Sleep Apnea

Sleep Apnea

Sleep apnea is a condition in which you stop breathing while asleep. With sleep apnea, your breathing while you are asleep apnea include: obstructive sleep apnea, which as apneic events. The types of sleep apnea can include: obstructive sleep apnea, which is the most common form of sleep apnea; central sleep apnea; and mixed sleep apnea, which combines the two other types. Sleep apnea, it can cause serious health problems. It can increase the risk of stroke, diabetes, obesity, heart attack, heart failure, irregular heartbeat, and high blood pressure. It increases the risk for accidents while walking, or driving, as some people with sleep apnea may fall asleep during those activities.

Central sleep apnea

In central sleep apnea, breathing is disrupted regularly during sleep because of the way the brain functions. It isn't that you can not breathe [ which is true in obstructive sleep apnea]; rather, you not try to breath at all. The brain doesn't tell your muscles to breathe. This types of sleep apnea is usually associated with serious illness, especially an illness in which the lower brainstem -- which controls breathing -- is affected. In infants, central sleep apnea produces pauses in breathing that can last 20 seconds.

Sleep Apnea Facts

• Sleep apnea is defined as a reduction or cessation of breathing during sleep.
• Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep.
• The three types of sleep apnea are central apnea, obstructive apnea, and a mixture of central and obstructive apnea. 
• Obstructive sleep apnea is caused by the collapse of the airway during sleep. 
• The complications of obstructive sleep apnea include high blood pressure, heart disease, strokes, automobile accidents, and daytime sleepiness as well as difficulty concentrating , thinking and remembering. 
• Obstructive sleep apnea is diagnosed and evaluated by history, physical examination and polysomnography.
• The nonsurgical treatments for obstructive sleep apnea include behavior therapy, medications, dental appliances, continuous positive airway pressure, bi-level positive airway pressure, and auto-titrating continuous positive airway pressure. 
• The surgical treatment for obstructive sleep apnea include nasal surgery, palate implants, uvulopalatopharyngoplasty, tongue reduction surgery, genioglossus advancement, maxillo-mandibular   advancement, tracheostomy, and bariatric surgery.

Causes of Sleep Apnea 

Obstructive sleep apnea occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate, the tonsils, the side walls of the throat and the tongue. When the muscles relax, your airway narrows or closes as you breathe in, and you cannot get an adequate breath in. This may lower the level of oxygen in your blood. Your brain senses this inability to breathe and briefly rouses you from sleep so you can reopen your airway. This awakening is usually so brief that you do not remember it.

You may make a snorting, choking or gasping sound. This pattern can repeat itself five to 30 times or more each hour, all night long. These disruptions impair your ability to reach the desired deep, restful phases of sleep, and you  will probably feel sleepy during your waking hours. People with obstructive sleep apnea may not be aware that their sleep was interrupted. In fact, some people with this type of sleep apnea think they sleep well all night.

Central sleep apnea, which is much less common, occurs when your brain fails to transmit signals to your breathing muscles. You may awaken with shortness of breath or have a difficult time getting to sleep or staying asleep. Like with obstructive sleep apnea, snoring and daytime sleepiness can occur. The most common cause of central sleep apnea is heart failure and, less commonly, a stoke. People with central sleep apnea may be more likely to remember awakening than are people with obstructive sleep apnea.

Symptoms of Obstructive  Sleep Apnea

Obstructive sleep apnea has many well-studied consequences. First, as one would expect, it disrupts sleep. Patients with disrupted sleep cannot concentrate, think, or remember as well during the day. This has been shown to cause more accidents in the work place and while driving. Thus, people with obstructive sleep apnea have a three-fold greater risk of a car accident that the general population. Sleep apnea symptoms at night time include:

• Gasping for air, witnessed apneas, or choking sensation
• Snoring, usually loud and bothersome
• Restless sleep 
• Insomnia 

Sleep apnea also can cause significant and sometimes serious daytime symptoms as a result of insufficient sleep at night, including:

• Fatigue 
• Daytime sleepiness
• Frequent day time naps 
• Headache 
• Irritability
• Sexual dysfunction 
• Mood and personality changes like depression and anxiety               

 It is important to note that the bed partner of individuals with sleep apnea may suffer from poor nighttime sleep and can have some to the same symptoms.                                                                                                                                                               

Sleepwalking - Causes, Symptoms, Diagnosis, Treatment, and Prevention

What is Sleepwalking?

