Sleep-Wake Disorder is a very uncommon syndrome which causes irregular sleeping patterns without any real schedule.

Causes
Persons with brain malfunctioning and those who do not have a regular routine during the day experience such disorders. People with changing work shifts often experience such disorder. Also, travellers who often move from one country to another with different time zones may also have these symptoms.
There's no cure for this disorder, but treatments, including hormones, medicine, and light therapy, can help get you closer to a normal sleeping pattern.

Symptoms

Symptoms may include any of the following:

Sleeping or napping more than usual during the day
Trouble falling asleep and staying asleep at night
Waking up often during the night
Exams and Tests
A person must have at least three abnormal sleep-wake episodes during a 24-hour period to be diagnosed with this problem. The time between each such episode varies from 1 to 4 hours. The doctor may advise you to go ahead with a device called actigraph in case the diagnosis is unclear. The device looks like a wristwatch, and it can tell when a person is sleeping or awake.

Treatment
Though there is no simple cure for irregular sleep-wake syndrome, however, several therapies and lifestyle changes may help a person return to a normal sleep-wake cycle. These include:

A regular daytime schedule of activities and mealtimes need to be fixed.
You should not stay in bed during the day for long.
Use bright light therapy in the morning like those from computer screens and television. The period of exposure should also be increased. Exposure to blue light should be minimized at night.
You should take melatonin at bedtime. This is a hormone that controls the sleep-wake cycle. By taking doses at the right times, you might be able to shift your body clock earlier or later.
Make sure to make the room dark, quiet, and as comfortable as possible at night.
Also one should try to minimize the amount of noise in the sleep environment.
Add more structure to the patient s day by scheduling social interaction, exercise, and other activities.
Your doctor may prescribe drug to control the timing of the sleep-wake cycle.
Finally, you should take proper care of yourself. Make positive changes in your lifestyle. You can even ask your boss to make your work schedule a bit flexible.

The ultimate goal of these lifestyle changes is to help the person sleep longer at night and make him feel active and awake during the day. Most people have sleep disturbances on occasion. But you need to see your doctor if such sleep disorders occur regularly.


Sleep Wake Disorder - Irregular Sleeping Patterns

Sleep apnea is a disorder which is characterized as interruptions in breathing when you are sleeping. These interruptions or pauses in breathing usually last for about 10 to 20 seconds and may be repeated over 100 times alongside the duration of your sleep. This condition leads to poor sleep resulting in drowsiness, fatigue and poor concentration throughout the day.

Sleep apnea can be classified as:
1. Central sleep apnea: Central sleep apnea impairs the central nervous system wherein the brain fails to control muscles which regulate breathing while you sleep.
2. Obstructive sleep apnea: This type of sleep apnea occurs when the soft tissues present in the back of the throat block the airway and thus resulting in loud snoring.

Signs and symptoms
The various signs and symptoms of sleep apnea are
1. Loud and chronic snoring during sleeping
2. Interruptions in breathing
3. Shortness of breath during sleep
4. Fatigue during the day
5. Choking and gasping during sleep
6. Extreme irritability and drowsiness
7. Experiencing headaches in the morning
8. impaired concentration and forgetfulness
9. Chronic sore throat and dry mouth
10. Depression

The various risk factors for sleep apnea are:
1. If you are overweight
2. If you are male
3. If you are over the age of 40
4. If you have a large tongue and tonsils
5. If someone in your family has sleep apnea
6. Nasal obstruction due to sinus problems

There are certain prevention measures to control sleep apnea, they are:
1. Limit smoking: Smoking may cause you to retain fluid in the throat which contributes to sleep apnea.
2. Exercise: You should exercise regularly to keep off weight as being overweight increases the chances of getting affected by sleep apnea.
3. Schedule your sleep: You should get enough sleep every day so that your body is refreshed and revitalized. Getting enough sleep, thus helps in preventing sleep apnea.

Risk Factors Associated with Sleep Apnea

We're all guilty of making fun of snorers, but sometimes this snoring can be a symptom of sleep apnea. Sleep apnea is a condition where breathing is not continuous and may start and stop many times while asleep. This affects the quality of your sleep and in turn can affect many aspects of your health including your cardiovascular health. Here's how:

High blood pressure
When a sleep apnea patient's breathing stops, the oxygen levels in the blood also suddenly fall. This can increase your blood pressure. High blood pressure means that the heart muscles need to work harder to pump blood through the body.

