Common Adult Sleep Problems/Disorders
Below is information – including symptoms, causes and possible treatment options — on some of the more common sleep-related problems and disorders in adults. Click on any of the problems listed below, or scroll down to read more about them all.
- Poor sleep habits/Sleep hygiene
- Sleep apnea
- Restless legs syndrome and periodic limb movement disorder
- Sleep disorders in medical illnesses
- Sleep disorders in mental illness
Poor Sleep Habits Poor sleep habits (referred to as hygiene) are one of the most common problems encountered in our society. We stay up too late and get up too early. We interrupt our sleep with drugs, chemicals, work, and we overstimulate ourselves with late-night activities such as television. Many of the tips in this site are “common sense,” but it is surprising how many people fail to follow these.
Insomnia Insomnia is the inability to sleep or inability to sleep well at night. Many different medical and mental health problems cause insomnia. Insomnia may be situational, lasting a few days to weeks, or chronic, lasting for more than 1 month. Around 9-12 percent of the American population report chronic insomnia. In severe cases, patients experience fatigue, sleepiness, difficulty concentrating and difficulty with thinking. Many sufferers feel that they have been robbed of the joy of life. Insomnia may be a symptom of breathing problems at night like sleep apnea, of medical illness like heart failure, a side effect of medications, or a symptom of severe anxiety or depression illness. While short-lasting insomnia periods are well treated with medication, chronic or long-lasting insomnia may not respond well to medications. Thus, throwing sleeping pills at many patients with chronic insomnia is not an effective way to treat the problem. An evaluation by the patient’s personal physician or a sleep specialist often helps get to the root of the problem. Many patients respond well to what is called “cognitive behavioral therapy.” In this form of therapy, incorrect ideas about sleep are corrected. In addition, relaxation and behavioral techniques may be used to help patients fall asleep. This combined with treatment of any underlying disorders is often the best way to treat the devastating symptom of insomnia.
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Sleep apnea is a common and potentially devastating sleep disorder. It is the most common reason that patients are referred to sleep centers around the country. The word apnea means “not breathing.” Patients with the usual form of sleep apnea actually close off their airway at night. This airway closure occurs either behind the tongue or behind the nose. Patients continue to make efforts to breathe. Then after 10 to 120 seconds, the brain, realizing it is not getting any oxygen, actually “wakes up.” The brain then tells the upper airway to open to let some air in. This is associated with loud bothersome snoring, often described as snorting and gasping. Patients may take a few breaths of air, the brain goes to sleep again and the cycle may repeat itself several hundred times a night. Patients are often not even aware that they are doing this (although the bed partner is). Sleep apnea is dangerous, common, relative easy to diagnose, and treatable. Patients with sleep apnea are at great risk for heart disease, heart attacks, strokes and high blood pressure. In addition, since the sleep is poor quality (remember the brain keeps waking up), patients are often sleepy during the day. Sleepiness is associated with inability to concentrate, remember or think. There is also increased risk in falling asleep while doing vital tasks such as driving or using heavy machinery. Medical treatment involves weight loss if the patient is overweight, avoidance of drugs, which increase the risk of apneas such as sleeping pills, alcohol and sedative medicines, and sometimes sleeping semi-upright. However, in most cases additional treatment is warranted. In some cases we use Continuous Positive Airway Pressure (CPAP for short) to treat patients. For this treatment a mask is fit over the nose or over the nose and mouth. The mask is pressurized slightly to hold the airway open and allow the patient to sleep normally. Newer technology has made the masks relatively comfortable to use. Some patients may be candidates for surgery on the upper airway. In the usual upper airway surgery the uvula (that punching bag in the back of the throat) and some of the surrounding soft tissue is removed to enlarge the air passage. In other cases a dental device designed to move the lower jaw down and outwards slightly may be worn at night. In a few cases, treatment is begun with an emergent tracheostomy when sleep apnea is considered to be immediately life-threatening. The decision about which form of treatment to use should be decided by the patient and his/her physician on the basis of the sleep studies and rest of the clinical data.
Narcolepsy Narcolepsy is a chronic sleep disorder that commonly begins during adolescence and is characterized by excessive daytime sleepiness with the occurrence of sleep attacks. Narcolepsy can run in families, but can occur in the absence of any family history as well. There are several other characteristic symptoms that may or may not be present, including cataplexy, sleep paralysis and hypnogogic hallucinations.