Sleepwalking is a sleep disorder belonging to the parasomnia family. Sleepwalking arise from the slow weave sleep stage in a state of low consciousness and perform activities that are usually performed during a state of full consciousness. These activities can be as benign as sitting up in bed, waking to the bathroom, and cleaning, or as hazardous as cooking, driving, grabbing at hallucinated objects, or even homicide.


Causes 

Sleepwalking has been described in medical literature dating before Hippocrates ( 460 BC-370 BC) is ascribe to her guilt and resulting insanity as a consequence of her involvement in the murder of her father-in -law. Sleepwalking is characterized by a complex behavior ( waking ) occurring while asleep. Occasionally nonsensical taking may occur. The person's eyes are commonly open, but have a characteristic glassy " look right through you" character. This activity most commonly occurs during middle childhood and young  adolescence. Approximately 15 percent of children between 4-12 years of age will experience sleepwalking. Usually, sleepwalking behaviors wane by late adolescence. Approximately 10 percent of all sleepwalkers begin their behavior as teens. It appears that persons with certain inherited genes have an increased tendency toward developing sleepwalking behaviors.

There are 5 stager of sleep. Stages 1, 2,3 and 4 are characterized as non-rapid eye movement (NREM) sleep. Rapid eye movement (REM) sleep is the sleep cycle associated with dreaming as  well as surges of important hormones essential for proper growth and metabolism. Each sleep cycle (Stages 1,2,3,4 and REM) last about 90-100 minutes and repeats throughout the night. The average person experiences four to five complete sleep cycles per night. Sleepwalking characteristically occurs during the first or second sleep cycles, during stages three and four. Due the short time frame involved, sleepwalking tends not to occur during naps. Upon walking the sleepwalking tends not to occur during naps. Upon walking the sleepwalker has no memory of his her behavior.

The sleepwalking activity may include simply sitting up and appearing awake while actually asleep, getting up and walking around, or complex activities like moving furniture, going to the bathroom, and similar activities. Some people even drive a car while actually asleep. The episode can be very brief or can last for 30 minutes or longer than it.

Symptoms

Following are the examples of symptoms of sleepwalking.

• Episodes range from quiet walking around the room to agitated running or attempts to "escape". The person sleepwalking may appear clumsy and dazed in his or her behavior.
• On questioning the person sleepwalking, responses are slow with simple thoughts, contain nonsense phraseology or absent responses. If the person is returned to bed without awakening, they  usually don't remember the event. 
• Typically, the eyes are open with a glassy, staring appearance as the person quietly roams the around the house. They do not, however, walk with their arms extended in front of them as is inaccurately depicted in movies.
• Older children, who may awaken more easily at the end of an episode, often are embarrassed by the behavior. In lieu of walking, some children perform repeated behaviors. 
• Sleepwalking isn't associated with previous sleep problems, sleeping alone in a room or with others, fear of the dark (achluophobia), or anger outbursts. 
• Some studies suggest that children who sleepwalk may have been more restless sleepers between the ages of four and five, and more restless with more frequent awakenings during first year of life. 

 Diagnosis

A person's history usually provides enough information for a doctor to diagnosis sleepwalking. This is particularly true in children. More difficult cases may require a consultation with a sleep specialist. The specialist may recommend overnight sleep test called polysomnography. During this test, various body functions are recorded while the person is sleeping. In rare cases, a brainwave recording may be ordered to rule out seizures.

