Sleep disorders affect people of all ages and can appear as a temporary childhood problem like night terrors or develop into a life threatening illness like apnea.
Many people suffer from insomnia or delayed sleep phase syndrome (difficulty falling asleep and waking up at the right time). The disorders that will be discussed here include apnea, narcolepsy, hypersomnia and sleepwalking.
Learn about the Sleep Center at Wake Forest Baptist Health.
Sleep apnea is a breathing disorder that occurs during sleep. It refers to non-breathing episodes during sleep, occurring as frequently as several hundred times per night. About 95% of all cases are obstructive apnea, which is characterized by repetitive episodes of upper airway obstruction during sleep usually associated with a reduction in blood oxygen saturation.
Apnea can progress in severity and become life threatening if not detected and properly treated. Over 20 million Americans suffer from sleep apnea. Although it seems to be more common in middle-aged men and affects 40 percent of all people over 60 years of age, anyone at any age may develop sleep apnea.
The symptoms of sleep apnea can include loud snoring, excessive daytime sleepiness and frequent episodes of obstructed breathing during sleep (usually recognized by the bed partner). The symptoms can range from mild to severe.
A sleep test called polysomnography (PSG) is usually performed to diagnose sleep apnea. It measures brain waves, muscle tension, eye movement, respiration, and oxygen level in the blood and noise, such as snoring or gasping.
A national study underway is looking for a link between obstructive sleep apnea and an increased risk for cardiovascular disease. So far the study has initially shown the possibility of a link between obstructive sleep apnea and high blood pressure.
Sleep apnea is treated by some behavioral changes. Losing weight and sleeping on 1 side can help. Oral mouth devices can help keep the airway open and reduce snoring. In addition, problems such as small jaws or enlarged tonsils also can contribute to sleep apnea and may require surgery to open up the airway.
Learn more about sleep apnea.
Narcolepsy is a lifelong neurological illness, primarily characterized by sudden
uncontrollable sleep attacks and persistent daytime sleepiness. Narcolepsy affects more than 500,000 Americans and symptoms may arise as early as the onset of puberty and continue throughout life. Narcolepsy itself is not life threatening, but it can have a major impact on functioning in life, like driving a car, that can have serious consequences.
Narcolepsy is characterized by excessive sleepiness associated with cataplexy (a sudden loss of muscle tone and paralysis of voluntary muscles that is associated with a strong emotion) and other REM sleep abnormalities such as sleep paralysis (immobility of the body that occurs in the transition from sleep to wakefulness) and hypnagogic hallucinations (pre-sleep dreams).
Polysomnography also can measure characteristics of narcolepsy, which can vary from mild to severe.
Narcolepsy research involves searching for a gene that may be an indicator of the condition. There is a suspicion that certain cells in the hypothalmus in the brain may be killed off in people with narcolepsy.
Narcolepsy is usually treated with medication to improve alertness.
Learn more about narcolepsy.
Hypersomnia is excessive sleepiness. It is an excessively deep or prolonged major sleep period and may be associated with difficulty in awakening. It is believed to be caused by the central nervous system. It typically appears before age 25 and comes on gradually.
The symptoms of hypersomnia include long sleep periods, excessive sleepiness or excessively deep sleep and gradual onset.
Polysomnography also can measure hypersomnia. A multiple sleep latency test (MSLT) also can measure how sleepy the person is.
The latest research for insomnia involves non-drug treatments, such as behavioral intervention that appears to be as successful as drugs. Bedtime routines, exercise and abstinence from alcohol and caffeine are among those behavioral modifications.
Treatment for hypersomnia may include good sleep hygiene and taking stimulants for alertness, limiting naps and avoiding shift work, caffeine and alcohol.
Learn more about hypersomnia.
Sleepwalking affects about 18 percent of the population. It is more common in children than in adolescents and adults. Boys are more likely to sleepwalk than girls. Sleepwalking can have a genetic tendency.
Sleepwalkers may feel embarrassment, shame, guilt, anxiety and confusion when they are told about their sleepwalking behavior.
Sleepwalking or somnambulism means not only that a person walks during sleep but also that person may be difficult to awaken during an episode and may have amnesia following an episode.
For some, the episodes of sleepwalking occur less than once per month and do not result in harm to the patient or others. In its most severe form, the episodes occur almost nightly or are associated with physical injury and may involve leaving the home.
Diagnosis of sleepwalking is fairly simple because either the person is aware of it or others observe the sleepwalker.
Sleepwalkers need to get plenty of rest, develop a calm bedtime ritual and remove harmful items from the bedroom. Hypnosis can be helpful, as well as an accurate psychiatric evaluation. Medications also can help.
Learn more about sleepwalking.
Other Sleep Disorders
For more information on other sleep disorders, click a link below.
The Sleep Disorders Center is devoted to the evaluation and treatment of sleep disorders in patients of all ages. The center functions as a diagnostic resource and short-term treatment facility to evaluate such problems as sleep apnea, narcolepsy, insomnia, common parasomnias (sleepwalking, nightmares, night terrors, nocturnal seizures).
The staff performs polysomnographic studies (PSG) and multiple sleep latency tests (MSLT) and provides education, advice and assistance to physicians regarding sleep disorders, medicine and testing available.
When patients are being referred to the sleep center, they have 2 choices of entry into the system. They can begin with a referral to the various clinics for an office- based evaluation, or they can be sent straight to the sleep lab for testing.
The Medical Center is working on sleeping pill studies that are evaluating middle of the night and intermittent dosing versus the routine of taking the pills right before bedtime each night.