Sleep Disorders
Types of Sleep Disorders
If you think you might be suffering from a sleep disorder, you’re not alone. Sleep disorders are more common than you think. In the United States alone, there are more than 40 million people suffering from a sleep disorder—meaning 1 in 8 of us isn’t able to get the sleep we need.
Snoring and sleep apnea are not the only sleep disorders that prevent people from getting a solid night’s sleep. In fact, there are over 100 different types of sleep disorders—ranging from trouble falling asleep at night to excessive daytime sleepiness—that make it impossible to wake up feeling refreshed.
Snoring
Snoring affects approximately 45% of normal American adults making it both a social and a medical problem. It can be disruptive to family life, frequently forcing partners to sleep separately, and preventing the snorer (and their partner) from getting a good night’s sleep. As snorers tend to have poor quality sleep, they are at risk for reduced daytime alertness, mood swings and other effects of sleep deprivation. In its most severe form, snoring can be an indicator of obstructive sleep apnea, or OSA.
Snoring sounds are caused when there is an obstruction to the free flow of air through the passages at the back of the mouth and nose. It is possible for anyone to snore, although snoring is more frequent in men and overweight persons, and usually becomes more pronounced with age. Common causes of snoring include:
- Throat weakness or relaxation (which could be caused by alcohol or drugs)
- Obesity
- Jaw misalignment
- An obstruction in the nasal passageway
Find Out if You Snore: To find out if you snore, our sleep doctors will likely recommend a Polysomnography (PSG). This test will record snoring, and determine whether it is preventing you from achieving a restful sleep. Insurance plans may not cover a sleep study for snoring alone, but our team is able to work with you to determine what your coverage includes.
Sleep Apnea
Sleep apnea is defined as the cessation of breath or periods of shallow breathing during sleep. There are three different types of apnea: obstructive, central, and mixed. People with severe cases of this disorder may cease breathing hundreds of times a night, constantly signalling to their brain to wake them and preventing them from achieving the deep sleep they need as part of a healthy and restorative sleep cycle. Sufferers of sleep apnea wake up in the morning feeling tired or unrefreshed, even if they have had a full night of sleep.
If you snore, wake up with headaches, suffer from daytime sleepiness and have reduced energy, it is possible you might have sleep apnea. Other warning signs include feeling fatigued, have difficulty concentrating or even unintentionally falling asleep during the day. The lack of oxygen your body receives can have negative long-term consequences for your health, including high blood pressure, heart disease, stroke, pre-diabetes and diabetes, and depression.
There are many people with sleep apnea who have not been diagnosed or received treatment—an estimated 20 million people in America suffer from sleep apnea, and up to 93% of women and 82% of men with moderate-to-severe sleep apnea are still undiagnosed.
Find Out if You Have Sleep Apnea: In most cases, our sleep specialists will recommend a Polysomnography (PSG) in-center test in one our comfortable, well-appointed facilities throughout Southern California. Another common option is an in-home test (HST). Both are used to diagnose or rule out sleep apnea. A split night study may also be ordered to both diagnose and treat sleep apnea in the same night, if possible.
Obstructive Sleep Apnea
Obstructive sleep apnea is a common and serious type of sleep disorder that causes you to stop breathing during sleep, and is the most commonly diagnosed form of sleep apnea. The airway repeatedly becomes blocked, limiting the amount of air that reaches your lungs. When this happens, you may snore loudly or make choking noises as you try to breathe. Your brain and body become oxygen deprived and you might wake up. This may happen a few times a night, or in more severe cases, several hundred times a night. Each apnea event prevents you from sinking into the deeper stages of sleep that are crucial to feeling rested.
In many cases, an apnea, or temporary pause in breathing, is caused by the tissue in the back of the throat collapsing. The muscles of the upper airway relax when you fall asleep. If you sleep on your back, gravity can cause the tongue to fall back. This narrows the airway, reducing the amount of air that reaches your lungs. The narrowed airway can also cause snoring by making the tissue in back of the throat vibrate as you breathe.
OSA can affect all age groups, men and women alike, although it is most common in overweight men. Obstructive sleep apnea in adults is considered a sleep-related breathing disorder, and causes and symptoms of OSA differing in children. If left untreated, sleep apnea can lead to serious consequences, including reduced cognitive function, increased risk of being in an accident, and even making diabetes and heart disease worse. Approximately 38,000 people die annually from the many resulting complications of this type of sleep disorder, but effective diagnosis and treatment is available.