Treatment 

Some people mistakenly believe that s sleepwalker should not be awakened. It is not dangerous to awaken a sleepwalker, although it is common for the person to be confused or disoriented for a short time when they wake up. Another misconception is that a person cannot be injured  while sleepwalking. Sleepwalkers are more commonly injured when they trip and lose their balance.
Actually, most people do not need any specific  treatment for sleepwalking. Safety measures may be needed to prevent injury. This may include moving objects such as electrical cords or furniture to reduce the chances of tripping and falling. You may need to block off stairways with a gate.
 In some cases, short-acting tranquilizers have been helpful in reducing sleepwalking episodes.

Non-Medical treatment of insomnia

Non-medical therapies are relaxation therapy, stimulus control, sleep hygiene, and sleep restriction. These also are referred to as cognitive behavioral therapies.

Relaxation Therapy

Relaxation therapy involves measures such as meditation and muscle relaxation or dimming the lights and playing sooting music prior to going to bed.

Stimulus Control

It  consists of a few simple steps that may help patients with chronic insomnia.

• Don't watch TV, eat, read or worry in bed. Your bed should be used only for sleep and sexual activity. 

• You have to go to bed when you feel sleepy.

• If you do not fall asleep 30 minutes after going to bed , get up and go to another room and resume your relaxation techniques. 

• You have to set your alarm clock to get up at a certain time each morning, even on weekends. Please, don't over sleep. 

• Avoid taking long naps in the day time. 

Sleep Hygiene 

Sleep hygiene is one of the components of behavioral therapy for insomnia. Some simple steps we can take to improve a patient's sleep quality and quantity. These steps include:

• Exercise regularly at least 30-40 minutes.

• Sleep as much as you need to feel rested.

• Avoid forcing yourself to sleep.

• Keep a regular sleep and awakening schedule.

• Do not smoke, especially in the evening. 

• Don't go to bed hungry. 

• Adjust the environment in the room.

• Don't go to bed with your worries. Try to resolve them before bedtime.

Sleep Restriction

Restricting your time in bed only to sleep may improve your quality of sleep. This therapy is called sleep restriction. This is achieved by averaging the time in bed that the patients spends only sleeping. Rigid bedtime and rise time are set, and the patients is forced to get up at the rising time even if they feel sleepy. This can help a patients sleep better the next night because of the sleep deprivation from the previous night. Sleep restriction has been helpful in some causes.

Other simple measures that can be helpful to treat insomnia include:

• Avoid large meals and excessive fluids before bedtime 

• Be conscious about light, noise, and undesirable room temperature that can disrupt sleep. Shift workers and night workers especially must address these factors. Dimming the lights in the bedroom, relaxation, limiting the noise, and avoiding stressful takes before going to bed can be beneficial.

• Avoid doing work in the bedroom that should be done somewhere else.

If we are conscious about insomnia or sleep disorders or sleep problem and take necessary steps and how to prevent or resolve then we will be free from this type of problem.

Prevention of Insomnia

Insomnia is a condition characterized by difficulty falling asleep and staying asleep. Insomnia can occur in response to a behavioral, physical, or mental health issue. Physical, psychological, environmental, and modifiable lifestyle factor can all play a role in preventing the condition, or alleviating the symptoms if it occurs.

There are many causes of insomnia. Below are some steps and tips for preventing insomnia and sleep disorders.

Treat Underlying Disease 

Pain and chronic disease can cause insomnia for a variety of reasons. Diseases or conditions that may disrupt sleep include depression, diabetes and chronic renal failure, chronic lung disease, alcohol abuse and alcoholism or drug abuse and drug addiction, arthritis, heart disease, gastric ulcer, sleep apnea, and chronic pain.

Please, discuss with your doctor whether these conditions or any other physical problems can be treated. Proper and timely treatment can reduce symptoms and often lead to an improved night's sleep.


