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Sleep Disorders

A sleep disorder includes difficulty falling asleep (insomnia), sleeping poorly, difficulty staying awake, falling asleep at inappropriate times (narcolepsy), sleeping too much (hypersomnia), and odd behaviors during sleep such as sleep walking or night terrors. Problems with sleep might last only a few days (transient), 2 to 3 weeks (short-term), or persist over months (chronic). Chronic sleep disorders can lead to poor performance during that day at work or school and lead to other health problems. You should see a doctor about a sleep disorder if it lasts more than a few weeks and interferes with daily living.

Insomnia

Insomnia describes difficulty falling asleep, staying asleep or waking early. It may be due to a variety of causes, such as physical illness, depression or anxiety, excessive caffeine use, alcohol, drugs, or as a side effect of certain medications. Insomnia is commonly due to a poor sleep environment with an uncomfortable bed or too much light, noise or movement. It may also result from habits that make it difficult for sleep to occur during regular sleep hours, such as taking daytime naps, going to bed too early or spending too much time in bed. Sometimes the sleep loss from insomnia leads to stress that can make sleep even more difficult to achieve.

Excessive Daytime Sleepiness

Excessive daytime sleepiness (EDS) may be due to a variety of causes, including narcolepsy, restless leg syndrome and sleep apnea. Sleep apnea should be suspected in people who snore loudly, wake frequently during the night and awake in the morning feeling unrefreshed. Excessive daytime sleepiness may occur when someone does not maintain a consistent sleep and wake schedule. This occurs when traveling between time zones (jet lag) and with shift workers on rotating schedules, such as nurses, pilots and night crews. Idiopathic hypersomnia is a term used when excessive sleepiness occurs without an identifiable cause.

Odd Behaviors During Sleep

Unusual behaviors during sleep are called parasomnias and are fairly common in children. They include sleep terrors and sleep walking.

Diagnosis

Most people are aware that they have a sleep disorder, but it is important to make a specific diagnosis to recommend an effective treatment plan. A medical exam and history are important for identifying any possible medical conditions causing sleep problems. The history will include details about the hours of sleep or wakefulness, details about one’s sleep environment, and medication use. A sleep diary can be helpful for tracking sleep patterns. Sleep studies may be ordered depending on the sleep disorder that is suggested by the history and medical exam. A polysomnogram (PSG) is one of the most commonly ordered sleep studies.

Treatment

The treatment your doctor recommends will depend upon the type of sleep disorder, its duration, its impact on your life, responses to past treatments and the existence of other medical conditions. Sleep medications may be recommended to help induce sleep for short periods of time. Commonly prescribed sleep medications include Ambien®, Lunesta®, Rozerem®, Sonata® and trazadone (Desyrel®). Overuse of sleep medications can create a dependency on sleep medications. Excessive daytime sleepiness may be treated with medication that helps to maintain wakefulness during the day, such as Provigil® and Nuvigil®. Some sleep disorders may go away without treatment.  Sleep hygiene measures (to correct contributory bad habits) are essential for all.  

Sleep Hygiene

The following steps can help establish quality sleep for anybody, and are important for treating sleep disorders.

  • Establish regular sleep habits, such as going to bed and waking at the same time every day.
  • Sleep in a quiet, comfortable room.
  • Exercise regularly, usually in the afternoons. 
  • Avoid caffeine or excessive alcohol consumption. 
  • Consider a nighttime snack high in tryptophan (an amino acid), such as a banana, cheese, turkey or milk.