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Sleep apnea and insomnia prevent restful sleep

Millions of people are affected by sleep disorders. They have a hard time sleeping or they have trouble getting restful, continuous sleep. But there are options for ensuring that the time you spend asleep leaves you rested for the following day.

1 What are the most common sleep disorders you see in your clinic?

• Sleep apnea is when you have one or more pauses in breathing or shallow breaths when you sleep. The most common type is obstructive sleep apnea, which means the airway has collapsed or is blocked during sleep. This type of sleep apnea is more common in people who are overweight, but it can affect anyone.

• Restless legs syndrome causes unpleasant sensations in the legs and an uncontrollable urge to move them for relief. Individuals affected with the disorder describe the sensations as burning, creeping, tugging, or like insects crawling inside the legs.

• Insomnia is a sleep disorder that is characterized by difficulty falling and/or staying asleep.

2 How would you describe a healthy sleeping environment?

Make sure you make time in the evening to unwind. That means “unplugging” from the computer and TV. Make sure you have a good quality bed/mattress/pillow (most people find a firm mattress best). Your sleeping area should be dark, quiet and cool.

3 You must see lots of patients who have trouble falling asleep at night or wake up in the middle of the night unable to go back to sleep. What advice do you give them?

Go to bed and wake up at the same time of the day. This helps maintain a good sleep routine. Don’t eat too close to bedtime. Avoid watching the clock. If you cannot sleep within 30 minutes, get out of bed and read or listen to music or do other quiet activities until sleepy and then attempt sleep again.

Avoid use of caffeine after noon and nicotine. Get regular exercise, but not too close to bedtime. Read the information on any medications you take. Some may cause insomnia. Assess if there is any anxiety, depression, or pain that might be contributing to your sleep trouble. If none of that helps, consider that insomnia may reflect an underlying sleep disorder.

4 How do I know if I have insomnia?

Insomnia is anything that causes difficulty falling asleep, staying asleep or both and that also causes impairment of daytime activities due to daytime fatigue.

5 Why do people snore and what are the options for treatment?

Snoring occurs most often in males, though the likelihood for women increases after menopause. It’s also common in people who are overweight and who have extra soft tissue in the back of the throat (uvula, soft palate, tonsils, adenoids), nasal abnormalities, craniofacial abnormalities like those with Down syndrome and hereditary factors

Snoring may be a sign not only of noisy breathing but may reflect a sleep disorder called obstructive sleep apnea (closure of the airway during sleep resulting in a lack of airflow to the lungs and other tissues like the brain that causes disturbed sleep). Sleep apnea can lead to significant chronic health disorders like hypertension, cardiovascular disease, cardiac arrhythmias like atrial fibrillation, stroke, diabetes, headaches, erectile dysfunction, and depression.

If there is concern a person has sleep apnea, a sleep study should be done to determine whether there is an abnormality. This will help determine proper treatment. Treatment of sleep apnea includes a continuous positive airway pressure machine or a bilevel positive airway pressure machine, oral appliances, weight loss, and a variety of surgical procedures.

Treatment of benign snoring includes avoiding of substances that promote snoring such as alcohol, nicotine, sedatives.

Dr. Kimberly Mebust is a neurologist specializing in sleep disorders and the medical director for MultiCare Sleep Medicine.

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