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Identifying Your Sleeping Disorder: Sleep Paralysis

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That it stands distinctively apart from its brothers, Night Terrors and Nightmares, indicates that there’s more to Sleep Paralysis than just the Hag Effect or the Incubus Effect as it is not so fondly yet aptly named. To get down to the basis of Sleep Paralysis, you might need to take a trip down bad memory lane to face the demons and clean up the closet of Sleep Paralysis. That it takes up vile names should not fall short of the gory impact considering the fact that “Hag” and “Incubus” bear the connotations of harlotry and a sex demon respectively…

 

( Fritz Schwimbeck's - My Dream, My Bad Dream - 1915 - Sleep Paralysis - Incubus Effect - Image Courtesy of en.wikipedia.org )
( Fritz Schwimbeck’s – My Dream, My Bad Dream – 1915 – Sleep Paralysis – Incubus Effect – Image Courtesy of en.wikipedia.org )

 

What to make of Sleep Paralysis – Identifying the Hag Effect

You know you’re sleep paralyzed when the imagery of your dream life from your sleep intrudes into your waking life upon arousal for that is how sleep paralysis manifests itself. Sleep paralysis is more common amongst the Narcoleptics but not even healthy typically normal sleepers are spared from the anguish of the Incubus Effect.

 

( Sleep Paralysis - Image Courtesy of flipboard.com )
( Sleep Paralysis – Image Courtesy of flipboard.com )

 

As nature would so cunningly have it, dreaming typically takes place during the REM sleep phase which is associated with muscle numbness and muscle paralysis. This not being a mere coincidence but a well thought-out and calculated phenomena according to evolutionary scientists so that while in that dreaming state one does not have to practically and physically live out and act out their dreams; something that would otherwise see partners hurt their bedfellows as they hack with buckler, axe and sword the pirates in their dreams.

 

( Sleep Paralysis - John Henry Fuseli - The Nightmare-1781 - Image Courtesy of en.wikipedia.org )
( Sleep Paralysis – John Henry Fuseli – The Nightmare-1781 – Image Courtesy of en.wikipedia.org )

 

However, there is an exception, as is the case in Sleep Paralysis where the dreaming state in REM sleep may very well intrude the waking state thereby leading to REM sleep paralysis. The result is an encumbering discombobulating fusion of wild and vivid dream life imaginations with waking life perceptions that leave the sleeper, you guessed it, paralyzed in terror and shock. Sleep Paralysis.

 

( Awake in Nightmare - Sleep Paralysis - Image Courtesy of  www.cbsnews.com )
( Awake in Nightmare – Sleep Paralysis – Image Courtesy of www.cbsnews.com )

 

What are the symptoms of Sleep Paralysis?

You don’t necessarily need to see a hag or the God-forsaken Incubus to know that you were held captive by REM sleep paralysis… Some of the most common symptoms to thus look out for include:

  • Terror – feeling extremely fearful and shell-shocked
  • Immobility – inability to remain calm and held down, or even to move
  • Heartbeat thumping hard – racing pulse rate and heavy heartbeat
  • Pressure build up – in your abdomen, chest and throat
  • Breathing difficulties – skipping a beat and breathing heavy out of shock
  • Bizarre sensations – awkward gravity shifts and intense body sensations
  • Hearing strange inexplicable sounds – crackling and buzzing sounds outside the norm of hearing patterns
  • Strange sensations of not being alone – feeling the presence of another being in the room
  • Supernatural sensations – feeling other beings or apparitions actually touch you or feeling their grip on you
  • Supernatural visions – seeing other beings or apparitions move about in the room, witnessing nightmarish beings and unnatural figures
  • Fully heightened mental awareness of the experience as being “very real”

 

( Sleep Paralysis - Image Courtesy of nymag.com )
( Sleep Paralysis – Image Courtesy of nymag.com )

 

What is the biology behind Sleep Paralysis?

Commonly quoted is the saying that “During Sleep Paralysis, it is the mind that is aroused to an awakened state while the body remains in a sleeping state”…

 

( Sleep Paralysis - Image Courtesy of  www.independent.co.uk )
( Sleep Paralysis – Image Courtesy of www.independent.co.uk )

 

You can relax and pop an Aspirin if you need to because as Biology would have it, Sleep Paralysis is apparently totally harmless and in fact just another naturally normal phenomena that occurs in the dreaming state of the sleep cycle. There should apparently be no cause for alarm unless if it is accompanied by observable symptoms of Sleep Apnea or even Narcolepsy in which case it should be a point of concern.

 

Relax, No, It’s NOT The Hag Or Incubus Who Paralyzed You…

You’ll be forgiven for thinking so, for when it does strike, sleep paralysis may very well leave you feeling like some supernatural being or apparition had held you captive and paralyzed…An ideology that is scientifically wrong and here’s why…

 

( Acetylcholine and Muscle Paralysis - Image Courtesy of  www.viresattached.com )
( Acetylcholine and Muscle Paralysis – Image Courtesy of www.viresattached.com )

 

Muscle Paralysis: During your sleep in the REM dreaming state, your brain is imbued by acetylcholine, a neurotransmitter responsible for the muscle paralysis as it suppresses your muscle tone in all the primary muscle groups that are typically not part of the Autonomous Nervous System (ANS); including – your heart, the lungs, and your intestines.

 

( Acetylcholine and Muscle Paralysis Mechanism - Image Courtesy of  www.gainesonbrains.com )
( Acetylcholine and Muscle Paralysis Mechanism – Image Courtesy of www.gainesonbrains.com )

 

Co-morbidities of Sleep Paralysis

Insomnia:

The possibility of actually losing sleep or the inability to fall asleep again could very easily crop up as a result of a sleep paralysis episode, and to no surprise given the terror and shock that accompanies the unnerving sensations you’re bound to undergo during and after an attack by sleep paralysis. This would consequently lead to additional secondary sleep disturbances and sleep deprivation through induced sleep disorders like Insomnia, not to mention that the odds of experiencing another sleep paralysis attack are further increased.

 

Hypnagogic Hallucinations:

Sleep Paralysis may very well be something straight out of the “Twilight Zone” as it knows no reservations in just how creepy, weird, and downright strange SP (short for Sleep Paralysis) can get… Case in point being yet another co-morbidity linking SP’s to the powerfully strong Hypnagogic Hallucinations (HH). When this combination occurs, the sleeper not only feels like they’re trapped in their own real-life episode of the “Twilight Zone” but also see themselves stark right in the middle of the goriest one.

 

( Sleep Paralysis -  Hypnagogic Hallucinations - Image Courtesy of www.girlsaskguys.com )
( Sleep Paralysis – Hypnagogic Hallucinations – Image Courtesy of www.girlsaskguys.com )

 

The terrifying scenario may be summarized as follows:

  • The sleeper can certainly feel their body and feel the sensations, but they cannot move their body (due to muscular paralysis)
  • The sleeper can even accurately perceive where they are sleeping in real waking life, but their visions and even senses are imbued with dreamy vivid imagery that is unreal but imagined (hypnagogic hallucinations)
  • In this state, also known as REM Intrusion, the dreamer is in a state of mind that is nothing short of magical, surreal yet unreal, in what may be described as a hybrid state of consciousness which can only be compared to full spectrum dreaming, but with your eyes wide open…
  • Not to burst the bubble, but in reality, and especially for the dreamer, this state is more terrifying than it is magical because their mind is awake but the body is asleep, therefore everything in that mostly usually horrifying REM intrusion dream is unreal but assumed, felt, sensed and perceived to be real.
  • In this state, the dreamer’s fear is compounded, and what this does is only further concoct the dreamy yet vivid imagery into more terrifying perceptions and imaginations resulting in the dreamer conceiving the worst imagery possible.

 

( Sleep Paralysis - Image Courtesy of  nerdsleep.com )
( Sleep Paralysis – Image Courtesy of nerdsleep.com )

 

What causes Sleep Paralysis?

It is a well known fact that an irregular erratic sleep-wake cycle is bound to cause problems in both waking and sleeping life, giving rise to common problems with sleep impairment and sleep deprivation or sleep loss.
The very same may be said of incidences of Sleep Paralysis given that an erratic, unregulated, disrupted sleep-wake cycle will easily result in REM intrusion attacks.

Other interesting factors that could easily culminate in Sleep Paralysis include:

  • Sleeping in a supine position – lying on your back
  • Physical tiredness and exhaustion leading to chronic fatigue
  • Too much use of stimulants like caffeine in coffee and tobacco in cigarettes, tea
  • High elevated levels of chronic anxiety such as and especially social anxiety
  • Some medications – ADHD prescriptions
  • Side effects of other medication being taken – e.g. Galantamine in Alzheimer’s patients
  • After major changes in lifestyle and when life’s curve-balls are thrown at you

 

( Sleep Paralysis - Le Cauchemar -The Nightmare by Eugène Thivier-1894 - Image Courtesy of en.wikipedia.org )
( Sleep Paralysis – Le Cauchemar -The Nightmare by Eugène Thivier-1894 – Image Courtesy of en.wikipedia.org )

 

It therefore follows that practicing appropriate Sleep Hygiene and engaging in grounding activities for relaxation of the mind, body and soul are key in curbing occurrences of SP’s. Some other tricks like wiggling your toes, clenching your fists and taking several deep and full breaths can easily shake you out of an REM intrusion, and ease the fear and tension away. Also very beneficial is the use of affirmations to speak the scary thoughts, sensations and perceptions away.

 

 

 

Identifying Your Sleeping Disorder: Sleep Bruxism

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( Bruxism - Image Courtesy of www.koreaherald.com )
( Bruxism - Image Courtesy of www.koreaherald.com )

 

If you’ve ever got so madly enraged you clenched your jaw and teeth in your angry reaction, then you definitely know a thing or two about Sleep Bruxism. With regards to the sleep disorder, Sleep Bruxism entails behavioural manifestation of the sleeper who will grind their teeth and clench their jaw in their subconscious state of sleep. You’re more likely to clench your teeth while awake rather than grind them, and are more likely to grind your teeth while asleep given that a whooping 80% of people who grind their teeth actually do so in their sleep as is seen in cases of Bruxism.

