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Snoring
is the act of breathing through the open mouth in
such a way as to cause a vibration of the uvula and
soft palate, thus giving rise to a sound which may
vary from a soft noise to a loud unpleasant sound.
This most commonly occurs during sleep.
The cause of snoring is having a blockage
in the airway passage. When the airflow in the breathing
passage becomes irregular due to the blockage, the
soft palate will start vibrating. This vibrating of
the soft palate is what causes the snoring sound.
Snoring
is a problem if:
- you stop breathing during sleep and
have to wake up to catch your breath,
- you are disturbing your sleep partner,
or
- you are losing sleep because of your
snoring.
In addition to problems stemming from
sleep deprivation, snoring can cause more serious
health problems. Snoring has been linked to increased
risk of stroke; diabetes; high blood pressure; and
heart disease. Snoring can also be a symptom of sleep
apnea.
Numerical statistics on snoring are
often contradictory, but at least 30% of the adult
population and perhaps as many as 50% of people in
some demographics snore. According to Dr. William
C Dement, of the Stanford Sleep Center, anyone who
snores and has daytime drowsiness should be evaluated
for sleep disorders. |
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Sleep
apnea is characterized by pauses in breathing
during sleep. These episodes, called apneas (literally,
"without breath"), each last long enough
so one or more breaths are missed, and occur repeatedly
throughout sleep. There are two distinct forms of
sleep apnea: Central and Obstructive. Breathing is
interrupted by the lack of effort in Central
Sleep Apnea, but from a physical block to airflow
despite effort in Obstructive Sleep Apnea.
Regardless of type, the individual affected with sleep
apnea is rarely (if ever) aware of having difficulty
breathing, even upon awakening. Sleep apnea is recognized
as a problem by others witnessing the individual during
episodes, or is suspected because of its effects on
the body. The definitive diagnosis of sleep apnea
is made by polysomnography.
In Central Sleep Apnea, the brain's
control centers "forget" to breathe during
sleep. The sleeper stops breathing, and then starts
again. There is no effort made to breathe during the
pause in breathing: there are no chest movements and
no struggling, just stillness. After the episode
of apnea, breathing may be faster for a period of
time, a compensatory mechanism to blow off retained
waste gasses and absorb more oxygen.
Obstructive Sleep Apnea is much more
common than central sleep apnea. Approximately 1 in
5 American adults have some form of obstructive sleep
apnea. Signs of obstructive sleep apnea can include
loud snoring, morning headaches, trouble concentrating,
irritability, daytime fatigue, mood or behavior changes,
increased heart rate, anxiety, and depression, increased
frequency of urination, bedwetting, esophageal reflux
and heavy sweating at night.
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Insomnia
is characterized by an inability to fall sleep and/or
remain asleep for a reasonable period. Insomniacs
typically complain of being unable to close their
eyes or "rest their mind" for more than
a few minutes at a time. Both organic and nonorganic
insomnia constitute a sleep disorder. It is often
caused by fear, stress, anxiety, medications, herbs,
caffeine or sometimes for no apparent reason. An overactive
mind or physical pain may also be causes. Finding
the underlying cause of insomnia is usually necessary
to treat it.
According to the U.S. Department of
Health and Human Services, approximately 60 million
Americans suffer from insomnia each year. Insomnia
tends to increase with age and affects about 40 percent
of women and 30 percent of men. The average American
gets 7 hours of sleep, instead of the 8 to 10 hours
recommended by doctors. |
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Narcolepsy
is a neurological condition characterized by Excessive
Daytime Sleepiness (EDS) and unintended episodes of
sleep.
The main characteristic of narcolepsy
is overwhelming excessive daytime sleepiness, even
after adequate nighttime sleep. A person with narcolepsy
is likely to become drowsy or to fall asleep, often
at inappropriate times and places. Daytime naps may
occur with or without warning and may be irresistible.
These naps can occur several times a day. They are
typically refreshing, but only for a few hours. Drowsiness
may persist for prolonged periods of time. In addition,
night-time sleep may be fragmented with frequent wakenings.
Four other classic symptoms of narcolepsy,
which may not occur in all patients, are:
- Cataplexy: sudden episodes of loss
of muscle function, ranging from slight weakness
(such as limpness at the neck or knees, sagging
facial muscles, or inability to speak clearly) to
complete body collapse. Episodes may be triggered
by sudden emotional reactions such as laughter,
anger, surprise, or fear, and may last from a few
seconds to several minutes. The person remains conscious
throughout the episode.
