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Posts tagged ‘Sleep Disorder’

REM Behavior Disorder – Do You Physically Act Out Your Dreams?

Have you ever physically acted out your dreams, injured yourself and/or your sleeping partner, leapt out of the bed, had frightening dreams, kicked, punched, or ran in your sleep? If any of these sounds familiar you could be suffering from REM Sleep Behavior Disorder (RBD). People with RBD attempt to act out their dreams, which often times are violent in nature.

We typically can’t act out our dreams. The majority of people dream around 4-6 times per night during the REM (rapid eye movement) stage of sleep, the brain becomes as active during this stage as it is when you’re awake. Although the neurons in the brain during REM sleep are functioning as much as they do when you’re awake, REM sleep is also characterized by temporary muscle paralysis. Most people, even when they are having vivid, active dreams, their bodies are still. But, people with RBD are lacking this muscle paralysis, allowing them to act out the contents of their dreams.

RBD can begin by talking, twitching, and jerking while dreaming up to years before a person begins fully acting out their dreams. The risk of developing RBD increases with age and men are more likely to develop RBD than women. For about 55% of people the cause for RBD is unknown, and the other 45% is linked with alcohol or sedative-hypnotic withdrawal, antidepressants, or serotonin reuptake inhibitors. RBD also often precedes the development of some neurodegenerative diseases like Parkinson’s disease and multisystem atrophy; however, not all people with RBD with develop a neurodegenerative disease. People with RBD should consult with a doctor about their problems and can begin medication if needed to treat RBD. Patients will also be encouraged to make their sleeping environment as safe as possible by removing all sharp and breakable objects and ensuring all windows and doors are locked.

 

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.

“Causes & Diagnosis of REM Behavior Disorder.” National Sleep Foundation. Web. 8 Jan. 2015.

Boeve M.D., Bradley. “REM Sleep Behavior Disorder: Updated Review of the Core Features, the RBD-Neurodegenerative Disease Association, Evolving Concepts, Controversies, and Future Directions.” National Institutes of Health. U.S. National Library of Medicine, 1 Jan. 2011. Web. 8 Jan. 2015.

“REM Sleep Behavior Disorder.” Diseases and Conditions-REM Sleep Behavior Disorder. Mayo Clinic, 11 July 2014. Web. 8 Jan. 2015.

How To Reach Your Peak Performance – Sleep DiagnosticTests

Have you ever wondered if you are getting the right amount of sleep or if you could be doing something to sleep better? Preparing your mind and body for peak performance through better sleep is vital, here are four quick True or False tests to help you understand more about sleep to help you reach your peak. Self-test A reveals your general knowledge of sleep, self-test B tells how likely it is that you are sleep deprived, self-test C examines your current sleep practices, and self-test D probes for problems that could indicate you have a sleep disorder.

Self-Test A: What’s My Sleep IQ?
Please indicate true or false for the following statements:

1. Newborns dream less than adults
2. Men need more sleep than women.
3. Not everyone dreams every night.
4. As you move from early to later adulthood you need less sleep.
5. By playing audiotapes during the night, you can learn while you sleep.
6. Chocolate candies provided on your hotel pillow will help you sleep better.
7. If you have insomnia at night, you should take a long nap during the day.
8. Sleeping pills are very helpful for people who have had insomnia for
months.
9. Arousing a person who is sleepwalking can be very dangerous.
10. A soft mattress is better than a hard one for obtaining good sleep.
11. You are most alert when you first wake up.
12. To promote optimal sleep the best time to exercise is early in the morning.
13. A sound sleeper rarely moves during the night.
14. A boring meeting, heavy meal, or low dose of alcohol can make you sleepy, even if you are not sleep-deprived.
15. Sleep before midnight is better than sleep that begins after midnight.

–This test reveals your general knowledge of sleep, all the above statements are false. How did you score?

Self-Test B: Am I Sleep-Deprived?
Please indicate true or false for the following statements:

1. I need an alarm clock in order to wake up at the appropriate time.
2. It’s a struggle for me to get out of bed in the morning.
3. Weekday mornings I hit the snooze button several times to get more sleep.
4. I feel tired, irritable, and stress-out during the week.
5. I have trouble concentrating and remembering.
6. I feel slow with critical thinking, problem solving, and being creative.
7. I often fall asleep watching TV.
8. I often fall asleep in boring meetings or lectures or in warm rooms.
9. I often fall asleep after heavy meals or after a low dose of alcohol.
10. I often fall asleep while relaxing after dinner.
11. I often fall asleep within five minutes of getting into bed.
12. I often feel drowsy while driving.
13. I often sleep extra hours on weekend mornings.
14. I often need a nap to get through the day.
15. I have dark circles around my eyes.