Cardiomyopathy
As a result of high blood pressure, the heart walls may become thicker and the heart muscles become stiffer. This is known as cardiomyopathy. As this condition worsens, the heart becomes weaker and is unable to maintain a regular rhythm. This can eventually lead to heart failure.

Arrhythmia
An irregular heartbeat is also known as arrhythmia. This may also be related to the changes in the heart's structure that follow the drop in blood oxygen levels. In many cases, arrhythmia has no visible symptoms and can often go undiagnosed. This can result in the formation of blood clots in the atria which can lead to a stroke.

Sleep apnea is easy to diagnose. If the doctor feels that you show symptoms of sleep apnea, you may be asked to stay on the hospital overnight and undergo a sleep evaluation. This tests a variety of body functions including brain activity, eye movements, heart rate, breathing patterns and blood oxygen levels.

Treatment for sleep apnea depends on the causes for this condition. If you are overweight, regular exercise and a change in diet can help you lose the excess weight and cure sleep apnea. Similarly, if your sleep apnea is triggered by an allergy, treating the allergy can help cure the sleep apnea. Other forms of treatment for sleep apnea may include:

Continuous positive airway pressure (cpap)
This is a machine which pumps air into the body through a nasal mask. By keeping the pressure in the machine higher than normal air pressure the upper airway passages are kept open and hence the quality of your sleep is improved. An auto cpap machine can modulate the air pressure such that it is higher when you inhale and lower when you exhale.;

Oral devices
Your doctor may suggest oral devices that allow you to keep your mouth open while you sleep. This is easier to use than cpap machine but less effective. Surgery is the last resort when it comes to treatment for sleep apnea.

Sleep Apnea and Its Link to Heart Failure

Insomnia is a disorder where a person has difficulty sleeping. One can have problem falling asleep or staying asleep for long. Some people also have disturbed sleep. This can be a major problem as due to lack of sleep one feels tired and fatigued all day.

Recurring cases of insomnia hamper your daily activities and interfere with the smooth functioning of your life. Therefore, this condition should not be ignored and treated immediately.

Here are the various ways to treat insomnia:
Non-Medical (Cognitive and Behavioral treatment)
Several psychological and behavioral techniques can be used for the treatment of insomnia. Many of these methods can be easily self-taught and others require a therapist to be carried out properly. 

1. Relaxation training, which is also called progressive muscle relaxation involves the patient to tense and relax his muscles systematically in various parts or regions of the body. Relaxation techniques, such as breathing exercises, various forms of meditation, mindfulness and guided imagery are used for treating insomnia people. The use of audio recordings for guidance in these techniques is quite popular.

2. Stimulus control enables building an association between the bedroom and sleep. This is done by limiting several kinds of activities done in a bedroom. This may include going to bed only when very sleepy and leaving bed if you cannot sleep within twenty minutes. A strict bedtime and wake up time schedule has to be maintained.

3. Cognitive behavioral therapy or CBT involves changes in behavior like maintaining a strict sleep time schedule, elimination of afternoon naps and other habits related to sleep. A cognitive component is also added to this method. Unhealthy beliefs and fear regarding sleep are challenged and positive, rational thinking is encouraged. CBT is a very effective procedure for treating insomnia and the track record regarding success is high.

4. Changes in lifestyle are required to treat insomnia and prevent recurrence of insomnia, you should change certain habits and start some new practices. You should limit your intake of caffeine, alcohol and nicotine. Do not consume coffee or tea before going to sleep and avoid smoking. The habits may be stimulating and will keep you awake. Your diet should be balanced. You should avoid having rich and spicy food before going to bed. Avoid late meals and maintain a proper schedule for meals. Regular exercise can improve the symptoms of insomnia and you should try to work out every day.

Medical Treatment
There are many forms of medicines, which can treat insomnia. This includes over-the-counter medicines, as well as prescribed medicines. The type of medicine required completely depends on the severity and symptoms of your insomnia and other factors related to health. Therefore, you must consult a doctor before having any kind of medicine for treating insomnia.

