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when health providers unite you save guide to sleep disorders symptoms treatment and solutions brought to you by the alliance health network the content in this guide is not intended to be a substitute for professional medical advice diagnosis or treatment always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition never disregard professional medical advice or delay in seeking it because of something you have read on the diabeticalliancegroup.com website or the guide to controlling your diabetes.

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you don t have to live with a sleep disorder according to the national institute of neurological disorders and stroke chronic sleep disorders affect at least 40 million americans each year left untreated sleep disorders ­ and the resulting sleep deprivation ­ can interfere with your work driving and social activities over time sleep disorders can even have negative effects on your physical and mental well-being you don t have to suffer from the effects of a sleep disorder new treatments and solutions have been developed for the wide range of sleep disorders affecting millions of americans today this guide provides you with important information about sleep disorders their symptoms and available treatments to help guide conversations with your health care professional 1 sleepdisorderalliance.com

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what is a sleep disorder a sleep disorder somnipathy is any disruption in the sleep patterns of an individual while some sleep disorders may leave you feeling unrefreshed a number of symptoms are more severe including excessive sleepiness snoring difficulty falling asleep during normal sleeping hours and abnormal behaviors such as restless leg syndrome there are even disorders that cause you to get too much sleep particular behaviors during normal daytime activities are telltale signs of sleep deprivation if you are experiencing one or more of the following symptoms during the day you may not be getting enough restful sleep at night and you may even have a sleep disorder do you · feel irritable or sleepy during the day · have difficulty staying awake when sitting still such as when watching television or reading · occasionally fall asleep while driving · have difficulty paying attention or concentrating at work school or home · perform below your potential in work school or sports · often hear that you look tired · have difficulty with your memory · have emotional outbursts · feel tired enough to require a nap almost every day · require caffeinated beverages to keep yourself awake each type of sleep disorder has its own particular symptoms but each results in some of the above signs of sleep deprivation if you suspect that you are not getting enough sleep or that you might have a sleep disorder speak to your physician or a sleep specialist if your health care professional feels that you may have a sleep disorder they may ask that you keep a sleep diary or they may even have you stay overnight at a sleep center for observation 2 sleepdisorderalliance.com

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evaluating and diagnosing your sleep disorder if you suspect you have a sleep disorder a sleep specialist can confirm if your suspicions are correct ­ and he or she can make a careful and detailed medical evaluation to find the source of your sleep problem if you suspect you have a sleep disorder a sleep specialist can confirm if your suspicions are correct ­ and make a careful and detailed medical evaluation to find the source of your sleep problem a doctor or a sleep specialist can diagnose your sleep disorder based on a number of factors including · a description of your symptoms · your age · your gender · your psychological history · your medical history · a partner s or loved one s observation of your sleep patterns diary or there are several free sleep diaries that you can download off the internet whichever version you choose to use a sleep diary should track · what time you went to bed each night · what time you got up in the morning · how many times you woke up during the night · whether you felt rested when you woke up · if you took naps during the day · whether you felt sleepy or rested throughout the day once your doctor or sleep specialist has reviewed your sleep diary and given you a sleep questionnaire he or she may determine that a sleep study is the most important next step keeping a sleep diary keeping a sleep diary may be helpful in discussing your daily patterns with your doctor or sleep specialist the information in your diary gives your health care professional clues about what is causing your problem and how to correct it a sleep diary records information about your sleep routine and daily life activities that can affect your sleep your doctor can give you a sleep studies in a sleep study sensors are used to monitor how your body acts while you sleep charts are made of many physical measurements including your brain waves heartbeats and breathing your sleep study provides doctors with the data that can help them find the cause of your sleep problem 3 sleepdisorderalliance.com

