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Sleep Disorders

Sleep disorders & problems

Few things in life are more important than sleep for our overall health and wellness, and many of us struggle with getting enough. If you find yourself waking up groggy, have trouble staying awake during the day, experience fatigue, or difficulty falling asleep at night you might be suffering from a sleep disorder. Sleep disorders plague millions of Americans each year and thankfully there are treatments offered at Los Angeles Sleep Study Clinic to treat and lessen the symptoms of many sleep disorders including:

Insomnia
Sleep Apnea
Narcolepsy
Abnormal nighttime activity
Restless leg syndrome
Shift work/circadian rhythm disorders
Snoring/breathing disorders
And more

Insomnia: Insomnia is one of the better known sleep disorders disallowing us to fall asleep and stay asleep.

If you are suffering from chronic or transient insomnia you may have trouble or an inability to fall asleep on your own and/or you may have trouble staying asleep during the night during the all-important REM sleeping. If you are suffering from nighttime insomnia the effects of the disorder follow you around all day. You might find yourself sleepy or find that you have an inability to concentrate or focus on daily tasks. If you have been suffering with any or all of these symptoms for over a month Los Angeles Sleep Study Clinic can help diagnose your sleep disorder and help you obtain the restful sleep your desire. Insomnia can exist due to biological factors, physical factors or a combination of both.

Biological factors may include but are not limited to:

Family history
Chronic conditions including arthritis, headaches, migraines or poor circulation
Breathing conditions such as sleep apnea, snoring or asthma
Thyroid issues
Restless leg syndrome
Enlarged prostate or incontinence
Dementia
Conditions related to the heart
Underlying deficiencies in vitamins
Electrolyte imbalances
….many more

Physical and environmental factors are sometimes the easiest factors to diagnose but the hardest to fix because physical factors exist in your everyday life through work, diet and relationships to name a few.

As a result of stress or anxiety in any or all of these areas sleep is often compromised. Environmental factors can take the form of living on a noisy block, having a loud barking dog next door or simply living in unhealthy conditions.

 Other physical or environmental conditions include:

Stress
Anxiety
Loud surroundings
Depression and other mental illnesses
Metabolic conditions

At Los Angeles Sleep Study Clinic we want to get to the root of your insomnia and take steps to adjust and fix your symptoms.

Give our expert team a call today and get back to feeling well rested every day! Are you getting too much sleep or falling asleep when you should be productive? Narcolepsy is a sleep disorder that is both disruptive to your daily life and dangerous for yourself and others. Narcolepsy is defined as excessive sleep or hypersomnia. Those suffering from narcolepsy might find themselves falling asleep at work, while driving, at random points during the day or inappropriate times in general.

Some symptoms of narcolepsy include:

Cataplexy:

A sudden weakness of muscles causing muscle stiffness or in extreme cases, paralysis. This can come about due to stress or an emotionally heightened mental state. Cataplexy is almost always a sign of narcolepsy as it indicates there isn’t enough hypocretin in the brain.

Frequent nighttime waking:

Some patients who experience narcolepsy are often woken up frequently at night due to stress related factors or physical factors like an overactive bladder, nighttime eating or excessive dreaming.

Sleep paralysis:

The inability to move or speak during sleep is called sleep paralysis and can be an indication that a patient is experiencing narcolepsy. Obesity: Excessive weight gain or obesity due to a patient’s inactivity during the day and loss of sleep during the night.

Hallucinations:

A lack of sleep over a consecutive period of time lasting more than a month can result in hypnagogic hallucinations or clear visions of the day’s activities while momentarily falling asleep or dozing. Diagnosing narcolepsy given these symptoms is fairly obvious, but in some cases if cataplexy is absent or the patient hasn’t been experiencing any of these symptoms for longer than a month, or the patient isn’t experiencing symptoms on a regular basis a sleep study is usually the best way to diagnose this sleep condition.

Los Angeles Sleep Study Clinic is fully equipped to monitor patients during their sleep and wake hours to properly and precisely diagnose narcolepsy. Treatment of this sleep disorder is conditional to the individual but may require one or more interventions including changing wake and sleep time behaviors, applying stress tests to find an underlying reason for sleep deprivation, administering medications and/or a mixture of the three. Above all else the experts at Los Angeles Sleep Study Clinic will create and manage a sleep schedule that both makes sense for the patient’s lifestyle and diagnosis. Abnormal nighttime activity Parasomnia is defined as abnormal behavior an individual undergoes while sleeping. The Los Angeles Sleep Study Clinic has employed a team that can accurately diagnose and treat abnormal sleep activity through home studies and a complete diagnosis of possible activities that are being performed while sleeping.

