National Sleep Foundation - Sleep Problems & Disorders en What are the Facts About Insomnia? <div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><p>Insomnia is a common sleep problem for adults. The National Institutes of Health estimates that roughly 30 percent of the general population complains of sleep disruption, and approximately 10 percent have associated symptoms of daytime functional impairment consistent with the diagnosis of insomnia.</p> <p>In a 2005 National Sleep Foundation (NSF) Poll, more than half of people reported at least one symptom of insomnia (difficulty falling asleep, waking up a lot during the night, waking up too early and not being able to get back to sleep, or waking up feeling un-refreshed) at least a few nights per week within the past year. Thirty-three percent said they had at least one of these symptoms every night or almost every night in the past year. The two most common symptoms, experienced at least a few nights a week in the past year, included waking up feeling unrefreshed and waking up a lot during the night. A 2002 NSF Poll found that 63 percent of women (versus 54 percent of men) experienced symptoms of insomnia at least a few nights per week.</p> <p> </p> <p>Other polls have found interesting trends associated with insomnia. For example, 68 percent of adults ages 18 to 29 report experiencing symptoms of insomnia, compared with 59 percent of adults ages 30 to 64, and only 44 percent of people over the age of 65. Not surprisingly, parents report more insomnia symptoms than adults without children in the household (66 vs. 54 percent).</p> <p><a href="/sites/default/files/info-insomnia_facts%20%281%29.jpg" title="Facts About Insomnia"><strong>View Larger &gt;&gt;</strong></a></p> <p><a href="/sites/default/files/info-insomnia_facts%20%281%29.jpg" title="Facts About Insomnia"><img src="/sites/default/files/info-insomnia_facts%20%281%29.jpg" alt="" width="125" height="183" style="margin: 4px; float: right;" class="image-popup" /></a></p> <!--young and hostile but not stupid--></div></div></div> Tue, 08 Jul 2014 17:34:32 +0000 admin 5697 at Non-24-Hour Sleep Wake Disorders <div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"></div></div></div> Tue, 07 May 2013 13:15:43 +0000 sleepfoundation 3401 at What causes RLS, is there a cure for RLS? <div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><p><strong>What causes RLS?</strong> In July of 2007, researchers discovered a gene variant for RLS, which helps explain why it may be traced through generations in families. Researchers believe this gene increases one’s risk for a type of hereditary RLS, known as primary or familial RLS. <strong>Is there a cure for RLS?</strong> There is currently no cure for RLS. However, in most cases RLS symptoms can be controlled through lifestyle changes, such as diet and exercise, and medical treatments as appropriate. People with RLS should speak with their health care professional to learn how to manage their RLS symptoms. To help you keep track of your symptoms and bridge the conversation about symptoms with your health care professional, click here to access the RLS Symptom Diary and RLS Symptom Diary Summary. Tracking and talking about your symptoms may help your health care professional make an accurate diagnosis and then help you develop a treatment plan that’s right for you. <strong>Who does RLS affect?</strong>RLS affects a range of people. In fact:</p> <ul> <li>Up to 10 percent of the U.S. adult population is affected by mild, moderate or severe symptoms of RLS, which often go undiagnosed or misdiagnosed.</li> <li>The average age of patients who begin to be affected by RLS is 46. A study of people living with RLS found that approximately 35 percent reported experiencing symptoms before the age of 20. Another study found that patients experienced symptoms before the age of 10.</li> <li>RLS is slightly more common in women than in men.</li> <li>RLS can affect people regardless of race/ethnicity.</li> <li>The severity of the condition increases as one ages; older patients experience symptoms more frequently and for longer periods of time.</li> <li>Sixty-three percent of people with RLS report that at least one family member lives with the condition.</li> </ul> <p><strong>Is there a difference between primary RLS and secondary RLS?