What You Should Know About
Sleep Disorders
Nearly everyone has had a sleepless night. But for some, disrupted sleep is a constant problem that produces nagging and sometimes dangerous daytime effects. Many disorders can disrupt sleep, including insomnia, sleep apnea, narcolepsy, restless leg syndrome, periodic limb movement disorder, and circadian rhythm disorders.
Insomnia
Insomnia refers to the inability to fall asleep, stay asleep, or both. As a result, the affected person doesn't feel rested. Insomnia is the most common of all sleep-related complaints and may be the main symptom of several different sleep disorders.
Sleep Apnea
Sleep apnea is a condition in which the airway partially closes during sleep. Usually, this is related to the tongue and soft palate relaxing downward in the back of the throat. This obstruction can lead to loud snoring and episodes of blocked breathing that can occur hundreds of times each night. As a result, the affected person may feel tired, irritable, and less able to concentrate and remember during the day. The person's work may suffer, and the risk of accidents and mistakes may rise. In addition, sleep apnea is associated with hypertension, heart attack, and stroke. In children, sleep apnea may lead to hyperactivity and increased bed-wetting.
Eighteen million Americans have sleep apnea, but many don't even know it. Commonly, a family member brings it to the attention of a health care provider by complaining about the person's snoring or interrupted breathing pattern during sleep. Excess weight, alcohol, and sleeping pills raise the risk of sleep apnea.
Narcolepsy
A person with narcolepsy falls asleep at unusual times during the day for seconds or minutes at a time. These periods of sleep may occur while the person is doing almost anything - reading, watching television, even driving. Some people with narcolepsy have a sudden loss of muscle tone in the face or limbs in response to emotions, such as laughter, anger, or surprise.
Restless Leg Syndrome
This condition usually occurs when a person is lying in bed attemping to sleep. Affected people describe having a restless, uncomfortable feeling in their lower legs. Restless leg syndrome can make it very difficult for a person to fall asleep. Restless leg syndrome can run in families.
Periodic Limb Movement Disorder
In this disorder, the legs, arms, or both move during sleep, which may cause frequent, brief interruptions of sleep.
Circadian Rhythm Disorders
Normally, people have an internal 24-hour sleep/wake cycle referred to as circadian rhythm. It prompts people to fall asleep at night and to be wake during the day. A circadian rhythm disorder is suspected when someone has trouble falling asleep at typical sleeping times or is falling asleep at times when he/she should be awake. The internal clock of someone with circadian rhythm disorder may tell the person to fall asleep too early in the evening or too late at night.
Sleepwalking
Walking during sleep can occur in children who are usually between the ages of 4 and 8 years. It generally transpires during the first part of the night when the most "deep" sleep happens. Medical treatment is not usually necessary because most children "outgrow" it. However, measures to ensure safety during episodes should be taken such as securing window locks and doors, or installing an alarm to alert parents.
Sleep Terrors
This condition is typically described as a child awakening with a terrifying scream. Parents arrive to comfort the child only to find that he/she appears to be petrified, but not truly awake. After awakening, the child may be somewhat confused and has no memory of the event. Many children have occasional episodes which are attributed to "bad dreams." However, like sleepwalking, sleep terrors arise out of "deep" sleep and are not dream phenomena. They usually occur during the first part of the night and affect children between 4 and 12 years of age. Most children "outgrow" this condition and medical treatment is usually not required. Parents of children who have frequent sleep terrors should consult with their children's physician.
Bedwetting
Bedwetting occurs in 1/3 of all 4 year olds and even 5% of 10 year olds. It usually resolves with time although this should not minimize the potential for worry and social embarrassment on the part of parents and the child. Consultation with the child's physician is recommended if this is a persistent problem.
Headbanging and Bodyrocking
Some young children engage in rhythmic body motion during sleep onset such as hitting their heads on the side of their crib. While this is worrisome for parents, injuries are uncommon. This activity subsides as the child grows older and is uncommon after age 4. Consultation with the child's physician is recommended if this is a persistent problem.
Diagnosing a Sleep Disorder
If you think your child has a sleep disorder, your doctor will do a complete history and physical examination and may ask family members about his/her sleep habits. Based on this information, the doctor may then recommend a sleep study.
A sleep study is a painless test that monitors his/her sleep through the night. It's usually performed in a sleep lab, which is a specialized facility staffed by health care providers and sleep disorder specialists.
During a sleep study, his/her breathing, heart rate, oxygen level, eye movement, and brain waves are monitored. From this information, your child's doctor can determine whether his/her sleep is interrupted or inadequate. It also gives the doctor enough information to recommend treatment if he/she have a sleep problem.
Treatments and Tips
Treatment varies depending on which sleep disorder your child has. The doctor may prescribe a medication for him/her to take. If he/she has sleep apnea, a machine called CPAP that produces a continuous pressure inside the throat to help keep it open during sleep may be prescribed. Sleep apnea in children is frequently cured with removal of the tonsils and adenoids.
Treatment probably will also include a sleep hygiene plan to increase the likelihood of successful sleep. It may include regular exercise, maintaining a regular sleeping schedule, avoiding stimulants such as caffeine at bedtime, and avoiding large evening meals. Measures to establish a comfortable, quiet, dark sleeping environment also may be recommended.
Where to Get More Information
For more information, try these online resources.
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