- Cataplexy is the sudden loss of muscle tone, commonly associated with strong emotions. It may be a subtle sensation of weakness or a complete loss of strength with a fall to the ground.
- Sleep paralysis is a sensation of not being able to move on waking, usually for a few seconds.
- Hypnogogic hallucinations are very vivid and sometimes violent or bizarre sensations, almost dreamlike, that occur on waking or falling asleep.
The treatment of narcolepsy and its associated symptoms commonly requires a combination of behavioral modification and drug therapy. Many patients with narcolepsy will do well with naps scheduled at specific times during the day. Stimulant medication may be used to alleviate symptoms of daytime sleepiness. Other medications, such as certain anti-depressants, are used to treat cataplexy. A new promising treatment for cataplexy using a drug called sodium oxybate has recently become available. Treatment for each patient must be individualized and each patient with his/her physician needs to discuss this on a case-by-case basis.
Restless Legs Syndrome and Periodic Limb Movement Disorder Restless legs syndrome (RLS) is characterized by an intolerable, internal itching sensation occurring in the lower extremities that causes an almost irresistible urge to move the legs. The sensation is commonly described as a “creepy” or “crawly” sensation and is typically relieved by movement of the legs or walking around. When movement stops, however, the sensations frequently return. The abnormal sensations are more common in the late afternoon or evening hours. In some patients, this problem persists into the nighttime and may prevent patients from getting a restful night’s sleep. Pregnancy and iron deficiency are associated with an increased frequency of this disease. In many patients, RLS is extremely distressing. Further, RLS is more common than previously thought, affecting 5-10% of adults and increasing with age. Almost all patients with restless legs syndrome have a problem called period limb movement disorder. In this, there are leg (sometimes arm) movements occurring at regular intervals during the night. These movements may fragment sleep, leading to poor quality, non-refreshing sleep. Periodic limb movement disorder can also occur as an isolated problem, often reported by the bed partner. Luckily, in most people, restless legs syndrome and periodic limb movement disorder are relatively easily treated. Treatment commonly includes the incorporation of both aerobic and leg stretching exercises. Leg stretching or even yoga exercises can be done prior to bedtime to alleviate symptoms and may be all that is needed in mild cases. Iron replacement therapy is used if patients are iron deficient. Drugs used to treat Parkinson’s disease are very effective in treating most cases. These include the drug pramipexole (Mirapex®) and ropinirole (Requip®). Medications, such as valium-type medications, such as clonazepam (Klonopin®) or analgesic medications related to morphine and opium, can be also be used. In some cases, anti-seizure medications may be effective. The University of Maryland Sleep Disorders Center is pleased to announce that Dr. Suzanne Lesage, a neurologist specializing in sleep disorders and restless legs syndrome, has joined the faculty.
Sleepwalking/Somnambulism Sleepwalking, also referred to as somnambulism, is characterized by walking or other physical activities during sleep. Sleepwalking is common in children — up to 15 percent of children have had this problem — but can occur at any age. In children, it can be associated with sleep deprivation or anxiety. In adults, it is more commonly associated with other medical disorders, medication use, or anxiety or depressive disorders. Clinically, the person may simply sit up with their eyes open, appearing to be awake, or they may engage in a complex task. Episodes can last from seconds to minutes. Contrary to popular belief, it is safe to wake a sleepwalker, but they may be confused and disoriented on waking. There is no specific treatment except to avoid triggers if known, or treat anxiety or depression. If severe, short-term use of sedatives may be considered. Otherwise it is best to keep the person safe and out of harm’s way. We often advise families to make sure the windows are closed and that there is no possibility of sleepwalking leading to danger for the patient.
Sleep Disorders in Medical Illnesses Many medical illnesses are associated with disturbances of sleep. Patients with chronic lung disease may experience low oxygen levels at night that disturb sleep. Patients with asthma may develop wheezing or shortness of breath at night, usually in the early morning hours. Patients with heart failure may develop abnormal breathing at night, which disturbs sleep much in the way that sleep apnea does. Patients with Parkinson’s or other neurological diseases may develop disturbed sleep.
