Sleep is one such time when people usually are expected to lie down still and get rest. However, we have all heard of sleepwalking, a condition where a person walks during the sleep. Though it may sound strange, there is a deeper explanation for it both from a causative point of view and from managing it.

Things you should know?

Sleepwalking happens when a person moves back from a deep sleep to a light sleep or awakening state.
The person who is sleepwalking is usually not aware of it.
Activities may range from simply getting up and sitting up in bed to walking around the room. They could also open the door and walk out to the neighbourhood. Moving furniture, changing dresses or driving a car, may also be some of the actions Most of these activities happens completely without their knowledge.
Mostly happens in children up to the age of 12, but can be seen in adults also, where it assumes a more severe form.
The person who is sleepwalking has a fixed stare with glassy eyes. They may appear dazed and lost when they are awakened.
They may not respond when they are actually sleepwalking, or respond very slowly
They can be brought back to bed and put back to sleep without being disturbed. Most children would go back to sleeping when this is done
Though the parents can be very worried when they see children sleepwalking, reassurance is required, as it usually disappears as they cross teenage.
There could be chances of small injury like tripping or fall during the sleepwalking episode
Sleepwalkers may be more restless compared to other children during their waking hours
Bedwetting is also quite common in children who sleepwalk
Causes

Inappropriate sleep pattern with lack of sleep for prolonged periods is one of the main reasons for sleepwalking
Stress
Excessive drinking
Medical conditions like heart rhythm problems, acidity, gastric reflux, and seizures
Psychiatric conditions like panic attacks and post-traumatic stress disorder can also lead to sleepwalking
Management

For a parent to see their child walking around in their sleep can be quite disturbing.
Reassurance is required stating that it is just a temporary phase and will not stay beyond the teenage years
Most people do not require any intervention unless accompanied by severe symptoms like going out of the house or driving
Once established, it is advisable to avoid by not drinking too much alcohol, avoiding stress and anxiety and taking precautions like extra-secure locks to prevent sleepwalking and/or other side effects.

Sleepwalking - 11 Things You Must Know!

Sleep is known to most as a period of rest and relaxation, but there are multiple disorders which are associated with sleep too. Hypersomnolence or hypersomnia is one of the most common sleep disorders. This is characterised by excessive daytime sleepiness and prolonged periods of sleep at night. They wake up fresh in the morning, but can easily go back to sleep any time of the day without feeling strained or tired. There is again no freshness associated upon waking up. Funny as it may sound, they can doze off even during a meal or in the middle of a conversation.

Causes: This condition is most common in men and in the early adolescent days.

There is no underlying cause that has been identified, though there is a genetic predisposition.
People with history of head trauma are more affected
People with anxiety, depression, bipolar disorders, epilepsy, and other mental disorders are also more likely to be affected
People with sleep apnea often are hypersomnolence
Restless legs syndrome, narcolepsy
Neurodegenerative disorders like Parkinson s and Alzheimer s tend to sleep more.
Symptoms:

Sleeping for longer hours at night time
Excessively sleepy during daytime
Able to doze off anytime during the day
Inappropriate and involuntary sleeping pattern
Having difficulty getting out of bed after waking up, even after prolonged sleep
Feeling of disorientation
Feeling agitated, anxious, lethargic, and irritated
Impaired cognition and memory
All these lead to extreme state of drowsiness
Increased tendency for hallucinations
Reduced appetite and even weight loss in some people
There is restlessness, reduced pace of thinking and speaking
Overall reduced energy levels
Social interactions are affected including work life, social functions, etc.
Diagnostic criteria:

If a person happens to sleep more at night or falls asleep during the day easily for more than 3 times a week, it is usually concerning.
The added feature of no tiring physical activity can also lead to suspicion
In acute cases, these symptoms are present for at least a month and in chronic cases, it could be seen for up to 3 months
It cannot be explained by lack of sleep on a regular basis
One or more of the above conditions could be present, which can help in making the diagnosis
Treatment:
Most cases of hypersomnia would need treatment only to improve their energy levels and improve the quality of life. Very often, treating the underlying condition can lead to improvement of hypersomnia. The tired, lethargic, restless feeling affects the overall performance of a person, leaving them with a lowered self-esteem. Brain stimulating drugs like amphetamines are used to improve daytime alertness and also reduce sleepy feeling during the day.


Hypersomnolence - How It Can Be Managed?

Pain related sleep disruption has affected a large number of people around the globe. Statistics has it that, in India, about 25% of the population suffers from pain-related sleep deprivation. Studies call it  the vicious cycle of pain and sleep  as pain affects your ability to sleep and lack of sleep makes the pain even worse.

Back pain and arthritis are examples of some common pain-related medical disorders. People with these types of chronic pains have reported persistent sleeplessness or have had immense trouble falling asleep.