( Bruxism - Image Courtesy of www.bellingham-dentist.com )
( Bruxism – Image Courtesy of www.bellingham-dentist.com )

 

Which factors contribute to Sleep Bruxism?

Just like in waking life, high levels of tension, stress and anxiety are key culprits that lead to Bruxism during the sleep phase. About 70% of Bruxism cases in sleep are attributed to the 3 culprits.

Other common causes of Sleep Bruxism include: ill health, dehydration and lack of enough body water, poor and wrong diet, normal sleep phase problems, teething in infants, poor alignment of the teeth and bad dental formula alignment.

Do note that as already established, Bruxism is not a reserve of the sleep cycle given that about 20% of the remaining cases manifest in the wake cycle.

The common ground for both the sleep and wake cycle Bruxism manifestations is that it typically occurs subconsciously. Majority of the Bruxism cases (about 80%) occur during one’s sleep in their subconscious state. While awake, you’re more likely to present Bruxism when deeply concentrating such as while studying or when highly focused on something you’re working on, in addition to highly stressful situations, and during great tension and anxiety.

Other common causes of Sleep Bruxism include: ill health, dehydration and lack of enough body water, poor and wrong diet, normal sleep phase problems, teething in infants, poor alignment of the teeth and bad dental formula alignment.

 

( Bruxism - Image Courtesy of blogs.psychcentral.com )
( Bruxism – Image Courtesy of blogs.psychcentral.com )

 

Do note that as already established, Bruxism is not a reserve of the sleep cycle given that about 20% of the remaining cases manifest in the wake cycle.

The common ground for both the sleep and wake cycle Bruxism manifestations is that it typically occurs subconsciously. Majority of the Bruxism cases (about 80%) occur during one’s sleep in their subconscious state. While awake, you’re more likely to present Bruxism when deeply concentrating such as while studying or when highly focused on something you’re working on, in addition to highly stressful situations, and during great tension and anxiety.

 

( Bruxism - Image Courtesy of www.arizonafamilydental.com )
( Bruxism and Stress – Image Courtesy of www.arizonafamilydental.com )

 

Medically speaking, the condition may either be referred to as:

  • primary Bruxism – when it occurs idiopathically and independent of any other condition, or,
  • secondary Bruxism – when it occurs as a result of other underlying factors or conditions.

Bruxism has also been attributed to certain medication in many cases where psychoactive prescriptions are involved, particularly:

  • antidepressants (especially SSRIs – Selective Serotonin Reuptake Inhibitors),
  • antipsychotics

Certain lifestyle habits are also attributed to manifesting Bruxism, and these include:

Substance Abuse:

  • Alcohol addiction
  • Smoking addiction

Recreational Drug Use:

  • Ecstasy
  • Cocaine

 

Prevalence of Sleep Bruxism

Strangely enough, it is thought that just about half the population in a community does indeed grind and clench their teeth from time to time. However, for the more serious cases, only just about 1 in every 20 people is seen to present a dire case of Bruxism. Further, it has been shown that a bigger percentage of children, about 30% actually present considerable cases of teeth grinding and clenching, but the good news is that most of them outgrow this manifestation; and therefore do not live to suffer any negative impacts of Bruxism on their adult teeth.

 

Strange link between Sleep Bruxism and Obstructive Sleep Apnea (OSA)

There is an odd and unexplained close association between Obstructive Sleep Apnea Syndrome (OSAS) and Bruxism. OSAS, also a sleeping disorder, mainly entails disrupted and anomalous breathing during the sleep phase that usually involves snoring, and could lead to cessation of breathing and even choking.

 

( OSAS and Upper Airways - Image Courtesy of obstructive-sleep-apnea.info )
( OSAS and Upper Airways – Image Courtesy of obstructive-sleep-apnea.info )

 

Complications due to Bruxism

You may be lucky to experience teeth grinding without having to undergo any additional symptomatic complications and associated problems, but many are the cases where further complications arise due to sleep disordered by Bruxism. Some of the associated problems due to Bruxism include:

  • Jaw pain
  • Neck pain
  • Headache
  • Teeth wearing out – Enamel wasting (by attrition, erosion and abrasion)
  • Ear ache

 

( Bruxism - Image Courtesy of www.nordimplant.com )
( Bruxism – Image Courtesy of www.nordimplant.com )

 

It may be difficult to automatically know if you do indeed suffer from Sleep Bruxism, unless if you do in fact have a sleep or bed partner who may notice the sleep behavior in your sleeping patterns. Other manifestations you may look out for include: feeling a somewhat numbing sensation in your jaws, a dull lingering headache in the morning when you wake up, feeling tightness or hurting jaws when you wake up, having difficulty in opening your mouth wide open as you normally would, a lingering and lasting facial pain also within your cheeks, damaged teeth and crowns, or even broken or cracked dental fillings, or even finding some broken enamel in your mouth upon waking up.

 

( Bruxism - Image Courtesy of www.mykidsdentist.com.au )
( Bruxism – Image Courtesy of www.mykidsdentist.com.au )

 

It is also beneficial to see not just a sleep specialist but a dentist too who will assess the condition and health of your teeth, jaws and gums and should be in a better position to point out any symptomatic complications of Bruxism that presents itself in your sleep.

 

Furthermore, you will also need to have a sleep study undertaken on your sleeping pattern and sleep behavior to assess just how much jaw movement, teeth grinding and clenching actually takes place while you sleep. This will not only be useful in assessing Sleep Bruxism but will also be instrumental in identifying any other anomalous sleep behavior and sleep disorder affecting your normal sleep-wake cycle and sleeping patterns.

 

( Bruxism - Image Courtesy of www.pneumon.org )
( Sleep Arousal due to Bruxism PSG Test – Image Courtesy of www.pneumon.org )

 

Treatment of Bruxism

Treating Bruxism as a sleeping disorder mostly involves behavioral therapies which have been shown to be effective in managing the symptoms during sleep phase. Though there a number of possible and usable treatment options for Bruxism, not too many have been proven to be as effective as desired. That said, here are the most effective treatment options for Bruxism:

  • Behavioral Therapies
  • Use of Mouth Guards
  • Use of Mouth Splints
  • Muscle Relaxation Exercises
  • CBT – Cognitive Behavioral Therapy
  • Sleep Hygiene

 

The main aim of behavioral therapies is to help you identify stress-causing factors in your life, things that are bound to stir you up in anger, tension or anxiety; identify key ways in dealing with them without causing any repercussion effects on your overall well-being. That way in dealing with them appropriately, the workup does not have to manifest as Sleep Bruxism when you lay down to sleep.

 

The mechanism of Mouth Guards and Mouth Splints (much like those used in Boxing and Ice Hockey) is pretty much the same as it guards and protects the mouth, jaw and teeth from the mechanical damage of teeth grinding and constant clenching which would otherwise lead to wear and tear, and tooth damage. The Bruxism patient will therefore wear the mouth guard or mouth splint in their mouth before going to sleep and have it on all the while they’re asleep.

 

( Bruxism - Image Courtesy of www.newdentalhealth.com )
( Bruxism – Image Courtesy of www.newdentalhealth.com )

 

Muscle relaxation techniques help in relieving the patient of any tension build up in the upper neck region, head and temples, jaw and mouth; and alleviating it so as to prevent the carry-forward during their sleep.

 

( Muscle Relaxation Techniques for Bruxism - Image Courtesy of asdresources.wordpress.com )
( Muscle Relaxation Techniques for Bruxism – Image Courtesy of asdresources.wordpress.com )

 

CBT – Cognitive Behavioral Therapy is useful in nipping any tension, stress and anxiety issues the patient may be dealing with in waking life and the benefit should be realized also in their sleep and in curbing any sleep behavioral anomalies.

 

Sleep Hygiene is basically a set of sleep guidelines aimed at rectifying bad personal habits, lifestyle choices and environmental factors that utlimately disrupt the healthy quality and quantity of sleep, and generally affecting the whole sleep-wake cycle. Some of the key tips include:

  • Avoiding the consumption of heavy meals that will bog down your gastrointestinal system before going to sleep
  • Avoidance of stimulants before going to sleep: caffeine in coffee, tea, chocolate, and even over-the-counter drugs containing stimulants like caffeine (painkillers or NSAIDs)
  • Avoidance of smoking cigarettes and cigars at least 6 hours before going to sleep
  • Avoidance of alcoholic drinks at least 6 hours before going to sleep

 

( Do you think he was wearing a Mouth Guard??! - Image Courtesy of www.pinterest.com )
( Do you think he was wearing a Mouth Guard??! – Image Courtesy of www.pinterest.com )

 

 

 

Identifying Your Seeping Disorder: Somnambulism (Sleep-Walking)

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( Controversial Life-like Statue called
( Controversial Life-like Statue called "Sleepwalker" - Image Courtesy of www.dailymail.co.uk )

 

The International Classification of Sleep Disorders, 3rd edition (ICSD-3) is quoted as saying the following of Somnambulism: That the behavior of a person intoxicated with alcohol could easily be confused with that of a person sleepwalking due to the superficial resemblances of the two states. This is not the first and only alcohol condition that is often misconstrued for a given sleep condition or sleep disorder. The same is the case for alcohol blackouts where the drunken person passes out due to high alcohol intoxication; in this state, the person is not unconscious but there certainly is a disruption of cognitive function and memory loss of the events that transpire during most of the intoxication episode. These blackouts due to alcohol are often indiscernible from the Sleep Arousal Disorders linked to NREM sleep. Further, right down to basics is the classic association of sleep and alcohol.

