Sleep Disorders

Article submitted by Benjamin Gerson, MD Medical Director of University Services.
For more information, he can be reached at 800-624-3784.

One of the most important processes of life is also one of the most overlooked. Sleep is necessary for survival, good health, and renewing your mental and physical health each day. Unfortunately, between twenty and thirty million Americans get an inadequate amount of sleep each night. What many people don't know is how severe the consequences of not getting enough sleep can be.

There are 88 recognized disorders of sleep. Patients typically complain of one of three types of problems:

• insomnia
• excessive daytime sleepiness
• parasomnia

Insomnia is the most commonly encountered sleep disorder, occurring in twenty to thirty three percent of the population. The highest reports of insomnia are generally reported by females, the elderly, and shift workers. Insomnia is also common among those with low socioeconomic status, poor education, chronic medical illness, life stress, and use of alcohol and/or drugs [legal and illegal]. Untreated Insomnia can lead to daytime sleepiness, mood impairment, difficulty with memory, poor performance, driving drowsy, accidents, illness, and an inability to enjoy life.

Excessive daytime sleepiness is an inability to stay alert during the day. Young adults and the elderly have shown to be the most prone of age groups to have this disorder. Their increase in sleepiness is related to the quantity and quality of nocturnal sleep that they are not receiving. The effects of this disorder can be devastating and even life threatening. Patients with EDS may exhibit psychosocial distress, decreased work or school performance, and an increased risk for accidents.

Parasomnias refer to inappropriate movement and behaviors occurring during sleep. The prevalence of parasomnias varies depending on the specific disorder. The most common disorders are nightmare disorder, sleep terror disorder, sleepwalking disorder, REM sleep behavior disorder, Restless legs syndrome (RLS), and periodic limb movement disorder (PLMD). RLS and PLMD may cause partial awakening, full awakening, or disturbances of sleep-stage transition and are most common in the elderly.

The diagnosis of sleep problems requires a systematic evaluation of both signs and symptoms. The first step is taking a careful sleep, medical and psychiatric, history. An assessment of medication and other drug use (e.g., alcohol or caffeine) is also important. Sleep logs are also collected for a two-week period prior to visiting the sleep specialist. The sleep log documents everything for the hour the individual goes to bed to the number of awakenings each night.

Evaluation by the Medical Sleep Specialist is then performed.

All night Polysomnography [sleeping overnight at the sleep laboratory] and sometimes the Multiple Sleep Latency Test [performed during the day] are performed to determine the cause of the sleep problem as well as its severity. The monitoring provides information about the quantity and quality of sleep. It also documents the presence of treatable sleep-related problems such as respiratory disturbances and leg movements during sleep.

About 50 percent of elderly persons complain about their difficulty falling and staying asleep but you don't have to suffer anymore. For more information about sleep disorders, contact your healthcare professional.