The following are the primary sleep disorders associated with chronic pain:

Insomnia: It is a medical condition that is characterized by an inability to fall asleep no matter how physically exhausted you are. Insomnia can be acute (lasting for one night to a week) or chronic (that lasts for more than 3 weeks).
Hypersomnia: It is a condition wherein you tend to sleep excessively; in this condition, you will have trouble being awake throughout the day or can fall asleep at any point of time.
Sleep Apnoea: This is a sleep disorder wherein breathing pauses and resumes repeatedly. Risk factors include obesity, age and gender; it is more commonly observed in men. This condition can be chronic with symptoms such as snoring loudly or feeling very tired even after one has had a night s sleep.
Restless leg syndrome: It is a sleep disorder wherein you continuously move your legs while sleeping. However, this condition can also cause you to move your legs even if you aren t sleeping.
Some of the causes of sleep disorders due to chronic pain are:

Pain
Worry and anxiety
Sweating at night
Depression and other mental disorders
Treatment

A pain and sleep disorder should be simultaneous as both the components of it, pain and sleep, are interrelated. Some of the ways people with chronic pain can still have a good night s sleep are:

Limiting caffeine intake
Abstaining from alcohol and smoking, as these disrupt the sleep cycles, thus aggravating the existing pain.
Practicing meditation and other relaxation techniques
Pain killers or sleeping pills can be administered, but only with the doctor s advice.
Hot water fomentation over painful area during night, for better sleep.

Back Pain and Bad Sleep

Trigeminal neuralgia is specified by the condition of a chronic pain that influences the trigeminal nerve. This nerve transfers sensation from one s face to his/her brain. If a person is suffering from trigeminal neuralgia, then a gentle stimulation of face (sourced from brushing teeth or applying makeup) might generate a fright of agonizing pain. The affected person might experience short and mild attacks initially. However, the trigeminal neuralgia might progress and generate more-frequently and longer attack of severely critical pain. Women get affected by this situation more than men get and it is more prominently occur in individuals older than 50 years.

Trigeminal neuralgia does not mandatorily mean that you need to experience a lifelong pain. Various types of treatment alternatives are available and so doctors can usually handle the particular condition effectively by taking help of injections, medications or surgery. Various types of triggers might cause the pain regarding trigeminal neuralgia, such as eating, drinking, shaving, brushing teeth, touching face, smiling, washing face etc.

Symptoms

The symptoms of trigeminal neuralgia might comprise of one or more patterns and some of these are described below:

Sequences of serious, jolting or shooting pain that might generate as an electric shock
Spontaneous pain attacks or attacks stimulated by different activities like face touching, speaking, chewing, or brushing teeth. Pain attacks last from a few moments to some minutes.
It is not a comprehensive list because Trigeminal neuralgia hosts various other symptoms as well. If a person feels facial pain, specifically recurring or prolonged pain or if the person does not get relief through the utilization over-the-counter pain relievers, then that person must consult a doctor.
How does Radiofrequency Ablation treat Trigeminal Neuralgia?
Trigeminal Neuralgia is a chronic and painful condition that involves the trigeminal nerve. There are two separate trigeminal nerves on both sides of the face, which carry the sensations like pain from the face to the body. Each nerve has three branches- forehand, midface and chin and trigeminal neuralgia can cause intense pain in any of these areas.

Causes-

This occurs when the trigeminal nerve functioning is disrupted. When the blood vessel/artery and the trigeminal nerve at the base of your brain come in contact, it puts pressure on the nerves and causes pain.
It also occurs as a result of ageing or multiple sclerosis
A disorder that damages the myelin sheath protecting the nerves can trigger pain
Sometimes pain occurs from tumors, which compresses the trigeminal nerves
Surgical strokes, facial trauma or strokes can also be the root cause of excruciating pain
Triggers-

Shaving
Touching your face
Eating and drinking
Putting on makeup
Brushing
Washing your face
Symptoms-
The pain can be mild and for a shorter duration or it can happen frequently for longer durations. Some experience the pain in cycles where it can come and go for days or even for weeks. Gradually the intensity of the pain lessens.

Cure by Radio-frequency Ablation
The treatment of trigeminal neuralgia is often a challenging process in clinical practice. When medicines do not prove as effective, surgery is the desired option.

Procedure-

After applying local anaesthesia, the Pain Specialist carefully inserts a needle through the corner of your mouth to reach the trigeminal nerve
The doctors then wake up the patient after stimulating the nerves and ask them to feel the stimulation at the same place where they undergo pain. This confirms their targeted location
Once you fall asleep again, the Pain Specialist uses radiofrequency heat to injure the nerve enough to create numbness and removes the pain
How Effective is Radio-frequency Ablation?
The pain is cured almost in 98% of the patients. 50% of patients report recurrence of pain after about two years. Hence the procedure can be repeated in the same patient if necessary.

