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A field guide to sleep disorders

While sleep-disordered breathing, such as apnea, makes up the bulk of
the disorders treated at the Sleep Disorder Centre, patients also receive
treatment for the following disorders:

Insomnia

We all tend to suffer from the inability to sleep from time to time, but a persistent inability to get to sleep or stay asleep is clinical insomnia. It can often be a symptom of other sleep disorders, such as apnea, but for most sufferers, its root causes are psychological, and as a result, often treated by psychiatrists.

Circadian rhythm disorders

The body's waking and sleeping cycle is controlled by the circadian (internal) clock. A sufferer from a circadian rhythm disorder is out of sync with conventional sleeping patterns. Some people cannot sleep at night, while others wake up very early in the morning. Shift work is often a contributing factor to this disorder. Medication or lifestyle changes are the most common treatments.

Sleep-disordered breathing

The most common form is obstructive apnea where the airway becomes blocked and the sufferer is roused from sleep by choking. It is often accompanied by hypopnea - laboured breathing from a partially obstructed airway. Another form is central apnea where the signal from the brain is causing irregular breathing patterns, often called Cheyne Stokes breathing. Continuous positive air pressure is often the best treatment.

Hyper-somnolence

Narcolepsy is the most common form. It is characterized by falling asleep unexpectedly during the daytime. Sufferers are believed to have abnormally low levels of neuro-proteins that regulate REM (rapid eye movement) sleep. Unlike normal individuals, who go through the first four stages of sleep before reaching REM, narcoleptics go from waking state straight into REM during daytime hours. It is often treated with stimulant medications similar to methamphetamine, but some patients have also responded well to non-medical treatments, such as scheduling several brief naps during the day.

Parasomnias

Sleepwalking and night terrors are two of the more common forms. Sleepwalking - or somnambulism - is more common among children around age 12, but about four per cent of adults sleepwalk as well. Researchers believe that non-REM deep sleep stages are disrupted, leaving a sufferer in a state between wakefulness and sleep. About three per cent of adults suffer night terrors, similar to sleepwalking, but characterized by disruptive arousal, involving screaming, panic and bodily harm from running into objects, in extreme cases. Treatment can involve medications and psychotherapy.

Bruxism

Often considered to be a form of parasomnia, this is the involuntary clenching or grinding of the jaw during sleep. Bruxism can be caused by stress, stimulants like caffeine, high blood pressure, or it may be a symptom of other sleep disorders. Treatment can include reducing stress, blood pressure or consumption of caffeine. It is usually identified by dentists, who often prescribe a custom-fit night-guard that fits over the teeth, reducing the negative impact of clenching and grinding.

Restless leg syndrome

This is marked by an uncontrollable urge to move one's legs - although, it can also be experienced in other parts of the body. Sufferers also often describe burning or itching in the affected parts of the body. It is often a symptom of an underlying illness, such as diabetes, sleep apnea and circulatory diseases. Treatment often involves medication ranging from antidepressants to iron supplements.

Source: American Academy of Sleep Medicine

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	About Wave Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books. Read the Summer 2009 issue of Wave