Restless Legs Syndrome

Overview

Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move your legs, usually because of an uncomfortable sensation. It typically happens in the evening or nighttime hours when you’re sitting or lying down. Moving eases the unpleasant feeling temporarily.

Restless legs syndrome, now known as restless legs syndrome/Willis-Ekbom disease (RLS/WED), can begin at any age and generally worsens as you age. It can disrupt sleep, which interferes with daily activities.

Simple self-care steps and lifestyle changes may help you. Medications also help many people with restless legs syndrome.

Symptoms

The chief symptom is an urge to move the legs. Common accompanying characteristics of RLS/WED include:

  • Sensations that begin after rest. The sensation typically begins after you’ve been lying down or sitting for an extended time, such as in a car, airplane or movie theater.
  • Relief with movement. The sensation of RLS/WED lessens with movement, such as stretching, jiggling your legs, pacing or walking.
  • Worsening of symptoms in the evening. Symptoms occur mainly at night.
  • Nighttime leg twitching. RLS/WED may be associated with another, more common condition called periodic limb movement of sleep, which causes your legs to twitch and kick, possibly throughout the night, while you sleep.

People typically describe RLS/WED symptoms as abnormal, unpleasant sensations in their legs or feet. They usually happen on both sides of the body. Less commonly, the sensations affect the arms.

The sensations, which generally occur within the limb rather than on the skin, are described as:

  • Crawling
  • Creeping
  • Pulling
  • Throbbing
  • Aching
  • Itching
  • Electric

Sometimes the sensations are difficult to explain. Affected people usually don’t describe the condition as a muscle cramp or numbness. They do, however, consistently describe the desire to move their legs.

It’s common for symptoms to fluctuate in severity. Sometimes, symptoms disappear for periods of time, then come back.

When to see a doctor

Some people with RLS/WED never seek medical attention because they worry they won’t be taken seriously. But RLS/WED can interfere with your sleep and cause daytime drowsiness and affect your quality of life. Talk with your doctor if you think you may have RLS/WED.

Causes

Often, there’s no known cause for RLS/WED. Researchers suspect the condition may be caused by an imbalance of the brain chemical dopamine, which sends messages to control muscle movement.

Heredity

Sometimes RLS/WED runs in families, especially if the condition starts before age 40. Researchers have identified sites on the chromosomes where genes for RLS/WED may be present.

Pregnancy

Pregnancy or hormonal changes may temporarily worsen RLS/WED signs and symptoms. Some women get RLS/WED for the first time during pregnancy, especially during their last trimester. However, signs and symptoms usually disappear after delivery.

Risk factors

RLS/WED can develop at any age, even during childhood. The disorder is more common with increasing age and more common in women than in men.

Restless legs syndrome usually isn’t related to a serious underlying medical problem. However, RLS/WED sometimes accompanies other conditions, such as:

  • Peripheral neuropathy. This damage to the nerves in your hands and feet is sometimes due to chronic diseases such as diabetes and alcoholism.
  • Iron deficiency. Even without anemia, iron deficiency can cause or worsen RLS/WED. If you have a history of bleeding from your stomach or bowels, experience heavy menstrual periods, or repeatedly donate blood, you may have iron deficiency.
  • Kidney failure. If you have kidney failure, you may also have iron deficiency, often with anemia. When kidneys don’t function properly, iron stores in your blood can decrease. This and other changes in body chemistry may cause or worsen RLS/WED.
  • Spinal cord conditions. Lesions on the spinal cord have been linked to RLS/WED. Having had anesthesia to the spinal cord, such as a spinal block, also increases the risk of developing RLS/WED.

Complications

Although RLS/WED doesn’t lead to other serious conditions, symptoms can range from barely bothersome to incapacitating. Many people with RLS/WED find it difficult to fall or stay asleep.

Severe RLS/WED can cause marked impairment in life quality and can result in depression. Insomnia may lead to excessive daytime drowsiness, but RLS/WED may interfere with napping.

