Desperately seeking sleep

Sleep disorders are among the most common clinical problems encountered in medicine . . .

Susan Locke

Sleep is a basic human need like eating, drinking and breathing. Sleep is a vital part of the foundation for good health and well-being throughout your life.

Sleep disorders are among the most common clinical problems encountered in medicine and psychiatry. Nearly 70 million Americans suffer from sleep disorders, most of which go untreated or undiagnosed. Sleep deficiency can cause problems with learning, focusing and reacting. You may have trouble making decisions, solving problems, remembering things, controlling your emotions and behavior, and coping with change. You may take longer to finish tasks, have a slower reaction time, and make more mistakes.

Insomnia. About 50% of adults experience occasional bouts of insomnia, and 10% complain of chronic insomnia. It’s twice as common in women and the incidence increases with age. Hallmarks of insomnia include: difficulty falling asleep, waking up often during the night with difficulty falling back asleep, and waking up too early.

As a result, symptoms include sleepiness during the day, irritability, low energy, and difficulties with concentration and memory. Insomnia can be acute (short term) or chronic, defined as occurring at least three nights a week for a month or longer or intermittent.

Causes of acute insomnia: stress, illness, medications, jet lag or environmental factors (light, noise, temperature). Chronic insomnia can be caused by depression, chronic stress, or pain.

Sleep apnea is a serious medical condition where breathing is disrupted during sleep. It occurs in 25% of men and 10% of women. It can affect people at any age. It’s more common in people with certain physical traits including excessive weight, large neck, and structural abnormalities of the upper airway. If untreated, sleep apnea can have serious health effects. There is an increased risk of hypertension, stroke, arrhythmias, enlargement of the heart, congestive heart failure, diabetes, and heart attacks. Cognitive impairment from sleep apnea may cause work impairment and motor vehicle accidents.

Other sleep disorders

Restless Leg Syndrome: Symptoms include an urge to move your legs associated with an unpleasant sensation, such as numbness, tingling, aching, cramping or pain. The urge occurs during periods of rest or inactivity and the sensations are partially or totally relieved by stretching or exercising the affected muscles. The sensations are worse in the evening or night.

Narcolepsy is a neurological disorder that effects control of wakefulness and sleep. People with narcolepsy have excessive, uncontrollable daytime sleepiness. Sleep “attacks” may occur during activity. Narcolepsy occurs in 1 in 2,000 in the U.S. and the risk increases if a first degree relative has narcolepsy. The first signs usually occur in the teenage years or 20s.

Sleep disorders and psychiatric conditions. Sleep issues are common in people with mood disorders, anxiety disorders, and substance abuse disorders.

Sleep disorders and medications. Many medications are known for causing sleep disturbances including: high blood pressure meds, hormones such as oral contraceptives, steroids, respiratory medications, diet pills, attention deficit disorder medications, antidepressants, pseudoephedrine (Sudafed), medicines with caffeine, nicotine, marijuana, heroin, cocaine, and amphetamines.

If you are concerned that you may have one of these disorders, it’s important to discuss your symptoms with your physician. Healthnetwork can provide a referral to a sleep disorder specialist who can perform more diagnostic studies.

SUSAN LOCKE, MD, is Healthnetwork Foundation’s medical director.

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