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sleep disorder diagnosis tests · epworth sleepiness scale ­ this sleep questionnaire asks you to rank whether certain situations make you sleepy and if so how sleepy · nocturnal polysomnogram ­ this test measures the electrical activity of your brain electroencephalogram and heart electrocardiogram and the movement of your muscles electromyogram and eyes electro-oculogram and usually requires an overnight stay at a sleep clinic for observation purposes · daytime multiple sleep latency test mslt ­ this test measures how long it takes for you to fall asleep during the day plus the kind of sleep you get during such a nap · repeated test of sustained wakefulness rtsw ­ this test measures how long it takes for you to fall asleep in a situation that challenges you to stay awake · blood test ­ depending upon the description of your symptoms and your personal and family medical histories your sleep specialist may also conduct a blood test 4 major categories of sleep disorders dyssomnias disturbance in the amount timing or quality of sleep dyssomnias result in excessive daytime sleepiness or an inability to fall asleep or stay asleep dyssomnias can originate from causes inside or outside the body there are over 100 different types of sleep disorders each has its own causes symptoms and treatments · insomnia · narcolepsy · inability to stay awake hypersomnia · sleep apnea · restless legs syndrome rls · periodic limb movement in sleep plms · circadian rhythm sleep disorder · sleepwalking · sleeptalking · nightmares · sleep terrors night terrors · nocturnal leg cramps · sleep paralysis · grinding or clenching of the teeth bruxism · bedwetting · sudden infant death syndrome sids parasomnias disorders of partial arousal from sleep or disorders that interfere with sleep stage transitions behaviors not normally associated with sleeping may occur during sleep sleep disorders due to medical neurological or psychiatric disorders · dementia · depression · alcoholism · night sweats · short-sleeping · long-sleeping proposed sleep disorders similar to other classified sleep disorders but different enough to be considered distinct sleep disorders 4 sleepdisorderalliance.com

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of these sleep disorders the most common are obstructive sleep apnea osa sleep apnea is characterized by episodes of cessation of breathing during night time sleep that can occur as often as several hundred times in a night snoring is a warning that the sleeper may be a victim of sleep apnea insomnia insomnia may mean you have a hard time going to sleep or that you have a hard time staying asleep usually you will know if you are experiencing insomnia because you will remember tossing and turning or being awake at night narcolepsy narcolepsy is a chronic neurological disorder which impairs the ability of your central nervous system to regulate sleep because falling asleep during some activities like walking driving or cooking can have drastic effects narcolepsy is a dangerous sleep disorder restless leg syndrome restless legs syndrome is a neurological disorder characterized by uncomfortable tingly or creeping sensations in your legs which create an uncontrollable urge to keep them moving rls is not necessarily confined to your sleep time am i at risk for developing a sleep disorder some sleep disorders can be triggered and conversely managed through your behavior and lifestyle the following habits and conditions are risk factors for developing a sleep disorder · poor sleep environment e.g too noisy too brightly lit too hot or too cold · excessive use of caffeine alcohol or certain medications and drugs · smoking or chewing tobacco · illness · obesity · anxiety depression or another mood disorder · stress such as the death of a loved one or job pressure · unhealthy or irregular sleep routine · early or late-night bedtimes · traveling between time zones · daytime napping · shift work with a rotating schedule 5 sleepdisorderalliance.com

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obstructive sleep apnea osa sleep apnea is a sleep disorder characterized by pauses in breathing during sleep these episodes called apneas literally without breath each last long enough so one or more breaths are missed and occur repeatedly throughout sleep sleep apnea is diagnosed with an overnight sleep test called a polysomnogram the individual with sleep apnea is rarely aware of having difficulty breathing even upon awakening sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body symptoms may be present for years or even decades without identification during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance symptoms of sleep apnea loud snoring cessation of breathing or choking spells in the night excessive daytime sleepiness frequent visits to the bathroom severe mood swings this can indicate breathing problems or blocked air passages in severe cases this can occur over fifty times an hour with each spell lasting as long as ten seconds daytime sleepiness can become so excessive that working becomes difficult and driving is dangerous individuals with sleep apnea often find that they require repeated trips to the bathroom throughout the night sleep deprivation can affect mental health often causing moods to shift rapidly from depression to irritability to anger although some slim people do suffer from sleep apnea the majority are overweight or obese because individuals with sleep apnea suffer from sleep deprivation they often find they lack the energy to perform daily activities and even lose interest in sex because individuals with sleep apnea suffer from sleep deprivation they often find they lack the energy to perform daily activities and even lose interest in sex sleep deprivation affects motor skills and memory obesity low sex drive and a general lack of energy dry mouth and sore throat in the morning lack of concentration and forgetfulness morning headaches lack of sufficient air throughout the night can cause headaches 6 sleepdisorderalliance.com