Some of these activities include:

Sleep walking
Sleep talking/walking
Sleep terrors/nightmares
Frequent, confusional arousals
Abnormal REM behavior
Paralysis

While sleeping Sleep walking/sleep talking Somnambulism or sleep walking/talking refers to behaviors exhibited by an individual who is sleeping but behaving in a way that would otherwise indicate the individual being awake. Sleep talking can come in the form of clear or muffled conversations or words being spoken by a sleeping individual during slow wave, non-REM sleep time. A person who exhibits the symptoms or actions of sleepwalking may perform daily routine activities as if they are awake. Eating, sitting up, walking and in extreme cases driving can all be actions of a sleepwalker.

Children and adults who are stressed, overtired, under the influence of alcohol or have a family history of sleepwalking are all prone to these behaviors and at risk for sleepwalking. Sleep terrors/nightmares Sleep terrors are frightening for a person who is watching the night or sleep terror occurring. Children are prone to sleep terrors due to being fatigued or not getting enough sleep during the day as are adults. Children and adults who are experiencing a night terror will abruptly wake from sleep screaming, crying, yelling or flailing and have no memory of the experience the next day. Much like sleepwalking and other sleep disorders sleep terrors often happen during non-REM sleep indicating that the person experiencing the sleep disorder is failing to fall asleep and into a healthy REM pattern. Nightmares are vivid dreams with frightening images causing distress and anxiety for the person who is experiencing it. Unlike night terrors nightmares normally occur when the individual is in the middle or tail end of REM sleep, so when they arise from the nightmare they can generally recall what happened in the dream and how they felt. This can be detrimental to the individual’s sleep especially in children since they fear a repeated episode.

Those experiencing symptoms linked to night terrors or nightmares might also be genetically predisposed to behaviors such as night terrors. Experts at Los Angeles Sleep Study Clinic can effectively diagnose this condition and administer a sleep routine after a sleep study has been conducted. Frequent, confusional arousals Confusional arousals are much like sleep terrors only instead of yelling, screaming of flailing the individual who has aroused from bed might speak in muffled tones and exhibit unusual behavior indicating that the individual is in fact asleep. Children who are overtired or adults with a family history are particularly prone to experiencing confusional arousals. Abnormal REM behavior REM sleep is the portion of a sleep cycle where a child or adult gets the best, deepest sleep. During REM sleep an individual experiences a full relaxation of muscles, the mind calms and dreaming occurs. REM stands for rapid eye movement which is nearly always an indication that the individual is experiencing good, deep sleep. Abnormal REM behavior occurs when the sleeping individual does not experience a full relaxation of the muscles and can twitch or move about in their sleep as if they are acting out an experience or dream.

The individual who is moving while dreaming can have violent episodes which are dangerous for themselves or another sleeping partner. Often the individual who is experiencing abnormal REM behavior will wake from their sleep and are able to account for the dream they were having which is vastly different than sleepwalkers who have no memory of the actions occurring while acting out. Diagnosis is best and most accurate during an observation of REM patterns during sleep. A sleep study is normally best for those who are experiencing abnormal REM behavior. Sleep paralysis Muscle relaxation is a normal part of a sleep cycle but sleep paralysis is not a normal part of a sleep cycle. Extreme muscle relaxation or sleep paralysis occurs when the individual is acutely or faintly aware of the REM cycle beginning. Paralysis can be frightening, especially when the person is fully aware of what is going on. Vivid dreams can occur during sleep paralysis where the individual believes he/she is included in activities that are going on around them when in fact they are dreaming. These can be chalked up to hallucinations of real time activities. Sleep paralysis can occur and be normal in some individuals, but if linked to other symptoms sleep paralysis is problematic and an indicator of narcolepsy.

In home sleep studies can be one of the best diagnostic tools that an individual can participate in to determine whether or not their symptoms are indicative of a sleep disorder or as a result of temporary stress. Restless leg syndrome Restless Leg Syndrome is a neurological disorder that causes affected patients to feel an uncontrollable urge to move their legs and feet, primarily during sleeping hours. The disorder affects twice as many women as it does men. Symptoms range from mild to severe. RLS can occur every night or be a transient disorder, coming and going during certain periods of life, such as during pregnancy. 3% of the population suffers from Restless Leg Syndrome, however it often goes undiagnosed and untreated.