</strong> There are two types of RLS, primary and secondary. Primary RLS, also known as idiopathic RLS, is the most common type of RLS5 and can be hereditary. Primary RLS has no known cause. Secondary RLS occurs as a result of an underlying medical condition or in association with the use of certain drugs. For example, some conditions that may cause secondary RLS include kidney failure, low levels of iron, anemia, pregnancy, and peripheral neuropathy. Stress, diet or other environmental factors may also play a role in the development of RLS. </p> </div></div></div> Tue, 13 Apr 2010 17:27:20 +0000 suzette gardner 2103 at What is restless legs syndrome (RLS)? <div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><p>RLS is a serious condition that has affected people for many years, but it has not always been taken seriously, and is often undiagnosed or misdiagnosed. Approximately 10 percent of American adults1 suffer from this neurological sensorimotor disorder, which causes uncomfortable and sometimes painful tingling, and tugging sensations in the legs. People with RLS often feel as though they have to move their legs, by walking or stretching, in order to make the uncomfortable feelings go away. These sensations tend to get worse with inactivity, sitting for a long time or even just relaxing, like when watching television or taking a long car ride. Because the symptoms usually intensify in the evening and at night, they often interfere with the ability to sleep. In July of 2007, researchers discovered a gene variant for RLS, which helps explain why it may be traced through generations in families. Researchers believe this gene increases one’s risk for a type of hereditary RLS, known as primary or familial RLS. There are two types of RLS – primary and secondary. And while there is extensive research into the origin of RLS being conducted worldwide, there is no single known cause for the condition.</p> <ul> <li><strong>Primary RLS</strong> is the most common type of RLS. It is also referred to as familial (because it is hereditary) or idiopathic (because the causes are unknown) RLS.</li> <li><strong>Secondary RLS</strong>, on the other hand, is believed to be caused by a separate underlying medical condition or in association with the use of certain drugs. For example, some of these conditions include kidney failure, low levels of iron or anemia, pregnancy, and peripheral neuropathy (a problem with the nerves that carry information to and from the brain and spinal cord that produces pain, loss of sensation, and inability to control muscles). Stress, diet or other environmental factors can also play a role in developing secondary RLS.</li> </ul> <p>RLS is a condition that can affect anyone; it does not discriminate among age, sex or race Symptoms can start at any age, and many people with RLS remember their first experience with RLS from childhood and being told they were just having "growing pains." RLS symptoms tend to get worse and occur more frequently with age, especially if they began in childhood or as a young adult. While there is currently no cure for RLS, in most cases, the symptoms can be controlled through lifestyle changes, such as diet and exercise, and in some cases medical treatments. People with RLS should speak with a health care professional about how to best manage their symptoms. Some people with RLS will not seek medical attention, believing that they will not be taken seriously, that their symptoms are too mild, or that the condition is not treatable. Some health care professionals inaccurately attribute the symptoms to nervousness, insomnia, stress, arthritis, muscle cramps or aging. Hopefully, the information and tools included on this site will help you and your health care professional have an informed conversation. </p> </div></div></div> Tue, 13 Apr 2010 16:03:39 +0000 suzette gardner 2097 at Teeth Grinding - Coping <div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><p>Tooth grinding at night is occasionally linked with daytime stress. To ease symptoms, try to relax in the hours before bedtime to reduce stress levels and to maintain a regular soothing bedtime routine. It is also important to create a sleep environment that is cool comfortable, dark, and quiet and to keep work-related items such as computers out of the bedroom. Tooth grinding during sleep may also be linked with back sleeping. Try side or stomach sleeping to ease symptoms. Finally, be sure to get adequate sleep and general physical exercise on a regular basis. Sleep deprivation may increase stress and exacerbate tooth grinding.</p> <p>If you or someone you are close to exhibits signs of bruxism it is important to address the symptoms and take action before <a href="" title="Consequences">permanent dental damage</a> occurs. If possible, seek an expert in <a href=""><span>dental sleep medicine</span></a>; otherwise, consult your dentist. For children, symptoms should also be discussed with a pediatrician. In addition to help from a dentist, adults may benefit by consulting a sleep specialist or those who can help teach stress reduction and relaxation techniques.</p> <!