 

SOURCE: MAYO CLINIC
Restless Legs Syndrome2018-11-21T22:17:09+00:00

Insomnia

Overview

Insomnia is a common sleep disorder that can make it hard to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. You may still feel tired when you wake up. Insomnia can sap not only your energy level and mood but also your health, work performance and quality of life.

How much sleep is enough varies from person to person, but most adults need seven to eight hours a night.

At some point, many adults experience short-term (acute) insomnia, which lasts for days or weeks. It’s usually the result of stress or a traumatic event. But some people have long-term (chronic) insomnia that lasts for a month or more. Insomnia may be the primary problem, or it may be associated with other medical conditions or medications.

You don’t have to put up with sleepless nights. Simple changes in your daily habits can often help.

Symptoms

Insomnia symptoms may include:

  • Difficulty falling asleep at night
  • Waking up during the night
  • Waking up too early
  • Not feeling well-rested after a night’s sleep
  • Daytime tiredness or sleepiness
  • Irritability, depression or anxiety
  • Difficulty paying attention, focusing on tasks or remembering
  • Increased errors or accidents
  • Ongoing worries about sleep

When to see a doctor

If insomnia makes it hard for you to function during the day, see your doctor to identify the cause of your sleep problem and how it can be treated. If your doctor thinks you could have a sleep disorder, you might be referred to a sleep center for special testing.

Causes

Insomnia may be the primary problem, or it may be associated with other conditions.

Chronic insomnia is usually a result of stress, life events or habits that disrupt sleep. Treating the underlying cause can resolve the insomnia, but sometimes it can last for years.

Common causes of chronic insomnia include:

  • Stress. Concerns about work, school, health, finances or family can keep your mind active at night, making it difficult to sleep. Stressful life events or trauma — such as the death or illness of a loved one, divorce, or a job loss — also may lead to insomnia.
  • Travel or work schedule. Your circadian rhythms act as an internal clock, guiding such things as your sleep-wake cycle, metabolism and body temperature. Disrupting your body’s circadian rhythms can lead to insomnia. Causes include jet lag from traveling across multiple time zones, working a late or early shift, or frequently changing shifts.
  • Poor sleep habits. Poor sleep habits include an irregular bedtime schedule, naps, stimulating activities before bed, an uncomfortable sleep environment, and using your bed for work, eating or watching TV. Computers, TVs, video games, smartphones or other screens just before bed can interfere with your sleep cycle.
  • Eating too much late in the evening. Having a light snack before bedtime is OK, but eating too much may cause you to feel physically uncomfortable while lying down. Many people also experience heartburn, a backflow of acid and food from the stomach into the esophagus after eating, which may keep you awake.

Chronic insomnia may also be associated with medical conditions or the use of certain drugs. Treating the medical condition may help improve sleep, but the insomnia may persist after the medical condition improves.

Additional common causes of insomnia include:

  • Mental health disorders. Anxiety disorders, such as post-traumatic stress disorder, may disrupt your sleep. Awakening too early can be a sign of depression. Insomnia often occurs with other mental health disorders as well.
  • Medications. Many prescription drugs can interfere with sleep, such as certain antidepressants and medications for asthma or blood pressure. Many over-the-counter medications — such as some pain medications, allergy and cold medications, and weight-loss products — contain caffeine and other stimulants that can disrupt sleep.
  • Medical conditions. Examples of conditions linked with insomnia include chronic pain, cancer, diabetes, heart disease, asthma, gastroesophageal reflux disease (GERD), overactive thyroid, Parkinson’s disease and Alzheimer’s disease.
  • Sleep-related disorders. Sleep apnea causes you to stop breathing periodically throughout the night, interrupting your sleep. Restless legs syndrome causes unpleasant sensations in your legs and an almost irresistible desire to move them, which may prevent you from falling asleep.
  • Caffeine, nicotine and alcohol. Coffee, tea, cola and other caffeinated drinks are stimulants. Drinking them in the late afternoon or evening can keep you from falling asleep at night. Nicotine in tobacco products is another stimulant that can interfere with sleep. Alcohol may help you fall asleep, but it prevents deeper stages of sleep and often causes awakening in the middle of the night.