 Patients typically experience one or more of the following symptoms:

Uncontrollable urge to move the legs that cannot be ignored.
Uncomfortable, creepy-crawly, tugging, itching, gnawing, or painful sensations in the legs.
Sensations of Restless Leg syndrome worsen when resting, especially at night when the patient is lying down in the evening. Sensations may improve partially or fully with activity. Relief only lasts as long as the activity does.
Restless Leg Syndrome often prevents patients from falling or staying asleep. The longer a patient is at rest, the higher the likelihood that the patient will experience symptoms.
Many patients with Restless Leg Syndrome also experience Periodic Limb Movements of Sleep.

Limbs jerk every 20-30 seconds throughout the night. This causes patients to partially or fully wake, preventing quality sleep. Several factors may play into the cause of Restless Leg Syndrome. Low blood ferritin levels are common in patients affect by RLS and iron deficiency is most obvious when measured in the brain or cerebrospinal fluid. Anemia, or hemoglobin and red blood cell count deficiency, and fatigue are often caused by low iron levels as well. Abnormal levels of dopamine in the brain can also affect those with Restless leg syndrome. Genetic and environmental factors can also cause the disorder. Other medical conditions, such as pregnancy or disorders involving the nervous system, can cause the onset of the disorder or worsen symptoms, as can medications. Restless Leg Syndrome is typically diagnosed after a discussion with your Sleep Specialist at Los Angeles Sleep Study about symptoms you are experiencing. Although a sleep study is not necessary to diagnose Restless Leg Syndrome, testing may be preformed to detect Periodic Limb Movement during Sleep, as well as sleep apnea, which can agitate or even cause Restless Leg Syndrome. Certain Periodic Limb Movement during Sleep patterns are indicative of Restless Leg Syndrome. Blood tests may also be preformed to measure blood iron levels.

A review of the medical history and drug use (prescription and otherwise), as well as ruling out any other neurological problems, will be used to diagnose. Los Angeles Sleep Study will come up with an individual treatment plan that best fits the patient and possible causes of their Restless Leg Syndrome. If testing shows that the patient is iron or vitamin deficient they will be given instructions on how to correct the deficiency. Lifestyle changes that may improve symptoms will also be discussed, such as limiting or avoiding alcohol and caffeine, use of exercise, stretches, heat/cold therapy, massage, acupuncture, or relaxation techniques. If these treatments are ineffective at managing Restless Leg Syndrome, drug therapy may be necessary. Your sleep specialist will discuss which medications will work best. Circadian Rhythm/Shift Work Disorders The human body works on an inner clock known as the circadian rhythm. This rhythm regulates when we are asleep and when we are awake. The body’s inner clock typically goes off of a 24 hour cycle and functions best when we operate on a consistent schedule, especially when we wake up and when we have enough exposure to daylight. Due to factors, such as a night work schedule, the circadian rhythm may be thrown off causing a Circadian Rhythm Disorder, such as one of the following: Delayed Sleep Phase Syndrome is when the patient is unable to fall asleep until very late in the night and then struggles to wake up at a “normal” time in the morning. This occurs when the brain’s sleep and waking signals are pushed back several hours from most people typically experience. Unless this co-occurs with another sleep disorder, such as insomnia or sleep apnea, the patient is able to get a restful quality and quantity of sleep, however this altered schedule interferes with many typical work or school schedules.

The disorder may appear during early childhood but is often noticed in adolescents and does not improve with age. Los Angeles Sleep Study seeks to treat Delayed Sleep Phase Syndrome through several methods. Light therapy uses artificial or natural light on strict schedule to help coax the brain into sending wakeful or restful signals at the appropriate times. Exposing the patient to light at increasingly earlier intervals can help patients wake earlier. Chronotherapy helps to correct the circadian rhythm by delaying bedtime by two hour periods. This method is used less frequently. Advanced Sleep Phase Syndrome occurs when the Circadian rhythm is altered so that patients struggle to stay awake in the evening and must go to bed extremely early due to their brain sending sleep signals earlier than most. Patients are able to wake up early and attain restful sleep, however they cannot stay awake into the evening, interfering with social events or responsibilities at home. Patients may need to avoid driving in the late afternoon or early evening because of drowsiness. The disorder is common in older adults and affects both genders equally.