–If you answered true to 3 or more of the 15 items, you are probably not getting enough sleep.

Self-Test C: How Good Are My Sleep Strategies?
Please indicate true or false for the following statements:

1. I go to bed at different times during the week and on weekends, depending on my schedule and social life.
2. I get up at different times during the week and on weekends, depending on my schedule and social life.
3. My bedroom is warm or often noisy.
4. I never rotate or flip my mattress.
5. I drink alcohol within two hours of bedtime.
6. I have caffeinated coffee, tea, colas, or chocolate after 6 pm.
7. I do not exercise on a regular basis.
8. I smoke.
9. I regularly take over-the-counter or prescription medication to help me sleep.
10. When I cannot fall asleep or remain asleep, I stay in bed and try harder.
11. I often read frightening or troubling books or newspaper articles right before bedtime.
12. I do work or watch the news in bed just before turning out the lights.
13. My bed partner keeps me awake by his/her snoring.
14. My bed partner tosses and turns or kicks/hits me during his/her sleep.
15. I argue with my bed partner in bed.

–If you answered true to one of the above questions, it is likely that at least one aspect of your lifestyle is interfering with your sleep.

Self-Test D: Might I have a Sleep Disorder?
Please indicate true or false or the following statements:

1. I have trouble following asleep.
2. I wake up a number of times during the night.
3. I wake up earlier than I would like and have trouble falling back asleep.
4. I wake up terrified in the middle of the night, but I do not know why.
5. I fall asleep spontaneously during the day in response to high arousal, such as when I hear a funny joke.
6. I have been told that I snore loudly and stop breathing temporarily during sleep.
7. I walk or talk in my sleep.
8. I move excessively in my sleep.
9. I have hurt myself or my bed partner while I was sleeping.
10. I become very confused, afraid, and/or disoriented after sundown.
11. I cannot fall asleep until very late at night or cannot wake up in the morning.
12. I cannot stay awake early in the evening and I wake up before dawn.
13. I feel mild pain or a tingling sensation in my legs just before falling asleep.
14. I physically act out my dreams during the night.
15. I am often too anxious, depressed, or worried to fall asleep.

–If you answered True to any of the above questions, you may have a sleep disorder.

 

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.

Mass, James B., Dr. “Sleep Diagnostic Tests.” Power Sleep. N.p., n.d. Web. 20 Dec. 2013. htdocs/diagnostics.htm>.

REM Sleep Behavior Disorder

When the majority of people enter into REM sleep they begin to dream, and during this time the body becomes paralyzed (sleep paralysis typically happens during this time when your brain becomes alert, but your body doesn’t). People with REM Behavior Disorder (RBD) aren’t always paralyzed during the REM portion of sleep and are able to act out dreams and/or nightmares, often causing harm to themselves and others.

The first time RBD was diagnosed was in 1985 by Dr. Mark Mahowald and Dr. Carlos Schenck at the University of Minnesota. They also found that more than 90% of RBD patients are male and the disorder doesn’t strike until after the age of 50, although kids have been diagnosed as early as the age of 9. They also go on to say that most RBD patients are calm, easy-going, and good-natured when awake, here are a few case histories documented by Drs. Mahowald and Schenck.

  • A 77-year old minister had been behaving violently in his sleep for 20 years, sometimes even injuring his wife.
  • A 60-year old surgeon would jump out of bed during nightmares of being attacked by “criminals, terrorists and monsters.”
  • A 62-year old industrial plant manager who was a war veteran dreamt of being attacked by enemy soldiers and fights back in his sleep, sometimes injuring himself.
  • A 57-year old retired school principal was inadvertently punching and kicking his wife for two years during vivid nightmares of protecting himself and family from aggressive people and snakes.

RBD can easily be confused with a number of parasomnias, this is why patients should be observed over night in a sleep center. A single night of monitoring almost always reveals a lack of muscle paralysis during REM sleep that leads to a diagnoses of RBD. After a diagnosis has been confirmed a treatment can begin, most commonly Clonazepam is prescribed, a benzodiazepine that can reduce or eliminate the disorder about 90% of the time.

