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what is sleep apnea

circadian rhythm disorders

hypersomnias

parasomnias

sleep breathing disorders

sleep movements disorders

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Millions of Americans don’t get enough sleep. Many times this is due to an untreated sleep disorder. Sleep is vital to your overall well-being and lack of it can lead to serious health complications. It is recommended that adults get 7-8 hours of sleep per night and that doesn’t mean just being in bed. You need sound, quality sleep every night to be at your best. If you, snore, feel fatigued, or wake up tired

If you snore, feel fatigued, or wake up tired, you might have an undiagnosed sleep disorder. We can help. It is our mission at The Respire Institute to diagnose and treat sleep disorders. This way you can get the healthy and revitalizing sleep you need.

There is more than one type of sleep apnea, but by far the most common is obstructive sleep apnea (OSA). An “apnea” is a temporary stop in breathing. In obstructive sleep apnea, this is usually caused by the collapsing of soft tissue in the back of the throat. When the muscles in your airway relax when you go to sleep, the airway becomes narrower and can make breathing difficult, at times impossible. When your body becomes deprived of oxygen, you wake up. People with obstructive sleep apnea can wake up a few times throughout the night or several hundreds times per night in severe cases. Often they don’t even realize they wake up and sleep apnea can go untreated as a result.

People suffering from sleep apnea are often fatigued throughout the day even though they think they got plenty of sleep. This fatigue can lead to trouble concentrating, difficulty staying awake, and many other problems associated with lack of sleep. In addition, the repeated lack of oxygen throughout the night can lead to numerous health problems, some severe. OSA can be a contributing factor to heart disease, stroke, high blood pressure, diabetes, and depression.

Diagnosis and Testing

A board certified physician can help you determine if you have sleep apnea. This can be done either through an in-lab or home sleep test. At your initial visit, your doctor will ask about risk factors and try to determine if there could be any other causes. If possible, ask your spouse, partner, or roommate if they have noticed anything like heavy snoring or breathing difficulty during your sleep and bring this information with you.

Symptoms

Along with fatigue, there are many other symptoms of sleep apnea:
  • Heavy snoring
  • Morning headaches
  • Insomnia
  • Dry mouth or sore throat
  • Frequent need to urinate during the night
  • Trouble concentrating or remembering things
  • Moodiness, irritability or depression

risk factors

Though being male and overweight are two of the main risk factors, sleep apnea can affect people regardless of age, body type or gender. Some of the other major risk factors include: having a large neck (17 inches or more), being overweight (BMI over 25), advanced age (40+ for men, 50+ for women), family history, high blood pressure, or being a smoker.

Jet Lag

Jet lag is a temporary condition caused by moving across timezones. The body’s circadian rhythm needs time to adjust to changing day and night patterns. It usually takes one day per timezone change to adjust, but can take less or more depending on the individual.

Advanced Sleep-Wake Phase

People with advanced sleep-wake phase often fall asleep earlier than desired and have trouble staying awake in the evening. They wake up earlier than usual, sometimes in the middle of night, and can’t fall back to sleep. This interferes with their daily life.

Delayed Sleep-Wake Phase

This is a two or more hour shift in normal sleeping patterns that interferes with daily life. People with this disorder often have trouble going to sleep at night and waking up early in the morning.

Irregular Sleep-Wake Rhythm

Irregular sleep-wake rhythm is a rare condition that causes sleep patterns to be out of alignment. The amount of sleep is abnormal and is broken up into segments that occur throughout the day. There is no regular pattern of sleep and when it does occur, the sleep is not sound.

Non-24-Hour
Sleep-Wake Rhythm

Non-24-Hour Sleep-Wake Rhythm

This sleep disorder arises from the body’s circadian rhythm not resetting itself on a daily basis. Each day, sleep patterns drift a little later until a person is going to sleep in the morning and waking up at night. It is most common among blind people because of light’s effect on regulating sleep.

Shift Work

As the name suggests, shift work disorder occurs among those whose work schedule takes place during the time most people sleep. Not everyone who works these shifts has shift work disorder. There is usually an adjustment period to changing sleep patterns, but if you have trouble sleeping or staying awake after 7-8 weeks, you may have this circadian rhythm disorder.

Hypersomnias are disorders marked by excessive sleepiness and being sleepy during abnormal times. People with this disorder may fall asleep at inconvenient, or even dangerous, times. The most common hypersomnia is narcolepsy.

long sleeper

A long sleeper will routinely sleep longer than is normally required, often 10-12 hours. The sleep is quality sleep, but it interferes with daily schedules and routines and getting less will cause the person to feel tired throughout the day. Many rely on stimulants to perk themselves up, but this can cause disturbed sleep and even more tiredness.

Narcolepsy

About 1 in 2000 people suffer from narcolepsy and many people do not know they have it. Narcolepsy is marked by a feeling of overwhelming sleepiness or sudden bouts of sleep that can occur anytime. It can be dangerous if these bouts occur during certain activities such as driving or operating machinery. Research suggests that some cases of narcolepsy are caused by low-levels of a neurotransmitter that regulates arousal, wakefulness, and appetite. Most people with narcolepsy do not sleep more than usual, they just fall asleep or have trouble staying awake throughout the day.

sleep walking

Also known as “somnambulism”, sleepwalking involves getting up and moving around while still asleep. A variety of behaviors can take place without the sleepwalker ever knowing or remembering. They are very hard to wake up and when they do, they are often confused due to lack of memory. It is most common in children and normally goes away during teenage years, but can occur at any age. About 4% of adults sleepwalk. There is also a strong genetic factor to sleepwalking and having parents who sleepwalk can double or triple the chances of having it.

