What is Restless Leg Syndrome?

What is Restless Leg Syndrome?

Restless legs syndrome (RLS) is a neurological condition that is characterized by the irresistible urge to move the legs. In order for you to be officially diagnosed with RLS, you must meet the criteria described in the four bullets below:

  • You have a strong urge to move your legs which you may not be able to resist. This need is often accompanied by uncomfortable sensations. Some words used to describe these sensations include:creeping, itching, pulling, creepy-crawly, tugging, or gnawing.
  • Your RLS symptoms start or become worse when you are resting. The longer you are resting, the greater the chance the symptoms will occur and the more severe they are likely to be.
  • Relief of symptoms improve when you move your legs. This can help relieve your symptoms a little or all together. As long as you are moving, you feel better.
    Your RLS symptoms are worse in the evening especially when you are lying down. Activities that bother you at night do not bother you during the day.

RLS can also cause difficulty in falling or staying asleep- one of the chief complaints of the syndrome. Some people who have RLS also have periodic limb movements of sleep (PLMS). These are jerks that occur every 20 to 30 seconds on and off throughout the night. These movements can often cause awakenings that disrupt sleep. This lack of sleep most likely leads to poor quality of health, concentration and personal relationships.

 

Additional information provided by National Sleep Foundation:

What is Narcolepsy: Sleep Attacks?

What is Narcolepsy?

Now and then, everyone can be sleepy at times during the day for many reasons. But, if you continually experience excessive daily daytime sleepiness — sometimes expressed as tiredness, lack of energy, and/or irresistible sleepiness — you could be suffering from another little-known, chronic sleep disorder called narcolepsy.

According to the American Narcolepsy Association, 1 out of every 100 Americans is afflicted with this disorder. Yet, between 50 and 80 percent of them remain undiagnosed.

People with narcolepsy suffer from sleep apnea more often than the general population, although apnea is not a core feature of the disorder. During an attack, the person may find it physically impossible to stay awake and will sleep for periods ranging from a few seconds to a half hour. An attack can occur while watching TV, reading, or listening to a lecture.

More surprisingly, these sudden attacks of sleep can also strike while walking, eating, riding a bike, or carrying on a conversation.

Despite growing knowledge about narcolepsy, people who have these symptoms often do not seek medical help for years. At first, the symptoms are rather mild, but over a period of years, they can increase in severity. Reserve time for a sleep test to help determine if this condition could relate to you.

 

Additional information provided by National Sleep Foundation:

What is Insomnia?

What is Insomnia?

 

It is a sleep disorder that results in a difficulty to fall and/or stay asleep. People with insomnia have one or more of the following symptoms:

  • Difficulty falling asleep
  • Waking up often during the night and having trouble going back to sleep
  • Waking up too early in the morning
  • Tired upon waking

 

Causes of insomnia include:

  • Significant life stresses such as a death in the family, moving home or job loss
  • Emotional or physical (pain) discomfort
  • Environmental factors such as light, noise and extreme temperatures (hot or cold) that interfere with sleep
  • Some medications (for example those used to treat colds, allergies, depression, high blood pressure and asthma) may interfere with sleep
  • Changes in normal sleep schedule such as jet lag or shift work (switching from a day to night shift)
  • Depression and/or anxiety
  • Chronic stress

 

How is insomnia treated?

Mild insomnia can be cured by following good sleep habits. Acute insomnia may not require treatment. Moderate to severe insomnia requires following good sleep habits and treatment of any underlying medical conditions.

Additional treatment may include the use of sleep aids and behavioral modification techniques. Sleep aids should only be prescribed by your doctor. Over the counter sleep aids may have undesirable side effects.

Behavioral techniques include relaxation exercise, sleep restriction therapy, and reconditioning.

What is Sleep Apnea?

What is Sleep Apnea?

During normal sleep, our airway muscles remain open permitting air to flow properly. However, with sleep apnea, the airway muscles can relax and become totally blocked resulting in diminished air flow or complete obstruction. This repetitive process is described as sleep apnea.

While many people have signs of snoring, not all snoring is related to sleep apnea. On the other hand, if snoring is associated with certain symptoms, such as sleepiness or non-refreshing sleep, this may be an indication of sleep apnea which requires further evaluation.