Sleep Disorders in Mental Illnesses Many people with mental illnesses, notably depression, anxiety, post-traumatic stress syndrome, and panic attacks, develop profound sleep disturbances. Insomnia is a common symptom in many people with these problems. Evaluation and treatment by a health care provider skilled in these disorders, usually in conjunction with evaluation by a sleep specialist, often brings about great improvement. In spite of the fact that we spend around 1/3 of our life asleep, until recently there has been relatively little attention paid to disorders of sleep. Some 40 million Americans suffer from chronic disorders of sleep and wakefulness. Unfortunately, these often remain unidentified and undiagnosed by patients and physicians alike. Consider:
- Six out of every 10 adults say they have sleep problems a few nights a week or more.
- Daytime sleepiness is severe enough in four out of 10 adults to interfere with their daily activities at least a few days each month.
- For 20 percent of adults, that interference occurs a few days a week or more.
- The annual direct cost of sleep-related problems in this country is $16 billion, with an additional $50-$100 billion in indirect costs (accidents, litigation, property destruction, hospitalization, and death).
- In this country, over 100,000 motor vehicle accidents annually are sleep-related.
- Disasters such as Chernobyl, Three Mile Island, Challenger, Bhopal, and Exxon Valdez were officially attributed to errors in judgment induced by sleepiness or fatigue.
Disordered or abnormal sleep is often the cause of major medical problems such as heart disease, strokes and high blood pressure. Failure to achieve a normal restful night of sleep is often the cause of a great deal of misery for patients and their loved ones. In addition to direct health risks, disordered or abnormal sleep may rob people of the joy of life, making each waking day a chore and a task. Sufferers may feel old before their time, and have a great deal of difficulty in just performing the usual tasks of daily living. There are, in fact, more than 80 different sleep-related disorders recognized by the medical profession. These can cause symptoms ranging from excessive sleepiness during the day, to abnormal or even violent behaviors at night. It is with this in mind that the University of Maryland has created a multidisciplinary, comprehensive sleep disorders center for the diagnosis and treatment of sleep disorders.
Sleep Disorders in Children
Many children experience sleep disorders. These range from night terrors and sleep walking to serious breathing disorders during sleep. A few of the breathing disorders known to affect children and their sleep are listed here. Click on any of the disorders listed below, or scroll down to read more about them all.
- Obstructive Sleep Apnea (OSA)
- Central Hypoventilation Syndrome (CHS)
- Central Apnea of Prematurity
- Chronic Lung Disease
One of the most common abnormalities of breathing during sleep with children is obstructive sleep apnea. OSA occurs in approximately 2 percent of all children, and is most common in preschool-age children. Symptoms of OSA in children include:
- Restless sleep
- Interruption of breathing (apnea)
- Chronic mouth breathing
- Difficulty awakening
- Problems with school performance
Factors that increase the risk of OSA include:
- Large tonsils and/or adenoids
- Abnormalities of the head and neck
The diagnosis of OSA cannot be made by asking questions about the childs sleeping pattern alone, but must be made by evaluating the child during sleep in a sleep laboratory (polysomnography). In addition, the sleep study is useful for identifying children of high risk of complications from anesthesia and surgery. Untreated OSA can lead to heart failure, poor school performance, and high blood count. Treatment of OSA depends on its severity and includes:
- Surgery if tonsils and/or adenoids are enlarged
- Weight reduction if the child is obese
- Non-invasive nasal pressure support (BiPap)
- Tracheostomy when severe
CHS is a problem of the central nervous systems signals to breathe. This disorder is frequently worse during sleep and is characterized by slow and/or shallow breathing inadequate for removing carbon dioxide from the lungs. CHS may occur at birth (congenital) or as a result of pressure on the brainstem (trauma, tumor, brain damage). Diagnosis can be made by overnight sleep study. Treatment may require relief of brainstem pressure depending on the cause, or chronic support with a ventilator.
Central apnea of prematurity is common in newborns and is more likely the more premature the newborn. It may be associated with color changes (blue around the lips or face) and low heart rate (bradycardia) and is due to an immaturity of the central respiratory drive. Apnea of prematurity can be diagnosed by daytime sleep study or by cardiorespiratory monitoring. Treatment consists of caffeine and or oxygen and typically resolves over the first few months of life.