--HubSpot Call-to-Action Code --><p><span id="hs-cta-wrapper-03fd6313-4c76-4a0c-b5d8-a8f55b50b282" class="hs-cta-wrapper"> <span id="hs-cta-03fd6313-4c76-4a0c-b5d8-a8f55b50b282" class="hs-cta-node hs-cta-03fd6313-4c76-4a0c-b5d8-a8f55b50b282"> </p> <!--[if lte IE 8]><div id="hs-cta-ie-element"></div><![endif]--><p> <a href=""><img src="" style="border-width: 0px;" class="hs-cta-img" id="hs-cta-img-03fd6313-4c76-4a0c-b5d8-a8f55b50b282" /></a> </span>// </span></p> <!-- end HubSpot Call-to-Action Code --></div></div></div> Thu, 03 Dec 2009 18:35:20 +0000 Matthew 1979 at Teeth Grinding - Treatment <div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><p>Often, minimizing stress can <a href="" title="Treatment">alleviate</a> symptoms of sleep bruxism among adults and symptoms often disappear on their own in children. For severe and persistent bruxism, a dentist may prescribe an oral appliance made of soft plastic to protect the teeth. Self-directed therapies, such as jaw-aligning exercises, may also help.</p> <p>Reviewed by David G. Davila, MD (December 2009).</p> </div></div></div> Thu, 03 Dec 2009 18:33:11 +0000 Matthew 1978 at Teeth Grinding - Symptoms <div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><p><a href="" title="Etiology/Risk Factors">Symptoms</a> of sleep bruxism include:</p> <ul> <li>Worn down teeth</li> <li>Headaches</li> <li>Earaches</li> <li>Sore gums, teeth, jaw, and face</li> </ul> <p>The severity of these symptoms can vary. Some may experience interrupted sleep during the night. High stress levels and anxiety are linked to bruxism.</p> <p>Reviewed by David G. Davila, MD (December 2009).</p> </div></div></div> Thu, 03 Dec 2009 18:27:22 +0000 Matthew 1977 at Sleep Aids and Insomnia <div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><p>If you have trouble falling or staying asleep, or you wake up feeling unrefreshed, you may be suffering from <a href="" target="_blank" title="insomnia">insomnia</a>. Insomnia is a symptom. It may be caused by stress, anxiety, <a href="" target="_blank" title="depression">depression</a>, disease, pain, medications, sleep disorders or poor sleep habits. Your sleep environment and health habits may also play a role in your sleep problems.</p> <div id="TextSizeModify"> <p>Some medications can lead to insomnia as well. These include medications for cold and allergy (some <em>antihistamines</em> and <em>decongestants</em>, high blood pressure (<em>antihypertensives</em>), heart disease (<em>betablockers</em>), thyroid disease and birth control (<em>hormones</em>), as well as asthma and pain medications (containing caffeine).</p> <div class="m-video"> </div> <p>Some common sleep disorders can also cause poor sleep. These disorders range from <em><a href="" target="_blank" title="Restless Legs Syndrome&#9;">restless legs syndrome</a></em> (a creeping, crawling sensation in the legs only relieved by movement) to a bed partner's<a href=";" target="_blank" title="Sleep apnea"> <em>sleep apnea</em></a> (a breathing disorder with loud snoring and brief periods when breathing stops).</p> <p>Insomnia may be experienced for a few days, for two to three weeks, or it may be <em>chronic</em>, lasting for three weeks or more. Chronic insomnia is more difficult to treat, and doesn't go away on its own. You may need to see a physician or sleep specialist.</p> <p>Many people experience insomnia, particularly women before and at the onset of the menstrual cycle, during pregnancy and menopause.</p> <h2>POLL DATA:</h2> <ul> <li>Forty-eight percent of Americans report insomnia occasionally, while 22 percent experience insomnia every or almost every night.*</li> <li>Women are 1.3 times more likely to report insomnia than men.</li> <li>People over age 65 are 1.5 times more likely to complain of insomnia than younger people.</li> <li>Divorced, widowed and separated people report more insomnia.</li> </ul> <h2>SYMPTOMS:</h2> <p>Before you can treat insomnia, you need to identify its cause. Your doctor may ask about your mood. Are you depressed? Anxious? Under stress? Could your insomnia be caused by pain, medications, disruption in your life due to travel across time zones, or working non-traditional shifts? Could caffeine, alcohol, nicotine or spicy foods play a part in your difficulty sleeping? Questions you answer with a "no" may help point to a diagnosis of primary insomnia.</p> <p>Insomnia can have a very serious impact on quality of life, productivity and safety:</p> <ul> <li>People with insomnia are four times as likely to suffer from depression than people who sleep well.</li> <li>Lack of sleep due to insomnia may contribute to illness, including heart disease.</li> <li>Safety on the job, at home, and on the road may be affected by sleepiness.</li> <li>People with insomnia may miss more time from work or receive fewer promotions.</li> <li>After a poor night's sleep, many people report accomplishing fewer daily tasks and enjoying activities less.