Insomnia and aging

Insomnia becomes more common with age. As you get older, you may experience:

  • Changes in sleep patterns. Sleep often becomes less restful as you age, so noise or other changes in your environment are more likely to wake you. With age, your internal clock often advances, so you get tired earlier in the evening and wake up earlier in the morning. But older people generally still need the same amount of sleep as younger people do.
  • Changes in activity. You may be less physically or socially active. A lack of activity can interfere with a good night’s sleep. Also, the less active you are, the more likely you may be to take a daily nap, which can interfere with sleep at night.
  • Changes in health. Chronic pain from conditions such as arthritis or back problems as well as depression or anxiety can interfere with sleep. Issues that increase the need to urinate during the night ―such as prostate or bladder problems ― can disrupt sleep. Sleep apnea and restless legs syndrome become more common with age.
  • More medications. Older people typically use more prescription drugs than younger people do, which increases the chance of insomnia associated with medications.

Insomnia in children and teens

Sleep problems may be a concern for children and teenagers as well. However, some children and teens simply have trouble getting to sleep or resist a regular bedtime because their internal clocks are more delayed. They want to go to bed later and sleep later in the morning.

Risk factors

Nearly everyone has an occasional sleepless night. But your risk of insomnia is greater if:

  • You’re a woman. Hormonal shifts during the menstrual cycle and in menopause may play a role. During menopause, night sweats and hot flashes often disrupt sleep. Insomnia is also common with pregnancy.
  • You’re over age 60. Because of changes in sleep patterns and health, insomnia increases with age.
  • You have a mental health disorder or physical health condition. Many issues that impact your mental or physical health can disrupt sleep.
  • You’re under a lot of stress. Stressful times and events can cause temporary insomnia. And major or long-lasting stress can lead to chronic insomnia.
  • You don’t have a regular schedule. For example, changing shifts at work or traveling can disrupt your sleep-wake cycle.

Complications

Sleep is as important to your health as a healthy diet and regular physical activity. Whatever your reason for sleep loss, insomnia can affect you both mentally and physically. People with insomnia report a lower quality of life compared with people who are sleeping well.

Complications of insomnia may include:

  • Lower performance on the job or at school
  • Slowed reaction time while driving and a higher risk of accidents
  • Mental health disorders, such as depression, an anxiety disorder or substance abuse
  • Increased risk and severity of long-term diseases or conditions, such as high blood pressure and heart disease

Prevention

Good sleep habits can help prevent insomnia and promote sound sleep:

  • Keep your bedtime and wake time consistent from day to day, including weekends.
  • Stay active — regular activity helps promote a good night’s sleep.
  • Check your medications to see if they may contribute to insomnia.
  • Avoid or limit naps.
  • Avoid or limit caffeine and alcohol, and don’t use nicotine.
  • Avoid large meals and beverages before bedtime.
  • Make your bedroom comfortable for sleep and only use it for sex or sleep.
  • Create a relaxing bedtime ritual, such as taking a warm bath, reading or listening to soft music.

 

SOURCE: MAYO CLINIC

 

Insomnia2018-11-21T22:44:51+00:00

Snoring

Overview

Snoring is the hoarse or harsh sound that occurs when air flows past relaxed tissues in your throat, causing the tissues to vibrate as you breathe. Nearly everyone snores now and then, but for some people it can be a chronic problem. Sometimes it may also indicate a serious health condition. In addition, snoring can be a nuisance to your partner.

Lifestyle changes, such as losing weight, avoiding alcohol close to bedtime or sleeping on your side, can help stop snoring.

In addition, medical devices and surgery are available that may reduce disruptive snoring. However, these aren’t suitable or necessary for everyone who snores.

