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Sleep Talking

Sleep talking, often times accompanying sleepwalking and other sleep disorders, is known as somniloquy. Most sleep talkers are completely unaware that they are speaking in their sleep until informed by a bed partner or housemate.

Sleep talking can be classified as simple mumbling, strange sounds or even long drawn out speeches or conversations. The sleep talker also varies in volume from whispers to shouting. Many sleep talkers’ bed mate (or house mates depending on volume) are disturbed by the noise and suffer from insomnia as consequence.

The condition is more common in males and children, but can affect anyone. 1 Also, episodes can occur in any stage of sleep; however, the lighter the sleep, the more intelligible the content. 1 In stages one and two, individuals may appear to be continuing a conversation from moments before or talk about the day’s events. In stages three and four, the speech may be limited to gibberish and mumbling, but can consist of comprehensible conversation.

Half of children between ages 3 and 10 carry out conversations during their sleep as do about 5 percent of adults. 2 Sudden commencement of sleep talking for the first time may be associated with mental disorders. 1

Normal episodes of sleep talking occur for no longer than 30 seconds; however, the content of the talking can be alarming, erotic and vulgar. 2 Content of sleep talking should be taken lightly as it is associated with no known psychological significance. 3

While sleep talking is thought to be genetic, various circumstances and behaviors can trigger episodes, such as:

  • Drinking alcohol before bed
  • Stress
  • Mental disorders
  • Certain medications

Other symptoms of sleep talking may include:

  • Sleep Terrors
  • Sleepwalking
  • Nocturnal Seizures
  • REM Sleep Behavior Disorder
  • Obstructive Sleep Apnea

While the disorder may be a serious problem for some, it typically does not require treatment. If the disorder is thought to be a side effect of a corresponding sleep disorder, treatment may be necessary. See your doctor if sleep talking is a problem and regularly disrupts sleep.

Bibliography

1. National Sleep Foundation—Sleep Talking; http://www.sleepfoundation.org/article/sleep-related-problems/sleep-talking

2. WebMD—Talking in Your Sleep; http://www.webmd.com/sleep-disorders/excessive-sleepiness-10/talking-in-your-sleep

3. Carskadon, Mary A. Encyclopedia of Sleep and Dreaming. New York: Macmillan Pub., 1993.

Teeth Grinding and Sleep

Bruxism or teeth grinding affects 85 to 90 percent of people during their sleep. 1 Only about 5 percent of those are chronic teeth grinders. Most infants and children grind their teeth when they first come in during teething and when adult teeth come in. 2 Most people are unaware they are engaging in teeth grinding until they are informed by their sleep partner.

Signs of teeth grinding include a dull consistent headache the following morning and jaw or gum soreness. Teeth grinding typically does not disturb the grinder’s sleep, but can be very disruptive to the sleep partner.

Teeth grinding is most likely stress related and, therefore, can be remedied by decreasing stress. This can be done through medication, increasing exercise and getting more sleep. In some cases, teeth grinding is brought on as a side effect from other medication. In such instances, medication should be changed according to your doctor’s orders.

Teeth grinding has the potential to cause serious dental problems such as fracturing, loosening or loss of teeth. Extreme cases of chronic teeth grinding can result in damage to the jaw affecting hearing or even changing the shape of the face. Grinding can wear the teeth down resulting in the need for expensive dental procedures needed to fix the problem. 3

Treatment

Treatment for teeth grinding is limited but effective. Dentists can fit the mouth for a soft plastic mouth guard to prevent damaging the teeth. Mouth guards may become dislodged over time or increase the severity of teeth grinding in some individuals. Splints are similar to mouth guards, but much thinner, harder and more expensive. The reason for teeth grinding may also be crooked teeth, in which case braces and other teeth alignment treatments may correct the problem. 2

Other factors can help prevent teeth grinding such as:

  • Reduce caffeinated beverage and alcohol intake as they tend to increase the severity of teeth grinding. 3
  • Avoid chewing gum as it gets the jaw used to clenching as a natural motion. 3
  • Relax the jaw before bed by holding a warm washcloth to your check in front of the earlobe. 3
  • Train yourself to not clench your teeth. If you find yourself grinding or clenching during the day, place the tip of the tongue in between your teeth in order to train the jaw to relax. 3

Bibliography

1. Maas, Dr. James B., Megan L. Wherry, David J Axelrod, Barbara R. Hogan, and Jennifer A. Blumin. Power Sleep: The Revolutionary Program That Prepares Your Mind for Peak Performance. New York : Villard, 1998.

2. Mayo Clinic—Bruxism/Teeth Grinding: Treatments and drugs; http://www.mayoclinic.com/health/bruxism/ds00337/dsection=treatments-and-drugs

3. WebMD—Teeth Grinding (Bruxism); http://www.webmd.com/oral-health/guide/teeth-grinding-bruxism

Sleep and Depression: An Endless Cycle

A common symptom of many sleep disorders is depression. Those with depression report having difficulty sleeping. This correlation represents that both sleep and depression affect and are affected by each other. It is not certain whether one disorder is more dominant; however, sleep deprivation affects mood and a negative mood affects sleep, making an endless cycle of mood and sleep disorders.

