfunction with loss of desire or impaired sexual functioning.
  • Awakening during the night either gasping or choking and experiencing “air hunger.”

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Other Common Adult Sleep Disorders

The patient is unable to fall asleep and/or remain asleep for a reasonable amount of time.

The patient experiences sleep walking, teeth grinding, and night terrors. These symptoms are sometimes associated with stress and depression.

The patient has a chronic neurological condition caused by the brain’s inability to regulate the sleep–wake cycle normally. Patients with narcolepsy have uncontrollable urges to sleep at inappropriate times during the day. They may also experience muscle weakness after laughing or crying outbursts.

The patient experiences sudden jerking or bending of the arms and legs during sleep. These symptoms can range from small shudders of the ankles and toes to leg kicks and flailing of arms and legs. These periodic movements often wake the sufferer, significantly disturbing the quality of the one’s sleep.

The patient experiences dream-related abnormal sleep states including recurring nightmares, sleep paralysis, and REM sleep behavior disorder (RBD). Nightmares and isolated sleep paralysis are common and do not constitute an abnormality unless they occur several times a week and disturb the patient’s sleep. REM behavior disorder (RBD) is a serious condition that occurs during the REM stage of sleep and involves patients acting out their dreams and can include punching, kicking, leaping, and running from the bed. The disorder is more common in middle-aged and elderly men. One sees a high statistical association with neurologic conditions such as Parkinson disease, Alzheimer dementia, stroke, and multiple sclerosis. RBD is due to the body’s inability to turn off the voluntary muscles during dream sleep, which manifests itself as the person “acting out” his or her dream mentation.

RLS often appears in otherwise healthy people and is not related to emotional or psychiatric disorders. As the name implies, this disorder affects the legs, but it can involve the arms as well. People experience a restless sensation in many different ways, but all describe a particularly uncomfortable sensation in the muscles of the affected limbs whenever they try to relax in either a sitting or lying position. The sensation is relieved by moving or walking or, in extreme cases, by application of warm soaks or a hot bath. The sensation can be painful and frequently leads to problems falling asleep because of the inability to “relax.” Careful questioning allows one to differentiate the pain of leg cramps and the pins-and-needles sensation that patients with diabetes or those with peripheral neuropathies experience.

Some people’s internal biologic clocks are out of alignment with the usual 24-hour cycle of light and dark. These people cannot fall asleep until very late at night or in the early morning hours and then have difficulty waking up in the morning and tend to stay asleep until late morning or early afternoon. Others go to sleep early in the evening and wake up well before daybreak, unable to fall asleep. These sleep problems are treated by exposure to bright light at certain times of the day or night, depending on the specific complaint. In some cases they are used in conjunction with medications that help control the body’s internal clock. People who work nights or rotating shifts as well as people who travel across two (2) or more time zones are especially prone to circadian rhythm disturbances.