 

(Controversial Life-like Statue called "Sleepwalker" - Image Courtesy of www.campusreform.org )
(Controversial Life-like Statue called “Sleepwalker” – Image Courtesy of www.campusreform.org )

 

So What Exactly is Sleepwalking?

Otherwise known as Noctambulism if not Somnambulism, sleepwalking may be adequately described as a sleeping disorder in which the affected person, or Sleepwalker, is aroused from SWSSlow Wave Sleep into a state of very minimal consciousness but the sleepwalker will carry out activities only typically handled by a fully awake and conscious person.

 

( Hazards of Sleepwalking - Image Courtesy of www.islamiclife.com )
( Hazards of Sleepwalking – Image Courtesy of www.islamiclife.com )

 

In a general overview, the activities sleepwalkers may engage in can be grouped as:

  1. Harmless activities: sitting up, walking about the house, cleaning
  2. Hazardous activities: driving, cooking, grabbing harmful or imagined objects (hallucinating), violent motions
  3. Criminal activities: violent attacks of secondary parties, homicide

 

( Homicidal or Hazardous Somnambulism - Image Courtesy of darkparadox88.blogspot.com )
( Homicidal or Hazardous Somnambulism – Image Courtesy of darkparadox88.blogspot.com )

 

It has been observed that typical cases of sleepwalking usually entail patterned or repetitive but simple behavior and actions. Nonetheless, there have been reported cases of unusually complex behavior and activity in sleepwalkers whose legitimacy and validity is however disputed and unconfirmed.

 

( Eating during Somnambulism - Eating in Sleepwalking - Image Courtesy of epherielldesigns.com )
( Eating during Somnambulism – Eating in Sleepwalking – Image Courtesy of epherielldesigns.com )

 

The duration of a sleepwalking episode could be as brief as just about 30 seconds or even as protracted as half an hour in most cases.

 

( Sleepwalking or Somnambulism - Image Courtesy of www.howtogetrid.org )
( Sleepwalking or Somnambulism – Image Courtesy of www.howtogetrid.org )

 

Recollection of Somnambulism Episodes

Given that the Sleepwalker remains in an altered state of consciousness (semi-conscious), the following may be observed about their episodes of Sleepwalking:

  • They have hazy recollection or no recollection at all of the somnambulism incident
  • Their eyes are open (as if awake) while sleepwalking
  • The facial expression may be defined as indistinct, distracted, blurry, or nondescript

 

( Sleepwalking - Somnambulism - Image Courtesy of www.latimes.com )
( Sleepwalking – Somnambulism – Image Courtesy of  www.latimes.com )

 

The Slow Wave Sleep occurs during the early night hours, about 3 or 4 hours into your sleep whilst still in the NREM sleep stage of Non Rapid Eye Movement. In this state, there is consolidation of your body systems, support for immunity via specific leukocytes called Cytokines, and both the cells and organs altogether undergo recovery processes for regeneration and restoration.

 

According to the official classification provided by the ICSDInternational Classification of Sleep Disorders, Sleepwalking is categorized under the class of sleeping disorders called Parasomnias, which also include:

  • Night terrors
  • Rapid Eye Movement (REM) sleep Behavior Disorder – (RBD)
  • Somniloquoy
  • Catathrenia

The Parasomnias generally entail anomalous behavior and movement during sleep or episodes of arousal from sleep, without necessarily disrupting the structure of sleep.

 

( Sleepwalking Parasomnia - Image Courtesy of www.enkivillage.com )
( Sleepwalking Parasomnia – Image Courtesy of www.enkivillage.com )

 

Testing and Analyzing Sleepwalking in Diagnostic Procedures

Spectral Analysis has been promoted by sleep experts as a reliable and efficient lab testing method in diagnosing Sleepwalking. The propensity to sleepwalking has time and again been linked to a decrease or absence of Slow-Wave Activity earlier on into the night, and to sleep arousal or awakenings from Slow-Wave Sleep, however even this is still not a conclusive indicator or measure.

 

( Polysomnograph Sleep Analysis Test of Somnambulism - Image Courtesy of raycomgroup.worldnow.com )
( Polysomnograph Sleep Analysis Test of Somnambulism – Image Courtesy of raycomgroup.worldnow.com )

 

According to the ICSD-3 specifications on the analysis and diagnosis of Somnambulism, diagnosing Sleepwalking should not be carried out while the person is intoxicated with alcohol or under its influence; further, spectral analysis is still not endorsed as a valid method of analysis and diagnosis of Somnambulism.

Sleepwalking in Ancient History

Interesting to note is that famous ancient greats were reported to have experienced episodes of Sleepwalking; including:

  • Aristotle (384 – 322 BCE),
  • Hippocrates II of Kos (circa 460 – 370 BCE),
  • Diogenes Laërtius (circa 200 – 300 CE), and
  • Claudius Galen the Roman Physician (circa 129 – 200 AD).

In fact, in the case of the Roman Galen, he had spent the whole night in Somnambulism, in a sleepwalking episode from which he would only awaken after having struck a stone with his foot (Umanath, Finger, Sarezky, 2011).

 

( Lady Macbeth aroused from sleep and Sleepwalking - Image Courtesy of luna.folger.edu )
( Lady Macbeth aroused from sleep and Sleepwalking in “The Tragedy of Macbeth” by William Shakespeare – Image Courtesy of luna.folger.edu )

 

The famous play by William Shakespeare, The Tragedy of Macbeth (~ 1606), elicited scenes of Somnambulism when Lady Macbeth sleepwalked upon arousal from her sleep in Act 5, not too long before her tragic death which was announced but later on. She is reported to have recalled tragic memories and painful horrifying flashbacks from her past…

 

( Lady Macbeth Sleepwalking in "The Tragedy of Macbeth" by William Shakespeare - Image Courtesy of imgur.com )
( Lady Macbeth Sleepwalking in “The Tragedy of Macbeth” by William Shakespeare – Image Courtesy of  imgur.com )

 

Prevalence of Sleepwalking in the General Population

On the whole, about 2.5% of the general population are likely to experience Somnambulism or have significant episodes of Sleepwalking (Kales, et al., 1980) and (Umanath, Finger, Sarezky, 2011).

It has been reported that about 15% of children are more likely to experience at least one episode of Somnambulism (Vgontzas and Kales, 1999). The same percentage prevalence of 15% to 1% of the population in general has been set forth by the U.S. National Sleep Foundation. Though the consensus remains that children are more likely to experience Somnambulism given that majority of sleepwalkers tend to fall within that age bracket; but the good news is that the sleepwalking episodes are seen to diminish and even vanish altogether by the time they get to their adolescent years.

In looking at adults, it is interesting to note that despite being a less common occurrence compared to children, when Somnambulism does affect adult persons, the sleepwalking episodes tend to occur 3 times more per annum, and even last longer-persisting for a couple more years than is seen in children.

Prevalence figures of Somnambulism with regards to gender indicate that in comparison to females, the males are more likely to suffer from lethal behavior and more likely to incur injuries due to sleep disorders (Siclari, et al., 2010).

 

( Sleepwalking Infographic - Image Courtesy of metro.co.uk )
( Sleepwalking Infographic – Image Courtesy of  metro.co.uk )

 

You’re not off the cuff, just yet, for it is worthy to remember that the use and abuse of substances and drugs, as well as consumption and intoxication of alcohol may very well induce somnambulism in adults who would not have otherwise sleepwalked. …Just another thing you can only do under the influence!

 

Sleepwalker Lawbreaker

Bizarre as it may sound, you could actually fall on the wrong side of the long arm of the law due to offenses committed during a sleepwalking episode; and this does not rule out the consequent possibility of being sentenced to jail for criminal offenses committed during an episode of Somnambulism. It has been indicated that the intended motive of a sleepwalker cannot be ascertained neither can the intentions of any violent acts that culminate from the Somnambulism (Cartwright, 2004).

 

 

 

Identifying Your Sleeping Disorder: Restless Leg Syndrome (RLS)

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RLS

Considered to be perhaps the most commonly experienced movement disorder associated with sleep disorders, many who have RLS have easily passed it up for plain restlessness, while others barely notice their unusual movements and anomalous sleep behavior save for observations made by their bed partner. According to the set classification of sleeping disorders laid down by the ICSD-2 – International Classification of Sleep Disorders – 2nd Edition, Restless Leg Syndrome (RLS) is pegged under Sleep-Related Movement Disorders, together with other conditions in the same class such as PLMS (Periodic Limb Movement in Sleep) and Bruxism, among others.

 

( RLS - Image Courtesy of www.uratex.com.ph )
( RLS – Image Courtesy of www.uratex.com.ph )

 

Gray Area In Diagnosing Restless Leg Syndrome

Unlike most of the other sleeping disorders which have elaborate diagnostic measures established for their testing and analysis, the same is not so for RLS. Therefore Restless Leg Syndrome is identified purely from observation of clinical features and symptomatic manifestations as there no lab tests for RLS or diagnostic testing metrics available. Guiding this is the standard of various criteria as stipulated and established in the year 1995 (and later revised moderately in the year 2003) by (IRLSSG) which is the International Restless Leg Syndrome Study Group.

 

( IRLSSG logo - Image Courtesy of irlssg.org )
( IRLSSG logo – Image Courtesy of irlssg.org )

 

Before the standardization of the diagnostic criteria for RLS back in the middle of the 20th century, the description of the condition was vaguely defined let alone diagnosed. Since then, it is now no longer a gray area with regards to definition and diagnosis, and is clearly identified using 4 primary criteria for diagnosis. These criteria are based on two broad categories, behavioral and physiological benchmarks, which further classify the sleep phase into two stages: NREM (Non Rapid Eye Movement) Sleep and REM Sleep (Rapid Eye Movement). The NREM stage has 3 stages – N1 stage, N2 stage, and the N3 stage. Therefore the entire sleep phase is assessed based on the progression of behavioral and physiological changes manifested in the sleeper from the N1, N2, N3 stages of NREM sleep and on to REM sleep.

