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Posts from the ‘Sleep Disorders’ Category

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

Restless Legs Syndrome

Restless legs syndrome (RLS) is a disorder resulting in discomfort, aching or strange sensations in the legs that are only relieved upon moving the legs. 1Insomnia is the major byproduct of RLS and can make staying rested very difficult. The sensations felt in the legs have been described as tingling, itching, creeping and aching. These sensations distract the mind and make sleeping nearly impossible due to lack of comfort.

Symptoms of RLS are most evident in the nighttime, especially when trying to fall asleep. The urge to move the legs can disrupt sleep causing insomnia and daytime drowsiness the following day. Over half of those suffering from RLS symptoms report taking more than 30 minutes to fall asleep each night. 2

Between 5 and 15 percent of the population suffer from restless leg syndrome, although many are misdiagnosed or not diagnosed at all. 2 RLS is commonly diagnosed as simple insomnia or depression as many of the symptoms are similar.

RLS can begin at any age but it more severe and pains last longer as age increases. The peak onset period is around middle age. 1 Additionally, RLS is known to run in families. More than 70 percent of children diagnosed with RLS also had a parent with RLS. 2 RLS is more common in females and those who are pregnant, suffer from rheumatoid arthritis or are anemic are at higher risk. 1

Treatment

Treatment for RLS is typically prescribed medication and relaxation therapy. 1 Walking, massaging the legs and acupressure are a few of the techniques proven to help reduce RLS symptoms. Relaxation techniques such as Yoga and Pilates, especially late in the day can assist in stretching the legs and help to alleviate symptoms. 2 Heat therapy in the form of heat or ice packs or simply a hot bath have also been shown to help with relaxation of muscles and helping to ease symptoms.

Caffeine intake can increase chances of developing RLS and can worsen symptoms if intake is not suppressed. Also, those with low iron levels or anemia may develop RLS and should take actions to increase iron intake.

The best way to combat the symptoms associated with RLS is through relaxing and going through the process to get better sleep overall. This includes making the bedroom quiet, cool and comfortable, not eating close to bedtime and exercising regularly.  Additionally, memory foam mattresses and latex mattresses may help with RLS as they help to reduce pressure points.

Teamed with the many other sleep problems and disorders, especially in adults, individuals suffering from RLS can experience a very difficult time sleeping resulting in lack of focus, lack of attentiveness and onset of depression.

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. National Sleep Foundation—Restless Legs Syndrome (RLS) and Sleep; http://www.sleepfoundation.org/article/sleep-related-problems/restless-legs-syndrome-rls-and-sleep