Sleep More Soundly

Everyone has had nights when sleep just won’t come — whether it’s stress, feeling under the weather or a child who wakes up at 2:00 am or a sleep condition which ought to be treated. But when sleep problems persist, they shouldn’t be ignored. Sleep disorders like insomnia aren’t just frustrating — they can affect your daily life. You might struggle to focus, remember details or even stay awake while driving.

“People who don’t get enough sleep accumulate sleep debt, which is the difference between the amount of sleep you should be getting and the amount you actually get,” says Joanna Cooper, M.D., a neurologist and sleep medicine specialist with Sutter. “Sleep deprivation can lead to excessive daytime sleepiness, loss of concentration and attention, and other serious health and cognitive disorders.”

Ideally, you spend about a third of your adult life asleep, which is when your body repairs muscles, helps your brain store memories and releases hormones regulating growth and appetite. Sleep is also directly related to how energetic and focused you are during the other two-thirds of your day. 

Signs of a Sleep Disorder

How can you tell if you have a sleep disorder? Ask yourself a few questions. If your answer is yes to any of the following questions and these symptoms occur on a regular basis, you may have a sleep disorder.

• Am I irritable during the day?
• Am I having a hard time concentrating?
• Am I slow to react?
• Am I using caffeine to keep myself awake?
• Do I use alcohol to fall asleep?
• Do I have trouble falling asleep or staying asleep?
• Do I feel sleepy most of the day?
• Do I have trouble staying awake during activities?
• Have I fallen asleep or felt very tired while driving?
• Do I snore or gasp in my sleep?

Adults ages 50 and older, women, and people with depression are more prone to sleep disorders than any other demographic groups. Many older people have more fragile sleep and are easily disturbed by light, noise, pain, and various medical conditions.  

If you regularly get less than seven to eight hours of sleep, it increases your risk for health problems like diabetes, high blood pressure, heart disease, stroke, cognitive dysfunction, depression, cancer and obesity.

Types of Sleep Disorders

Sleep problems aren’t all the same. In fact, doctors recognize more than 80 different sleep disorders. Some make it hard to fall asleep or stay asleep, while others cause unusual behaviors during sleep or extreme daytime fatigue. Here are some of the most common ones.

• Insomnia
  Insomnia is the most common sleep disorder. People with insomnia have trouble falling asleep, staying asleep or both and suffer next-day consequences. It often shows up during periods of stress, anxiety or depression, but it can also be connected to underlying health conditions. Lifestyle habits — like getting little exercise or using caffeine, nicotine or alcohol close to bedtime — can make the problem worse. Learn how to cope with this disorder.
• Sleep apnea
  Sleep apnea occurs when breathing repeatedly stops or becomes very shallow during sleep. These pauses can happen dozens of times per hour, often without the person realizing it. The condition usually happens when the airway becomes partially or completely blocked, leading to disrupted sleep throughout the night. People who are male, overweight or who have a family history of sleep apnea are at higher risk. Post-menopausal women are also at risk. Symptoms may include loud snoring, morning headaches, daytime fatigue and trouble concentrating. Left untreated, sleep apnea can increase the risk of high blood pressure, heart disease, dementia and stroke.
• Upper airway resistance syndrome 
  This condition is related to sleep apnea. Instead of breathing stopping completely, the airway becomes narrowed, making breathing more difficult during sleep. As a result, people may experience loud snoring and frequent awakenings. Over time, the effects can be similar to sleep apnea, including poor sleep quality and daytime fatigue. A sleep study (polysomnogram) is needed to diagnose sleep apnea and upper airway resistance.
• Snoring 
  Snoring is extremely common and doesn’t always indicate a serious problem. However, persistent or very loud snoring can sometimes signal an underlying sleep disorder such as obstructive sleep apnea or upper airway resistance syndrome. If snoring is disruptive or concerning, a doctor may recommend a sleep study to evaluate what’s happening during sleep.
• Restless legs syndrome 
  Restless legs syndrome is a neurological condition that causes an uncontrollable urge to move the legs, often accompanied by uncomfortable sensations such as tingling, throbbing or aching. Symptoms tend to worsen when resting,  lying down or trying to fall asleep, which can make falling asleep difficult. Many people experience leg jerking or cramping during the night and symptoms often become more common with age.
• Narcolepsy 
  Narcolepsy is a condition that causes overwhelming daytime sleepiness and sudden “sleep attacks,” where a person may fall asleep for a few seconds or several minutes at a time. People with narcolepsy may also experience sudden loss of muscle tone (called cataplexy), vivid dreamlike hallucinations or brief periods of paralysis when falling asleep or waking up. Although narcolepsy is quite rare, it can significantly affect daily life if left untreated.

Treating Sleep Disorders

If you’ve tried to regulate your sleep schedule and used this checklist for a better night’s sleep, but sound sleep is still out of reach, then it’s time to call your doctor. Before your appointment, consider using a sleep log to track your sleep patterns, including how many hours of sleep you get each night and how you feel during the day.

The good news is that many sleep disorders can be treated. Depending on the cause, your doctor may recommend lifestyle changes, medication, breathing devices or other therapies. While restless legs syndrome and narcolepsy have no cure, medication and medication-free treatments can offer relief.

If you snore or have sleep apnea — depending on its severity — you may get recommendations to lose weight, exercise regularly, drink less alcohol, and limit the use of sleeping pills and muscle relaxants. These changes can help reduce, or even eliminate, problems. In some cases, doctors may consider prescribing a continuous positive airway pressure device, known as a CPAP machine, which provides an air splint for the collapsed airway during sleep.

For some people with mild to moderate sleep apnea, another option is a custom molded retainer worn in the mouth at night to advance the lower jaw and make more room in the back of the throat, preventing it from obstructing the airway. Surgery, including implantable devices such as the “INSPIRE” device, are complex and are typically the last course of action.

Good sleep isn't a luxury — it's a foundation for everything else. If restless nights are becoming your norm, don't wait it out. We're here to help you figure out what's going on and get you back to the rest you need. Reach out to your primary care doctor to start the conversation.