 

( Sleep Stages by EEG-EOG-EMG - Image Courtesy of universitipetronas.hostoi.com )
( Sleep Stages by EEG-EOG-EMG – Image Courtesy of universitipetronas.hostoi.com )

 

RLS is more appropriately defined as a neurological disorder (as opposed to a sleeping disorder) which affects both sensory functionality and motor functionality in the affected person. It typically affects the person all their life and may be detected from their earlier years when young but often are the cases diagnosed later on in the middle ages or even in old age.

 

( RLS - Image Courtesy of www.health.com )
( RLS – Image Courtesy of www.health.com )

 

Susceptibility of RLS

The prevalence of RLS cases has been shown to grow with increasing age; further, though the reason for which is unexplained, it reaches a plateau phase between the 85 and 90 age bracket. There is also a higher likelihood for women more than men to have RLS which is indicated to both progressive and chronic.

Further scientific research has revealed that it has some strong genetic links, particularly affecting family relations of the first degree, of whom RLS incidence was found to be about 40% to 50% for cases where the relative is suffering from  primary or idiopathic Restless Leg Syndrome. Prevalence was shown to be even higher, at 83%, in identical twins (of the same zygote or monozygotic siblings).

 

( Monozygotic Identical Twins - Image Courtesy of www.dailymail.co.uk )
( Monozygotic Identical Twins – Image Courtesy of www.dailymail.co.uk )
( Monozygotic Identical Twins - Image Courtesy of genetics.thetech.org )
( Monozygotic Identical Twins – Image Courtesy of genetics.thetech.org )

 

 

 

 

 

 

 

 

 

 

 

In addition to these findings, it also came to light, following sophisticated analysis in segregation, that there are a number of specific genes associated with or resulting in the occurrence of Restless Leg Syndrome in given cases with dominant inheritance of autosomes. The analysis in linking and segregation set aside 5 distinct chromosomes, 14Q, 12Q, 22P, 2P, and 9P, associated with inherited RLS.

 

( Monozygotic Identical Twins - Image Courtesy of abcnews.go.com )
( Monozygotic Identical Twins – Image Courtesy of abcnews.go.com )

 

Clinical Manifestations and Symptoms of Restless Leg Syndrome

Sensory functionality is affected symptomatically by RLS in any or all of the following ways:
Intensely Discomfiting Feelings, Cramps, Tingles, Aches, Itches, Creepy sensations, Burning sensations, Razor-like sensations.

 

( Restless Leg Syndrome - Limb Section - Image Courtesy of www.medicinenet.com )
( Restless Leg Syndrome – Limb Section – Image Courtesy of www.medicinenet.com )

 

Notably, the affected person will experience the above sensory symptoms in their limbs, particularly in the region that runs down from the knees to the ankles. Typical complaints presented are that patients experience strong urges to move their legs about so as to achieve some relief from these sensations. Other parts of the body may experience the RLS sensational symptoms, including the arms, and this is mainly attributed to the more progressed phases of the condition.

 

( RLS - Image Courtesy of www.health.com )
( RLS – Image Courtesy of www.health.com )

 

Another factor that could lead to advanced manifestation of sensory symptoms to other parts of the body is when the affected person also has a Hypermotor Syndrome (RLS augmentation). In this case, the augmentation may take place up to about 2 hours in advance, occurring with greater intensity that spreads on to the rest of the body. This usually pertains to cases where the affected has been on long-term treatment with Dopamine-inducing psychoactive prescriptions (such as anti-psychotics, some antidepressants, and mood stabilizers).

 

( Dopamine Drugs and RLS - Image Courtesy of www.rlcure.com )
( Dopamine Drugs and RLS – Image Courtesy of www.rlcure.com )

 

Timing of the manifested body movements usually occurs in the later hours (evening to nighttime) while the affected person is lying in bed. There are however, certain severe RLS cases where the patients have complained of experiencing the body movements even during the day, while awake but rested or seated.

 

( Prevalence: Idiopathic RLS and Secondary RLS - Image Courtesy of www.medscape.com )
( Prevalence: Idiopathic RLS and Secondary RLS – Image Courtesy of www.medscape.com)

 

 

Co-morbidities Linked to Restless Leg Syndrome

More likely than not, cases or RLS further present additional co-morbidities, particularly sleeping disorders. A whooping 80% of patients diagnosed with Restless Leg Syndrome were also found to suffer from:

  • PLMS – Periodic Limb Movement in Sleep
  • PLMW – Periodic Limb Movement in Wakefulness

 

( PLMS Comorbidity with Sleep Disorders - Image Courtesy of slideplayer.com )
( PLMS Comorbidity with Sleep Disorders – Image Courtesy of slideplayer.com )

 

The general consensus on the impact of RLS on the affected person is the negative impact it has on their sleep and normal sleeping pattern, especially since most complain of impaired sleep and struggling to fall asleep (initiation of the sleep phase). Where PLMS is co-morbid, the ability to stay asleep (maintenance of the sleep phase) is naturally complicated further.

( Circadian Rhythm Plot of PLMS and PLMW - Image Courtesy of clinicalgate.com )
( Circadian Rhythm Plot of PLMS and PLMW – Image Courtesy of clinicalgate.com )

 

 

Another co-morbidity linked to the RLS-PLMS condition pairing is Sleep-Related Eating Disorders which are, to no surprise, more common among the female population aged between 20 and 30 years old.

 

( Sleep-Related Eating Disorder - Image Courtesy of www.omicsonline.org )
( Sleep-Related Eating Disorder – Image Courtesy of www.omicsonline.org )

 

Symptoms to look out for in this dysfunctional trio are repeated episodes of automatic and abnormal consumption (eating and drinking) in the middle of one’s sleep; the behavioral manifestations are rather strange and may involve ingestion of edible and or unconventional food items (raw, uncooked, cold, frozen, rotten, stale), animal feed (such as pet feed for cats and dogs), inedible substances, and even toxic substances.

 

( Sleep-Related Eating Disorder - Image Courtesy of www.daftynews.com )
( Sleep-Related Eating Disorder – Image Courtesy of www.daftynews.com )

 

 

Classic Brands Adjustable Bed Review – TOP 10 Pros and Cons

Classic Brands Adjustable Bed Remote Controller

The Classic Brands Adjustable Comfort adjustable bed is very popular on Amazon.com. The same model is seen on Walmart.com too. We’ve seen similar looking adjustable beds on several other retailers. They look very similar to the Classic Brands adjustable foundation and seem to have the same features, but oddly enough, they have different names. Whether manufacturers sell the same bed under different brand names at different retailers or not, we don’t know. But it certainly looks like it… you be the judge! Either way, we advise you to purchase from a reputed retailer like Amazon or Walmart.

Recommended: 10 BEST Adjustable Beds – Reviews, PROS, CONS (Updated for 2017)

Despite its popularity on Amazon.com and many other ‘independent’ reviewers rating it very high, our rating on the Classic Brands bed is a little low. It cannot compete with the big guns in the market! However, for an entry-level adjustable bed, the Classic Brands works OK, but even for that level, there are better models in the same price range. Don’t take our word for it; study our Classic Brands Adjustable Comfort review and decide for yourself!

Classic Brands Adjustable Bed Review – 5 Pros and 5 Cons

1. Four Customizable Memory Positions

Most adjustable beds in this price range generally don’t have programmable or customizable memory positions. In other words, you have to be content with whatever the manufacturer gives you. Don’t take it wrong; you CAN adjust the bed to any position you like. But, you have to press the ‘up’ and ‘down’ buttons a gazillion times to get the position right. You can’t programme the remote to ‘remember’ your favorite position, which may be a 37 degree elevation of the head section and a 14 degree elevation of the foot section.

However, the Classic Brands base is an exception. It comes with 4 factory-preset positions that can be overridden. In other words, you can reprogramme the pre-programmed positions based on your liking.

The four factory-preset positions are:

  1. TV/PC
  2. Lounge
  3. Zero-gravity, and
  4. Flat

Let’s say you don’t like the preset ‘Lounge’ position. You can adjust the bed to a lounging position that you like best, long-press the ‘lounge’ button for 3 seconds and that will override the factory setting. This is a very neat feature not many entry-level adjustable beds have.

The only ‘negativity’ of this setup is that if you want to programme a ‘feet up’ position; it will replace one of the above four positions which means that your ‘feet up’ position may be named ‘flat’ on the remote. This is not a big deal at all.

2. Three-Speed Upper and Lower Body Massage

The fact that you get full body therapeutic massage on a $500 adjustable base is great. However, if you expect the quality of massage of the Classic Brands to be comparable to the massage quality of a high-end adjustable base, you will be disappointed. As this reviewer found out, massage was “barely noticeable”. Some other complained that it was too loud. Others said you need to be right in the middle of the bed to feel it… so on an so forth.

Our recommendation is that if you buy the Classic Brands electric bed, don’t buy it for the massage; expect less and you won’t be disappointed with the massage you’ll get!!

3. Adjustable Legs

Some people are tall, some are not. Some will have 4 inch mattresses, others will have 12 inch mattresses. Not everybody wants their beds at the same height. This is why adjustable legs is a must for all beds whether adjustable or otherwise.

Fortunately, the Classic Brands adjustable comfort comes with six legs that can be adjusted to 4″, 7″ or 10.5″ in height.

4. TWO USB Ports

It’s not often that you find USB ports on cheap adjustable beds like the Classic Brands. But the Classic Brands adjustable comfort bed is an exception to the above rule. It has two USB ports  to charge your favorite devices like your smartphone and iPad.

Unfortunately, both these ports are located on the right side of the platform. One on each side or two on each side would have been better if it’s a queen or king-sized adjustable bed shared by a couple. However, two USB ports on the same side isn’t a deal breaker.

5. Cheap price-point

High-end adjustable beds can go all the way above and beyond the $5,000 mark as of 2017. Only a handful economically priced adjustable beds like the Classic Brands bed can be found for less than $500 for a queen size. If that is your budget, Classic Brands Adjustable Comfort bed is the right model for you.