Because sleep disorders are so closely related to depression, misdiagnosis is very common. Misdiagnosis makes treatment difficult and costly as trial and error with expensive medications can add up with little relief from symptoms. This correlation also makes it so that some treatments for depression work for certain sleep disorders such as prescription medication that treat depression and cause drowsiness.

Many of the same neurochemical and physiological processes involved in regulating sleep are also used in regulating mood. 1 Women and older individuals are more likely to experience depression. 2 These groups are also amongst those that report the most difficulty sleeping. Those with depression also commonly report fragmented sleep and early morning awakening before fully rested. 1

Common sleep disorders that list depression as a main symptom include:

  • Narcolepsy
  • Insomnia (chronic and irregular): Those with insomnia are ten times as likely to become depressed. 2
  • Restless legs syndrome: Forty percent of those diagnosed with RLS experience symptoms of depression if a sleep disorder were not already considered. 2
  • Obstructive sleep apnea: Those with depression are five times more likely to develop OSA based on a European study; however, with regular use of a CPAP (continuous positive airway pressure) machine, both OSA and depression symptoms were suppressed. 2

It is not certain if depression causes sleep disorders or sleep disorders cause depression, but it is clear that the mind is truly affected by sleep deprivation. Because some sleep disorders influence the ability to do certain tasks and can affect activities while awake, it is reasonable to believe that depression could stem from this added difficulty in life. Additionally, it had been shown that depression and related trouble sleeping could be genetically related just as restless legs syndrome and obstructive sleep apnea are thought to be genetic. 1

Studies have also shown that those experiencing symptoms of depression tend to have decreased amount of slow wave sleep (SWS) and increased brain activity during rapid eye movement sleep (REM sleep). 1 Therefore, those with depression experience more dreams.

Though the depth of the connection between sleep and depression is not yet certain, one thing is evident: Do not undervalue sleep. It is vital to well-being and happiness and can make the difference in living a fulfilled life. Taking steps to improve sleep hygiene and sleep environment can help to ease the symptoms of both depression and sleep disorders and stop the endless cycle of sleep and mood disruption.

Bibliography:

1. Carskadon, Mary A. Encyclopedia of Sleep and Dreaming. New York: Macmillan Pub., 1993.

2. National Sleep Foundation—Depression and Sleep; http://www.sleepfoundation.org/article/sleep-topics/depression-and-sleep

Acid Reflux (GERD) and Sleep Difficulty

If you wake up coughing and experience a burning in the chest, you a likely suffering from GERD (gastroesophageal reflux disease) or, more commonly, acid reflux. Acid reflux affects six to seven percent of the world population and is commonly dismissed as heartburn.

Symptoms

Main symptoms of GERD are heartburn, acidic regurgitation, inflamed gums, chronic bad breath and belching. Because of acid buildup in the body, it is not uncommon for tooth enamel to deteriorate.

Some individuals may not experience any symptoms at all. Many of the symptoms of GERD may be confused with heart problems, therefore misdiagnosis is common.

Those with acid reflux symptoms should also be tested for sleep apnea as the disorders seem to occur simultaneously, especially in overweight individuals. Traveling may also increase GERD symptoms. Fifty percent of travelers say that in addition to jet lag they suffer from gastrointestinal issues. 2 This is possibly due to eating during times you would normally be sleeping.

Overcoming GERD

  • Elevate the upper body during sleep. This can be done with special wedge pillows, adding blocks under the mattress or purchasing an adjustable bed.
  • Do not lie down immediately after eating a large meal.
  • Avoid eating within three hours of bedtime. This is recommended for all individuals who experience trouble sleeping.
  • Avoid foods and beverages that increase acid in the stomach such as chocolate, onions, spicy food, citrus fruits, soft drinks, alcohol, caffeine, vinegar, ketchup, mustard and fatty foods.
  • Some medications are calcium-channel blockers such as aspirin and other pain killers, which can worsen acid reflux symptoms.3 Check with your doctor before stopping any medications.
  • Do not wear night clothes that fit tightly around the chest, stomach or waist as they can irritate GERD symptoms.
  • Laying on the left side of the body has been proven to help with digestion. 3
  • Smoking may irritate symptoms and cause other sleep disruptions.
  • Chewing gum in the evening can increase saliva production. Saliva counteracts stomach acid.
  • If overweight, losing weight may be the best way to reduce symptoms.
  • Treatments include over-the-counter medications, prescription medications and antacids that prevent acid buildup and help to heal the esophagus. Surgery typically follows if medications do not prove effective.

Acid reflux is among the main causes of disturbed sleep in middle-aged individuals. 1 While inconvenient, GERD is not an unmanageable disorder. Simple lifestyle changes can reduce painful symptoms as well as more intensive medication use or surgery.

Bibliography:

1. National Sleep Foundation—GERD and Sleep; http://www.sleepfoundation.org/article/sleep-topics/gerd-and-sleep

2. Maas, Dr. James B., Megan L. Wherry, David J Axelrod, Barbara R. Hogan, and Jennifer A. Blumin. Power Sleep: The Revolutionary Program That Prepares Your Mind for Peak Performance. New York : Villard, 1998.

3. WebMD—Tips for Sleep without Heartburn; http://www.webmd.com/heartburn-gerd/guide/tips-for-sleep-without-heartburn