A Brief Overview of Sleep Disorders

1. A Brief Overview of Sleep Disorders http://sleephygiene.web.unc.edu/

2. Sleep Apnea • Sleep apnea is a sleep disorder that is characterized by pauses or decreased breathing lasting at least 10 seconds during sleep • There are three types of sleep apnea: • Obstructive (OSA): there is effort to breathe but the airway is blocked or restricted • Central (OSA): there is no effort to breathe; the brain fails to signal the body to breathe • Mixed (Complex): a mixture of obstructive and central sleep apnea • Sleep apnea is diagnosed with an overnight sleep study

3. Symptoms of Sleep Apnea • Loud snoring • Witness apnea • Waking gasping for air • Excessive daytime sleepiness • Insomnia • Frequent awakenings during the night; inability to stay asleep • High blood pressure that is not controlled by medication • Waking in the morning with dry mouth • Morning headaches

4. Risk Factors of Sleep Apnea • Obesity: BMI greater than 30 • Male: Sleep apnea is more common in men than women • Age: more common over the age of 40 • Family history of sleep apnea • Smoking • Use of alcohol, sedatives, and/or tranquilizers: these relax the muscles in the throat • Heart disease • Stroke

5. Effects of Sleep Apnea • High blood pressure or other heart problems • Excessive daytime sleepiness • Memory problems • Weight gain • Impotence • Headaches • Sleep deprive bed partners • Car accidents

6. When should you speak with your doctor about a sleep study? If your bed partner complains of loud snoring and/or has witness you not breathing while asleep If you wake with a dry mouth or sore throat, cough choking and unable to catch your breath If you have excessive daytime sleepiness and decreased energy during the day Inability to remain awake while driving Wake up not feeling refreshed or experience restless sleep Experience headaches in the morning Inability to recall, retain information, mood changes Be sure to take a completed Epworth Sleepiness Scale and Sleep Diary with you to your visit!

7. Treating Sleep Apnea • Positive airway pressure (PAP) therapy • CPAP • BiPAP • Mandibular devices • Surgical options • Lifestyle changes (mild sleep apnea)

8. Insomnia • Insomnia is a disorder that consists of difficulty falling asleep or staying asleep, that prevents the affected person from getting enough quality sleep • Those who suffer from insomnia wake feeling un-refreshed or feel they have not slept at all

9. Symptoms of Insomnia • Difficulty falling asleep • Frequent awakenings • Awakening too early • Excessive daytime sleepiness or fatigue • Headaches • Inability to focus on tasks • Increased errors or accidents • Irritability, depression, and/or anxiety

10. When to see your physician • You should see your physician when you have difficulty functioning during the day and you have tried to improve your sleep hygiene without any results • Take a copy of your completed Epworth Sleepiness Scale and Sleep Diary with you • Your physician may refer you to a sleep specialist

11. Excessive Daytime Sleepiness Disorder (Hypersomnia) • Constant or recurrent events of extreme sleepiness during the day despite getting the recommended 7-8 hours of sleep • There are many causes for hypersomnia, such as Narcolepsy, sleep apnea, and insomnia, these should be ruled out with sleep testing before treatment of Hypersomnia

12. Narcolepsy • Narcolepsy is characterized by sudden sleep attacks, insomnia, and sleep paralysis; can occur with cataplexy • Cataplexy is a sudden loss of muscle tone, usually brought on by an emotional response • Symptoms most often begin between the ages of 10 to 25

13. Narcolepsy Symptoms Treatment • Excessive and uncontrollable daytime sleepiness • Cataplexy • Sleep paralysis- inability to move or speak when falling asleep or waking • Hallucinations- as you are falling asleep or waking • There is no cure for Narcolepsy • Medications: stimulants to improve alertness • Behavioral therapy: scheduling naps during the day

14. Talking to your physician about excessive daytime sleepiness • You should see your physician when you have difficulty functioning during the day and you have tried to improve your sleep hygiene without any results • Take a copy of your completed Epworth Sleepiness Scale and Sleep Diary with you • Your physician may refer you to a sleep specialist for a sleep study and additional testing called a multiple sleep latency test

15. Restless Leg Syndrome (RLS) • RLS is a neurologic disorder that causes an overwhelming urge to move the legs • While legs are the most commonly affected, it can be the arms, face, or torso • The symptoms are different for each individual, but the sensation is usually couple with unpleasant sensations • It is more severe at night, when resting • It is believed that there is a genetic link for RLS

16. RLS Symptoms Treatment • Urge to move legs, usually associated with an uncomfortable feeling, such as tingling, itching, aching, or creepy • Difficulty falling asleep due to the sensations • May be alleviated by rubbing the legs or getting up and moving around • While there is no cure for RLS there are medications that may help to alleviate the problem

17. Speaking with your physician about sleep disorders • If you are concerned that you may have a sleep disorder, speak with your physician explaining your symptoms. • Take your completed sleep diary to help you explain your concerns. • Take a copy of your completed Epworth Sleepiness Scale if you are experiencing daytime sleepiness. • Your physician may refer you to a sleep specialist

18. References • http://www.mayoclinic.com/health/sleep-apnea/DS00148/DSECTION=risk-factors • http://www.webmd.com/sleep-disorderss/guide/sleep-disorders-overview-facts • http://office.microsoft.com/en-us/images/ • http://www.sleepapnea.org/learn/sleep-apnea.html • http://www.sleepfoundation.org/article/sleep-related-problems/narcolepsy-and-sleep