6. NO Pillow Tilting on the Classic Brands adjustable base

If you have read our reviews on the top rated adjustable beds, you know that we really like the ‘Pillow Tilting’ feature. Pillow tilting simply allows you to straighten your head further, taking away any and all tensions on the neck when you’re watching TV, reading a book or working on your laptop, using the sit-up position on your adjustable bed. On a bed without the pillow tilting feature, there is a limit to the level you can straighten your head/neck. This is not to say that the Classic brands is not suitable to you; but just to say that if you plan on doing a lot of ‘sit-up’ activities on your bed, you may want to consider an adjustable bed with pillow tilting. Of course, pillow tilting comes at an extra price… which you probably guessed yourself :wacko:

7. The Classic Brands base is NOT a Wall Hugger

Again, if you’ve read our adjustable foundation reviews, you know how useful wall hugging is. Wall hugging allows the headboard to ‘hug’ the wall so that you stay close to your nightstand when the upper body is raised. On non-wall hugger models, when the upper body is raised, you move away from the headboard, towards your footboard, taking you away from your nightstand. So, should you need to reach for something on the nightstand, you’re going to have to reach back, which can potentially sprain your neck, back, arms etc.

Again, this is not to say you shouldn’t buy the Classic Brands; but just to make you aware of a limitation of the bed. If you generally will not use a nightstand to reach for a glass of water, your spectacles, or the TV remote, wall hugging is of no value to you and this base will do just fine.

On the other hand, if you think you’ll need wall hugging, do check out our Leggett and Platt Prodigy 2.0 Review which comes with not only wall hugging, but also, pillow tilting and all the other high-end features you’d want in an adjustable base.

8. NO under-bed lighting

Some of the fancy beds of modern times come with an under-bed light which acts as a night light. The Classic Brands doesn’t have one; but it’s not a deal breaker. If you must have night lighting, simply buy a night light for five bucks and plug it in near your bed!

9. Not smartphone-ready

Another feature of modern, high-end adjustable beds. Some adjustable bed brands like the Leggett and Platt Prodigy 2.0, the Reverie 8Q etc. have Android and Apple smartphone apps that can control certain features of your bed like alarm clock, memory positions, sleep timer etc. As you would have already expected, the Classic Brands foundation, priced ~$500, doesn’t come with these fancy features.

10. No Alarm, No Sleep Timer

Some adjustable beds come with a sleep timer which will automatically lower the bed from TV watching position to a sleeping, flat position after a set time. These same, high-end beds also come with an alarm ‘clock’ that will wake you up by turning the vibration on at a set time. The split-king models even have an extra feature where only one side will vibrate without disturbing the other partner.

Aren’t these features awesome? They sure are; but are not absolutely essential features to an adjustable bed… obviously, for $500, Classic Brands can’t include those in their bed!

Conclusion

It’s got the majority of the features you can see in a 2017/2018 adjustable bed. However, the lack of wall hugging and pillow tilting have to be listed down as considerable drawbacks. But then again, you’d be crazy to expect such features on a $500 adjustable bed. You’ll need to pitch in with another $500 to own those features as well.

While it does have great reviews on Amazon, we’re a little bit concerned about quite a few consumers complaining of breakdowns after a few months of use. Don’t take our word for it; check out the customer reviews on the Classic Brands adjustable bed, yourself.

Read our Hofish Adjustable Bed Review and let us know what you think of it. It has a similar price bracket; however, has a generally higher quality standard as the adjustable foundation is made in Germany.

 

 

 

 

Hofish Adjustable Bed Review – TOP 10 Pros and Cons

Hofish Adjustable Bed Review

7 Pros and 3 Cons of the Hofish Adjustable Bed

10Simple Assembly

It only takes THREE MINUTES to put the Hofish adjustable bed together. No other adjustable bed can match this feat.

9Two Customizable/Programmable Memory Positions

Generally, this is a feature found on $1000+ adjustable beds. But, this <$700 Hofish adjustable bed comes with two memory positions that you can customize as you wish. The remote has two factory-preset memory positions for TV watching and Zero gravity. These can be customized to your preference. This is a rarity for adjustable foundations in this price range.

8Anti Crushing Motor Technology

Again a feature seen in high-end adjustable beds. We all adore the comfort of adjustable beds; but did you ever stop to think that something could potentially get caught and crushed between the bed base and the frame. It could be your shoe, it could be your pet, it could be your hand or even a small child. Doesn’t sound like fun at all, does it? This is where this ‘anti-crushing’ technology comes in handy. If and when something gets in the way of a lowering base, the Hofish bed instantly ‘senses’ that and quits lowering/raising preventing ‘crushing’ of your shoe, your clothes or even your hand.

7FOUR USB Ports

Again a rare feature for a $700 adjustable bed. The four USB ports will undoubtedly come in handy to charge your smartphone, iPad/tablet computer, Bluetooth headset etc. etc. overnight, just by your side, should you need to reach for them in the middle of the night!

6Lightening Protection Adaptor

Another rare spec for an adjustable bed. Adjustable beds don’t come cheap. Why take the chance of getting your investment fried with lightening? Hofish seems to have got that covered as well. No wonder this is being voted as one of the best adjustable beds for the entry-level category

5Noise-free operation

Sure, the high-end adjustable beds are obviously very quiet; you can barely hear them going up and down during regular operation. If the electrical beds do make any noise, that will be during massage sessions.

But, when it comes to cheaper, entry-level adjustable beds, they’re very noisy (in an unpleasant way)… not the Hofish electric bed; it’s as quiet as a sleeping baby!

4750 lbs of weight lifting

If you thought that this cheap adjustable bed was weak and won’t be able to lift up a heavy, strong individual… you’re wrong my friend. This beast of an adjustable bed is fixed with a super-powerful German motor that can lift to the tune of 750 lbs without breaking a sweat!

Note: 750 lbs is including the weight of the adjustable mattress. Mattresses are generally no more than 150 pounds; they can even be as light-weight as 50 pounds.

3No Pillow Tilting

We’ve said it before, and we’ll say it again. Pillow tilting is awesome; but it’s not a deal breaker. If your neck easily gets sprained when you read/work on the bed, you need pillow tilting in your adjustable bed. If you’re young and strong and you don’t even know what a neck sprain is, forget worrying about pillow tilting. Just grab the Hofish with both hands, while the good price lasts!

2No Massage

You’re spending $600, and complaining that it doesn’t offer full body, therapeutic massage? You gotta be kidding me! Some cheap adjustable beds do offer massage; but read a few reviews of those beds and you’ll find dozens of actual users complaining about what a joke it is on those cheap models. If you want an adjustable bed with high-quality massage, go for one of our top-of-the range adjustable beds; or to a skilled masseur from your local spa!

1Hofish is NOT a Wall Hugger

A pity… but it’s the truth and it’s probably too much to expect wall hugging from a $600 adjustable bed. Is it a deal breaker? Probably yes, if you’re not 25 anymore and you will be constantly reaching for your nightstand while watching TV from your adjustable bed.

Hope you found our Hofish adjustable bed review useful and informative. If you did, don’t forget to show us some love by liking us, tweeting about us, sharing the page, commenting on the page etc. etc. All of these will encourage us to keep doing what we’re doing, for the benefit of the consumer!

Recommended Reads:

  1. Leggett & Platt Prodigy 2.0 Adjustable Bed Reviews: 15 PROS and CONS
  2. Reverie 8Q vs 7S vs 5D vs Leggett & Platt Prodigy 2.0 Comparison
  3. Pros and Cons of Adjustable Beds

Identifying Your Sleeping Disorder: Narcolepsy-Cataplexy Syndrome

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Sleep-Wake Disorders
( Sleep-Wake Disorders - Image Courtesy of www.nationalregister.org )

The sleep disorder Narcolepsy-Cataplexy is one of the conditions specified by the International Classification of Sleep Disorders (ICSD-2, 2nd edition) as a variant type of Narcolepsy. It differs from the two other variants of Narcolepsy, namely: Secondary Narcolepsy, and Narcolepsy without Cataplexy.

 

( International Classification of Sleep Disorders ICSD-2 - Image Courtesy of durmiendomejor.com )
( ICSD-2 – Image Courtesy of durmiendomejor.com )

 

Common Complaints in Narcolepsy-Cataplexy Syndrome

People suffering from Narcolepsy with Cataplexy (otherwise known as Narcolepsy-Cataplexy Syndrome) usually complain of the following symptoms:

  • Sleep paralysis
  • Automatic behavior
  • Hallucinations that are hypnagogic in nature
  • Impaired sleep at night

 

( Narcolepsy and Halllucinations - Image Courtesy of journal.frontiersin.org )
( Narcolepsy and Halllucinations – Image Courtesy of journal.frontiersin.org )

 

Cataplexy is typically characterised by a prompt loss of muscle tone in all of the patient’s voluntary reflexive muscles save for those present in the eyes (ocular muscles) and in the respiration airways (respiratory muscles). When the cataplexy episodes strike they usually strike after the patient experiences a sleep attack, although there may be episodes where the cataplexic spell strikes first in the symptomatic manifestation.

 

( Hypocretin-Orexin and Cataplexy - Image Courtesy of www.dovepress.com )
( Hypocretin-Orexin and Cataplexy – Image Courtesy of www.dovepress.com )

 

Symptomatic Sleep Attacks

Sleep attacks may be defined as an inevitably strong urge to go to sleep regardless of the circumstance or time or location one may be in, and the sleep attack often strikes the patient in rather inappropriate incidences such as while driving, eating, playing, running, working, talking, sitting, watching TV, while in class, when one is carrying out some monotonous or uninspiring activities or boring tasks, and even while engaging in sexual intercourse. The sleeping attacks may last a few minutes or even up to half an hour or longer, but upon waking up from a sleep attack the patient usually reports of feeling recovered and refreshed.