Advanced Sleep Phase Syndrome is also treated with light therapy to help extend the hours during which the brain is sending alert signals to the patient’s body. Shift Work Sleep Disorder is a common disorder experienced by patients that work second or third shift jobs. Patients struggle to fall or stay asleep and experience extreme sleepiness throughout the day due to their inconsistent sleep schedule caused by rotating shifts and shifts that conflict with their natural circadian rhythm. Shift Work Sleep Disorder suffer from difficulty concentrating, low energy, and headaches. Shift work often runs longer than a typical 8 hour work day, leading to even more exhaustion. Treating Shift Work Sleep Disorder can be tricky. Many patients do not have the option to work a different shift, which means they must adjust their internal clock to line up with their work schedule to gain the most restful sleep possible. Your sleep specialist will discuss the best methods to help patients with Shift Work Sleep Disorder. Creating an optimal sleep environment, such as a cool, quiet, dark room, limiting light exposure on the drive home, maintaining the same schedule on days off, and using bright lights during waking hours are several suggestions Los Angeles Sleep Study may make to those struggling with the disorder. Snoring Sleep Related Breathing Disorders Several sleep disorders are caused by increased airway resistance that causes sleep disturbance are classified as Snoring Sleep Related Breathing Disorders. These disorders can cause insufficient sleep for those affected by the disorders and even be extremely harmful, depending on the severity of the disorder. The disorders that fall into this group include the following: Snoring is a common disorder that occurs when the airway is partially obstructed during sleep.

The vibrations caused by air passing through relaxed tissue of the throat and palate create the noise known as snoring. Snoring can be nothing more than a bothersome sound to the patient’s sleeping partner or it could be an indicator of a serious issue such as obstructive sleep apnea. Snoring can be responsible for poor sleep quality and quantity, which can be disruptive during waking hours. Treatment of snoring depends on the severity of the condition. Surgical treatment may be necessary for the most effective treatment. Surgical procedures focus on reducing the tissue in the airway that may cause the snoring. Mouth guard or retainer style appliances help position the tongue, jaw, and palate to create a more open airway.

Lifestyle changes may also be advised to improve snoring as well. Your Los Angeles Sleep Study specialist will discussion the best options based on your condition. Obstructive Sleep Apnea is a condition where there is full or partial collapse of the airways or obstruction which can lead to decrease in oxygen saturation’s, frequent awakenings, difficulty staying sleep, loud snoring, irritability, attention problems and more. Upper Airway Resistance Syndrome Similar to Obstructive Sleep Apnea, Upper Airway Resistance Syndrome occurs when the soft tissue of the throat relaxes during sleep, resulting in difficulty breathing which wakes the patient. Upper Airway Resistance Syndrome is typically less severe than OSA but produces the same troublesome effects for the patient, including excessive daytime fatigue and impairment due to the sleep disturbances that occur throughout the night. Symptoms are similar to OSA, but on a lesser scale, including snoring, frequent night wakings, daytime fatigue and impairment, and sleep that does not feel restful to the patient. Treatment for Upper Airway Resistance Syndrome will be discussed with your Los Angeles Sleep Study specialist, but can include some of the following options.

Lifestyle changes:

managing underlying medical conditions
hypertension
diabetes
nasal allergies

Losing weight are important for patients as well as other medical therapies and procedures. The use of surgical procedures, oral appliances that help position the jaw, tongue, or soft palate to open airway, or behavioral therapies, such as restricting the patient to certain sleeping positions, are all helpful techniques in controlling Upper Airway Resistance Syndrome. Other Sleep Related Respiratory Disorders Los Angeles Sleep Study will also help detect and treat other respiratory disorders that are directly related to sleep. Sleep Related Hypoventilation/Hypoxemic Syndromes may be found in patients that are exposed to low oxygen or high carbon dioxide levels and result in recurrent periods of shallow breathing during sleep that lasts longer than 10 seconds. Central Sleep Apnea is a condition found in patients where the brain does not send the proper signals to the body that cue breathing. Unlike OSA the lapse in breathing is not due to an obstruction in the airway. A thorough review of the patient’s health history and a physical exam are the first steps to diagnosing a sleep related respiratory disorder. The sleep specialist will then order appropriate diagnostic testing, such as an overnight sleep study. Treatment options, such as Bilevel Airway Pressure or Auto Servo-Ventilation devices, will be discussed depending on your test findings.