Chronic lung disease is frequently a result of premature birth, but may be secondary to lung injury after the neonatal period as in aspiration syndromes, sickle cell disease, and neuromuscular diseases such as certain types of muscular dystrophy. Chronic lung disease is characterized by low blood oxygen and high blood carbon dioxide levels. Evaluation is possible by day (age < 6 months) or overnight (age > 6 months) sleep study and can determine when the lung disease is resolving or progressing. Therapy consists of oxygen, non-invasive ventilatory support (nasal BiPap), or when severe may require tracheostomy with ventilator support.
Sleep Hygiene: Helpful Hints to Help You Sleep
Poor sleep habits (referred to as hygiene) are among the most common problems encountered in our society. We stay up too late and get up too early. We interrupt our sleep with drugs, chemicals and work, and we overstimulate ourselves with late-night activities such as television. Below are some essentials of good sleep habits. Many of these points will seem like common sense. But it is surprising how many of these important points are ignored by many of us.
- Fix a bedtime and an awakening time. Do not be one of those people who allows bedtime and awakening time to drift. The body “gets used” to falling asleep at a certain time, but only if this is relatively fixed. Even if you are retired or not working, this is an essential component of good sleeping habits.
- Avoid napping during the day. If you nap throughout the day, it is no wonder that you will not be able to sleep at night. The late afternoon for most people is a “sleepy time.” Many people will take a nap at that time. This is generally not a bad thing to do, provided you limit the nap to 30-45 minutes and can sleep well at night.
- Avoid alcohol 4-6 hours before bedtime. Many people believe that alcohol helps them sleep. While alcohol has an immediate sleep-inducing effect, a few hours later as the alcohol levels in your blood start to fall, there is a stimulant or wake-up effect.
- Avoid caffeine 4-6 hours before bedtime. This includes caffeinated beverages such as coffee, tea and many sodas, as well as chocolate, so be careful.
- Avoid heavy, spicy, or sugary foods 4-6 hours before bedtime. These can affect your ability to stay asleep.
- Exercise regularly, but not right before bed. Regular exercise, particularly in the afternoon, can help deepen sleep. Strenuous exercise within the 2 hours before bedtime, however, can decrease your ability to fall asleep.
- Use comfortable bedding. Uncomfortable bedding can prevent good sleep. Evaluate whether or not this is a source of your problem, and make appropriate changes.
- Find a comfortable temperature setting for sleeping and keep the room well ventilated. If your bedroom is too cold or too hot, it can keep you awake. A cool (not cold) bedroom is often the most conducive to sleep.
- Block out all distracting noise, and eliminate as much light as possible.
- Reserve the bed for sleep and sex. Don’t use the bed as an office, workroom or recreation room. Let your body “know” that the bed is associated with sleeping.
- Try a light snack before bed. Warm milk and foods high in the amino acid tryptophan, such as bananas, may help you to sleep.
- Practice relaxation techniques before bed. Relaxation Techniques such as yoga, deep breathing and others may help relieve anxiety and reduce muscle tension.
- Don’t take your worries to bed. Leave your worries about job, school, daily life, etc., behind when you go to bed. Some people find it useful to assign a “worry period” during the evening or late afternoon to deal with these issues.
- Establish a pre-sleep ritual. Pre-sleep rituals, such as a warm bath or a few minutes of reading, can help you sleep.
- Get into your favorite sleeping position. If you don’t fall asleep within 15-30 minutes, get up, go into another room, and read until sleepy.
Most people wake up one or two times a night for various reasons. If you find that you get up in the middle of night and cannot get back to sleep within 15-20 minutes, then do not remain in the bed “trying hard” to sleep. Get out of bed. Leave the bedroom. Read, have a light snack, do some quiet activity, or take a bath. You will generally find that you can get back to sleep 20 minutes or so later. Do not perform challenging or engaging activity such as office work, housework, etc. Do not watch television.
Many people fall asleep with the television on in their room. Watching television before bedtime is often a bad idea. Television is a very engaging medium that tends to keep people up. We generally recommend that the television not be in the bedroom. At the appropriate bedtime, the TV should be turned off and the patient should go to bed. Some people find that the radio helps them go to sleep. Since radio is a less engaging medium than TV, this is probably a good idea.
- Several physical factors are known to upset sleep. These include arthritis, acid reflux with heartburn, menstruation, headaches and hot flashes.
- Psychological and mental health problems like depression, anxiety and stress are often associated with sleeping difficulty. In many cases, difficulty staying asleep may be the only presenting sign of depression. A physician should be consulted about these issues to help determine the problem and the best treatment.