Trigeminal Neuralgia And Radio-Frequency Ablation - What Causes It?

Hypopituitarism is defined as a condition in which the pituitary gland is unable to produce enough hormones. Under-secretion of pituitary hormones affects reproduction, body growth and blood pressure. It also results in pre-mature aging.

The pituitary gland is a small bean-shaped gland situated at the base of your brain, behind your nose and between your ears. Despite its size, this gland secretes hormones that influence nearly every part of your body.

In hypopituitarism, you have a short supply of one or more of these pituitary hormones. This deficiency can affect any number of your body's routine functions, such as growth, blood pressure and reproduction.

Few Causes:

Head injury

Tuberculosis

Radiation treatment

Stroke

Brain tumors

Brain surgery

Meningitis (brain infection)

Hypophysitis (autoimmune inflammatory disorder)

Sarcoidosis is an infiltrative (accumulation of cells and tissues in excess of the normal amount) disease which occurs in various organs.

Impaired hormone secretion by the pituitary gland is caused by genetic mutations.

Sheehan s syndrome: It is a condition in which the pituitary gland gets damaged due to severe blood loss during childbirth.

Hypothalamus (a part of the brain which is located above the pituitary gland) diseases wherein the pituitary activities are directly affected by the hypothalamus.

Symptoms:

Fatigue

Reduced sex drive

Decreased appetite

Anemia

Irregular menstruation, pubic hair loss, hot flashes (feverish heat), and inability to breast-feed properly because of low breast milk production).

Dwarfism in children

Weight loss

Increased sensitivity to cold temperature

Infertility

Facial puffiness

Reduction in body hair or facial hair

Treatment Options:

Hormone replacement drugs include:

Corticosteroids: Adrenocorticotropic hormone deficiency leads to low production of adrenal hormones (different kinds of hormones such as cortisol and adrenalin, produced in the endocrine glands). These drugs act as a replacement of adrenal hormones.

Growth hormone: Growth hormone, also known as somatropin, is injected beneath the skin. This treatment method promotes growth, which balances the height in children. Growth hormone deficiency in adults is also cured by these medications to some extent.

Surgery: Surgical procedure is needed if the condition of hypopituitarism is the result of a tumor. The doctor will remove the tumor through surgery, thus resulting in normal growth.

Radiation: Radiation therapy helps in reducing the size of the tumor which causes stunted growth or pre-mature aging.

Hypopituitarism: Causes, Symptoms and Treatment

Sleep Apnea refers to sleep disorder which is characterized by irregular pauses or interruption in breathing during sleep. Every pause usually lasts for a few minutes or seconds and occurs several times at night. This may indicate that your brain as well as rest of your body is not getting sufficient supply of oxygen. Sleep apnea is of two types - Central Sleep Apnea (CSA) and Obstructive Sleep Apnea (OSA).

Obstructive Sleep Apnea- This occurs when the air passage gets blocked, generally when the throat muscles periodically relax and obstruct your air passage during sleep. It is the most common type of sleep apnea and is characterized by snoring.
Central Sleep Apnea- In this case, the airway does not get blocked, but the brain stops passing signals to the muscles that control your breathing.
Mostly people who are diagnosed with a number of underlying medical conditions such as obesity, diabetes, hypertension, chronic nasal congestion etc. are prone to Obstructive Sleep Apnea. Although Central Sleep Apnea is a less common type of sleep disorder, and does not lead to serious complications, various research studies show that Obstructive Sleep Apnea can pose adverse consequences if not treated at the right time.

One such fatal consequence is cardiovascular problems. Sudden drops in the levels of oxygen in blood that happens during Obstructive Sleep Apnea results can lead to increased blood pressure and damage of the cardiovascular system, which in turn increases the chance of a heart attack. Since men are more prone to heart ailments than women, men with sleep apnea are at a greater risk of heart ailments like stroke or heart failure, coronary artery disease and others.

Since Obstructive Sleep Apnea occurs due to interruption in the breathing procedure, it can lead to abnormal irregular heartbeats, known as arrhythmia. Arrhythmia can decrease the level of oxygen in blood and if there s an underlying heart condition, these repetitive encounters of low blood oxygen can even lead to a sudden cardiac arrest.

Most research studies have established a positive correlation between sleep apnea and heart ailment. According to researchers, the risk of untimely death increases as the acuteness of sleep apnea increases. However, there are ways of seeking treatment for this particular sleep disorder. You should consult a doctor immediately and get yourself proper medical assistance to prevent the condition from aggravating.

Can Sleep Apnea Be Fatal?

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