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causes of sleep apnea sleep apnea causes the throat to collapse during sleep blocking the airway and preventing air from getting to the lungs generally your throat muscles keep the throat and airway open causes of an obstructed airway include · shape of head and neck ­ some head and neck shapes can create a smaller than normal airway · large tonsils or adenoids ­ this or other anatomical differences such as a deviated septum enlarged tongue or receding chin can also create difficulties breathing during sleep · excess weight or obesity ­ although slim people can suffer from sleep apnea obesity is a risk factor for sleep apnea · abnormally relaxed throat muscles and tongue ­ this can be due to alcohol or sedative use before bedtime other risk factors for sleep apnea include · irregular sleep hours · snoring · smoking or exposure to secondhand smoke · nasal congestion nasal blockages and nasal irritants · family history of sleep apnea other physical conditions such as immune system abnormalities severe heartburn or acid reflux and high blood pressure are also commonly associated with sleep apnea it isn t clear whether these conditions are among causes or merely the result of sleep apnea disorders and syndromes associated with sleep apnea · hypothyroidism · acromegaly · amyloidosis · vocal cord paralysis · post-polio syndrome · neuromuscular disorders · marfan s syndrome · down syndrome how sleep apnea is diagnosed speak with your health care professional if you suspect you might have sleep apnea or any other sleep disorder you will most likely be asked to keep a sleep diary for a few nights if necessary your health care professional may schedule a sleep test overnight in a sleep center sleep centers are set up much like hotels with private rooms and baths you will be observed while sleeping ­ using cameras as well as monitors attached to your body treatments for sleep apnea sleep apnea is highly treatable and most individuals find that they experience relief from employing one or sometimes a combination of treatments mild to moderate sleep apnea can often be treated with behavioral modification but most cases of sleep apnea require a physician s assistance to find the most effective treatment the following treatments are for informational purposes only sleep apnea is a serious condition ­ it s important to consult with your physician to find the treatment that is best for you 7 sleepdisorderalliance.com

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behavioral treatments for sleep apnea weight loss losing even 10 of your weight can reduce sleep apnea incidents and dramatically improve the quality of your sleep avoiding the use of stimulants and depressants can reduce the likelihood of airway closure during the night reduce consumption of alcohol tobacco and sedatives such as sleeping pills sleep on your side some individuals with sleep apnea find that they experience temporary relief when sleeping on the side rather than the back irregular sleep hours can throw off your sleep cycles and lead to breathing problems during the most important sleep stages establish a regular sleep routine medical treatments for sleep apnea continuous positive airway pressure cpap a cpap machine blows pressurized air into a mask worn over the nose to keep the patient s airway open during sleep this is the most common long-term treatment for severe sleep apnea an electronic circuit monitors the patient s breathing and provides two different pressures one for inhalation and one for exhalation this treatment is sometimes used for patients who find breathing out against increased pressure to be uncomfortable or disruptive to their sleep oral devices such as dental appliances open the patient s airway by bringing the lower jaw or tongue forward during sleep two common oral devices are the mandibular respositioning device and the tongue retaining device surgically removing tissue such as tonsils adenoids or excess tissue at the back of the throat or inside the nose increases the size of the patient s airway allowing better airflow during sleep oxygen is provided to the patient via a small tube that fits inside the nose this treatment is rarely used although it is occasionally employed in conjunction with cpap bilevel positive airway pressure bipap oral devices surgery oxygen administration 8 sleepdisorderalliance.com

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insomnia insomnia is a sleep disorder characterized by an inability to sleep and/or inability to remain asleep for a reasonable period insomniacs typically complain of being unable to close their eyes or rest their mind for more than a few minutes at a time insomnia can be caused by fear stress anxiety medications herbs caffeine depression or other mental conditions and sometimes occurs for no apparent reason an overactive mind or physical pain may also be causes finding the underlying cause of insomnia is usually necessary to cure it symptoms of insomnia difficulty getting to sleep and staying asleep waking up unrefreshed this symptom continues night after night for a month or more in cases of chronic insomnia individuals with insomnia often feel like they haven t slept at all morning headaches this is often called the hangover effect when in fact the person did no drinking the night before sleep deprivation affects motor skills and memory difficulty concentrating irritability sleep deprivation can affect mental health often causing moods to shift rapidly from depression to irritability to anger insufficient oxygen to the cornea causes small blood vessels in the eyes to become inflamed fatigue can cause your eyes to become bloodshot daytime sleepiness can become so excessive that working becomes difficult and driving is dangerous 9 sleepdisorderalliance.com bloodshot eyes daytime sleepiness.