Drs. Mahowald and Schenck made a startling discovery while conducting research on RBD; they found that 38% of 29 otherwise healthy patients with RBD went on to develop a parkinsonian disorder. “We don’t know why RBD and PD are linked,” says Dr. Mahowald, “but there is an obvious relationship, as about 40% of individuals who present with RBD without any signs or symptoms of PD will eventually go on to develop PD.” Other research has also shown a connection between RBD and neurodegenerative diseases related to Parkinson’s.

If you have any concerns about RBD you should consult with your doctor or find a sleep specialist in your area.

 

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.

The Sleep Foundation—REM Behavior Disorder and Sleep
Web. 01 Jan. 2014. <http://www.sleepfoundation.org/article/sleep-related-problems/rem-behavior-disorder-and-sleep&gt;.

Narcolepsy

Narcolepsy is a sleep disorder that causes overwhelming sleepiness and frequent attacks of sleep throughout the day. Narcolepsy is caused when the brain doesn’t have the ability to regulate a normal sleep-wake cycle; which can lead narcoleptics to fall into REM sleep instead of falling into a light to deep sleep cycle. Narcolepsy seems to affect both genders equally and begins showing signs in adolescence or young adulthood, and is often left undiagnosed.

Narcolepsy is characterized by excessive daytime sleepiness, hypnagogic hallucinations, sleep paralysis, cataplexy, interrupted nocturnal sleep, leg jerks, nightmares and restlessness. Along with excessive sleepiness and sudden onset of sleep the next primary symptom is cataplexy; a momentary loss of muscle tonus typically causing the person to fall to the ground, this usually results from a strong emotion such as surprise, laughter, anger, or elation. Hypnagogic hallucinations and sleep paralysis are also common and can be extremely scary symptoms of narcolepsy, causing feelings of suffocation, being on fire, drowning, or being attacked.

What causes narcolepsy? While there isn’t one definite answer, doctors have found that people suffering from narcolepsy have low levels of Hypocretin and even lower levels were found in people who also suffered from cataplexy. Hypocretin is a chemical that helps regulate sleep-wake cycles and REM sleep, what causes the loss of Hypocretin producing cells in the brain is still unknown. There are studies being conducted on Hypocretin replacement, Hypocretin gene therapy, and stem cell transplant in hopes of finding a more effective treatment or cure.

How to cope with narcolepsy: start by adding several short naps to your daily routine, establish a routine sleep schedule, eat and exercise on a regular schedule, and avoid caffeine, alcohol, and nicotine. If the above behavior treatments don’t work on the narcolepsy then there are different treatment options available. Medications for narcolepsy include stimulants, drugs that stimulate the nervous system to help them stay awake during the day. If stimulants aren’t effective then amphetamines may be prescribed, but can produce side effects such as nervousness, heart palpitations, and can be addictive. Tricyclic antidepressants may be used with people who also suffer with cataplexy; and in more extreme cases Sodium Oxybate can be prescribed, but can include some serious side effects.

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.

“Narcolepsy and Sleep.” Narcolepsy Symptoms, Treatment & Remedies. N.p., n.d. Web. 15 Dec. 2013. <http://www.sleepfoundation.org/article/sleep-related-problems/narcolepsy-and-sleep&gt;.

Mayo Clinic Staff. “Narcolepsy.” Mayo Foundation for Medical Education and Research, 24 Oct. 2012. Web. 16 Dec. 2013. <http://www.mayoclinic.com/health/narcolepsy/DS00345/DSECTION=treatments-and-drugs&gt;.

 

Your Guide to the Perfect Mattress

Choosing a mattress is ultimately left to personal preference, although it has been shown that certain mattresses can increase comfort and restful sleep in certain situations. For instance, different sleep disorders affect people in different ways, making finding an ideal bed a difficult process. Mattresses can have a significant impact on quality of sleep, especially if coping with a sleep disorder or back pain.

Sleep Disorders:

  • Fibromyalgia: These patients have extremely sensitive joints and experience fatigue and sleep deprivation because comfort is hard to come by in a mattress. Latex and memory foam mattresses are good for these patients because they reduce the amount of stress on the pressure points. 1
  • Sleep Apnea: Sleep apnea or chronic snoring is common in overweight individuals and those who regularly sleep on their backs. Because of these factors, a thicker mattress may be necessary to ensure it holds to the test of time.
  • Restless Legs Syndrome: These individuals require a bed that is not too soft as it takes more energy to move in an overly-soft bed. 1
  • Insomnia: Insomnia can be attributed to many different factors, both psychological and environmental. A common cause is heat, a reoccurring problem with memory foam mattresses. Cooling Gel memory foam mattress toppers or mattresses may help with inability to sleep. Additionally, the Outlast Bedding line will assist with heat regulation.

