Sleep Disorders
Donald Aulds, M.D.
Sleep disorders are estimated to be at least a part of 60% of visits to primary care physicians. These disorders can include insomnia, somnorexia, sleep apnea, narcolepsy, and others. This article will attempt to introduce you to the most common disorders. If you feel that you might have any of these conditions, please see your physician to discuss your symptoms and concerns.
What is the ideal amount of sleep that a person needs?
Studies done by scientist and physicians have revealed that eight hours of sleep per night is important. The body has a certain rhythm called circadian rhythms which have been referred to as the internal clock of the body. During the night, the body goes through cycles of deep and light sleep and eight hours are needed to get enough of these cycles for the body to function well. During the episodes of deep sleep, the brain sorts out the information gathered throughout the day and sorts memories. The cells and muscles rest and get revitalized with each episode of deep sleep. These cycles help your body to regulate its energy levels, digestion, cardiac function and hormone levels.
Insomnia
Insomnia is not a disorder but is a complaint that is often associated with an underlying problem. In trying to determine the underlying cause, many things have to be considered including use of medications, life events, anxiety, depression, and use of non-prescription products including street drugs, caffeine, and alcohol. Types of insomnia can be divided into transient lasting just a few days, short-term lasting two to four weeks, and chronic occurring a month or longer. Symptoms during the day include sleepiness, anxiety, impaired concentration, decreased memory, and irritability. Transient and short-term insomnia may not require treatment since the episodes usually last only a few days at a time. Chronic insomnia must first be evaluated for underlying medical or psychological conditions. Therapy may include reducing behavior or habits that might worsen insomnia, drug therapy if it is indicated after considering risks and side effects, and behavioral therapy including relaxation therapy, reconditioning, and sleep modification therapy.
Somnorexia
Somnorexia is a pattern of sleep in which a person gets limited sleep for several days to a couple of weeks and then crashes and sleeps extended periods of time. A typical pattern is limited sleep through the work week followed by ten or more hours of sleep on weekends. To exist through the week the person may depend on caffeine to keep going and stay awake. The National Sleep Foundation performed a survey which reported that over seventy percent of Americans get fewer than eight hours of sleep a night with nearly half getting more than ten hours on weekends. Often people with this pattern are too stressed or caffeinated to fall to sleep easily. Behavior modification is the best approach for therapy.
Narcolepsy
Narcolepsy can be simply described as an .irresistible need to sleep.. People can fall asleep lasting from a few seconds to a half hour and can occur while talking, driving, or at work. It is a disabling disorder of sleep regulation and has been described as an intrusion of dream sleep into the waking hours. Symptoms include excessive daytime sleepiness, disturbed nighttime sleeping, tossing and turning in bed, leg jerks, nightmares, and frequent awakening. Therapy may include behavior therapy and medications. Lifestyle adjustment including keeping a good sleep schedule, improving diet, and exercise can often improve symptoms. Narcolepsy is a life-long condition that can be improved with proper therapy and approach a normal lifestyle.
Sleep apnea
Sleep apnea is a disorder of altered breathing during sleep with brief periods of decreased or loss of breathing. The most common symptoms may include loud snoring, waking up unrefreshed with trouble staying awake during the day, headaches in the early morning, sweating, frequent trips to the bathroom during the night, weight gain, and waking and gasping for air. Many of the individual diagnosed with sleep apnea have high blood pressure, obesity, depression, heartburn, decreased libido, and difficulty concentrating. Sleep testing is usually done to diagnose sleep apnea. If you think you might have sleep apnea, see your doctor soon for testing. This condition may be a life-threatening condition if it is severe.
Somnambulism
Sleepwalking is a series of complex behaviors that are initiated during slow wave sleep and result in walking during sleep. This behavior usually starts in children prior to puberty and may last lifelong. It is actual walking or moving about during sleep with difficulty in arousing the person during the episode and usually no memory of the episode. Studies have shown as high as 20% of the population may be prone to sleepwalking. It is more common in boys and if it disappears, it will usually go away by late teens. Therapy may include developing a calming bedtime ritual, meditation, relaxation exercises, removing hazardous or harmful objects from the bedroom, hypnosis, and psychiatric evaluation.
Sleep bruxism
This condition is a movement disorder characterized by grinding or clenching of the teeth during sleep. The teeth grinding and clenching may produce abnormal wearing of the teeth, jaw muscle pain, and strange sounds from the grindings. Sleep testing is needed to accurately diagnose the condition. Consult your physician if you feel that this might be a problem that you might have.
The above conditions are some of the most common conditions of sleep disturbances. Only your physician or a sleep specialist can help in diagnosing these conditions and advising on proper therapy options.
More about Dr. Aulds
Donald G. Aulds, MD is an Obstetrician and Gynecologist and currently serves as the Medical Director for both the Women's Center and the Best Start Program of North Alabama. He is a Diplomat of the American Board of Obstetrics and Gynecology and Fellow of the American College of Obstetricians and Gynecologists.
Dr. Aulds completed his medical education at Louisiana State University School of Medicine, New Orleans, LA and his Internship and Residency in Obstetrics and Gynecology at Ochsner Medical Foundation, New Orleans, LA.
Dr. Aulds has been an active member of the Huntsville Hospital Medical Staff since 1980.