Avoid Nicotine, Caffeine, and Alcohol

Tobacco use disorder and caffeine stimulate the nervous system. Although this may give you a sense of energy during the day, these substances may interfere with your ability to go to sleep at night. Alcohol can depress nervous system. Although alcohol makes you feel drowsy at bedtime, it interferes with normal sleep patterns during the night and causes restlessness. You must avoid using tobacco products and drinking beverages that contain caffeine or alcohol in the afternoon or evening. They can create a vicious cycle of poor sleep at night and an increased use of stimulants during the day to counteract the drowsiness from poor  sleep.

Reduce Stress

Stress is considered by the most  sleep experts to be the number one cause of short-term sleeping difficulties.  Some common triggers include job or school related pressures, a family or marriage problem, and a serious illness or death of close person. Exercise regularly that helps relieve stress. Other techniques that may reduce stress are meditation and deep breathing.

Adjust Daily Activities

Habits and activities that you do during the day time or night can interfere with getting a good nights' sleep. Set your time schedule in order to avoid eating a large meal prior to bedtime, exercising close to bedtime, working or doing other mentally intense activities right before or after getting into bed.

Follow Bedtime Rituals If You Work at night Shift

Night shift work forces you to try to sleep when activities around you and your own "biological rhythms" signal you to be awake. One study shows that night shift workers are 2-5 times more likely than are employees with regular, daytime hours to fall asleep on the job because of poor sleep quality. If you work the night shift, speak with your employer about how to minimize the dangers of fatigue. You have to discuss with your family members so that you can create a proper environment to sleep in the day time.

Create Better Sleep Habits and Environment

A distracting sleep environment, such as a room that is too hot or cold, too noisy, or too brightly lit may be a barrier to sound sleep. Interruptions from pets, children, or other family members can also disrupt sleep. Other influences may be the comfort and size of your bed and the habits of your sleep partner. Try to create an environment that is restful by painting your room a light blue or green, using shades to block light, and playing soothing music or white noise like fan. Seek medical help for a sleeping partner who snores loudly, or consider separate sleeping arrangements.

Establish a regular, relaxing bedtime routine that will allow you to unwind and send a "signal" to your brain that it is time to sleep. Avoiding exposure to bright light before bedtime and taking a warm bath can help. Avoid "clock watching" after going to bed and avoid drinking fluids just before bedtime.

If we want to be lead a happy life then we need to acquire knowledge about how to prevent all types of disease such as sleep disorders , insomnia, sleep walking, sleep apnea etc. and we must be conscious about diseases and their prevention , after that we can lead a happy and healthy life. I think that you will learn more after reading this article about prevention of insomnia. 

Insomnia

Insomnia is a condition characterized by difficulty falling asleep and staying asleep. It include wide range of sleep disorders, from lack of quantity of sleep to lack of quality of sleep. There are two types of insomnia primary insomnia and secondary insomnia. Primary insomnia means that a person is having sleep problems that are not directly associated with any other health condition or problem. Secondary insomnia means that a person is having sleep problems because of something else, such as a health condition [like asthma, depression, arthritis, cancer, or heartburn] ; pain; medication they are taking; or a substance they are using like alcohol.

Causes of insomnia

Insomnia may be caused  by a host of different reasons. These causes may be divided into situational factors , medical or psychiatric conditions, or primary sleep problems. Insomnia could also be classified by the duration of the symptoms into transient, short-term, chronic. Transient insomnia generally last less than seven  days; short-term insomnia usually lasts for about one to three weeks, and chronic insomnia lasts for more  than  three weeks.

Many of the causes of transient and short-term insomnia are similar and they include-

•  Jet lag

• Changes in shift work

• Uncomfortable room temperature

• Excessive or unpleasant noise

• Stressful situation in life

• Withdrawal from drug, alcohol, sedative, or stimulant medications

• Insomnia related to high altitude(mountains)

Uncontrolled physical symptoms [fever, pain, breathing problems, nasal congestion, cough, diarrhea etc ] may also cause someone to have insomnia.