 

( Narcolepsy Sleep Attack - Image Courtesy of www.healthtopia.net )
( Narcolepsy Sleep Attack – Image Courtesy of www.healthtopia.net )

 

With regards to frequency and patterns of occurrence of sleep attacks, it varies much from one patient to another. Some patients experience sleep attacks as often as daily, or weekly, or on a monthly basis, or every few months.

Further, it has been shown that the sleep attacks generally continue to occur all through the lifetime of the patient, albeit with fluctuations in occurrence from time to time, and even remissions of the sleep attacks once in a while though not permanently as the attacks recur after a period of remission.

Nonetheless, regardless of sleep attacks being a life-long chronic condition, their severity has been shown to diminish with age and in some cases, the sleep attacks have completely ceased to occur later on in life as the patient ages.

Interestingly, sleep attacks may be triggered by various emotional states, including anger or rage, and laughter for all of over 95% of the occurrences. In addition, the sleep attacks are usually partial but not too commonly do they occur unilaterally.

 

( Cataplexy - Image Courtesy of www.imreference.com )
( Cataplexy – Image Courtesy of www.imreference.com )

 

Some of the observable body movements experienced during the sleep attack include nodding of the head, knee buckling, having their jaw sagging down, dropping items they were holding in their hands, loss of the victim’s voice (voice loss), slumping their posture, dysarthria, and even falling down straight ahead to the floor for a brief while. When the patient has fallen, they may be in that state for anything from seconds or minutes, but their consciousness is not lost at any one point all through the duration of the sleep attack.

 

( Narcolepsy and Falling Down - Image Courtesy of www.itv.com )
( Narcolepsy and Falling Down – Image Courtesy of www.healthtopia.net )

 

Various aspects of the patient’s life are consequently affected by the sleep attacks and the associated Excessive Daytime Somnolence (EDS), including academic performance, functionality and performance at work, their psychological welfare, their social lives and interactions, and their economic wellbeing.

 

( Narcolepsy - Image Courtesy of www.huffingtonpost.com )
( Narcolepsy – Image Courtesy of www.huffingtonpost.com )

 

 

Identifying Your Sleeping Disorder: Narcolepsy

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Sleeping Disorders

Physicians and other medical practitioners may very well verify that one of the most common sleep disorders of modern age is Narcolepsy, which seems to be affecting more and more people all around the world due to demanding lifestyles and economic reasons.

 

( Narcolepsy - Image Courtesy of www.empowher.com )
( Narcolepsy – Image Courtesy of www.empowher.com )

 

Classification of Types of Narcolepsy

The ICSD-2 (International Classification of Sleep Disorders, edition 2) is an internationally approved, medical standardization recognized and utilized by medical professionals as a glossary outlining and categorizing all the known sleeping disorders. It clearly stipulates various types of Narcolepsy which is categorized into 3 related yet distinct classes as follows:

1.  Narcolepsy without Cataplexy
2.  Narcolepsy with Cataplexy (also known as Narcolepsy Cataplexy Syndrome)
3.  Secondary Narcolepsy

Thereby the main focus here is on the type of Narcolepsy that is incident without Cataplexy, which is rather distinct from the Narcolepsy Cataplexy Syndrome.

 

( International Classification of Sleep Disorders ICSD-2 - Image Courtesy of durmiendomejor.com )
( ICSD-2 – Image Courtesy of durmiendomejor.com )

 

What are the symptoms of Narcolepsy?

Clinical manifestations of Narcolepsy are shown to commonly reach peak levels in patients between the age bracket of 15 years to 30 years old.

Some of the most common complaints made by people suffering from Narcolepsy include: EDS (Excessive Daytime Somnolence or Sleepiness), intense desire and constant urge to go to sleep, as well as feeling rather refreshed and rested after catching extra sleep during the day (in addition to already having slept during the night, but not refreshed by nighttime sleep by the time one wakes up in the morning).

 

( Narcolepsy - Image Courtesy of blog.mattressesforless.net )
( Narcolepsy – Image Courtesy of blog.mattressesforless.net )

 

However, the above complaints are also closely linked to other sleeping disorders, and therefore further investigation and analysis is necessary on the part of the medical practitioner lest a misdiagnosis is made; for instance, as Partial Arousal Disorder, Insomnia, or Obstructive Sleep Apnea Syndrome (OSAS).

 

( Narcolepsy Cause - Hypocretin or Orexin - Image Courtesy of healthresearchfunding.org )
( Narcolepsy Cause – Hypocretin or Orexin – Image Courtesy of healthresearchfunding.org )

 

Major Narcolepsy Symptoms with Figures of Occurrence

  • Sleep Attacks (of the Narcoleptic nature) – 100 per cent prevalence
  • Sleep Paralysis – 25 to 50 per cent prevalence
  • Hallucinations (Hypnagogic in nature) – 20 to 40 per cent prevalence
  • Cataplexy 60 to 70 per cent prevalence
  • Automatic behaviour 20 to 40 per cent prevalence
  • Impaired nighttime sleep70 to 80 per cent prevalence

 

( Narcolepsy and Falling Down - Image Courtesy of www.itv.com )
( Narcolepsy and Falling Down – Image Courtesy of www.itv.com )

 

Co-morbidity or concurrent or secondary occurrence of Narcolepsy with other sleeping disorders cannot be ruled out or ignored. In many cases of patients diagnosed with Narcolepsy, an additional co-morbid diagnosis of one of the following sleep disorders is also observed:

  • PLMS Periodic Limb Movements in Sleep
  • Sleep Apnea
  • Nocturnal Eating Disorder
  • RBD – REM (Rapid Eye Movement) Behavior Disorder

 

( Narcolepsy Comorbidities - Image Courtesy of books.publications.chestnet.org )
( Narcolepsy Comorbidities – Image Courtesy of books.publications.chestnet.org )

 

Various sleep disorders are genetic as they may be passed on, and Narcolepsy is one among these; therefore careful history analysis of family background is necessary in the diagnosis of Narcolepsy.

 

( Narcolepsy Symptoms - Image Courtesy of www.pinterest.com )
( Narcolepsy Symptoms – Image Courtesy of www.pinterest.com )

 

Differentiating between Narcolepsy and Hypersomnia

It is also possible for a case of Narcolepsy to be misdiagnosed as Hypersomnia (specifically primary or idiopathic Hypersomnia) to which it is very closely related – they both have the same age bracket of disorder onset, but the sleeping patterns observed in Narcolepsy differ from those associated with idiopathic Hypersomnia.

One of the key differences is that while additional daytime sleep or napping is observed to be refreshing and restorative in Narcolepsy, the same is not the case with Hypersomnia, whereby the patient sleeps for long extended durations of sleep that is non-refreshing and non-restorative, thereby constantly desiring to fall asleep while the Narcoleptic patient is usually well rested after catching some extra sleep during the day.

 

( Narcolepsy vs. Hypersomnia - Image Courtesy of www.aasmnet.org )
( Narcolepsy vs. Hypersomnia – Image Courtesy of www.aasmnet.org )

 

Differentiating between Narcolepsy and Sleep Apnea

An underlying case of Narcolepsy may also be misinterpreted as a case Sleep Apnea, particularly due to the EDS (Excessive Daytime Somnolence) or Daytime Sleepiness presented in both Narcolepsy and Sleep Apnea.

In this case, a clear distinction should be made with other symptomatic manifestations of Sleep Apnea not presented in Narcolepsy, such as: snoring, frequent and constant awakening from one’s sleep all through the night, cataplexy and cessation of breathing; all of which are typical symptoms of Sleep Apnea, specifically Obstructive Sleep Apnea Syndrome (OSAS), and are not typical of Narcolepsy.

 

( Sleep-Wake Disturbances in Sleep Disorders Comparison - Image Courtesy of brain.oxfordjournals.org )
( Sleep-Wake Disturbances in Sleep Disorders Comparison – Image Courtesy of brain.oxfordjournals.org )

 

Lab Analysis and Testing for Narcolepsy

The Polysomnograph PSG Test, used to diagnose Obstructive Sleep Apnea Syndrome (OSAS), may be run overnight to assess the sleep disordered patient suspected to have Narcolepsy as it has been shown to also be beneficial in diagnosing Narcolepsy. With the PSG testing, various physiological factors are assessed, including the determination of optimized pressure measurements for CPAPContinuous Positive Airway Pressure.

 

( CPAP Titration in OSAS Treatment - Image Courtesy of www.alamy.com )
( CPAP Titration in OSAS Treatment – Image Courtesy of www.alamy.com )

 

MSLT Multiple Sleep Latency Testing has been fundamental in the documentation, observation and analysis of pathological chronic sleepiness, such as that presented in patient cases of Narcolepsy. It quickly picks up on the latency of sleep onset that is detected to having occurred quickly in 8 minutes or less which is a key indicator for a Narcolepsy diagnosis. Another relative indicator picked up on by the MSLT in diagnosing Narcolepsy is the occurrence of 2 sleep onset Rapid Eye Movement (REM) phases obtained from the analysis of 4 to 5 sleeping or napping sessions.

 

( MSLT Multiple Sleep Latency Test - Image Courtesy of www.medscape.com )
( MSLT Multiple Sleep Latency Test – Image Courtesy of  www.medscape.com )

 

On the other hand, an MWT Maintenance of Wakefulness Test (which is a variation of the MSLT), may be beneficial in confirming a suspected case of Narcolepsy. However, it should be noted that Multiple Sleep Latency Testing is more superior to Maintenance of Wakefulness Testing which is less sensitive in detecting and diagnosing Narcolepsy. Nonetheless, the MWT is considered to be a more effective option in analyzing the effectiveness of treatment administered for Narcolepsy and other sleeping disorders like Obstructive Sleep Apnea Syndrome (OSAS) when being treated with CPAP Titration.