</li> </ul> <h2>COSTS:</h2> <p>While individual suffering is hard to measure, researchers can estimate specific direct and indirect costs to the nation. Direct costs include dollars spent on insomnia treatments, healthcare services, hospital and nursing home care. The most recent annual estimate of the direct costs of insomnia is nearly $14 billion!</p> <p>Indirect costs - such as work loss, property damage from accidents, and transportation to and from healthcare providers - are estimated at double the direct costs near $28 billion. One conservative report places total costs at up to $35 billion. (A National Sleep Foundation 1997 survey calculated that lost productivity alone from insomnia topped $18 billion!)</p> <h2>TREATMENT:</h2> <p>Treating insomnia with medication is the most common treatment for these sleep problems. Twenty-five percent of Americans take some type of medication every year to help them sleep.</p> <p>Medications may be taken when:</p> <ul> <li>The cause of insomnia has been identified and is best treated with medication.</li> <li>Sleep difficulties cause problems in accomplishing daily activities.</li> <li>Behavioral approaches have proven ineffective and the person is unwilling to try them.</li> <li>A person is suffering insomnia-related distress and beginning behavioral therapy.</li> <li>Insomnia is temporary or short-term.</li> <li>Insomnia is expected or occurs in association with a known medical or biological condition (e.g. <em>Premenstrual Syndrome</em>) or an event such as giving a speech or traveling across time zones.</li> </ul> <h2>GUIDELINES:</h2> <p>Treatment with medications should:</p> <ul> <li>begin with the lowest possible effective dose</li> <li>be short-term, if used nightly</li> <li>be intermittent, if used long-term</li> <li>be used only in combination with good sleep practices and/or behavioral approaches</li> </ul> <p>Prescription medications that promote sleep are called <em>hypnotics</em>. These are the most effective sleep aids available.</p> <p>The particular medication prescribed to treat insomnia should depend on a patient's diagnosis, medical condition, use of alcohol or other drugs, age, and need to function when awakened during the usual sleep period. If the cause of the sleep problem is depression, an <em>antidepressant</em> may be the best solution. Anti-anxiety drugs (anxiolytics) are prescribed if anxiety is related to insomnia.</p> <p>Note: Some antidepressants cause insomnia, so patients should be sure to discuss their sleep problems with their doctor. Also, some antidepressants (the <em>tricyclics</em>) may worsen <em>restless legs syndrome</em> and periodic limb movements (characterized by jerking legs during sleep).</p> <p>Increasingly, some sedating antidepressants have been prescribed in low doses for insomnia. However, many experts believe that in the absence of clinical depression, there is little evidence to support the use of these drugs for insomnia.</p> <p>Among the prescription hypnotic drugs, a group of hypnotics called <em>benzodiazepine agonists</em> were developed in the l960's. These sleep-promoting drugs have since proven effective and safe. Benzodiazepine agonists can be either <em>benzodiazepines</em> or <em>nonbenzodiazepines</em>; each has a different chemical structure. All hypnotics induce and maintain sleep. The benzodiazepines agonists work by acting at areas in the brain believed to be involved in sleep promotion. They are the drugs of choice because they have the highest benefit and the lowest risk as sleep-promoting drugs.</p> <p>Hypnotics differ by <em>half-life</em> as well as chemical structure. Half-life refers to how long a drug is active in the body. Drugs that have a shorter half-life are effective in the body for a shorter time. Shorter half-lives are usually preferred so that daytime functioning is not impaired the next day or after waking. The benzodiazepine <em>triazolam</em> has a short half-life, as do the non-benzodiazepines <em>zolpidem</em> and <em>zaleplon</em>.</p> <p>Hypnotics also differ in the dose range over which they are effective. Scientists have established the effective dose range for each hypnotic. Dose becomes a problem when higher doses than those established as effective are used. Use of high doses increases the risk of <em>rebound insomnia</em>. Rebound insomnia occurs when a person stops taking the medication and experiences one or two nights of insomnia that is worse than they experienced before treatment. It only occurs with short half-life hypnotics and can be avoided by gradually tapering the dose. Consult your physician before increasing your dose or stopping high dose treatment.