Obstructive Sleep Apnea
Learn more about sleep apnea.
Obstructive sleep apnea is a disorder in which breathing is briefly and repeatedly interrupted during sleep. The "apnea" in sleep apnea refers to a breathing pause that lasts at least ten seconds. Obstructive sleep apnea occurs when the muscles in the back of the throat fail to keep the airway open, despite efforts to breathe. Another form of sleep apnea is central sleep apnea, in which the brain fails to properly control breathing during sleep. Obstructive sleep apnea is far more common than central sleep apnea.
Sleep Apnea Symptoms
- Chronic snoring
- Difficulty concentrating, excessive sleepiness during the day
- Learning and memory difficulties
Are you at risk for sleep apnea? Take our sleep apnea questionnaire to find out.
Treatments for Sleep Apnea
If you suspect you may have sleep apnea, the first thing to do is see your doctor. Continuous Positive Airway Pressure (CPAP) is now regarded as the first-line treatment for obstructive sleep apnea. Some patients may need dental devices inserted into the mouth at night to keep the jaw forward. In some cases, surgery may also be an option.
Learn more about obstructive sleep apnea.
Periodic Limb Movement
Periodic limb movements in sleep are repetitive movements, most typically in the lower limbs, that occur about every 20-40 seconds. If you have PLMS, or sleep with someone who has PLMS (also referred to as PLMD, periodic limb movement disorder), you may recognize these movements as brief muscle twitches, jerking movements or an upward flexing of the feet. They cluster into episodes lasting anywhere from a few minutes to several hours.
Symptoms of Periodic Limb Movement
- Restless Legs Syndrome (RLS), which is an irritation or uncomfortable sensation in the calves or thighs that most often occurs at night. (see below)
Treatments for Periodic Limb Movement
A number of medications have been shown to be effective in treating PLMS, but treatment is only necessary when PLMS are accompanied by restless legs (RLS), insomnia or daytime fatigue.
Learn more about periodic limb movements.
If you have trouble falling or staying asleep, or you wake up feeling unrefreshed, you may be suffering from insomnia. Insomnia is a symptom that can be caused by stress, anxiety, depression, disease, pain, medications, sleep disorders or poor sleep habits.
Symptoms if Insomnia
- Difficulty falling/staying asleep
- Lower productivity during the day
- Depression, anxiety, stress
Treatments for Insomnia
There are several ways your physician may treat insomnia. Sleep hygiene is an important first step for controlling insomnia. These simple self-help measures include establishing a regular bedtime routine, regulating mealtimes and fluid consumption, and limiting caffeine consumption. Behavioral therapy methods include various approaches for training new sleep behaviors and helping patients relax and sleep well. If self-help or behavioral therapy do not solve the problem, a doctor may prescribe medications for use on a short-term basis. Non-benzodiazepine sedative hypnotics are usually the preferred type of drugs. They include zolpidem (Ambien, generic), zaleplon (Sonata), eszopiclone (Lunesta), and ramelteon (Rozerem).
Learn more about insomnia.
Restless Legs Syndrome (RLS)
Restless Legs Syndrome (RLS) is a neurologic sensorimotor disorder that is characterized by an overwhelming urge to move the legs when they are at rest. The urge to move the legs is usually, but not always, accompanied by unpleasant sensations.
Symptoms of Restless Legs Syndrome
- The urge to move the legs - often associated with an uncomfortable feeling in the legs (tingling, itching, pulling or aching.)
- Involuntary jerking of the limbs
- Tiredness due to lack of sleep
Treatments for Restless Legs Syndrome
There is no specific diagnostic test for RLS. Until recently, there were no FDA-approved drugs for the treatment of RLS. In May 2005, a drug called Requip® (ropinirole hydrochloride) that is commonly used to treat Parkinson disease was given FDA approval at lower doses for the treatment of moderate-to-severe primary RLS after patients in clinical trials enjoyed more and better quality sleep as early as one week after starting treatment. In 2006, a drug by the name of Mirapex® was also approved by the FDA for the treatment of moderate-to-severe primary RLS.
Learn more about Restless Legs Syndrome (RLS).
Narcolepsy is a neurological disorder caused by the brain's inability to regulate sleep-wake cycles normally. The main features of narcolepsy are excessive daytime sleepiness and cataplexy. The disease is also often associated with sudden sleep attacks, insomnia, dream-like hallucinations, and a condition called sleep paralysis.
Symptoms of Narcolepsy
- Excessive daytime sleepiness. Someone who has narcolepsy is prone to falling asleep while engaged in conversation, driving, eating dinner, or at other inappropriate times.
- Hypnogogic hallucinations - during transition from wakefulness to sleep, the patient has bizarre, often frightening dream-like experiences that incorporate his or her real environment.
- Sleep paralysis - a temporary inability to move during sleep-wake transitions. Sleep paralysis may last for a few seconds to several minutes and may accompany hypnagogic hallucinations.
- Disturbed nocturnal sleep - waking up repeatedly throughout the night. Leg jerks, nightmares, restlessness.
Treatments for Narcolepsy
There is currently no widely-accepted cure for narcolepsy but symptoms can be alleviated to the point of near-normal functioning in many patients. Treatment for narcolepsy includes the use of medication as well as behavioral therapy. In treating narcolepsy, doctors typically prescribe stimulants to improve alertness and diminish excessive daytime sleepiness. Antidepressants are also often used to treat cataplexy, hypnagogic hallucinations and sleep paralysis. Finally, sodium oxybate, a strong sleep-inducing agent, may be given at night to improve disturbed nocturnal sleep and reduce daytime sleepiness and cataplexy.
Learn more about narcolepsy.
Snoring is noisy breathing during sleep. It is a common problem among all ages and both genders, and it affects approximately 90 million American adults - 37 million on a regular basis. Snoring may occur nightly or intermittently. Persons most at risk are males and those who are overweight, but snoring is a problem of both genders, although it is possible that women do not present with this complaint as frequently as men.
Symptoms Related to Snoring
- Making a vibrating, rattling, noisy sound while breathing during sleep. Snoring can lead to excessive daytime sleepiness, morning headaches, weight gain, awakening in the morning unrested, shorter attention span and inability to remember.
Treatments for Snoring
Snorers are generally unaware of their snoring and must rely on the observations of their bed-partners. Some snorers may wake up at night choking and gasping for breath, but this occurs relatively infrequently.
Depending on the results of the sleep study, you will be presented with a series of options to treat snoring. These will generally include:
- lifestyle modification (i.e. avoidance of risk factors mentioned above, sleep position training if applicable, treatment of allergies if applicable, etc…);
- surgery (generally on the back of the throat and roof of the mouth, or the nose if applicable, using a variety of instruments including scalpel, laser, or microwaves);
- appliances (mainly oral appliances constructed by a dentist experienced in treatment of snoring and sleep apnea, but also other appliances such as nasal dilators);
- and sometimes CPAP (a continuous positive airway pressure appliance which blows room air into the back of the throat thus preventing it from collapse).
Learn more about snoring.
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