Symptoms

Snoring is often associated with a sleep disorder called obstructive sleep apnea (OSA). Not all snorers have OSA, but if snoring is accompanied by any of the following symptoms, it may be an indication to see a doctor for further evaluation for OSA:

  • Witnessed breathing pauses during sleep
  • Excessive daytime sleepiness
  • Difficulty concentrating
  • Morning headaches
  • Sore throat upon awakening
  • Restless sleep
  • Gasping or choking at night
  • High blood pressure
  • Chest pain at night
  • Your snoring is so loud it’s disrupting your partner’s sleep
  • In children, poor attention span, behavioral issues or poor performance in school

OSA often is characterized by loud snoring followed by periods of silence when breathing stops or nearly stops. Eventually, this reduction or pause in breathing may signal you to wake up, and you may awaken with a loud snort or gasping sound.

You may sleep lightly due to disrupted sleep. This pattern of breathing pauses may be repeated many times during the night.

People with obstructive sleep apnea usually experience periods when breathing slows or stops at least five times during every hour of sleep.

When to see a doctor

See your doctor if you have any of the above symptoms. These may indicate your snoring is associated with obstructive sleep apnea (OSA).

If your child snores, ask your pediatrician about it. Children can have OSA, too. Nose and throat problems — such as enlarged tonsils — and obesity often can narrow a child’s airway, which can lead to your child developing OSA.

Causes

When you doze off and progress from a light sleep to a deep sleep, the muscles in the roof of your mouth (soft palate), tongue and throat relax. The tissues in your throat can relax enough that they partially block your airway and vibrate.

The more narrowed your airway, the more forceful the airflow becomes. This increases tissue vibration, which causes your snoring to grow louder.

The following conditions can affect the airway and cause snoring:

  • Your mouth anatomy. Having a low, thick soft palate can narrow your airway. People who are overweight may have extra tissues in the back of their throats that may narrow their airways. Likewise, if the triangular piece of tissue hanging from the soft palate (uvula) is elongated, airflow can be obstructed and vibration increased.
  • Alcohol consumption. Snoring can also be brought on by consuming too much alcohol before bedtime. Alcohol relaxes throat muscles and decreases your natural defenses against airway obstruction.
  • Nasal problems. Chronic nasal congestion or a crooked partition between your nostrils (deviated nasal septum) may contribute to your snoring.
  • Sleep deprivation. Not getting enough sleep can lead to further throat relaxation.
  • Sleep position. Snoring is typically most frequent and loudest when sleeping on the back as gravity’s effect on the throat narrows the airway.

Risk factors

Risk factors that may contribute to snoring include:

  • Being a man. Men are more likely to snore or have sleep apnea than are women.
  • Being overweight. People who are overweight or obese are more likely to snore or have obstructive sleep apnea.
  • Having a narrow airway. Some people may have a long soft palate, or large tonsils or adenoids, which can narrow the airway and cause snoring.
  • Drinking alcohol. Alcohol relaxes your throat muscles, increasing the risk of snoring.
  • Having nasal problems. If you have a structural defect in your airway, such as a deviated septum, or your nose is chronically congested, your risk of snoring is greater.
  • Having a family history of snoring or obstructive sleep apnea. Heredity is a potential risk factor for OSA.

Complications

Habitual snoring may be more than just a nuisance. Aside from disrupting a bed partner’s sleep, if snoring is associated with OSA, you may be at risk for other complications, including:

  • Daytime sleepiness
  • Frequent frustration or anger
  • Difficulty concentrating
  • A greater risk of high blood pressure, heart conditions and stroke
  • An increased risk of behavior problems, such as aggression or learning problems, in children with OSA
  • An increased risk of motor vehicle accidents due to lack of sleep
SOURCE: MAYO CLINIC
Snoring2018-11-21T21:49:17+00:00

Sleep-Related Eating Disorder

Overview

Sleep-related eating disorder involves frequent episodes of out-of-control eating and drinking behaviors while in a state of sleep. You may be partially or fully unaware of your behavior while preparing and eating food, with little or no memory of these actions the next morning.

Sleep-related eating disorder can be dangerous because you could injure yourself during food preparation or eat inedible or toxic items. Sleep-related eating disorder can also have an impact on your health due to weight gain and obesity from eating high-carbohydrate and high-fat foods.

Sleep-related eating disorder can be associated with certain medications, eating disorders and other sleep disorders. Addressing these issues often resolves sleep-related eating disorder.