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causes of insomnia there are many possible causes of insomnia sometimes there is one main cause but often several factors interacting together will cause a sleep disturbance possible causes of insomnia include · psychological or mental health issues ­ issues such as stress fear anxiety depression or even more serious conditions such as bipolar disorder can adversely affect sleep cycles · food and drug consumption ­ consuming stimulants such as caffeine can disrupt sleep in addition drinking alcohol or using nicotine herbal supplements recreational drugs or some medications can cause insomnia · lifestyle ­ working shifts traveling napping during the day or even exercising just before bedtime can interfere with sleep · medical or physical conditions ­ pain disease or sleep disorders such as sleep apnea can often cause insomnia effects of insomnia · poor health and diminished quality of life · impaired social functioning · increased impatience and irritability · diminished mental alertness and memory · slower reaction times and impaired concentration · increased risk of disorders such as major depression anxiety disorder and substance abuse · increased likelihood of automobile home and workplace accidents · poor job performance missed work days and school absences how insomnia is diagnosed speak with your health care professional or a sleep specialist if you have trouble sleeping for a week or more if your insomnia is severe your doctor may recommend a visit to a sleep center where a team of sleep specialists will use the latest technology to monitor you while you sleep a sleep center can also provide you with equipment to monitor your activities awake and asleep at home insomnia statistics · according to the u.s department of health and human services approximately 60 million americans suffer from insomnia · insomnia is more likely to affect women ­ about 40 percent of sufferers are women as opposed to 30 percent of men insomnia is a serious condition that can have negative affects your health and wellbeing particularly if you have a chronic sleep problem surveys report that people with severe insomnia experience a quality of life similar to those who have chronic conditions such as heart failure treatments for insomnia insomnia can be treated through behavioral modification medication sleep aids or a combination of treatments it is a serious disorder that can affect all aspects of your life ­ mental physical and social the treatments outlined below are for informational purposes only it is important to consult with your physician to find the treatment that is best for you 10 sleepdisorderalliance.com

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behavioral treatments for insomnia progressive muscle relaxation pmr autogenic training this relaxation technique is practiced by tensing certain muscle groups and then totally relaxing them a relaxation method that calls for an individual to repeat a set of visualizations to induce a state of relaxation concentration on an object of thought or awareness that can calm and relax the body and mind being aware of and managing the amount of stress in your life can allow you to more easily relax at night when it s time to sleep stimulus control therapy reassociates the bed and bedroom with sleeping by limiting the amount of time spent in the bedroom for non-sleep activities reducing the use of stimulants and depressants and avoiding big meals just before bed can help reduce the risk of insomnia episodes these alternative treatments can have an extremely calming effect on your nervous system meditation stress management stimulus control diet management acupuncture acupressure and massage medicinal treatments for insomnia benzodiazepines the most commonly-used class of drugs prescribed for insomnia includes drugs such as temazepam diazepam lorazepam and midazolam includes drugs such as ambien and lunesta these drugs have a cleaner side effect profile than benzodiazepines but do appear to cause psychological dependence and physical dependence a hormone that has proved effective for some insomniacs in regulating the sleep/waking cycle many of these sleep aids use the antihistamine diphenhydramine the effectiveness of these aids often decrease over time and next-day sedation is common non-benzodiazepine prescription drugs melatonin over-the-counter sleep aids 11 sleepdisorderalliance.com

