Showing posts with label Sleep Disorders. Show all posts
Showing posts with label Sleep Disorders. Show all posts

What is Insomnia? What is the principal cause of Insomnia?

Understanding why we need sleep and knowing the root cause of insomnia is the first step in coming to terms with and treating it.
How do we define insomnia?
Insomnia is the term used to describe a lack of quality sleep; either taking ages to get to sleep, difficulty in staying asleep or waking up too early and being unable to get back to sleep.
What are the effects of insomnia?
People who suffer from poor quality sleep tend to be irritable, inattentive, lacking energy and accident prone.They are more likely to suffer from depression, heart disease and strokes.Continued sleep deprivation brings about changes in the activity and timing of important hormones such as melatonin, cortisol, leptin, thyroid hormones and prolactin. It has been shown in studies that this pattern of hormonal changes has also been witnessed in sufferers of depression and in age-related chronic conditions such as obesity, diabetes and hypertension.
This is just a taste of the negative effects of insomnia and that's without mentioning the adverse effect it has on our immune systems or the incredible impact from daytime fatigue on the occurrence of "accidents"; remember Chernobyl or Exxon Valdez.
What is sleep for anyway?
Nobody really knows exactly how sleep works. For centuries it was believed that sleep was just a neutral state of mind and body but modern science is beginning to identify the many positive affects a natural, good night's sleep has.
Moods
The brain's metabolic rate and temperature is reduced allowing the mending of certain brain cells which would otherwise have difficulty in regenerating.In our deepest sleeping, during the rapid eye movement (REM) phase we do most of our dreaming. It's at this stage when the receptors of the essential drugs serotonin, histamine and norepinephrine take a rest, restoring them to the appropriate level of sensitivity. This restorative measure is believed to be important in regulating our moods during the waking hours.
Sleep and weight loss
If you're trying to lose weight and believe that sleep loss won't adversely affect weight loss, think again. In childhood, human growth hormones (HGH) are responsible for tissue production, but as we grow into adults HGH becomes responsible for, amongst other things, weight regulation. HGH is only released when we sleep.
Sleep to learn
Many studies have been conducted and they have shown that whatever we take in and learn during the waking hours needs to be processed and consolidated before it is put to memory and reflected in our abilities. The process of sleep enhances this in an inestimable way.
So what is the main cause of insomnia?
There may be many reasons why we don't sleep well but the main cause of insomnia is simply stress.
Our lives, like that of any other organism, are kept for the most part at an optimum state of balance. Our hormonal secretions, fluid levels, temperature and so on are kept in balance so that the mind and body can perform at its peak.
The "flight or fight" response when being confronted by a predator is the most common example of a stress response but it can also be triggered by much less profound events such as crowding, noise or darkness. But even less obvious is that a stress response can happen to events such as fear, anger and even extreme pleasure.Sometimes we can live in a permanent state of stress response and prolonged states of stress can leave the body in a constant state of alarm and imbalance.
The process of sleep runs contrary to the effects of stress response. Falling to sleep involves the gradual shutting down of systems, a decrease in metabolism and the cessation of the readiness for action. Going to sleep makes us less alert and decreases arousal. The stress response increases arousal and makes us more alert.
Stress is the main cause of insomnia
The hormones secreted as a result of stress responses excite the body's systems. When stress is chronic we are hyperaroused.When we are hyperaroused we can't sleep.
If you are susceptible to the stresses brought about by daily life which impact on your night time sleep there are sleeping techniques using the senses that can maximize the quality of sleep, bringing enrichment to your waking days.
What is Insomnia? What is the principal cause of Insomnia?

Sleep Apnea - A Dangerous Sleeping Disorder

There are 3 types of sleep apnea:
  1. Central Apnea - caused by a failure of the brain to activate the muscles of breathing during sleep.
  2. Obstructive Sleep Apnea (OSA) - caused by a collapse of the airway during sleep.
  3. Mixed Apnea- a combination of central and OSA.
If interruptions in breathing (apnea) occur 15 or more times per hour the individual has significant sleep apnea. A normal Apnea Hypo Apnea Index (AHI) is < 5. A AHI of 5-15 is mild OSA, 15 to 30 is moderate OSA and > 30 apneic episode per hour is severe OSA.
Risk Factors for OSA include:
Increasing age (common among adults, rare in children)
More common in men than in pre-menopausal women, but the prevalence in post-menopausal women is about the same as men of same age.
Central/truncal obesity
Large neck size (> 17 inches in men and > 16 inches in women)
A large tongue that obstructs the airway
Smoking
Use of alcohol or other Central Nervous System (CNS) depressant drugs, sedatives and muscle relaxants.
Short-term OSA
Short-term OSA may be the result of upper airway infections, nasal congestion, swelling of the throat as in Infectious Mononucleosis and also in individuals with large tonsils. Here the apnea resolves once the underlying condition is treated.
Warning signs of OSA include:
Loud snoring
Excessive daytime sleepiness (fatigue), sleepy while driving
Apneic episodes witnessed by another person
Choking and gasping for air during sleep
Memory problems, irritability, anxiety and increasing depression.
Difficulty performing duties at work/home/school
Accidents on the job and /or Motor Vehicle Accidents (MVA).
Waking up due to acid reflux from the stomach- Gastro Esophageal Reflux Disease (GERD)
Morning headaches
Complications of OSA:
High Blood Pressure (hypertension)
Ischemic Heart Disease leading to heart attacks and stroke
Arrhythmias (irregular heartbeats)
Type 2 Diabetes Mellitus
Pulmonary Hypertension (elevated pressure in the blood vessels of the lungs) and Death.
Diagnosis of OSA:
Diagnosis is made by a careful history from patient and individual(s) who observe apneic episodes in the patient during sleep, and a careful physical examination. The gold standard test used to diagnose sleep apnea is an overnight polysomnogram(PSG) "sleep study". The polysomnogram can be performed either in a sleep laboratory or by Home Diagnostic Titration Testing (HDTT).
Treatment of OSA:
For mild to moderate cases of OSA, oral appliances may work; these can be made by a Dentist or Orthodontist. Upper airway surgery (on the soft palate) or nasal surgery (correction of nasal septum/rhinoplasty) may be recommended.
For Severe OSA the most common treatment is the use of CPAP therapy (Constant Positive Airway Pressure). The CPAP device is a small portable machine with a generator which delivers room air to the lungs at a positive pressure through a tubing via a full face mask worn every night during sleep.
For patients who find it difficult to sleep with a mask, a nasal pillow device can be substituted to increase compliance. If the CPAP pressure appears to be excessive bi-level therapy which uses a lower level of pressure can substituted.
RECOMMENDATIONS:
Behavior modification is the key to symptom improvement. Individuals should lose weight, engage in regular exercise, stop smoking, avoid sleeping on the back, avoid alcohol and sedating medications, treat any allergic/upper respiratory symptoms.
Summary:
Even if symptoms improve with behavior therapy, individuals should not discontinue their CPAP therapy without consulting with their Health Care Provider. The only accurate and safe way to determine if an individual no longer has sleep apnea is to perform a repeat polysomnogram.