- Many medications can cause sleeplessness as a side effect. Ask your doctor or pharmacist if medications you are taking can lead to sleeplessness.
- To help overall improvement in sleep patterns, your doctor may prescribe sleep medications for short-term relief of a sleep problem. The decision to take sleeping aids is a medical one to be made in the context of your overall health picture.
- Always follow the advice of your physician and other healthcare professionals. The goal is to rediscover how to sleep naturally.
Contrary to what is often thought, sleep is actually an active, organized process. How and when we sleep is governed by a number of factors. These include factors under our control, such as whether or not we are sleep deprived, and factors beyond our control. Chief among these is our internal biologic clock that regulates our biologic rhythm (also called a circadian rhythm) over a 24-hour period. Sleep also has an internal organization regulated by different areas of the brain. Sleep actually occurs in stages, which occur at different times during the night. There are two major divisions of our sleep state. These are called rapid eye movement (REM) sleep, and non-rapid eye movement (Non-REM) sleep. Non-REM sleep is in turn further divided into four different stages (1 through 4), with stages 3 and 4 often referred to as “deep sleep.” In adults, non-REM sleep occupies around 80 percent of the night, and REM sleep 20 percent. However, REM sleep does not occur in one large block. Actually, we go into REM sleep in cycles of around 90 minutes. That is, REM sleep occurs around once every 90 minutes.
Non-REM and REM Sleep
During non-REM sleep, many of the restorative functions of sleep occur. Hormones are released which help the body rebuild itself from damage done during the day. During REM sleep, memories and thoughts from the day are processed. REM sleep is the stage of sleep in which vivid dreams occur. The purpose of dreaming is not well understood, but it probably relates to processing mental information that was received during the day. During REM sleep, we normally lose the use of our limb muscles. Thus, we have an active mind in an inactive body. This normal loss of muscle activity in REM (or dream) sleep helps prevent us from acting out our dreams. Different sleep disorders may occur during different stages of sleep. For example, sleepwalking and night terrors, common problems in children, usually occur in non-REM sleep. There are disorders of REM sleep in which the normal loss of muscle tone is absent. Affected patients may act out violent dreams and harm themselves or others.
How Much Sleep Do I Need?
There is, in fact, a wide range of sleep time that is considered “normal.” While the average normal amount of sleep is around 7.5 hours per night, there are some people who do just fine on 5 hours per night, and some who require as much as 9 hours per night. The key is to find the right amount for you. The best way to tell is by seeing how you function during the day. For example, if after 6 hours of sleep you feel refreshed in the morning and awake during your daylight hours, then you don’t need more than that. If, on the other hand, you need 9 hours a night to feel refreshed and to function well during the day, then that is what your individual requirement is and sleeping the “normal” amount of 7.5 hours per night will actually leave you sleep deprived. If you are getting what you consider to be an adequate amount of sleep and are still unrefeshed and sleepy, then you might have an organic sleep disorder and should consider seeking professional consultation.
Sleep Disorders and Problems:
SYMPTOMS, TYPES, TESTS, AND TREATMENT CENTERS
Getting a good night’s sleep is essential for feeling refreshed and alert during the day Did you know that the average adult needs eight hours of uninterrupted sleep every night in order to maintain optimal mental and physical health? Unfortunately, not everyone is able to get the restorative eight hours they need. According to the National Institute of Neurological Disorders and Stroke, over 40 million Americans a year will suffer from some sort or sleep disorder – many whom will go undiagnosed, or turn to over-the-counter sleep aids for relief. However, ignoring the underlying causes, or covering the symptoms with drugs usually makes the problem worse. And untreated sleep disorders can even be hazardous to your health – a British study released in September 2007 found that people who do not get enough sleep are twice as likely to die of heart disease. Luckily, through proper testing, diagnosis and care, sleep disorders can be managed and overcome. 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?
- fall asleep sometimes while driving?
- have difficulty paying attention or concentrating at work, school, or home?
- perform below your potential in work, school, or sports?
- often get told by others that you look tired?
- have difficulty with your memory?
- react slowly?
- have emotional outbursts?
- feel like taking a nap almost every day?
- require caffeinated beverages to keep yourself going?
Each type of sleep disorder has its own particular symptoms, but all result in some of the above signs of sleep deprivation.