Parasomnias are categorized by any unwanted or unnecessary actions or behaviors that occur while falling asleep, during sleep or when waking up. These can include physical movements, such as sleepwalking, and dreams and emotions. Some of the actions can be complex and seem to have a purpose, but the person engaging in them is asleep the whole time.

Sleep Eating Disorder

Seemingly uncontrollable consumption of food during the night is known as sleep-related eating disorder. The foods are consumed very rapidly and episodes usually only last ten minutes. However, people with the disorder may eat very sloppily and leave a mess in the kitchen. Normally people eat foods high in sugar or fat and in strange combinations. Some may even attempt to cook. This can be dangerous. Many people with this disorder may feel ashamed and alter their eating during the day in anticipation of an episode at night. It is usually a long lasting condition and does not go away quickly.

Sleep Terrors

People also refer to these at “night terrors” and the name is fitting. These are episodes that involve someone usually sitting up and then screaming, kicking, or thrashing around in the middle of the night. People experiencing sleep terrors often do not remember the episode, but will exhibit signs of being terrified, including wide eyes, sweating, and heavy breathing. They do not respond to voices and are very difficult to wake up. It normally occurs in children and usually goes away on its own as the child becomes a teenager. 6.5% of children have sleep terrors. It is rare in adults, only about 2.2%. There is a strong genetic link and multiple members of the family can have sleep terrors.

Confusional Arousals

These involve a state of confusion when waking up in the middle of the night. They most often occur when someone has been physically woken up. People that have confusional arousal may seem distant or even confrontational. It can also be marked by slurred speech and memory loss. These symptoms usually occur during the first third of the night and the person with the condition usually never remembers the episode. However, sometimes these symptoms can occur in the morning. This is called sleep inertia and usually lasts 5-15 minutes, but can last as long as 30 minutes. People with sleep inertia can wake up agitated and do not respond well when people try to calm them down.

Obstructive Sleep Apnea

Obstructive sleep apnea is a very common and serious disorder. It is caused by obstructions in breathing that can occur a few times per night or hundreds of times per night, depending on severity. A person with this disorder awakes because the body is deprived of oxygen. The obstruction is often caused by collapse of tissue in the back of throat.

Sufferers are often tired, have trouble concentrating, and even fall asleep throughout the day due to sleep deprivation from waking up during the night. Many people are not even aware of waking up repeatedly. Due to the repeated oxygen deprivation caused by obstructive sleep apnea, it can be a risk factor for many conditions including high blood pressure, heart disease, stroke, diabetes, pre-diabetes, and depression. Continuous positive airway pressure (CPAP) therapy is the most often used tool to manage this disorder. Oral appliance therapy and surgery are other options.

Central Sleep Apnea

These are repetitive muscle movements that most often occur during sleep. These are not major movements that involve jerking or changing positions, but are small flexes in muscles. They most often affect the lower legs, usually both. It can be just big the toe or up into the ankle and calf. It is rare, but they can also take place in the arms and upper body. Usually periodic limb movements do not severely disrupt sleep, but if they do you might need treatment.

This apnea differs from obstructive sleep apnea in that it is not caused by blockage, but is rather due to a problem in the heart or brain. It is marked by a reduction in your body’s effort to breath during sleep. Normally, the brain and heart work together to properly regulate breathing. When central sleep apnea occurs, this coordination breaks down and they move an abnormal amount of air into the lungs. This can be due to heart failure, stroke, high altitude, drug use, or other causes. For all causes, the result is irregular breathing patterns marked by an increases or reductions in effort or complete stoppage.

Snoring

Snoring is caused by the vibration of tissues in the back of the throat and and can occur during any stage of sleep. About half of people will snore at some point in their lives and it is more common in men, but many women snore as well. Light snoring is usually not a problem, but heavy snoring can be disruptive to sleep and a sign of more serious conditions. While most people don’t even know they snore, it can be severe enough to wake the snorer up throughout the night.

Periodic limb Movements

These are repetitive muscle movements that most often occur during sleep. These are not major movements that involve jerking or changing positions, but are small flexes in muscles. They most often affect the lower legs, usually both. It can be just big the toe or up into the ankle and calf.

It is rare, but they can also take place in the arms and upper body. Usually periodic limb movements do not severely disrupt sleep, but if they do you might need treatment.

Restless Legs Syndrome

This a neurological sleep disorder most common in people over age 45 that causes an uncontrollable urge to move your legs, most often at night or while in bed. Many people describe a burning or itching in the legs that goes away once they get up and walk around.

Restless legs syndrome often goes untreated for long periods of time because people don’t think much of it, but the accumulated loss of sleep over time can lead to many other health problems. It can almost always be treated through medication and lifestyle changes.