Common symptoms associated with sleep apnea include restless sleep, awaking with a choking, gasping, smothering, or snorting sensation, morning headaches, dry mouth, frequent need to urinate during the night, sweating during sleep, waking up un-refreshed, daytime sleepiness, and memory impairment.

 

Who gets sleep apnea?

Risk factors for sleep apnea include:

  • increasing age
  • male sex
  • obesity
  • sedating medications or alcohol
  • abnormal upper airway or jaw shape

 

Neck Size?

  • Men with neck sizes of 17”, or greater have a higher risk of sleep apnea
  • Women with neck sizes of 16”, or greater have a higher risk of sleep apnea
  • Patients with poorly treated high blood pressure requiring at least two or three medications are at higher risk for sleep apnea
  • Patients with cardiac rhythm problems, such as atrial fibrillation in particular, are at increased risk of having sleep apnea
  • If a bed partner specifically identifies pauses in breathing, this is a very sensitive indicator of having this disease

 

How do I know if I have sleep apnea?

The best way to identify this particular disease is by performing an overnight sleep test called a polysomnogram. The test is performed in a comfortable hotel-like atmosphere with highly trained technicians that monitor breathing, brain, leg movements, and heart parameters throughout the night. It is a painless test and can provide invaluable information on how to proceed with further treatment. In some cases, a home sleep study can be arranged as well. It is advisable to have a board certified sleep physician review these results for the most accurate interpretation.

Treatment – CPAP and More

If one is diagnosed with obstructive sleep apnea, the severity of the disease can dictate the potential treatment options.

CPAP, BiPAP, VPAP – Most people are familiar with CPAP, a device that produces air pressure using a soft and pliable nasal mask placed over the nose which provides mild pressure support to prevent the throat from collapsing throughout the night. While it may take several weeks or months to get used to this particular treatment, it can be particularly rewarding as it can improve sleep and reduce multiple risk factors discussed above.

 

Alternatives to CPAP? Your sleep physician may also discuss alternative treatments.

Dental Treatments – With mild or moderate sleep apnea, an oral appliance which is a modified dental guard may be suggested. This is usually a custom designed dental guard that helps maintain an open airway throughout the night and is generally well accepted.

Nasal Valves – Newer alternative treatments for sleep apnea continue to develop including a novel nasal device called “Provent. “ Board certified sleep physicians are well versed on this newer form of therapy.

Surgery – On occasion, surgical treatment may be an alternative form of therapy or as additional therapy to help remove excess tissue in either the nasal area or the throat area which may improve airway movement. The success rate with surgery is roughly about 90% M.M.A. surgery. This opens the airway by advancing both the upper and lower jaws. This surgery has a 90% success rate.

Weight loss – Other forms of treatment for sleep apnea include weight loss. Weight loss can reduce the severity of sleep apnea and in some cases of mild sleep apnea can actually eliminate the disease. But one cannot assume that weight loss alone will cure the problem without retesting after weight loss has been achieved. Avoidance of alcohol and sedating medication can also decrease the severity of sleep apnea. Sometimes avoidance of sleeping on your back can reduce the severity of sleep apnea. Unfortunately this is difficult to achieve throughout the entire night on a consistent basis.

A board certified sleep physician is the best resource to determine which optimal treatment you should pursue. It is important to find an acceptable form of therapy. Consider sleep apnea as a chronic illness that requires control. No real cure currently exists. Just as in conditions such as high blood pressure or diabetes mellitus, it requires regular follow-up and treatment to help reduce complications and improve symptoms.

What are Pediatric Sleep Disorders?

What are Pediatric Sleep Disorders?

Children are not “little adults”.

Sleep problems in children has been linked to poor school performance, bed-wetting, ADHD, weight problems, headaches, asthma and many other problems. Sleep disorders can be seen in other common pediatric problems such as Down Syndrome, Epilepsy, and Spina Bifida.

Sleep Wellbeing strictly adheres to the guidelines established by the American Board of Pediatrics/American Academy of Sleep Medicine — gold standards achieved after passing a comprehensive examination covering all areas of health related to infants, children, and young adults.

If your physician suggests that your child see a sleep specialist, you can be assured that your child will receive the best possible care. A pediatric sleep specialist has special advanced training in disorders of sleep and wakefulness in youngsters through the age of adolescence.