Causes of long-term or chronic insomnia 

The majority of chronic or long-term insomnia are usually linked to an underling psychiatric or physiologic condition.

Psychological causes of insomnia

The most common psychological problems theses may lead to insomnia include:

•  Anxiety

• Depression

• Stress [mental, emotional, etc.]

• Schizophrenia

• Mania [bipolar disorder]

Insomnia may be an indicator of depression. Many people will have insomnia during the acute phases of a mental illness. As mentioned earlier, depression and anxiety are strongly associated with insomnia. Out of the all the other secondary medical and psychological causes of insomnia, anxiety and depression are the most common.

Physiological causes of insomnia

Physiological causes span from circadian rhythm disorders, sleep-wake imbalance, to a variety of medical conditions. The following are the most common medical conditions that trigger insomnia:-

• Chronic fatigue syndrome

• Chronic pain syndromes

• Congestive heart failure

• Acid reflux disease[GERD]

• Chronic obstructive pulmonary disease [COPD]

• Nocturnal asthma [asthma with night time breathing symptoms]

• Obstructive sleep apnea

• Brain tumors, strokes, or trauma to the brain

Symptoms of insomnia 

Doctors associate a variety of signs and symptoms with insomnia. Often the symptoms intertwine with those of other medical or mental conditions. 


Some people with insomnia may complain of difficulty falling asleep or waking up frequently during the night. The problem can begin to associate the bed with your inability to sleep, the problem can become chronic.

Most often daytime symptoms will bring people to seek medical attention. Daytime problems caused by insomnia include the following:

•  Poor concentration and focus

• Difficulty with memory

•  Impaired motor coordination [being uncoordinated]

•  Irritability and impaired social interaction

•  Motor vehicle accidents because of fatigued, sleep-deprived drivers.

Many people with insomnia don't complain of daytime sleepiness, and in fact, they may have difficulty falling asleep during intentional daytime naps.

Treatment of insomnia

In general, transient insomnia resolves when the underlying trigger is removed or corrected. Most people seek medical attention when their insomnia becomes chronic.

The main focus of treatment for insomnia should be directed towards finding the cause. Once a cause is identified, it is very important to manage and control the underlying problem, as this alone may eliminate the insomnia all together. Treating the symptoms of insomnia without addressing the main cause is rarely successful. Chronic insomnia can cured in the majority of causes if its medical or psychiatric causes are evaluated and treated properly.

The following therapies can be used in conjunction with therapies directed towards the underlying medical or psychiatric cause. They are also the recommended therapies for some of the primary insomnia disorders.

Usually,  treatment of insomnia entails both non-medical and medical aspects. It is best to tailor treatment for individual patient based on the potential cause. Studies have shown that combining medical and non-medical treatments typically is  more successful in treating insomnia than either one alone.

Sleep Problems/Disorders

At present sleep problem are common. Seep is a natural state of rest which involves less body movements and no awareness of the actual surroundings. Sleep can be distinguished from other sleeplike states such as hibernation and coma becausesleep disorder.
it involves certain conditions like rapid eye movement or REM. Almost allcreatures sleep, including of course animals. Of course varying positions and manners of doing this exist in every person. This however, is characterized by a lack of appropriate regeneration of a person's basic bodily requirements. Less sleep means a lesser productive you! when a person lacks sleep it is very too much difficult for sufferers to go through the day with ease. As this problem progresses, it can be considered a

Below is information- including symptoms, causes and some possible treatment options, on more common sleep-related problems and disorders in adults.

Poor Sleep Habits :

Now a days poor sleep habits are one of the most common problems. We are too late to go to sleep or bed but get up too early in the morning. We interrupt our sleep with drugs, work,  and we overstimulate ourselves with late night activities such as television or using facebook. So we have to avoid this poor sleep habits.