Symptoms

Sleep-related eating disorder is a parasomnia — abnormal activity or behavior that occurs while you’re falling asleep, sleeping or waking up.

Episodes of sleep-related eating disorder occur in the first half of the night after you’ve been sleeping and include:

  • Frequent episodes, generally nightly, of eating and drinking in an out-of-control manner
  • Impaired consciousness while preparing and eating food
  • Little or no memory of these actions the next morning
  • Eating high-carbohydrate and high-fat foods or odd combinations of food
  • Possibly eating inedible or toxic substances, such as frozen foods, coffee grounds, cleaning solutions or cigarette butts
  • Possibly experiencing injuries or engaging in dangerous food preparation activities
  • Not being easily awakened or redirected during the episode
  • Experiencing a negative impact on your health from the nighttime eating

When to see a doctor

Sleep-related eating disorder can be dangerous and impact your health and safety. If you have any of the symptoms listed above, see your doctor.

Causes

Sleep-related eating disorder usually occurs during non-rapid eye movement sleep in the first half of the night and is associated with the transition from non-rapid eye movement to arousal during sleep.

The exact mechanism for why it occurs is not known, but sleep-related eating disorder often occurs in people who have a history of sleepwalking, so these conditions may be related.

Risk factors

Sleep-related eating disorder is more common in women and typically starts in the teenage years or the early 20s.

Increased risk of developing sleep-related eating disorder is associated with:

  • Other sleep disorders, such as obstructive sleep apnea, sleepwalking, narcolepsy and restless legs syndrome
  • Hypnotic sleep medications, such as zolpidem (Ambien, Edluar, Intermezzo, Zolpimist), and certain other medications, such as antidepressants or antipsychotics
  • Having a daytime eating disorder, such as bulimia or anorexia
  • Having a mental health disorder, such as stress, anxiety or depression
  • Having a first-degree relative — a parent, child or sibling — with sleep-related eating disorder or sleepwalking
  • Experiencing sleep deprivation

Complications

A sleep-related eating disorder can result in:

  • Dangerous use of kitchen appliances, falls, cuts, burns, choking, injury from eating something inedible or toxic, or eating something you’re allergic to
  • Health problems, such as weight gain, poor diabetes control or dental cavities
  • Feelings of guilt and helplessness over the lack of control
  • Daytime tiredness from disrupted sleep

 

SOURCE: MAYO CLINIC
Sleep-Related Eating Disorder2018-11-21T21:03:25+00:00

Sleep Apnea

Overview

Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full night’s sleep, you might have sleep apnea.

The main types of sleep apnea are:

  • Obstructive sleep apnea, the more common form that occurs when throat muscles relax
  • Central sleep apnea, which occurs when your brain doesn’t send proper signals to the muscles that control breathing
  • Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, which occurs when someone has both obstructive sleep apnea and central sleep apnea

If you think you might have sleep apnea, see your doctor. Treatment can ease your symptoms and might help prevent heart problems and other complications.

Symptoms

The signs and symptoms of obstructive and central sleep apneas overlap, sometimes making it difficult to determine which type you have. The most common signs and symptoms of obstructive and central sleep apneas include:

  • Loud snoring
  • Episodes in which you stop breathing during sleep — which would be reported by another person
  • Gasping for air during sleep
  • Awakening with a dry mouth
  • Morning headache
  • Difficulty staying asleep (insomnia)
  • Excessive daytime sleepiness (hypersomnia)
  • Difficulty paying attention while awake
  • Irritability

When to see a doctor

Loud snoring can indicate a potentially serious problem, but not everyone who has sleep apnea snores. Talk to your doctor if you have signs or symptoms of sleep apnea. Ask your doctor about any sleep problem that leaves you fatigued, sleepy and irritable.

Causes

Obstructive sleep apnea

 

Illustration showing soft tissues of the throat

Obstructive sleep apnea

This occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils, the side walls of the throat and the tongue.

When the muscles relax, your airway narrows or closes as you breathe in. You can’t get enough air, which can lower the oxygen level in your blood. Your brain senses your inability to breathe and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don’t remember it.