</p> <p>Studies have examined data on the effectiveness of hypnotics and have concluded that they are effective and reliable for:</p> <ul> <li>shortening the time it takes to fall asleep</li> <li>increasing total sleep time</li> <li>decreasing the number of awakenings</li> <li>improving sleep quality</li> </ul> <p>This conclusion is based on studies of short-term use of hypnotics at appropriate doses in comparison with a placebo or sugar pill. Some studies demonstrate little decrease in the effectiveness of hypnotics over the course of months.</p> <p>The length of treatment depends on various circumstances:</p> <ul> <li>Accepted insomnia guidelines call for short-term treatment, but long-term use of sleep aids is not uncommon.</li> <li>Four weeks is the recommended limit.</li> <li><em>Not</em> prescribing hypnotics may cause unnecessary patient distress, particularly when the person does well on the same dose and has <em>no</em> side effects.</li> <li>Still, most sleep specialists share the belief that sleep aids shouldn't be a long-term answer to poor sleep for most people who have trouble sleeping.</li> </ul> <p>More studies are needed on long-term effects of the use of sleep aids.</p> <p>All individuals who take sleep aids need to also focus on improving their sleep practices. The sedating or calming effects of hypnotics may lead to falls for those awakening at night. Hypnotics may also increase the risk of sleepwalking in some people.</p> <p>One study also found a higher risk for car accidents in older adults taking long-acting sleeping medications, particularly during the first week of use.</p> <p>Moreover, many persons taking hypnotics need to understand that sleep aids should be gradually decreased rather than stopped all at once. Without gradual tapering, stopping hypnotic use may cause insomnia to come back. Individuals should work with their doctors to discontinue medication gradually.</p> <p>People at risk while taking hypnotics include:</p> <ul> <li>Individuals who drink alcohol. <em>Why?</em> The two drugs taken together intensify the action of both.</li> <li>The elderly, and anyone who needs to get up during the night. <em>Why?</em> The sedating effects of hypnotics increase the risk for falls. Doses should be lower for the elderly.</li> <li>Those who have to operate machinery soon after awakening. <em>Why?</em> In medications with long half-lives, the risk of accidents may be increased.</li> <li>People who have <em>sleep apnea</em>. <em>Why?</em> Breathing may be further impaired.</li> </ul> <p>While many people worry about prescription sleep aids, believing them to be addictive (or habit-forming), researchers offer a reassuring picture. Studies show that people with insomnia don't tend to abuse sleep aids. They don't tend to take higher doses than prescribed.</p> <p>Negative effects or abuses tend to be linked to excessive doses or to individuals who abuse other drugs or alcohol. Side effects of prescription sleep aids are related to the person's age, dose and half-life. Selecting the proper dose is especially important for older people. When hypnotics stay in the body longer, they remain active and can cause daytime sleepiness or forgetfulness.</p> <p>Younger people can be at risk for side effects too. People who use higher doses and hypnotics with longer half-lives tend to experience more side effects. To avoid these side effects, sleep specialists often advise the use of hypnotics with short half-lives. Any change in dosage should be discussed with your doctor.</p> <p>Many people use sleep medications that are available without a prescription. These sleep aids are available "over-the-counter" (OTC) because they have been found to be safe when used according to their directions. However, OTC sleep aids may be less effective and they may have been subjected to less rigorous testing. Many non-prescription sleep products include <em>antihistamines</em>. These substances are designed to block chemicals released during a cold or allergy attack, not to promote sleep. However, many have sedating (calming) effects. Some OTC sleep aids may also include pain relievers.</p> <p>As with hypnotics, OTC sleep aids should <em>no</em>t be used by individuals who are also taking alcohol or other drugs with sedating effects. Older persons should be cautious about these drugs because of their slower metabolisms. Drugs stay in the body longer and can then cause daytime sleepiness. In addition, OTC sleep aids should be avoided by people with breathing problems, glaucoma, chronic bronchitis, and difficulty urinating because of an enlarged prostate gland, or women who are pregnant or nursing.