While insomnia is the best-known sleep disorder, over 100 types of sleep disorders actually exist. In order to get a proper diagnosis, it’s important to understand the symptoms and causes of the most common forms of sleep problems – insomnia, sleep apnea, RLS, and narcolepsy.
Insomnia is a significant lack of high-quality sleep. It can be short-term or chronic. Insomnia may be caused by stress, a change in time zones or sleep schedule, poor bedtime habits, or an underlying medical or psychiatric condition. Symptoms include:
- Difficulty falling asleep despite being tired
- Requiring sleeping pills or alcohol to fall asleep
- Awakening frequently during the night or lying awake in the middle of the night
- Awakening too early in the morning despite not feeling refreshed
- Daytime drowsiness, fatigue, and irritability
In most cases, insomnia can be helped by improving bedtime habits, relieving stress, and relaxation exercises. However, certain medications may be prescribed by your doctor if these alternative treatments do not have the desired effect.
Sleep apnea sleep disorders
Sleep apnea is a common disorder that can be very serious, and even life-threatening. In sleep apnea, your breathing stops or gets very shallow while you are sleeping. Each pause in breathing typically lasts 10 to 20 seconds or more. These pauses can occur 20 to 30 times or more an hour. The most common type of sleep apnea is obstructive sleep apnea. During sleep, enough air cannot flow into your lungs through your mouth and nose, even though you try to breathe. When this happens, the amount of oxygen in your blood may drop. Normal breaths then start again with a loud snort or choking sound. Symptoms can be quite scary – frequent waking episodes at night, usually accompanied by a feeling of “choking” or gasping for air. Significant others or roommates of those with sleep apnea often report hearing gasping, gagging, or choking sounds from their partners. The severity of this disorder makes treatment essential. Treatment may include behavioral changes, physical and mechanical devices, and in some cases, surgery.
Restless Legs Syndrome (RLS) and Periodic Limb Movements in Sleep (PLMS)
Restless legs syndrome (RLS) is a sensory disorder causing an almost irresistible urge to move the legs. The urge to move the legs is usually due to uncomfortable, tingly, or creeping sensations that occur when at rest. Movement eases the feelings, but only for a while. RLS is not necessarily confined to your sleep time. Symptoms most often occur when you are relaxed or lying down. You may also notice small, jerky movements of the toes, feet, and legs as you are trying to fall asleep. Periodic Limb Movement Disorder (PLMD) is a related condition involving involuntary, rhythmic limb movements, either while asleep or when awake. While most people who have Restless Legs Syndrome also have PLMD, only some people with PLMD also have RLS. Because of the discomfort the symptoms cause, RLS can make it difficult falling (and staying) asleep. Alternative therapies, lifestyle changes, and even nutritional supplements have proven helpful for RLS and PLMD sufferers.
Narcolepsy is a disorder that causes a person to have difficulty staying awake. Narcolepsy can cause a person to suddenly fall asleep during the day. These “sleep attacks” occur even after getting enough sleep at night. The unusual sleep pattern that people with narcolepsy have can affect their schooling, work, and social life. Falling asleep during activities like walking, driving, cooking, or talking can have dangerous results, both professionally and personally. Symptoms include:
- Intermittent, uncontrollable episodes of falling asleep during the daytime
- Excessive daytime sleepiness
- Sudden, short-lived loss of muscle control during emotional situations (cataplexy)
As narcolepsy involves the nervous system, treatment requires a combination of medication, behavioral treatments, and counseling.
To determine if you have a sleep disorder, first pay attention to your sleep habits and daily routine. Whether you are trying to help yourself or planning to visit a doctor, it is helpful to record your sleep habits. Your sleep history will help you and your doctor find the cause of your sleep problems. Keeping a sleep diary can help you identify lifestyle factors related to sleep disorders, and make it easier to discuss your daily patterns if you do decide to see a doctor or sleep specialist. A sleep diary should record all sleep-related information, including:
- time you went to bed and woke up (total sleep hours)
- quality of your sleep – times that you were awake during the night and what you did (e.g., stayed in bed with eyes closed, or got up, had a glass of milk, and meditated)
- types and amount of food, liquids, caffeine, or alcohol you consumed before bed, and times of consumption
- feelings and moods before bed – happiness, sadness, stress, anxiety
- drugs or medications taken, amounts taken, and times of consumption
A sleep partner can add observations to your sleep diary as well. The details can be important, and a sleep diary might reveal that your pre-bedtime behavior is thwarting your chance for a good night’s sleep. For example, a two-week sleep diary might reveal that you don’t sleep well if you have had more than two alcoholic drinks before bedtime, or that you have more trouble falling asleep on days when you haven’t exercised.
