Key Sleep Disorders Insomnia. Insomnia is characterized by an inability to initiate or maintain sleep. ... Narcolepsy. Excessive daytime sleepiness (including episodes of irresistible sleepiness) combined with sudden muscle weakness are the hallmark signs of narcolepsy. ... Restless Legs Syndrome (RLS) ... Sleep Apnea.
Sleep-related difficulties affect many people. The following is a description of some of the major sleep disorders. If you, or someone you know, is experiencing any of the following, it is important to receive an evaluation by a healthcare provider or, if necessary, a provider specializing in sleep medicine.
Insomnia
Insomnia is characterized by an inability to initiate or maintain sleep. It may also take the form of early morning awakening in which the individual awakens several hours early and is unable to resume sleeping. Difficulty initiating or maintaining sleep may often manifest itself as excessive daytime sleepiness, which characteristically results in functional impairment throughout the day. Before arriving at a diagnosis of primary insomnia, the healthcare provider will rule out other potential causes, such as other sleep disorders, side effects of medications, substance abuse, depression, or other previously undetected illness. Chronic psychophysiological insomnia (or “learned” or “conditioned” insomnia) may result from a stressor combined with fear of being unable to sleep. Individuals with this condition may sleep better when not in their own beds. Health care providers may treat chronic insomnia with a combination of use of sedative-hypnotic or sedating antidepressant medications, along with behavioral techniques to promote regular sleep.
Narcolepsy
Excessive daytime sleepiness (including episodes of irresistible sleepiness) combined with sudden muscle weakness are the hallmark signs of narcolepsy. The sudden muscle weakness seen in narcolepsy may be elicited by strong emotion or surprise. Episodes of narcolepsy have been described as “sleep attacks” and may occur in unusual circumstances, such as walking and other forms of physical activity. The healthcare provider may treat narcolepsy with stimulant medications combined with behavioral interventions, such as regularly scheduled naps, to minimize the potential disruptiveness of narcolepsy on the individual’s life.
Restless Legs Syndrome (RLS)
RLS is characterized by an unpleasant “creeping” sensation, often feeling like it is originating in the lower legs, but often associated with aches and pains throughout the legs. This often causes difficulty initiating sleep and is relieved by movement of the leg, such as walking or kicking. Abnormalities in the neurotransmitter dopamine have often been associated with RLS. Healthcare providers often combine a medication to help correct the underlying dopamine abnormality along with a medicine to promote sleep continuity in the treatment of RLS.
Sleep Apnea
Snoring may be more than just an annoying habit – it may be a sign of sleep apnea. Persons with sleep apnea characteristically make periodic gasping or “snorting” noises, during which their sleep is momentarily interrupted. Those with sleep apnea may also experience excessive daytime sleepiness, as their sleep is commonly interrupted and may not feel restorative. Treatment of sleep apnea is dependent on its cause. If other medical problems are present, such as congestive heart failure or nasal obstruction, sleep apnea may resolve with treatment of these conditions. Gentle air pressure administered during sleep (typically in the form of a nasal continuous positive airway pressure device) may also be effective in the treatment of sleep apnea. As interruption of regular breathing or obstruction of the airway during sleep can pose serious health complications, symptoms of sleep apnea should be taken seriously. Treatment should be sought from a health care provider.
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There are 5 main symptoms of narcolepsy, referred to by the acronym CHESS (Cataplexy, Hallucinations, Excessive daytime sleepiness, Sleep paralysis, Sleep disruption). While all patients with narcolepsy experience excessive daytime sleepiness, they may not experience all 5 symptoms.
Cataplexy Estimated to be present in 65%-75% of patients with narcolepsy9 This most specific symptom of narcolepsy type 1, is the sudden, generally brief (<2 minutes) loss of muscle tone with retained consciousness. It is usually triggered by strong emotions, such as laughter, surprise, or anger.2,3,10
Hallucinations (hypnagogic and/or hypnopompic) May affect 33%-80% of patients with narcolepsy11 Hypnagogic hallucinations are vivid dreamlike experiences that occur while falling asleep. When they happen while waking up, they are called hypnopompic hallucinations.2,3 These events may occur with sleep paralysis.3
Excessive daytime sleepiness Affects 100% of patients with narcolepsy9,11,12 Excessive daytime sleepiness is the inability to stay awake and alert during the day, resulting in periods of an irrepressible need for sleep or unintended lapses into drowsiness or sleep.2,3 Excessive daytime sleepiness is the cardinal symptom of narcolepsy and often the most disabling.2
Sleep paralysis May affect 25%-50% of patients with narcolepsy11 Sleep paralysis is the disturbing, temporary inability to move voluntary muscles or speak during sleep-wake transitions. It is often accompanied by hypnagogic or hypnopompic hallucinations.1-3,13
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