Find Out if You Have OSA: To diagnose OSA, our sleep specialists typically order a polysomnography (PSG) to diagnose or rule out sleep apnea. You can have your PSG in-center or in-home. In some cases, your sleep doctor may recommend a split night study to both diagnose and treat sleep apnea in the same night.
Central Sleep Apnea
Central sleep apnea is a type of breathing disorder that causes your body to decrease or stop the effort of breathing during sleep due to a problem in the brain or heart. This occurs in an off-and-on cycle, and it is different from obstructive sleep apnea (OSA) as the problem is not caused by a blockage of the airway.
The brain and heart normally interact to direct, monitor, and change the amount of air that we breathe. For sufferers of CSA, the brain and heart move an abnormal amount of air into the lungs. CSA syndromes in adults are divided into these five categories:
Primary Central Sleep Apnea: The breathing pattern consists of the repetitive absence of breathing effort and air flow, and the cause is unknown.
Cheyne-Stokes Breathing Pattern: The breathing pattern consists of a rhythmic increase and decrease of the breathing effort and the amount of air flow, usually due to heart failure, stroke, and possibly kidney failure.
Medical Condition Not Cheyne-Stokes: CSA caused by medical conditions, but without the typical Cheyne-Stokes breathing pattern. It is caused by heart and kidney problems. It may also result from a problem in the base of the brain where breathing is controlled.
High-Altitude Periodic Breathing: The breathing pattern is similar to the Cheyne-Stokes Breathing Pattern although the cycle time is shorter, and is caused by sleeping at altitudes higher than about 15,000 feet. The difference in this case is that there is no history of heart failure, stroke, or kidney failure.
Due to Drug or Substance: Breathing may stop completely or increase and decrease in a regular pattern. In some cases, breathing is quite irregular. CSA in this case is caused by the use of drugs, mainly pain medicines in the opioid category. It can even have the elements of obstruction in breathing that is seen in sufferers of OSA.
Source: American Academy of Sleep Medicine
Find Out if You Have CSA: To determine whether you have CSA, a physician may order a Polysomnography (PSG) which you can take either in-center or at home. Where possible a split night study or second night titration with a variable setting PAP device may also be ordered.
Insomnia
The inability to fall asleep or stay asleep is called insomnia. Insomnia, in its chronic form, can last for weeks, months, or even years. It may be related to worry, anxiety, depression, medical/psychiatric problems, or substance abuse. Insomnia is a symptom of a wider issue and in order to treat it, physicians must first find the underlying cause. Most insomnia sufferers sleep better after the appropriate evaluation and treatment.
Find Out if You Have Insomnia: To diagnose or rule out whether sleep apnea may be a cause of insomnia, our sleep specialists will likely order an in-center or in-home polysomnography (PSG).
Narcolepsy
Narcolepsy is a sleep disorder that involves the body’s central nervous system and is characterized by uncontrollable attacks of sleep. A person with narcolepsy is likely to fall asleep at inappropriate times and places. Daytime sleep attacks may occur with or without warning and can occur repeatedly in a single day. Nighttime sleep may be fragmented with frequent arousals. While there is not yet a cure, recent technology and pharmacology has allowed those with this sleep disorder to live normal lives.
Find Out if You Have Narcolepsy: Polysomnography (PSG) in-center followed by multiple sleep latency testing (MSLT) may be ordered to diagnose or rule out suspected cases of narcolepsy.
Restless Leg Syndrome
RLS is often described as a “creepy, crawly” feeling in the legs when they are still, and is particularly common at bedtime. Stretching or moving the legs temporarily relieves these feelings; however the constant need to move the legs to get rid of the discomfort often prevents the person from falling asleep, resulting in daytime sleepiness. Roughly 5 to 10% of people experience the pain of RLS at some point in their lives. RLS can occur at any age but is more common in the elderly, and approximately 30% of RLS cases have a hereditary link. If you are suffering from RLS, there are effective diagnoses and treatments available to help you enjoy restful sleep again.
