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Sleep-related
difficulties affect many people. The following is a
description of some of the major sleep disorders. If you, or
someone you know, is experiencing any of the following, it
may be important to receive an evaluation by a healthcare
provider or, if necessary, a provider specializing in sleep
medicine.
Insomnia
Insomnia is characterized by an
inability to initiate or maintain sleep. It may also take
the form of early morning awakening in which the
individual awakens several hours early and is unable to
resume sleeping. Difficulty initiating or maintaining sleep
may often manifest itself as excessive daytime sleepiness,
which characteristically results in functional impairment
throughout the day. Before arriving at a diagnosis of
primary insomnia, the healthcare provider will rule out
other potential causes, such as other sleep disorders, side
effects of medications, substance abuse, depression, or
other previously undetected illness. Chronic
psychophysiological insomnia (or “learned” or
“conditioned” insomnia) may result from a stressor combined
with fear of being unable to sleep. Individuals with this
condition may sleep better when not in their own beds.
Health care providers may treat chronic insomnia with a
combination of use of sedative-hypnotic or sedating
antidepressant medications, along with behavioral techniques
to promote regular sleep.
Narcolepsy
Excessive daytime sleepiness
(including episodes of irresistible sleepiness)
combined with sudden muscle weakness are the hallmark signs
of narcolepsy. The sudden muscle weakness seen in narcolepsy
may be elicited by strong emotion or surprise. Episodes of
narcolepsy have been described as “sleep attacks” and may
occur in unusual circumstances, such as walking and other
forms of physical activity. The healthcare provider may
treat narcolepsy with stimulant medications combined with
behavioral interventions, such as regularly scheduled naps,
to minimize the potential disruptiveness of narcolepsy on
the individual’s life.
Restless Legs Syndrome (RLS)
RLS is characterized by an
unpleasant “creeping” sensation, often feeling like it is
originating in the lower legs, but often associated with
aches and pains throughout the legs. This often causes
difficulty initiating sleep and is relieved by movement of
the leg, such as walking or kicking. Abnormalities in the
neurotransmitter dopamine have often been associated
with RLS. Healthcare providers often combine a medication to
help correct the underlying dopamine abnormality along with
a medicine to promote sleep continuity in the treatment of
RLS.
Sleep Apnea
Snoring may be more than just
an annoying habit – it may be a sign of sleep apnea. Persons
with sleep apnea characteristically make periodic gasping or
“snorting” noises, during which their sleep is momentarily
interrupted. Those with sleep apnea may also experience
excessive daytime sleepiness, as their sleep is commonly
interrupted and may not feel restorative. Treatment of sleep
apnea is dependent on its cause. If other medical problems
are present, such as congestive heart failure or
nasal obstruction, sleep apnea may resolve with treatment of
these conditions. Gentle air pressure administered during
sleep (typically in the form of a nasal continuous
positive airway pressure device) may also be effective
in the treatment of sleep apnea. As interruption of regular
breathing or obstruction of the airway of the individual
during sleep can pose serious complications for the health
of the individual, symptoms of sleep apnea should be taken
seriously.
Source: Reite M, Ruddy J, Nagel
K. Concise guide to evaluation and management of sleep
disorders (3rd ed). Washington, DC: American Psychiatric
Publishing, Inc., 2002.
How Much Sleep Do I Need?
While there is variability
between each of us in how much sleep we need, the National
Sleep Foundation has noted that the need for sleep changes
as we age. The National Sleep Foundation has recommended the
following sleep guidelines for selected age groups
(*including naps):
|
INFANTS |
|
(0–2 months) |
10.5–18 hours* |
|
(2–12 months) |
14–15 hours* |
|
TODDLERS/CHILDREN |
|
(12–18 months) |
13–15 hours* |
|
(18 months–3 years) |
12–14 hours* |
|
(3–5 years) |
11–13 hours* |
|
(5–12 years) |
9–11 hours |
|
ADOLESCENTS |
|
|
8.5–9.5 hours |
|
ADULTS
|
|
|
7–9 hours |
(Taken from the National Sleep
Foundation Web site.)
For further information—and a
more comprehensive listing of recommended hours of sleep for
different age groups—please see the National Sleep
Foundation Web site at
http://www.sleepfoundation.org/site*
A fun way for kids to learn
about the importance of getting enough sleep, featuring
America’s favorite feline, Garfield, can be found at
http://www.nhlbi.nih.gov./health/public/sleep/index.htm.
Reprinted with Permission:
Division of Adult and Community Health,
National Center for Chronic Disease Prevention and Health
Promotion
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