Common sleep disorders

What are the most common sleep disorders and does it differ with age groups?

It’s different with age groups with the disorder somewhat in the mind of the beholder. For example, a teenager’s mother would say the kid sleeps too late and never gets out of bed. The kid is actually fine. And all college kids are sleep deprived but that’s not a serious disorder. There are two general types, you would call them disorders. One, is people who can’t sleep well, insomnia, which usually is not a serious disease and usually is a reflection of some underlying stress in someone’s life or depression. A huge number of the population, intermittently has a little bit of insomnia. A Gallup Poll in 1991 found that thirty six percent of adult males have some type of insomnia. And, nine percent have chronic sleep difficulty. So, thirty six percent have some difficulties intermittently.

What qualifies it as insomnia and not just a little trouble sleeping?

If it takes you more than thirty minutes to fall asleep. That’s one definition of it. But that’s a common problem. Everybody complains about that periodically and what’s the best thing to do if somebody has it is just to reassure them that it’s normal and don’t worry if you don’t sleep for a few days. You will usually get over this.

What are the recommendations to do, to not go to sleep and keep lying there or what do you do?

The general recommendation is to not stay in bed awake for more than ten or fifteen minutes. If you can’t sleep, get out of bed, go into the other room, turn a light on and read or do something. Don’t do your taxes or anything like that but do something kind of mindless for fifteen or thirty minutes and then go back to bed. And that works for most people. Every once in a while people are going to have a restless night and not sleep well and they’ll be all right.

When does it become dangerous, can insomnia cause accidents or accidents at work? Or, is it sleep apnea?

Sleep apnea is the real serious problem. Some studies found that it’s dangerous for driving. Sleep apnea is a condition in which the throat collapses during sleep and people can’t breathe until they wake up. And studies have shown that nine percent of men and four percent of women stop breathing over fifteen times an hour during sleep. That’s astonishing. And if it happens enough they can have accidents at work. People who have a lot of this, have a higher rate of automobile accidents than normal.

What are some of the treatments for sleep apnea?

Three quarters of the people who have sleep apnea are overweight. If they lose weight it will get better and disappear. Now most people cannot lose enough weight to make it disappear but they should try. The best and most uniformly effective treatment is called nasal CPAP, continuous positive airway pressure. And that’s a mask that goes over the nose, is attached to a hose which is attached to a little box that has a fan in it that blows air into their nose. It works, works for everybody. That’s the good news, the bad news is people have to sleep with it all night. Most people do surprisingly well with it although studies have shown that the average duration of use is only about four point seven hours per night. And it’s enough to get them through the worst part of the night.

Are there any sleep disorders that are so serious or get to the point of needing medications?

One disease is narcolepsy and that’s a condition in which the boundary between wakefulness and REM sleep is blurred. And most people think of REM sleep, that’s when you do most of your dreaming. And people with narcolepsy for one thing they don’t sleep very well at night and they may when they are awake have this REM sleep intrude upon their wakefulness when they are laughing or angry. For some reason or another they start going into a partial REM sleep, when you are in REM sleep your muscles become limp and so they fall to the ground and their face droops and all. There’s medication that can prevent that.

Narcolepsy is a disease that we don’t really understand. They can’t find anything wrong with the brain and it’s probably an imbalance in neurotransmitters or something is not quite working right up there.

The least understood problem in sleep is what is sleep for. We can spend six to eight hours a night and we still don’t know what causes it, we still don’t know why. We know in animals if they don’t sleep they die. Nobody has ever done that with humans. But you feel bad and you don’t function well but we don’t know how that happens. We don’t know what the chemistry is, we just don’t understand it.

People do differ but there have been studies that if you take somebody who gets five hours, six hours sleep a night and you make him sleep eight hours a night when you do a test the next day they are not as sleepy. So there is some data that suggests that people do better with eight hours of sleep rather than with six. But there are people who function quite well and will only get six hours of sleep at night.

What about restless leg syndrome?

Restless legs is what happens during the day when you feel you have to keep your legs moving. And people who have that frequently have what’s called periodic limb movements during sleep. And it’s similar to what we all experience sometimes when we go to sleep, you’ll jerk and wake yourself up. Well some people do this all night long. Some people wake themselves up, some people jerk all night long and they don’t wake themselves up. And this is another disorder that is not completely understood. We have no idea-one of the interesting things about these jerks, these periodic limb movements is that they’re rhythmical. They occur generally every twenty to eighty seconds or so and it’s kind of like a clock. And we don’t know where the impulse generator for this is. We don’t know whether it’s in the brain or whether it’s in the spinal cord. There’s one doctor who thinks there’s something in the muscle that starts it and then the circuit goes up and around. And we just don’t know what causes it. That can be caused by certain drugs, by withdrawal from certain drugs and that is also a disease if it’s not caused by drugs, it can be treated by a drug.

What is yawning. Most vertebrate animals experience yawning and then it says it’s most common when we’re sleepy and bored. Scientists have not identified a function of yawning but at least in a human it does seem to be contagious since observers are likely to yawn when they spot someone else. They say in this sense yawning is a type of social behavior that is largely involuntary.

The most important thing about sleep disorders is that they are common, that they can interfere with people’s lives. They can cause automobile accidents, they can cause accidents on the job or they don’t even have to do that.

What are the three or five symptoms to look for if you think you have sleep apnea?

Loud snoring, gasping for breath, if somebody else is in bed with you they should look to see if you stop breathing, excessive daytime sleepiness, and presence of high blood pressure is suggestive. And also obesity, people who are overweight are more likely to have it than people who are not overweight. So those are the key things.

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