The most common medicines for insomnia, which are usually prescribed by doctors are benzodiazepine hypnotics, non-benzodiazepine hypnotics and melatonin receptor agonists. However, medicines should only be taken after consulting with a specialist. Insomnia not only affects your health but also interferes with all your daily activities. Proper treatment should be taken to treat the same.

Ways to Treat Insomnia

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

Snoring is something that not only spoils the sleep of your partner but leaves you embarrassed while travelling or any family gatherings. It is more popular among males but these days, women are also facing this issue. The problem only worsens with age and weight. On the other hand, the person suffering from Sleep Apnoea not only affects his and his partner's sleep but puts his life at risk.

Difference Between Sleep Apnoea And Snoring:

There is a huge difference between just Snorers and those suffering from Sleep Apnoea. Sleep Apnoea almost always results in frequent and loud snoring, while disturbing the breathing pattern. This leads the person suffering from Sleep Apnoea to feel tired even after long sleeping hours.

While Sleep Apnoea will almost always lead to loud snoring, snoring alone does not mean that one is suffering from Sleep Apnoea.



Causes And Symptoms

Snoring

  When a person sleeps, the throat muscles relax and the tongue bends backwards. This narrows down the throat to some extent.
  As the person keeps inhaling and exhaling, the throat muscles vibrate. These vibrations lead to snoring. The narrower the throat becomes, the more are the vibrations and the sound.
  The throat muscles tend to relax more with age. This is why snoring usually increases with age.
  If a person has obstructions in the form of Tonsils, Nasal polyps or Deviated nasal septum, the narrowing gets worse and leads to extensive snoring.
  If there is an inflammation in the throat or nose due to some infection or allergy, the throat may become narrower and result in loud snoring.
  In some people, sleeping positions like sleeping on the back or otherwise may abate snoring.
  Alcohol consumption during evening time may abate throat muscle relaxation and give rise to snoring.

Sleep Apnoea

  It is better described as episodes of pauses in breathing for more than 10 seconds at a time.
  The immediate cause of Sleep Apnoea is extensive narrowing or complete collapse of the upper airway.
  As breathing is paused temporarily, it causes a shortfall of Oxygen in blood. As it happens, the heart works harder to make up for it, even when the person is sleeping. This increases the risk of heart attack and stroke.
  It causes disturbance in the natural sleep cycle.

Treatment

Snoring

  Avoidance of risk factors like various allergies
  Correction of sleeping position with training

Sleep Apnoea

  The most common treatment is CPAP (Continuous Positive Airway Pressure). This is a mask like device worn on the nose before sleep. It keeps the upper airway open with a small positive pressure delivered.
  There is also the option of Uvulopalatopharyngoplasty. This is a surgical intervention to remove excess of soft palate tissue and open up the airway. The remaining tissue becomes stiff and thus minimize vibration.
  If there is a Tonsil or Deviated Nasal Septum or Nasal Polyp, it needs to be resected out in order to minimize obstruction to the airway.

Snoring and Sleep Apnoea are very common issues and can be treated by experienced doctors very easily.

Ways to diagnose snoring and sleep apnoea:

The doctors ask about the allergies you are suffering from, as well as your eating patterns, medicines and drinking and smoking habits. The doctor also examines your throat and nasal passages to ascertain if there are any kind of nasal, dental, mouth jaw, or throat deformities that are triggering your snoring. If your doctor will feel that you may be suffering from sleep apnoea, then your partner may be asked to keep a diary noting your sleeping and snoring patterns.

Polysomnography and CPAP Titration are some other ways through which the doctors diagnose sleep apnoea.

Polysomnography: Polysomnography, also called a sleep study, is a type of test that is conducted to diagnose sleep disorders. In this test, the doctors record the brain waves, the oxygen level in the blood, heart rate and breathing, as well as eye and leg movements of the patient.

CPAP Titration: A CPAP titration study is a type of in-lab sleep study that is carried out to calibrate continuous positive airway pressure (CPAP) therapy. It is a common treatment that is used to manage sleep-related breathing disorders including obstructive sleep apnea, central sleep apnea and hypoventilation and hypoxemia.

In case you find out that you are suffering from snoring or sleep apnoea, you should immediately visit a pulmonologist to get the proper treatment. 

Snoring And Sleep Apnoea - How To Get Rid Of Them?

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