Do You Have a Sleep Disorder?

We’ve all experienced our fair share of sleepless nights from stress and busy schedules, but when is an ongoing lack of sleep truly a sleep disorder? An estimated 50 million to 70 million adults in the United States have a sleep or wakefulness disorder, according to the Centers for Disease Control and Prevention. These people have trouble performing daily tasks, remembering details, operating vehicles and staying awake throughout the day.

"People who do not 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 the Sutter East Bay Medical Foundation. “Sleep deprivation can lead to excessive daytime sleepiness, loss of concentration and attention, and other serious cognitive disorders.”

We spend about a third of our lives asleep, during which time our bodies repair muscles, consolidate memories and release hormones regulating growth and appetite. Sleep plays a direct role in how energetic and focused we are during the other two-thirds of our lives.

Andrew McClintock-Greenberg, M.D. , Ph.D, a pulmonary, critical care and sleep medicine specialist with the Sutter East Bay Medical Foundation, says many people don’t realize how deeply a lack of sleep can impact them during their waking hours.

"Recently, I saw a young man for a respiratory disorder. During the visit he could barely keep his eyes open. I asked him to take a sleep study. I ended up treating him for respiratory issues and sleep apnea,” Dr. McClintock-Greenberg says. “Many people never talk with their doctors about their problems sleeping or their fatigue, but they should."

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.

• Do I have persistent daytime sleepiness?
• Am I feeling irritable during the day?
• Am I having trouble concentrating?
• Are my reaction times slow?
• Is it difficult for me to stay awake during activities?
• Have I fallen asleep or felt very tired while driving?
• Am I using caffeine as a way to keep myself awake?
• Am I using alcohol as a self-medication tool to fall asleep?
• Am I having trouble falling asleep or staying asleep?

Adults ages 60 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.

Dr. McClintock-Greenberg says adults who consistently fail to get seven to eight hours of sleep often have underlying health issues that can be exacerbated by an ongoing lack of sleep.

"Not getting enough sleep for a long period of time can cause health problems. For example, it can make health problems like diabetes, high blood pressure, heart disease, stroke, depression, cancer and obesity worse,” Dr. McClintock-Greenberg says.

Types of Sleep Disorders

There are more than 80 sleep disorders that can lead to problems such as difficulty falling asleep and staying asleep, excessive sleepiness during the day, sleepwalking, sleep talking and other various abnormal behaviors. The most common sleep disorders seen by Dr. Cooper and Dr. McClintock-Greenberg are insomnia, snoring, sleep apnea, restless leg syndrome, narcolepsy and respiratory disorders.

• Insomnia — The inability to fall asleep or stay asleep, is the most common type of sleep disorder. Insomnia is frequently a symptom of stress, depression or an underlying health condition. A lack of exercise can magnify the problem, as can the use of caffeine, nicotine and alcohol. To learn how to cope with this disorder, find out what to do for insomnia. Also take proactive steps to help yourself sleep by reviewing this checklist for a better night’s sleep.

• Sleep apnea — This condition affects an estimated 12 million to 18 million Americans, according to the National Heart, Lung and Blood Institute. People with sleep apnea have episodes where they stop breathing or take shallow breaths while sleeping. These episodes can occur 20, 30 or even more times per hour. Sleep apnea can be caused by either complete or partial obstruction of the airway, resulting in chronic sleep deprivation. People who are male, overweight or have a family history of the disorder are at a higher risk. Side effects include morning headaches, daytime sleepiness, reduced ability to concentrate, high blood pressure, heart attacks, heart-rhythm disorders, stroke and decreased life expectancy.

• Upper airway resistance syndrome — a disorder related to sleep apnea. In this disorder, breathing does not cease, but rather the work of breathing becomes more difficult and labored. The result is very loud crescendo snoring and periodic awakening. The adverse health consequences are similar to those of sleep apnea.

• Snoring — very common disorder that does not cause significant health consequences, but is often linked to obstructive sleep apnea and upper airway resistance syndrome. If you or your partner is concerned about your snoring, your doctor may recommend you undergo a sleep study called polysomnogram to rule out any sleep disorder.

• Restless leg syndrome — a neurological disorder in which people feel the uncontrollable urge to move their legs while experiencing throbbing, tingly or aching sensations. Symptoms are worse when lying down and only increase with age. The legs may cramp and jerk during sleep. As many as 10 percent of Americans may have restless leg syndrome, according to the National Institute of Neurological Disorders and Stroke.

• Narcolepsy — a disorder characterized by excessive daytime sleepiness. People with the disorder experience irresistible bouts of sleep throughout the day, falling asleep for a few seconds or minutes. Loss of muscle tone, hallucinations and brief episodes of paralysis at the start or end of sleep are often part of the experience.

Treating Sleep Disorders

If you have tried to regulate your sleep schedule and used this checklist for a better night’s sleep, but sleep still evades you, then it’s time to call your doctor. Before your appointment, use a sleep log to track your sleep patterns, including how many hours of sleep you get each night. 

Dr. Cooper says she’s always surprised at how many of her patients do not realize they have a problem because of a lack of sleep or poor sleep. They often attribute it to other factors.

“It has become the new 'normal' for them. People accept insomnia as something they have to deal with, and they often self-medicate by using over-the-counter medications or alcohol,” she says. “Time after time, I hear patients tell me they just didn’t know how much their sleep impacted their life.”

Luckily, many sleep disorders are treatable with lifestyles changes, medications, airway devices and even counseling. For those with restless leg syndrome and narcolepsy, which have no cure, drug therapy is often the only way to find relief. Hot baths, massages and heating pads or ice packs may help relieve the symptoms of some restless leg syndrome symptoms.

Insomniacs are taught to practice good sleep hygiene and follow a checklist for a better night’s sleep, which includes creating a sleep routine. Sometimes medications may be used to help people fall asleep, but Dr. Cooper says medications aren’t a quick fix for sleep problems.

"Sleeping pills seem like the easy solution, but they do not cure insomnia. They are highly addictive and can lose their effectiveness," she says.

For those who suffer from snoring and sleep apnea, lifestyle changes such as losing weight, exercising regularly, decreasing alcohol consumption, and monitoring the use of sleeping pills and muscle relaxants can help reduce, or even eliminate problems. For more serious cases, doctors may consider issuing a continuous positive airway pressure device, known as a CPAP machine, which provides an air splint for the collapsed airway during sleep. Another option is a dental or oral appliance, a custom molded retainer worn in the mouth at night to prevent soft throat tissues from collapsing and obstructing the airway. Some devices are designed to hold the lower jaw forward during sleep, while others directly affect tongue position. Surgery is typically the last course of action.

Dr. McClintock-Greenberg says his sleep apnea patients often struggle with their airway devices, but that they are truly the best treatment option.

"I find it’s easy to get people to do a sleep study, but it can be very hard to convince them to take the treatment," he says. "I often tell patients to be patient with their CPAP device and to not settle for a mask they do not feel comfortable with. Today’s machines are quieter and smaller, providing a patient with more options."

He says those who stick with their treatments will be rewarded.

"It’s amazing to see the difference in people who follow the treatment plans. They have more energy, their health improves and they look great.”