 

Symptoms of Sleep Disorders in Children:

  • Frequent snoring
  • Mouth breathing
  • Bedwetting
  • Difficulty sleeping and restless sleep
  • Excessive daytime sleepiness
  • Daytime cognitive and behavioral problems, including inattention, aggressive behavior and hyperactivity
  • Frequent nighttime awakening
  • Morning headaches
  • Night sweats.
  • Respiratory pauses
  • Sleep Walking

 

Medical Conditions Often Associated with Sleep Disorders in Children:

  • Obesity
  • Premature birth
  • Enlarged tonsils and adenoids
  • Craniofacial abnormalities
  • Genetic abnormalities (e.g. Down’s Syndrome)
  • Spina Bifida
  • Low muscle tone
  • Treatment resistant epilepsy
  • Sickle Cell Anemia
  • Visual impairment
  • Autism
  • ADHD
  • Developmental delay
  • Psychiatric conditions

 

How serious is sleep apnea in children?

It is a potentially life-threatening condition that requires immediate medical attention. The risks of undiagnosed sleep apnea in children include learning problems, developmental delays, and other behavior problems.  The neuro-developmental consequences related to untreated sleep apnea can have a lasting impact affecting school performance and behavior.

In some cases, failure to grow, heart problems and high blood pressure can be linked to sleep apnea. In some children and adolescents, obstructive sleep apnea causes daytime sleepiness that can result in personality changes, lost productivity in school and interpersonal relationship problems. When a child has sleep apnea, he or she may lag behind in many areas of development. The child may become frustrated and depressed.  Once sleep apnea is treated, these symptoms may be reversed.

 

How does the doctor determine if my child has obstructive sleep apnea?

A sleep test, called polysomnography (PSG) is performed to diagnose sleep apnea. An overnight polysomnography test involves monitoring brain waves, muscle tension, eye movement, respiration, oxygen level in the blood and audio monitoring (for snoring, gasping, etc.). The test is painless.

 

How is sleep apnea treated in children?

In children, there are different treatment options based on the severity of the sleep apnea. It may require the reduction or removal of tonsils or adenoids, CPAP (continuous positive airway pressure), medications, or a dental device. CPAP is a machine that blows air into your nose through a mask, keeping the airway open.

The sleep doctor will “prescribe” the pressure for the CPAP setting.  A home healthcare company will set up the machine and provide training in its use and maintenance.

 

What is insomnia?

It is a sleep disorder that results in a difficulty to fall and/or stay asleep. People with insomnia have one or more of the following symptoms:

  • Difficulty falling asleep
  • Waking up often during the night and having trouble going back to sleep
  • Waking up too early in the morning
  • Tired upon waking
  • Many children have behavioral insomnia of childhood.

 

Here are two common causes in children:

1. Sleep-onset association

All of us wake up briefly a number of times during the night. This occurs most often during the stage of sleep when we have most of our dreams. This sleep stage is known as rapid eye movement (REM) sleep. Usually, we are unaware of these awakenings and return to sleep quickly.

Young children may cry when they wake up. Parents naturally may feel that they need to help their child return to sleep. Parents do this by feeding, rocking, holding or lying down with their child. As a result, many young children become unable to fall asleep on their own. They depend on their parents help instead of learning to comfort themselves.

The child learns to connect or associate going to sleep with a person or activity. If this describes your child, then he or she may have a problem with sleep-onset association. A parent may recognize this problem by saying something like this: I am exhausted. I have to rock my child to sleep every night and for every nap. If she wakes up during the night, she is unable to fall asleep until I rock her again. This child appears to be connecting the action of falling asleep with being rocked. She is unable to fall asleep when that action is missing.

 

2. Limit-setting problems

Limit-setting problems usually begin after the age of two. It occurs when your child refuses to go to bed, stalls, or makes it hard for you to leave the bedside. Limit-setting problems can occur at bedtime, nap time, or when your child wakes up during the night. Parents need to assert that they are the ones who decide when it is time for bed.

They should enforce this time even if the child disagrees or seems active and alert. Children can get very creative when they want to stay up later. They may ask for one more hug, a tissue, a drink of water, another story, to have the light turned off or on, or to tell you something important. It can be hard to know what is real and what is simply a delay tactic. You need to be firm and consistent when you respond to the delays. Giving in to them will only encourage the behavior. Parents need to give their children well-defined limits.

If your child or you have an ongoing sleep problem, then you should talk to your pediatrician or to a sleep specialist.