- Sleep paralysis: temporary inability
to talk or move when waking up. It may last a few
seconds to minutes. Often frightening but not dangerous.
- Hypnagogic hallucinations: vivid,
often frightening, dream-like experiences that occur
while dozing, falling asleep and/or while awakening.
- Automatic behavior: Automatic behavior
occurs when a person continues to function (talking,
putting things away, etc.) during sleep episodes,
but awakens with no memory of performing such activities.
It is estimated that up to 40 percent of people
with narcolepsy experience automatic behavior during
sleep episodes.
It is estimated that there are as many
as 3 million people worldwide affected by narcolepsy.
In the United States it is estimated that narcolepsy
afflicts as many as 200,000 Americans, but fewer than
50,000 are diagnosed. It is as widespread as Parkinson's
disease or multiple sclerosis. Narcolepsy is often
mistaken for depression, epilepsy, or the side effects
of medications.
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| Restless
legs syndrome is a neurological disorder that
is poorly understood.
RLS may be described as uncontrollable urges to move
the limbs in order to stop uncomfortable, painful
or odd sensations in the body, most commonly in the
legs. Moving the affected body part reduces the sensations,
providing temporary relief. The sensations and need
to move may return immediately after ceasing movement,
or at a later time. RLS may start at any age, including
early childhood, and is a progressive disease for
a certain portion of those afflicted. It often
results in a lifelong insomnia unless properly treated.
In 2003 National Institutes of Health
(NIH) defined RLS to include the following:
- an urge to move the limbs with or
without sensations
- worsening at rest
- improvement with activity
- worsening in the evening or night.
About 10 percent of adults in North
America and Europe may experience RLS symptoms, according
to the National Sleep Foundation.
Often sufferers think they are the only ones to be
afflicted by this peculiar condition and are relieved
when they find out that many others also suffer from
it. The severity and frequency of the disorder vary
tremendously. Many people only experience symptoms
when they try to sleep, while other experience symptoms
during the day. It is common to have symptoms on long
car rides or during any long period of inactivity
(like watching television or a movie, attending a
musical or theatrical performance, etc.) Approximately
80-90% of people with RLS also have PLMD, Periodic
Limb Movement Disorder, which causes slow "jerks"
or flexions of the affected body part.
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| Periodic
Limb Movement Disorder (PLMD) is a sleep disorder
where the patient moves involuntarily during sleep.
It can range from a small movement in the ankles and
toes to wild flailing of all four limbs. These movements,
which are more common in the legs than arms, occur
for between 0.5 and 10 seconds, recurring at intervals
of 5 to 90 seconds. A formal diagnosis of PLMD requires
documentation of these movements observed on a polysomnogram.
PLMD is a cause of insomnia and daytime sleepiness.
The incidence of this disorder increases with age.
It is estimated to occur in 5% of people age 30 to
50 and in 44% of people over the age of 65. As many
as 12.2% of patients suffering from insomnia and 3.5%
of patients suffering from excessive daytime sleepiness
may experience PLMD.
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Rapid
Eye Movement Behavior Disorder or RBD was
first described in 1986. The major feature of RBD
is loss of muscle atonia (paralysis) during otherwise
intact REM sleep (the stage of sleep in which most
vivid dreaming occurs). This loss of motor inhibition
leads to a wide spectrum of behavioral release during
sleep. This extends from simple limb twitches to more
complex integrated movements where sufferers appear
to be unconsciously acting out their dreams. These
behaviors are often violent in nature and commonly
result in injury to either the patient or their bed
partner. Injuries range from bruises and cuts to fractures
and other serious injuries. In contrast, all other
aspects of sleep appear similar to normal.
The estimated prevalence of RBD is around 0.5% in individuals aged 15-100. It is far more common in males: most studies report that only around a tenth of sufferers are female. The mean age of onset is estimated to be around 60 years of age.
Various conditions are very similar to RBD in that sufferers exhibit excessive sleep movement and potentially violent behavior. Such disorders include sleepwalking and sleep terrors, which are associated with other stages of sleep, nocturnal seizures and obstructive sleep apnea which can induce arousals from REM sleep associated with complex behaviors. Because of the similarities between the conditions, polysomnography plays an important role in confirming RBD diagnosis.
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