 Sleep Apnea 

The word apnea means"not breathing". Patients with the usual form of sleep apnea actually close off their airway at night .

This airway closure occurs either behind the tongue or behind the nose. Patients continue to make effort to breath. And then after 10-120seconds, the brain, realizing it is not getting any oxygen, actual" week up". The brain then tells the upper airway to open to let some air in.

Sleep apnea, it is dangerous, common, relative easy to diagnose and treatable. Patients with apnea have risk for heart disease, heart attacks, stokes, and high blood pressure. In addition, since the sleep is poor quality , patients are often sleepy during full time of the day. Sleepiness is associated with inability to concentrate, remember or think. There is risk  in falling asleep while doing vital tasks such as driving or using heavy machinery.

Medical treatment involves weight loss if the patients are overweight, avoidance of drugs, which increase the risk of apnea like sleeping pills, alcohol, and  sedative  medicines, and sometimes sleeping semi-upright. In the most cases additional treatments are warranted.

Some patients may be candidates for surgery on the upper airway. In the upper airway surgery the uvula (that punching bag in the back of the throat)andsome  some  of the surrounding soft tissue is removed to enlarge the air passage. IN other cases a dental device designed to move the lower jaw down and out wards slightly may be worn at night. 

In a few cases,  the treatment is started with an emergent tracheostomy when sleep apnea is considered to be immediately life-threatening. This decision about which form of treatment to take should be decided by the patients and their physician on the basis of the sleep studies and rest of the clinical data.

 Insomnia

Insomnia is the inability to sleep enough at night. People who have insomnia do not feel as if they get enough sleep at night. They may have trouble falling asleep or may week up frequently during the night or early in the morning. Insomnia is a problem if it affects your daytime activities. Insomnia has some possible causes, including stress,anxiety, depression, poor sleep habits, circadian rhythm disorders. Insomnia may be situational, lasting a few days to weeks, or chronic, lasting for more than one month.

 Around 90 to 12 percent of the American report chronic insomnia. In severe cases, patients experience fatigue, sleepiness, difficulty concentrating and difficulty with thinking. Insomnia may be a symptom of breathing problems at night like sleep apnea, of medical illness like heart failure, or a symptom of severe anxiety  or depression illness.

While short lasting insomnia periods are well treated with medication, chronic or long lasting insomnia mayn't respond to medication. Thus throwing sleeping pills at many patients with chronic insomnia is not an effective way to treat the problem.  

An evaluation by the patient's personal physician or sleep specialist can help to get to the root of the problem. Many patients respond well to what is called "cognitive behavioral therapy". Relaxation and behavioral techniques , these may be used to help patients fall asleep. This combined with treatment of any underlying disorders is often the best way to treat the devastating symptom of insomnia.

Sleepwalking  

Sleepwalking , also referred to as somnambulism, is characterized by walking or physical activities during sleep. Sleepwalking is very common in children . In children, it can be associated with sleep deprivation or anxiety. In adults, it can be more commonly associated with other medical disorders, medication use , or anxiety.

Clinically, the person may simply sit up with their eyes open, appearing to be awake or they may engage in a complex task.  Episodes can last from seconds to minutes. Contrary to popular belief, it is safe to wake a sleepwalker but they may be confused or disoriented on waking.
There no specific treatment without avoiding triggers if known , or treat anxiety or depression. If severe, short-term use of sedatives may be considered. Otherwise it is best to keep the person safe and out of harm's way. We often advise families to make sure the windows are closed and that there is no any possibility of sleepwalking leading to danger for the patient.

Narcolepsy 

Narcolepsy is a  chronic sleep disorder, that begins during adolescence and is characterized by excessive daytime sleepiness with the occurrence of sleep attacks. Narcolepsy can run in families but can occur in the absence of any family history as well.