</p> <p>Other products sold to promote sleep include:</p> <ul> <li><em>valerian</em> (a root that may be steeped in hot water for tea)</li> <li><em><a href="" target="_blank" title="Malatonin&#9;">melatonin</a></em> (an artificial or animal form of a substance produced by humans that is linked to sleep)</li> </ul> <p>Herbal products and nutritional supplements (such as melatonin) are not required to undergo the same rigorous testing as drugs do in order to meet government standards. Their long-term impact, side effects and possible interactions with other drugs or medical conditions are often not known. More research is needed.</p> <h2>OTHER TYPES OF TREATMENT:</h2> <p>Fortunately, sleep specialists have devised a variety of approaches for treating insomnia. <em>Behavioral</em> approaches involve actions you can take. Medication may help you sleep as you try these sleep-friendly practices. Combining behavioral and medical approaches works well for many people.</p> <p>Behavioral approaches range from limiting the time spent in bed to making a stronger mental connection between bed and sleep. This latter approach is called <em>stimulus control</em>. Studies suggest that these two strategies are the most effective behavioral approaches.</p> <p>Stimulus control focuses on the association between your bed and sleep. Do you find yourself balancing a checkbook or writing a letter in bed? In this way you link bedtime with alerting activities rather than sleeping. The stimulus control approach helps you think more about your bed as a place for sleeping.</p> <p>Also, put relaxation back in your bedroom by using your bed only for sleep and sex, getting in bed only when you're tired, and getting <em>out</em> of bed if you don't fall asleep within 15 minutes. Try a relaxing activity.</p> <p>A sleep specialist may help you use stimulus control and sleep restriction strategies properly.</p> <p>If you suffer from insomnia, consider the following guidelines for better sleep:</p> <ul> <li>Exercise regularly, about six hours before you want to sleep.</li> <li>Avoid napping.</li> <li>Go to sleep and wake at the same time every day.</li> <li>Save your worries for daytime. (If concerns come to mind in bed, write them down in a "worry" book, then close the book until the morning).</li> <li>Select a relaxing bedtime ritual, like a hot bath or listening to calming music.</li> </ul> <p>If sleep problems persist, it may be time to seek professional help. Your doctor can help determine how to treat your problem and may refer you to a sleep specialist.</p> <p><strong>Reviewers:</strong></p> <p>J. Christian Gillin, MD; Timothy Roehrs, PhD; and Thomas Roth, PhD.</p> </div> </div></div></div> Fri, 17 Apr 2009 20:50:46 +0000 admin 71 at Sleep Apnea and Sleep <div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><p>Obstructive sleep apnea is a disorder in which breathing is briefly and repeatedly interrupted during sleep. The "apnea" in sleep apnea refers to a breathing pause that lasts at least ten seconds. Obstructive sleep apnea occurs when the muscles in the back of the throat fail to keep the airway open, despite efforts to breathe. Another form of sleep apnea is central sleep apnea, in which the brain fails to properly control breathing during sleep. Obstructive sleep apnea is far more common than central sleep apnea.</p> <p>Obstructive sleep apnea, or simply sleep apnea, can cause fragmented sleep and low blood oxygen levels. For people with sleep apnea, the combination of disturbed sleep and oxygen starvation may lead to hypertension, <a href=";" target="_blank" title="Heart disease&#9;">heart disease</a> and mood and memory problems. Sleep apnea also increases the risk of <a href=";" target="_blank" title="Drowsy driving">drowsy driving</a>. Sleep apnea can be life-threatening and you should consult your doctor immediately if you feel you may suffer from it.</p> <p>More than 18 million American adults have sleep apnea. It is very difficult at present to estimate the prevalence of childhood OSA because of widely varying monitoring techniques, but a minimum prevalence of 2 to 3% is likely, with prevalence as high as 10 to 20% in habitually snoring children. OSA occurs in all age groups and both sexes, but there are a number of factors that increase risk, including having a small upper airway (or large tongue, tonsils or uvula), being overweight, having a recessed chin, small jaw or a large overbite, a large neck size (17 inches or greater in a man, or 16 inches or greater in a woman), smoking and alcohol use, being age 40 or older, and ethnicity (African-Americans, Pacific-Islanders and Hispanics). Also, OSA seems to run in some families, suggesting a possible genetic basis.