Other Circumstances:

  • Back Problems/Spine Injury: A firmer mattress may help keep spine aligned. Soft mattresses can cause the spine to dip. Most memory foam mattresses teamed with the correct pillow for your sleep position will keep the spine aligned helping to relieve injury.
  • Elderly: Some elderly individuals may prefer a firmer mattress in order to make it easier to get in and out of bed.
  • Osteoarthritis: Adjustable beds may help these individuals open up the back when used with both the upper body and knees elevated. It is also said that mattresses that are too firm can increase pain and injury in the back. 2
  • Overweight: Heavier individuals should use a firmer mattress, as they are more likely to sink down into a mattress lacking adequate support. 1

Overall, mattress firmness will be a matter of preference, although choosing a mattress that is too firm or too soft can have very negative effects on spine alignment and increase back and neck pain. The ideal mattress to benefit will be a medium firm, but not so firm it is uncomfortable. Choosing a mattress that does not personally offer you a great deal of comfort will not help with restful sleep, not matter its positive impact on back and spine health.

Bibliography:

1. Haex, Bart. Back and Bed: Ergonomic Aspects of Sleeping. Boca Raton: CRC, 2005.

2. Spine-Health—Mattresses and Sleep Positions for Each Back Pain Diagnosis; http://www.spine-health.com/wellness/sleep/mattresses-and-sleep-positions-each-back-pain-diagnosis

How Do You Treat Sleep Apnea?

Sleep apnea is the involuntary obstruction of the airway causing difficulty breathing. Many individuals are not diagnosed and believe that they are simply horrible snorers. This is because it is difficult to test for sleep apnea in the typical doctor’s office visit because many of the symptoms must be observed while one sleeps and there are no blood tests for the disorder. 1

There are two types of sleep apnea: central and obstructive. Central sleep apnea is the least common of the two and is characterized by the brain failing to send the correct signals to the muscles involved in breathing causing individuals to not breathe for brief periods of time. Obstructive sleep apnea is much more common and is characterized by the airway being narrowed or blocked during sleep.

Many are affected by sleep apnea, and risk of experiencing symptoms increases as individuals get older. Of individuals over the age of 65, 1 in 10 will be affected by sleep apnea. 1

The best way to combat sleep apnea is through weight loss. Around 70 percent of those who have obstructive sleep apnea or snoring are overweight. 2 Weight loss helps with snoring alone, but has also been shown to assist in sleep apnea because of positioning and overall increased health.

Because of this chronic interruption in the sleep cycle, individuals are prone to experiencing all of the negative factors that occur from sleep deprivation. These factors include weight gain, consistent drowsiness and decreased alertness, which can lead to increased stress.

Positional therapy is the concept of training the body to sleep in a different position. Many individuals with sleep apnea report sleeping on their back, which only worsens the snoring. An effective way to combat this is by sewing a tennis ball to the back of your pajama shirt to make sleeping on your back very uncomfortable. Be sure to change your pillow to one suited for your new sleep position.

Surgery on the nasal passages is somewhat effective in treating snoring, however, because it is difficult to determine exactly where the obstruction in the airways occurs, it is not guaranteed to cure individuals of sleep apnea. 2

Oral appliances resemble athletic mouth guards and help push the jaw forward to aid in opening airways. 2 They have been proven to help stop snoring; however, sleep apnea can still occur and go untreated.

For those with moderate to severe sleep apnea, a positive airway pressure (PAP) device is suggested and most widely used. The device is a nose or facial mask that is connected to a machine by a flexible hose that allows constant air flow into the mouth and nose helping to keep airways open.

Sleep apnea can also be treated through elevating the head while still keeping the spine aligned. This can be accomplished through the use of an adjustable bed or inserting a firm pillow below the mattress.

Those with sleep apnea should exercise caution when using alcohol, sleeping pills or other depressants due to the risk of dying because the body cannot be fully aware of when the breathing passage is closed during sleep. Additionally, treating snoring can dilute the warning signs that sleep apnea may be present. Therefore, it is not required to snore in order to have sleep apnea. 2

Bibliography:

1. National Heart Blood and Lung Institute http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/

2. American Sleep Apnea Association http://sleepapnea.org/diagnosis-and-treatment/treatment-options.html