 

( MSLT and MWT - Image Courtesy of www.aasmnet.org )
( MSLT and MWT – Image Courtesy of www.aasmnet.org )

 

Further, sleep experts have previously authored the possibility of mediation of Narcolepsy, among other sleeping disorders, by the leukocyte proteins called cytokines, in particular, IL-6 (Inter-Leukin) and TNF-α (Tumor Necrosis Factor).

 

( Cytokines in Disease - Image Courtesy of biologicalexceptions.blogspot.com )
( Cytokines in Disease – Image Courtesy of biologicalexceptions.blogspot.com )

 

Thus histo-compatibility analysis of leukocyte antigens is also beneficial in diagnosing suspected underlying Narcolepsy in patients with a sleeping disorder.

 

( Autoimmunity in Narcolepsy - Image Courtesy of www.nature.com )
( Autoimmunity in Narcolepsy – Image Courtesy of  www.nature.com )

 

In addition, analyzing fluid levels of Hypocretin-1, a cerebrospinal sample, may also confirm the diagnosis of possible underlying Narcolepsy in the patient.

 

( Hypocretin from Hypothalamus in Narcolepsy - Image Courtesy of www.nature.com )
( Hypocretin from Hypothalamus in Narcolepsy – Image Courtesy of  www.nature.com )

 

Sleep experts suggest the possibility of Narcolepsy actually being a degenerative medical condition that affects the neurons which contain Hypocretin within the lateral region of the hypothalamus.

 

( Narcolepsy - Image Courtesy of new.lakeforest.edu )
( Narcolepsy – Image Courtesy of  new.lakeforest.edu )

 

 

 

Identifying Your Sleeping Disorder: Insomnia And Hypersomnia

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Insomnia

 

Insomnia, perhaps the most rampant sleep disorder, so prevalent is it that some don’t even know they have it, or that what they experience has a name, or that it is an anomalous sleeping condition…!

 

( Insomnia - Image Courtesy of sleepingresources.com )
( Insomnia – Image Courtesy of sleepingresources.com )

 

Symptoms of Insomnia

As a basic intro, Insomnia is one of the 4 most common sleeping disorders, and it symptomatically presents itself in one or all of these complaints:

  • Having difficulty falling asleep (sleep onset)
  • Having difficulty staying asleep (sleep maintenance)
  • Constantly or frequently waking up in the middle of the night
  • Waking up too early in the morning (premature awakening)
  • Experiencing fatigue and exhaustion during the day (despite having slept at night)
  • Low quality sleep that is not restorative, and not restful
  • Aching, sore painful muscles
  • Depression
  • Moodiness and irritability
  • Anxiety
  • Poor or no concentration

 

( Insomnia - Image Courtesy of menhealthcare.net )
( Insomnia – Image Courtesy of menhealthcare.net )

 

Analyzing Possible Insomnia

In a majority of patients, Insomnia remains as a stubborn persistent problem that affects their normal functionality and productivity during the day. The symptoms present themselves at least 3 to 4 times a week, and prevail for extended periods of time, longer than 1 month, while disrupting diurnal productivity and functionality.

( Insomnia - Image Courtesy of www.sleepeducation.org )
( Insomnia – Image Courtesy of www.sleepeducation.org )

 

The occurrence of Insomnia may be independent as a primary condition that is not necessarily caused by any other condition, or co-morbid occurring alongside another medical condition such as: neurological conditions, psychiatric disorders, cases of alcoholism, drugs and substance abuse. When the patient is affected by a case of acute Insomnia it is usually linked to a predominant stressful incident or event affecting the patient and disrupting their overall well-being and functioning. In cases where no other underlying cause or contributing factor may be attributed to for the occurrence of the patient’s Insomnia and all it’s associated symptoms, the diagnosis is therefore identified medically as psycho-physiological Insomnia, also known as primary Insomnia or alternatively, idiopathic Insomnia.

 

( Actigraphy Test- Image Courtesy of www.youtube.com )
( Actigraphy Test – Image Courtesy of www.youtube.com )

Testing Insomnia

Insomnia may be tested and detected using Actigraphy lab testing which entails wearing an Actigraph upon the patient’s wrist or their ankle; measurements of decelerations or accelerations in their body movements are then taken as clear indicators of their sleeping or wakeful state.

 

( Actogram in Actigraphy Testing - Image Courtesy of www.env-econ.net )
( Actogram in Actigraphy Testing – Image Courtesy of www.env-econ.net )

 

Conditions Linked to Insomnia

Medical professionals administering sleeping medication most commonly encounter cases of Insomnia in their practice. There are also various other sleeping disorders and medical conditions (psychiatric disorders and neurological conditions) associated with or that present Insomnia as a symptom, and careful testing, observation, and analysis should therefore be carried out for accurate diagnosis; this includes conditions such as: OSAS (Obstructive Sleep Apnea Syndrome), Anxiety and Mood disorders, ADHD (Attention Deficit Hyperactivity Disorder), Bipolar Disorder, PTSD (Post Traumatic Stress Disorder), as well as Depression.

 

( Sleep Deprivation - Image Courtesy of healthpromotion.caltech.edu )
( Sleep Deprivation – Image Courtesy of healthpromotion.caltech.edu )

 

Historical Scientific Research of Insomnia

Various scientific experiments have been shown to link Insomnia with stimulation of the brain’s preoptic region of the hypothalamus. This is one of the active regions of hypnogenic neurons for NREM sleep, the other active region being located within the brain’s medulla where the NTS (Nucleus Tractus Solitarius) is. The studies are based on the active stimulatory effects, ablations and lesions, and also recordings or the intracellular and extracellular activity of these brain regions.

 

( The Hypothalamus - Image Courtesy of www.slideshare.net )
( The Hypothalamus – Image Courtesy of www.slideshare.net )

 

One such experiment, Batini’s, has proven the actively inhibiting function of The hypnogenic neurons of the brain’s lower stem on the brain’s upper stem. The behavioral sleeping state, as well as the synchronization produced by an EEG (Electro Encephalograph), both of which are produced by electrical stimulation of the brain’s preoptic area were also assessed in experiments by Nauta in 1946. Findings from Nauta’s experiments further elicited the onset or occurrence of Insomnia due to lesions present in the brain’s preoptic region. These findings would be later used to hypothesize the presence of actively working hypnogenic neurons within the brain’s preoptic region (in the forebrain). Later experiments in 1968 by Sterman and McGinty went ahead to confirm the findings from Nauta’s studies. Even so, not too long ago, further studies have gone to confirm that lesions of the ibotenic nature present within the brain’s preoptic area may also lead to Insomnia; thus further supporting the results that show the preoptic region as having a hypnogenic function that is active.

 

( Insomnia- The Hypothalamus and Homeostasis - Image Courtesy of wiki.bethanycrane.com )
( Insomnia- The Hypothalamus and Homeostasis – Image Courtesy of wiki.bethanycrane.com )

 

Little Less Known Hypersomnia Sleep Disorder

Hypersomnia, a sleeping disorder that is related to Insomnia, involves complaints of EDS (Excessive Daytime Sleepiness), concentration problems, impaired motor abilities, poor cognitive function, and persistence of symptoms even after extended sleep at night.

( Hypersomnia - Image Courtesy of www.pinterest.com )
( Hypersomnia – Image Courtesy of www.pinterest.com)

 

Lab testing such as pulmonary functional analysis may be done to assess the diagnosis of underlying Hypersomnia diagnosis.

 

( Pulmonary Function Analysis - Image Courtesy of err.ersjournals.com )
( Pulmonary Function Analysis – Image Courtesy of err.ersjournals.com )

 

( Pulmonary Function Testing - Image Courtesy of emedicine.medscape.com )
( Pulmonary Function Testing – Image Courtesy of emedicine.medscape.com )

 

Occurrence of Hypersomnia

Hypersomnia that occurs idiopathically (idiopathic Hypersomnia) without any other co-morbid conditions may be easily confused with Narcolepsy, another sleeping disorder which entails excessive sleepiness. Though it is yet to be proven, it is assumed that the cause of Hypersomnia originates from the CNS (Central Nervous System).

 

( Hypersomnia - Image Courtesy of chicagosleepcenter.com )
( Hypersomnia – Image Courtesy of chicagosleepcenter.com )

 

Testing Hypersomnia

Symptomatic Hypersomnia is typically syndicated with extended nighttime sleep (over 10 hours) or even normal sleep (about 6 to 10 hours): that is, Hypersomnia may occur with long sleeping time or without long sleeping time. These sleeping hours may be assessed by using sleep pattern history assessments, actigraphy, sleeping logs, and PSG (polysomnography) tests. Observations from the MSLT (Multiple Sleep Latency Tests) of Hypersomnia evidence admissible indications of pathological sleepiness but with the exception of sleep onset Rapid Eye Movement (REM).

Onset of Hypersomnia is usually seen around 15 to 30 years of age, which is much like the onset of Narcolepsy; however the two sleeping disorders differ in the nature of the sleeping pattern. In Hypersomnia, the patient is generally seen to sleep for many hours though the sleep is neither refreshing nor sufficient, nonetheless.

 

( Hypersomnia - Image Courtesy of www.utsleepdisorders.org )
( Hypersomnia – Image Courtesy of www.utsleepdisorders.org )

 

Hypersomnia and EDS

Because Excessive Daytime Sleepiness (EDS) is another symptom of Hypersomnia, it may be easily confused with a misdiagnosis of Sleep Apnea. Therefore the patient needs to be further assessed for the following symptoms to rule out Sleep Apnea: frequent or intermittent awakening episodes all through the night, snoring, and cataplexy. Careful diagnosis should be made for many are the cases where Hypersomnia is misdiagnosed and confused for other conditions associated with EDS.

 

( Hypersomnia - Image Courtesy of healthysmart.org )
( Hypersomnia – Image Courtesy of healthysmart.org )

 

Various sleep experts have suggested the possibility of arbitrated by Cytokine proteins (like interleukin – specifically IL-6, and tumor necrosis factor – specifically TNF-α) in both Insomnia, and Hypersomnia that is idiopathic.