Seeing a doctor
You can address most common sleep problems through lifestyle changes and improved sleep hygiene but it is important to see your doctor or a sleep specialist for a diagnosis if your sleep does not improve. A doctor who specializes in sleep problems is most skilled in diagnosing and treating sleep disorders. Sometimes sleep specialists work out of a sleep center; others are independent. Medical professionals diagnose sleep disorders based on a number of factors including your description of symptoms, your age and gender, and your psychological and medical history. Along with your sleep diary and the answers to a sleep questionnaire, your doctor should interview you to figure out the cause of your sleeping problems. The doctor will want to rule out possible medical conditions and may want you to make behavioral and environmental changes as first steps of your treatment. In addition, your doctor may recommend any number of common tests used to diagnose sleep disorders.
How sleep centers diagnose sleep disorders
If your physician refers you to a sleep center, a team of sleep specialists will use the latest technology to monitor you while you sleep. You will be given a private room, where a technician will attach a variety of monitoring devices to your body once you are ready for bed. Sleep specialists, who are on premises studying several patients at any given time, will observe your sleep patterns using these devices, which monitor brain waves, heart rate, rapid eye movements, and more. While sleeping with a bunch of wires attached to you might seem difficult, most patients find they fall asleep very easily. The next morning, the technician will remove all the monitoring devices, and you will be able to go straight to work or on to your daily activities. The sleep specialists will analyze the results from your sleep study, and either they or your referring physician will set up a time with you to go over these results, and design a treatment program if necessary. A sleep center can also provide you with equipment to monitor your activities (awake and asleep) at home.
|Common tests for diagnosing sleep disorders|
|Epworth Sleepiness Scale||This sleep questionnaire asks you to rank whether certain situations make you sleepy and, if so, how sleepy. Your responses assist your doctor in providing a formal diagnosis.|
|Overnight sleep study (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.|
|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. Sleep specialists analyze your brain waves (EEG), heart rate (EKG), muscle activity, and eye movements.|
|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. During the test, you are placed in a quiet room with dim lighting, told to close your eyes, and asked to stay awake.|
|Blood test||Depending upon your description of your symptoms and your personal and family medical histories, your sleep specialist may also conduct a blood test. The blood test may not be conclusive but can be helpful in establishing the possibility and probability of certain sleep disorders.|
The following tips will hopefully give you relief with your snoring problems. It’s important to remember that different remedies will have varying success depending on the individual.
Elevate your head by sleeping on a thicker pillow or multiple pillows will help reduce your snoring.
Don’t drink alcoholic beverages, take sleeping pills, tranquilizers, or antihistamines right before going to sleep, they will cause your muscles to relax and limit your air passage way.
Avoid dairy products, which can cause mucus build-up right before you go to sleep.
If you are overweight, losing some weight will reduce snoring by increasing the space in your air passage way.
Sleeping on your side instead of your back will help to prevent snoring.
A common remedy to prevent sleeping on your back is to sew a tennis ball to the back of your shirt; the discomfort of sleeping on the ball will prevent you from staying on your back.
Try following a regular sleep routine.
Try taking in a little bit of honey before sleeping.
Don’t eat a big meal right before bed, if your stomach is full it will push up on your diaphragm and limit breathing passage ways.
Avoid eating “rich” foods such as cakes, cookies, chocolate and pizza.
Sleep on a firmer pillow, a pillow that’s too soft encourages your throat muscles to relax and narrows your air passageway.
Inhale steam before sleeping or sleep in a room with a humidifier turned on, which will reduce congestion and moisturize the throat.
Purchase some nasal strips and put them on before going to sleep. Nasal strips will open up your nostrils and allow more air to come in, thus reduce snoring.
If you are a smoker, stop smoking, if that is not feasible then avoid smoking right before you go to bed. Smoking causes inflammation and swelling of the throat.
Take anti-snoring pills or use anti-snoring nasal spray.
Consult a medical profesional if your snoring continues to adversely affect your sleep.