 

Healthy Sleep

It is important to instill healthy sleeping habits in your child. Medical studies have demonstrated that sleep plays a role in brain development. A tired child may have developmental or behavioral problems. Your child’s sleep problems not only affect him/her, but can also be a source of stress and concern for the entire family.  For this reason, it is important to make sure that your child gets enough sleep and sleeps well.

The recommended sleep requirements for age

How much sleep should my child get?

  • Infants (3 to 11 months): 14 to 15 hours
  • Toddlers: 12 to 14 hours
  • Preschoolers: 11 to 13 hours
  • School-age children: 10 to 11 hours

 

Here are some tips to help your child sleep better

  • Follow a consistent bedtime routine.
  • Set aside 10 to 30 minutes to get your child ready to go to sleep each night.
  • Establish a relaxing setting at bedtime.
  • Interact with your child at bedtime.
  • Don’t let the TV, computer or video games take your place.
  • Keep your children from TV programs, movies, and video games that are not right for their age.
  • Do not let your child fall asleep while being held, rocked, fed a bottle, or while nursing.
  • At bedtime, do not allow your child to have foods or drinks that contain caffeine. This includes chocolate and sodas.
  • Try not to give him or her any medicine that has a stimulant at bedtime. This includes cough medicines and decongestants.
  • A child who gets enough sleep and sleeps well is more likely to be cheerful during the day. The better the child sleeps, the happier the entire family will be.

What are Healthy Sleep Habits?

What are Healthy Sleep Habits?

Good “hygiene” is anything that helps you to have a healthy life.

The idea behind sleep hygiene is the same as dental hygiene. Dental hygiene helps you stay healthy by keeping your teeth and gums clean and strong. Sleep hygiene helps you stay healthy by keeping your mind and body rested and strong. Following these tips will help you sleep better and feel your best.

Dental hygiene can even be a part of your sleep hygiene. It is easier for you to fall asleep at night if you have bedtime “rituals.” These are things that you do every night just before going to bed. Brushing and flossing your teeth is a good example of this kind of ritual. Both your dentist and your doctor will approve if you do this every night.

 

Tips for Improving Your Sleep Hygiene

  1. Don’t go to bed unless you are sleepy.
    If you are not sleepy at bedtime, then do something else. Read a book, listen to soft music or browse through a magazine. Find something relaxing, but not stimulating, to take your mind off of worries about sleep. This will relax your body and distract your mind.
  2. If you are not asleep after 20 minutes, then get out of the bed.
    Find something else to do that will make you feel relaxed. If you can, do this in another room. Your bedroom should be where you go to sleep. It is not a place to go when you are bored. Once you feel sleepy again, go back to bed.
  3. Begin rituals that help you relax each night before bed.
    This can include such things as a warm bath, light snack or a few minutes of reading.
  4. Get up at the same time every morning.
    Do this even on weekends and holidays.
  5. Get a full night’s sleep on a regular basis.
    Get enough sleep so that you feel well-rested nearly every day.
  6. Avoid taking naps if you can.
    If you must take a nap, try to keep it short (less than one hour). Never take a nap after 3 p.m.
  7. Keep a regular schedule.
    Regular times for meals, medications, chores, and other activities help keep the inner body clock running smoothly.
  8. Don’t read, write, eat, watch TV, talk on the phone, or play cards in bed.
  9. Do not have any caffeine after lunch.
  10. Do not have a beer, a glass of wine, or any other alcohol within six hours of your bedtime.
  11. Do not have a cigarette or any other source of nicotine before bedtime.
  12. Do not go to bed hungry, but don’t eat a big meal near bedtime either.
  13. Avoid any tough exercise within six hours of your bedtime.
    You should exercise on a regular basis, but do it earlier in the day. (Talk to your doctor before you begin an exercise program.)
  14. Avoid sleeping pills, or use them cautiously.
    Most doctors do not prescribe sleeping pills for periods of more than three weeks. Do not drink alcohol while taking sleeping pills.
  15. Try to get rid of or deal with things that make you worry.
    If you are unable to do this, then find a time during the day to get all of your worries out of your system. Your bed is a place to rest, not a place to worry.
  16. Make your bedroom quiet, dark, and a little bit cool.An easy way to remember this: it should remind you of a cave.

 

These are just a few tips that we recommend at Sleep Wellbeing.