</p> <h2>SYMPTOMS:</h2> <p>Chronic <a href=";" target="_blank" title="Snoring&#9;">snoring</a> is a strong indicator of sleep apnea and should be evaluated by a health professional. Since people with sleep apnea tend to be sleep deprived, they may suffer from sleeplessness and a wide range of other symptoms such as difficulty concentrating, depression, irritability, sexual dysfunction, learning and memory difficulties, and falling asleep while at work, on the phone, or driving. Left untreated, symptoms of sleep apnea can include disturbed sleep, excessive sleepiness during the day, high blood pressure, heart attack, congestive heart failure, cardiac arrhythmia, stroke or depression.</p> <h2>TREATMENT:</h2> <p>If you suspect you may have sleep apnea, the first thing to do is see your doctor. Bring with you a record of your sleep, fatigue levels throughout the day, and any other symptoms you might be having. Ask your bed partner if he or she notices that you snore heavily, choke, gasp, or stop breathing during sleep. Be sure to take an updated list of medications, including over the counter medications, with you any time you visit a doctor for the first time. You may want to call your medical insurance provider to find out if a referral is needed for a visit to a sleep center.</p> <p>One of the most common methods used to diagnose sleep apnea is a <a href=";" target="_blank" title="sleep study&#9;">sleep study</a>, which may require an overnight stay at a sleep center. The sleep study monitors a variety of functions during sleep including sleep state, eye movement, muscle activity, heart rate, respiratory effort, airflow, and blood oxygen levels. This test is used both to diagnose sleep apnea and to determine its severity. Sometimes, treatment can be started during the first night in the sleep center.</p> <p>The treatment of choice for obstructive sleep apnea is continuous positive airway pressure device (<a href=";" target="_blank" title="CPAP&#9;">CPAP</a>). CPAP is a mask that fits over the nose and/or mouth, and gently blows air into the airway to help keep it open during sleep. This method of treatment is highly effective. Using the CPAP as recommended by your doctor is very important.</p> <p>Second-line methods of treating sleep apnea include dental appliances, which reposition the lower jaw and tongue, and upper airway surgery to remove tissue in the airway. In general, these approaches are most helpful for mild disease or heavy snoring.</p> <p>Lifestyle changes are effective ways of mitigating symptoms of sleep apnea. Here are some tips that may help reduce apnea severity:</p> <ul> <li>Lose weight. If you are overweight, this is the most important action you can take to cure your sleep apnea (CPAP only treats it; weight loss can cure it in the overweight person).</li> <li>Avoid alcohol; it causes frequent nighttime awakenings, and makes the upper airway breathing muscles relax.</li> <li>Quit smoking. Cigarette smoking worsens swelling in the upper airway, making apnea (and snoring) worse.</li> <li>Some patients with mild sleep apnea or heavy snoring have fewer breathing problems when they are lying on their sides instead of their backs.</li> </ul> <h2>COPING:</h2> <p class="sleep-bg">The most important part of treatment for people with OSA is using the CPAP whenever they sleep. The health benefits of this therapy can be enormous, but only if used correctly. If you are having problems adjusting your CPAP or you're experiencing side effects of wearing the appliance, talk to the doctor who prescribed it and ask for assistance.</p> <p>Getting adequate sleep is essential to maintaining health in OSA patients. If you have symptoms of insomnia such as difficulty falling asleep, staying asleep, or waking up unrefreshed, talk to your doctor about treatment options. Keep in mind that certain store-purchased and prescription sleep aids may impair breathing in OSA patients. One exception is ramelteon, which was studied in mild and moderate OSA patients and found to not harm their breathing.</p> <h2>POLL DATA:</h2> <p>In the 2005 <em>Sleep in America</em> poll, 8% of respondents experienced or had been observed having pauses in their breathing during sleep at least three nights per week. Adults in the poll were also given the Berlin questionnaire, a standardized test assessing risk for sleep apnea. Based on the quetionnaire, 26% of all poll respondents were at risk. Of those at risk, 70% said that they snored, slept on average 6.4 hours/weeknight (compared to overall mean of 6.8 hours); 66% were experiencing daytime sleepiness at least 3 days per week and over half (58%) were obese. Of adults in this population who had been diagnosed with high blood pressure or depression, almost half were also at risk for sleep apnea. 33% of those who drink 4 or more caffeinated beverages daily are designated at risk for sleep apnea.</p> <p>Reviewed by Barbara Phillips, M.D., M.S.P.H.