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narcolepsy narcolepsy is a chronic neurological condition which impairs the ability of your central nervous system to regulate sleep individuals with narcolepsy typically experience disturbed nocturnal sleep often confused with insomnia and abnormal rapid eye movement rem sleep narcolepsy affects about 1 in 2,000 people symptoms of narcolepsy excessive daytime sleepiness abnormal rem sleep most individuals experience their first symptoms between the ages of 10 and 25 evidence suggests that the condition is genetic and while it is a lifelong condition it does not usually get progressively worse however narcolepsy is a serious disorder with potential physical mental and social consequences narcoleptics may find it impossible to stay awake and often have uncontrollable episodes of sleep during the day people with narcolepsy enter the rem or dream phase of sleep right after falling asleep whereas most people take about 90 minutes to enter the rem phase some people with narcolepsy experience vivid sometimes frightening visual or auditory sensations while falling asleep or upon awakening people with narcolepsy often have a sudden loss of muscle control while awake usually experienced during strong emotion such as anger grief or while laughing sleep paralysis is the inability to move or talk at the beginning or end of sleep about 25 to 50 of narcolepsy sufferers experience sleep paralysis people with narcolepsy may have periods of wakefulness at night this disrupted nighttime sleep adds to daytime sleepiness 12 sleepdisorderalliance.com hypnagogic hallucinations cataplexy sleep paralysis nighttime wakefulness.

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causes of narcolepsy researchers continue to seek out the root cause of narcolepsy currently the general consensus is that genetics accompanied by an environmental trigger of some sort ­ a virus for example ­ may affect brain chemicals and contribute to the disorder diagnosis of narcolepsy can take a very long time sometimes more than one year or even up to several decades tests used to diagnose narcolepsy · epworth sleepiness scale ­ this sleep questionnaire asks you to rank whether certain situations make you sleepy and if so scientists have recently discovered that people how sleepy with narcolepsy are lacking in hypocretin · nocturnal polysomnogram ­ this test also called orexin a chemical in the brain will measure the electrical activity of your that activates arousal and regulates sleep brain electroencephalogram and heart narcoleptics generally do not have as many electrocardiogram and the movement of hcrt cells or neurons that secrete hypocretin your muscles electromyogram and eyes inhibiting their ability to fully control their electro-oculogram and usually requires alertness and sleep cycles an overnight stay at a sleep clinic for observation purposes heredity appears to be a factor in narcolepsy · multiple sleep latency test mslt ­ this but environmental triggers also play a strong test measures how long it takes for you to fall role research is also investigating these triggers asleep during the day people with narcolepsy tend to fall asleep very quickly narcolepsy affect · spinal fluid analysis ­ the lack of many areas of life hypocretin in the cerebrospinal fluid may be · physical well-being and safety a marker for narcolepsy examining spinal · mental health fluid is a new diagnostic test for narcolepsy · social and professional relationships · intimate relationships treatments for narcolepsy · memory and attention although no cure yet exists for narcolepsy a combination of treatments can control the how narcolepsy is diagnosed symptoms the most commonly recommended narcolepsy is often misdiagnosed or treatment for narcolepsy includes a undiagnosed the most common and combination of counseling medication and sometimes the only symptom of narcolepsy is excessive daytime sleepiness because excessive behavioral changes daytime sleepiness is a symptom of other sleep the following treatments are for informational disorders and of depression narcolepsy can be purposes only narcolepsy is a serious condition difficult to diagnose ­ it s important to consult with your physician to find the treatment that is best for you 13 sleepdisorderalliance.com

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behavioral treatments for narcolepsy schedule sleep periods individuals with narcolepsy find that a few brief scheduled naps no longer than 15 minutes at a time during the day can prevent unplanned lapses into sleep during the daytime stimulants and depressants can interfere with sleep cycles during your normal sleeping hours exercise can make you feel more awake during the day and stimulate normal sleep patterns at night a medical id is useful to alert others to your condition if you suddenly fall asleep or become unable to move or speak avoid caffeine alcohol and nicotine exercise on a regular basis wear a medical alert bracelet or necklace medicinal and herbal treatments for insomnia methylphenidate such as ritalin and various amphetamines modafinil provigil effective in treating narcolepsy but can have strong side effects and can be addictive a stimulant which acts on the central nervous system to help individuals stay alert and awake during the day effective with not as many side effects chance of addiction is also lower than with amphetamines these drugs suppress rem sleep and alleviate the symptoms of cataplexy hallucinations and sleep paralysis controls cataplexy and daytime sleepiness has strong side-effects antidepressants such as vivactil prozac and zoloft sodium oxybate xyrem 14 sleepdisorderalliance.com

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