Find Out if You Have Restless Leg Syndrome: Our sleep specialists will likely order an in-center polysomnography (PSG) to measure leg movements throughout the night and diagnose RLS.
Periodic Leg Movement Disorder
PLMD refers to involuntary movements of the legs and arms during sleep. These movements cause arousals and sleep disturbances, preventing sufferers from reaching the deep sleep they need to feel rested. PLMD is more common in people who have kidney disease or narcolepsy, and individuals with PLMD may also experience Restless Legs Syndrome (RLS).
Find Out if You Have Periodic Leg Movement Disorder: To measure leg movements and arousals caused by leg movements throughout the night and diagnose PLMD, our sleep specialists might recommend an in-center polysomnography (PSG).
Parasomnias
Parasomnia refers to a variety of disruptive sleep-related events that interrupt sleep and can lead to injury or disturbance of the sufferer or others in the bed or house. Parasomnias are relatively uncommon but can be effectively diagnosed and treated in most cases. Parasomnias include:
Sleepwalking: Sleepwalking is a temporary sleep mechanism malfunction that occurs during deeper stages of sleep. It can be linked to anxiety or fatigue and tends to run in families. Sleepwalking affects up to a quarter of children and tends to go away after puberty, with only 4% of adults experiencing this type of disorder. People who sleepwalk do not remember their nocturnal walk the next day.
Sleep Talking: Sleep talking is generally harmless and usually temporary. It is most commonly brought on by illness or stress. Sleep talking can sometimes be associated with sleep apnea or night terrors. As with many sleep disorders, the sleeper has no memory of sleep talking.
Night Terrors: Night terrors are more common in children and typically do not continue into adulthood, although they are prevalent in people who suffer from post-traumatic stress disorder (P.T.S.D.). Night terrors usually happen during Stage 3 NREM sleep, and are marked by a sudden awakening with intense physical feelings of fear and panic. Events can last about 15 minutes, after which the person goes back to sleep and (in most cases) forgets it happened.
REM Movement Disorder: In this type of disorder, the paralysis that normally occurs during REM sleep is incomplete or absent, allowing the sleeper to act out their dreams. This disorder is most common in men and can lead to violent behavior or injuries.
Find Out if You Have Parasomnia: To diagnose whether you are suffering from a parasomnia sleep disorder, our sleep specialists will recommend an in-center polysomnography (PSG) to record your sleep behaviors throughout the night.
Circadian Rhythm Disorders
Circadian rhythms are the body’s 24-hour internal clock that govern feeling alert during the day and sleepy at night. Circadian Rhythm Disorders refer to either a temporary or chronic disruption in a person’s sleep-wake cycle. People who suffer from these disorders are unable to properly time their sleeping periods because their body clock is not aligned with the time of day. These disorders can result in either insomnia or excessive sleepiness, difficulty functioning at work or school, and social impairment. Some common types of Circadian Rhythm Disorders include:
Shift Work Disorder: This affects people who work unusual or irregular hours, and in particular, people who work night shifts. Disrupted sleep patterns can result in excessive sleepiness, lack of concentration, and several other problems.
Delayed/Advanced Sleep Phase Disorder: This type of sleep disorder is when a person’s sleep pattern either becomes consistently shifted backward (going to bed in the middle of the night and waking up very late or even in the afternoon) or forward (going to bed early in the evening and waking up in the early morning).
Non-24-Hour Sleep-Wake Disorder: This disorder occurs when the body’s internal clock runs on a cycle of more than 24 hours, so that sleep—and the period of peak alertness—becomes shifted further and further back each day.
Irregular Sleep-Wake Disorder: In this case, sufferers experience periods of sleeping and wakefulness that are irregularly spaced, often occurring at least twice per day.
Jet Lag: The disruption in sleep patterns that occurs when traveling across time zones is an example of a circadian rhythm disruption.
Find Out if You Have Circadian Rhythm Disorders: Since Circadian Rhythm Disorders primarily identify when sleep is occurring, as opposed to the quality of the sleep itself, they are not possible to diagnose with a sleep study alone.
Identifying such a disorder requires a consultation with a sleep specialist. Using a sleep log or motion-tracking (actigraphy) can help identify irregular sleep patterns.
Do any of these types of sleep disorders sound familiar? If you are suffering from any of these symptoms, request your sleep study today!