</p> </div></div></div> Fri, 17 Apr 2009 20:49:15 +0000 admin 67 at Frequent Urination at Night <div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><p>A frequent need to get up and go to the bathroom to urinate at night is called nocturia. It differs from enuresis, or <a href="" target="_blank" title="bedwetting">bedwetting</a>, in which the person does not arouse from sleep, but the bladder empties anyway. Nocturia is a common cause of sleep loss, especially among older adults. In fact, nearly two-thirds (65%) of those responding to NSF's 2003 <em>Sleep in America</em> poll of adults between the ages of 55 and 84 reported this disturbance at least a few nights per week.</p> <p>Most people without nocturia can sleep for 6 to 8 hours without having to urinate. Some researchers believe that one event per night is within normal limits; two or more events per night may be associated with daytime tiredness. Patients with severe nocturia may get up five or six times during the night to go to the bathroom.</p> <p>Nocturia is often a symptom of other medical conditions including urological infection, a tumor of the bladder or prostate, a condition called bladder prolapse, or disorders affecting sphincter control. It is also common in people with heart failure, liver failure, poorly controlled diabetes mellitus, or diabetes insipidus. Diabetes, pregnancy and diuretic medications are also associated with nocturia.</p> <p>Until recently, nocturia was thought to be caused by a full bladder, but it is also a symptom of <a href="" target="_blank" title="sleep apnea">sleep apnea</a>. According to Michael J. Thorpy, MD, and Jan Yager, PhD, authors of <em>The Encyclopedia of Sleep and Sleep Disorders</em>, relief of the sleep apnea syndrome will alleviate the nocturia.</p> <p>Nocturia becomes more common as we age. As we get older, our bodies produce less of an anti-diuretic hormone that enables us to retain fluid. With decreased concentrations of this hormone, we produce more urine at night. Another reason for nocturia among the elderly is that the bladder tends to lose holding capacity as we age. Finally, older people are more likely to suffer from medical problems that may have an effect on the bladder.</p> <h2>SYMPTOMS:</h2> <p>Nocturia or frequent nighttime urination may occur only occasionally or nightly. Symptoms of nocturia include excessive urination (need to urinate too much fluid), frequent urination (too many visits to the bathroom for various reasons), urinary urgency (need to urinate sometimes without much result), or reduced urine. Nocturia may result when a person's normal "body clock" allows for daytime urination pattern to occur at night. Sometimes, nocturia may simply be the result of drinking too many fluids, especially <a href="" target="_blank" title="caffeine">caffeine</a>, before going to bed.</p> <h2>TREATMENT:</h2> <p>If you are experiencing nocturia, consult your doctor as soon as possible and follow his or her recommended therapy. It may be helpful to keep a diary of times and amounts of urine voided to bring with you to the doctor. Also, bring a record of your sleep habits as well as any daytime <a href="" target="_blank" title="fatigue">fatigue</a> you may be experiencing. After an initial evaluation, your doctor may prescribe medications, diagnostic testing such as urinalysis, cystometry (a measurement of the pressure within the bladder), neurological tests (for some urgency problems), or ultrasound, or refer you to a sleep center for testing.</p> <h2>COPING:</h2> <p>Drink your normal amount of liquid but do so earlier in the day. Cut down on any drinks in the last two hours before you go to bed - especially alcohol, coffee or tea as these stimulate urine production. Keep a diary of how much you drink, what you drink, and when. This may be helpful in identifying situations which may make the nocturia worse. While there is limited scientific research and no proof of their effectiveness, some people believe that homeopathic medicines, hypnosis or acupuncture can be beneficial. Be sure to seek advice from a trained practitioner.</p> <h2>POLL DATA:</h2> <p>In the 2003 <em>Sleep in America</em> poll, 65% of adults age 55-84 report the need to get up to go to the bathroom a few nights a week or more (53% every or almost every night).</p> <p>Reviewed By:</p> <p><strong>Donald L. Bliwise, PhD</strong></p> <p>Professor of Neurology at Emory University Medical School in Atlanta, Georgia. He serves as Director of the Program in Sleep, Aging and Chronobiology in the Department of Neurology and as a Professor at the Nell Hodgson Woodruff School of Nursing at Emory University. His specific area of interest has been the description, elucidation of pathophysiology, and treatment of sleep disorders in the aged, with special interest in sleep in neurodegenerative conditions such as Alzheimer's disease and Parkinson’s disease.</p> </div></div></div> Fri, 17 Apr 2009 20:48:54 +0000 admin 66 at