( Cytokines and Sleep Loss - Image Courtesy of www.researchgate.net )
( Cytokines and Sleep Loss – Image Courtesy of www.researchgate.net )

 

It may very well be said of both Insomnia and Hypersomnia to be life-long chronic conditions that are disabling and lower the quality of one’s life.

( Hypersomnia - Image Courtesy of www.americansleepmedicine.com )
( Hypersomnia – Image Courtesy of www.americansleepmedicine.com )

 

 

Identifying Your Sleeping Disorder: OSAS – Obstructive Sleep Apnea Syndrome

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( OSAS Clinical Manifestations - Image Courtesy of jtd.amegroups.com )
( OSAS Clinical Manifestations - Image Courtesy of jtd.amegroups.com )

 

Considered to be more prevalent in men than in women, Obstructive Sleep Apnea Syndrome shortened OSAS affects about 4% of men in the age bracket from 30 to 60 years old, and about 2% of women within the same age group.But as scientific research would have it, the age and gender are not the only key factors with a strong correlation to the OSAS sleeping disorder which is also linked to weight and obesity.

 

( Obesity and Obstructive Sleep Apnea OSA - Image Courtesy of www.nycva.org )
( Obesity and Obstructive Sleep Apnea OSA – Image Courtesy of www.nycva.org )

 

How gender sensitive is Obstructive Sleep Apnea Syndrome?

The prevalence of Obstructive Sleep Apnea Syndrome is much higher in older male persons over the age of 40, and its prevalence in female persons is commonly noted to be higher after the onset of their menopause stage which also comes around their 40’s and 50’s.

With regards to gender sensitivity, research clearly shows that a whooping 85% of OSAS patients are actually male, leaving only about 15% of the OSAS patients being female.

 

( Men with OSAS and Snoring - Image Courtesy of www.qmedicine.co.in )
( Men with OSAS and Snoring – Image Courtesy of www.qmedicine.co.in )

 

Obesity and Obstructive Sleep Apnea Syndrome

There has been shown to be a clear link between OSAS and weight or obesity. Scientific research has since confirmed that a majority of patients suffering from OSAS also have weight problems which are identified upon further physical examination; more specifically, a generous 70% of OSAS patients also concurrently have obesity weight issues.

 

( OSAS and Upper Airways - Image Courtesy of obstructive-sleep-apnea.info )
( OSAS and Upper Airways – Image Courtesy of obstructive-sleep-apnea.info )

 

Further, physical examination of OSAS patients has also been shown to reveal some anatomic anomalies present within the upper respiratory airways in some patients.

( Obstructive Sleep Apnea OSAS and Upper Airways in Respiratory Tract - Image Courtesy of www.docsopinion.com )
( Obstructive Sleep Apnea OSAS and Upper Airways in Respiratory Tract – Image Courtesy of www.docsopinion.com )

 

Hypertension and Obstructive Sleep Apnea Syndrome

Various longitudinal scientific studies have drawn up a clear link relating systemic hypertension with OSAS. The results revealed a concurrent incidence of systemic hypertension in patients also suffering from OSAS. On the other hand, approximately 30% of OSAS patients were also found to have essential hypertension. Additionally, round about 15% to 20% of OSAS patients were also confirmed to have a diagnosis of pulmonary hypertension.

 

( Pulmonary Hypertension in OSAS - Image Courtesy of www.phaonlineuniv.org )
( Pulmonary Hypertension in OSAS – Image Courtesy of www.phaonlineuniv.org )

 

 

( Pulmonary Function Analysis - Image Courtesy of err.ersjournals.com )
( Pulmonary Function Analysis – Image Courtesy of err.ersjournals.com )

 

In hypertensive patients with Obstructive Sleep Apnea Syndrome, it was shown that effective treatment of OSAS together with CPAP (Continuous Positive Airway Pressure) Titration had a positive impact on the hypertension. The observation made is that there was an overall improvement of the condition and relief from hypertensive symptoms, or that there was a reduced need for use of antihypertensive drugs.

 

( CPAP Titration in OSAS Treatment - Image Courtesy of www.alamy.com )
( CPAP Titration in OSAS Treatment – Image Courtesy of www.alamy.com )

 

Another key correlation worth mentioning in connection to this is the link between OSAS and metabolism dysfunction, particularly metabolic syndrome which is a concoction of the following medical conditions: hypertension, obesity, insulin resistance, Diabetes Mellitus Type 2, and hypertriglyceridaemia.

 

( Metabolic Syndrome - Image Courtesy of www.livefitlean.com )
( Metabolic Syndrome – Image Courtesy of www.livefitlean.com )

 

Symptoms of Obstructive Sleep Apnea Syndrome

To identify the symptomatic manifestations of OSAS, two classes of symptoms are first categorized: OSAS symptoms which present themselves during the patient’s sleeping phase, and OSAS symptoms which occur while the patient is not asleep in the waking phase.

 

( Obstructive Sleep Apnea Symptoms - Image Courtesy of orthodonticreviews.blogspot.com )
( Obstructive Sleep Apnea Symptoms – Image Courtesy of orthodonticreviews.blogspot.com )

 

OSAS symptoms during sleep phase:

  • Snoring which occurs frequently and loudly
  • Sitting up amid sleep to fight for one’s breath
  • Breathing cessation (which is also witnessed by the bed fellow or pexcessive sweating artner in bed)
  • Episodes of choking while asleep
  • Heartburn due to GER (Gastro-Esophageal Reflux)
  • Anomalous nocturnal motor activity such as: jerking and shaking movements, thrashing motions in bed, arousals with confusion, walking while asleep (sleep-walking)
  • Intense disruptions of sleep
  • Increased and excessive sweating during the night (observed in some OSAS patients)
  • Enuresis that’s nocturnal and Nocturia (particularly observed in child patients)

 

( OSAS Sleep Attack at Steering Wheel - Image Courtesy of www.webmd.com )
( OSAS Sleep Attack at Steering Wheel – Image Courtesy of www.webmd.com )

 

OSAS symptoms during wakeful phase:

  • EDS – Excessive Daytime Sleepiness
  • Extended Sleep Attacks which may last from 30 minutes to 2 hours (These sleep attacks mostly affect the patient while they are in a relaxed state such as when seated, rested, while watching TV. There is however a key distinction between the Sleep attacks associated with OSAS from those that occur due to Narcolepsy in that OSAS Sleep Attacks are both prolonged with regards to the duration of the Sleep Attack, and are also non-refreshing)
  • Dryness of the mouth upon waking up
  • Decreased sexual function and libido in male patients
  • Hyperactive behavior in child patients
  • Forgetfulness, memory issues, as well as impaired cognitive function
  • Depression and mood disorders
  • Impaired hearing (observed in some OSAS cases)
  • Headaches occuring in the morning (observed in some OSAS patients)

 

( Upper Airway Obstruction in OSAS - Image Courtesy of advan.physiology.org )
( Upper Airway Obstruction in OSAS – Image Courtesy of advan.physiology.org )

 

Symptoms presented in Severe Cases of OSAS:

  • Impotence in men (this is especially noted in male patients who have suffered from chronic, persistent OSAS)
  • Heart problems: pulmonary valve hypertension, cardiac arrhythmia (sinus pausing, ventricular tachycardia, ventricular premature contraction, third degree cardiac blockages), myocardial infarction, heart failure (systolic cardiac failure and diastolic cardiac failure), sudden cardiac death
  • Polycethemia
  • Stroke

 

( OSAS and COPD - Image Courtesy of www.researchgate.net )
( OSAS and COPD – Image Courtesy of www.researchgate.net )

 

It follows suit that Obstructive Sleep Apnea Syndrome is linked to in increase in mortality rates and higher morbidity due to the symptoms presented in short term basis (such as accidents at work, road accidents, lowered quality of life), and also due to symptoms presented in the long haul (such as heart problems and stroke).

 

Diagnosing Obstructive Sleep Apnea Syndrome

Besides analysis of the typical symptoms of OSAS being constant and frequent awakenings amidst one’s sleep all through the night, breathing cessations, snoring, Excessive Daytime Somnolence (EDS), and fatigue during the day; a background check into the patient’s family history is also necessary since OSAS is also genetically linked and therefore may run in the family.

 

( OSAS Analysis - Image Courtesy of emedicine.medscape.com )
( OSAS Analysis – Image Courtesy of emedicine.medscape.com )

 

Detection of OSAS may be effectively achieved using Polysomnography (PSG) tests which analyze various key physiological aspects such as the flow of air in the mouse, flow of air in the nose, respiration effort, saturation of oxygen; and using medical instruments such as the EEG, EOG, EMG, and EKG.

 

( Polysomnogram Test Results in OSAS - Image Courtesy of advan.physiology.org )
( Polysomnogram Test Results in OSAS – Image Courtesy of advan.physiology.org )

 

Treatment of Obstructive Sleep Apnea Syndrome involves titration of the optimal and ideal pressure levels for CPAP Continuous Positive Airway Pressure.

 

( OSAS Treatment with CPAP Titration - Image Courtesy of www.webmd.com )
( OSAS Treatment with CPAP Titration – Image Courtesy of www.webmd.com )

 

Physical examinations of the body are also key in revealing underlying symptoms associated with OSAS such as weight-related complications in overweight and obese patient cases, as well as obstructions and other anomalies present in the upper respiratory airways (which affects breathing during sleep, and may cause blockages, snoring, and choking among other symptomatic complications associated with OSAS). There is also the likelihood of comorbidity with other sleeping disorders in the diagnosis of Obstructive Sleep Apnea Syndrome.

 

( OSAS Upper Airway Obstruction - Image Courtesy of en.wikipedia.org )
( OSAS Upper Airway Obstruction – Image Courtesy of
en.wikipedia.org )