You might snort, choke or gasp. This pattern can repeat itself five to 30 times or more each hour, all night, impairing your ability to reach the deep, restful phases of sleep.

Central sleep apnea

This less common form of sleep apnea occurs when your brain fails to transmit signals to your breathing muscles. This means that you make no effort to breathe for a short period. You might awaken with shortness of breath or have a difficult time getting to sleep or staying asleep.

Risk factors

Sleep apnea can affect anyone, even children. But certain factors increase your risk.

Obstructive sleep apnea

Factors that increase the risk of this form of sleep apnea include:

  • Excess weight. Obesity greatly increases the risk of sleep apnea. Fat deposits around your upper airway can obstruct your breathing.
  • Neck circumference. People with thicker necks might have narrower airways.
  • A narrowed airway. You might have inherited a narrow throat. Tonsils or adenoids also can enlarge and block the airway, particularly in children.
  • Being male. Men are two to three times more likely to have sleep apnea than are women. However, women increase their risk if they’re overweight, and their risk also appears to rise after menopause.
  • Being older. Sleep apnea occurs significantly more often in older adults.
  • Family history. Having family members with sleep apnea might increase your risk.
  • Use of alcohol, sedatives or tranquilizers. These substances relax the muscles in your throat, which can worsen obstructive sleep apnea.
  • Smoking. Smokers are three times more likely to have obstructive sleep apnea than are people who’ve never smoked. Smoking can increase the amount of inflammation and fluid retention in the upper airway.
  • Nasal congestion. If you have difficulty breathing through your nose — whether from an anatomical problem or allergies — you’re more likely to develop obstructive sleep apnea.

Central sleep apnea

Risk factors for this form of sleep apnea include:

  • Being older. Middle-aged and older people have a higher risk of central sleep apnea.
  • Being male. Central sleep apnea is more common in men than it is in women.
  • Heart disorders. Having congestive heart failure increases the risk.
  • Using narcotic pain medications. Opioid medications, especially long-acting ones such as methadone, increase the risk of central sleep apnea.
  • Stroke. Having had a stroke increases your risk of central sleep apnea or treatment-emergent central sleep apnea.

Complications

Sleep apnea is a serious medical condition. Complications can include:

  • Daytime fatigue. The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible, making severe daytime drowsiness, fatigue and irritability likely.You might have difficulty concentrating and find yourself falling asleep at work, while watching TV or even when driving. People with sleep apnea have an increased risk of motor vehicle and workplace accidents.You might also feel quick-tempered, moody or depressed. Children and adolescents with sleep apnea might perform poorly in school or have behavior problems.
  • High blood pressure or heart problems. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system. Having obstructive sleep apnea increases your risk of high blood pressure (hypertension).Obstructive sleep apnea might also increase your risk of recurrent heart attack, stroke and abnormal heartbeats, such as atrial fibrillation. If you have heart disease, multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from an irregular heartbeat.
  • Type 2 diabetes. Having sleep apnea increases your risk of developing insulin resistance and type 2 diabetes.
  • Metabolic syndrome. This disorder, which includes high blood pressure, abnormal cholesterol levels, high blood sugar and an increased waist circumference, is linked to a higher risk of heart disease.
  • Complications with medications and surgery. Obstructive sleep apnea is also a concern with certain medications and general anesthesia. People with sleep apnea might be more likely to have complications after major surgery because they’re prone to breathing problems, especially when sedated and lying on their backs.Before you have surgery, tell your doctor about your sleep apnea and how it’s being treated.
  • Liver problems. People with sleep apnea are more likely to have abnormal results on liver function tests, and their livers are more likely to show signs of scarring (nonalcoholic fatty liver disease).
  • Sleep-deprived partners. Loud snoring can keep anyone who sleeps near you from getting good rest. It’s not uncommon for a partner to have to go to another room, or even to another floor of the house, to be able to sleep.

 

SOURCE: MAYO CLINIC

Sleep Apnea2018-11-21T21:12:48+00:00
Bitnami