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Sims Management Inc. :: Adult and Pediatric Sleep & Neurophysiology - Providing neurodiagnostic testing for patients suffering from sleep disorders and patients requiring EEGs neurological testing, including ambulatory and long-term EEGs. - Sleep Disorders

Sleep Disorders

Sleep Disorders

The majority of sufferers remain undiagnosed; the good news is most sleep disorders can be effectively treated. A Sleep Test, or Polysomnogram, is used to help diagnose sleep disorders. Sleep studies generally take place in a sleep lab during a person's normal sleeping hours. A Sleep Test uses various instruments to gather information about a person’s sleep stages, body position, and physiological conditions such as brain wave activity, eye movement, muscle movement, and possibly even the electrical activity of the heart. This data is then evaluated by your physician.

If left untreated, sleep disorders can pose significant adverse consequences. Not only is insufficient sleep often responsible for motor vehicle and machinery-related accidents, but it is also linked to the development of a broad range of chronic diseases, including hypertension, cardiovascular disease, heart attack, stroke, obesity, diabetes, and depression.

Patients who have the following conditions may benefit from our comprehensive evaluations:

      Morbid obesity

      Chronic renal failure with daytime fatigue or restless legs

      Unusual sleep behaviors such as sleep walking and dream enactment

      Sleep disorders associated with shift work

      Polycystic ovarian disease

      Obesity and pregnancy with snoring

      Fibromyalgia and excess fatigue

      Depression with sleep complaints

      Leg cramps at night

      Obese patients for preoperative evaluation, including bariatric patients

      Difficulty falling asleep or frequent awakenings

      Loud snoring

      Excessive daytime sleepiness, chronic fatigue

      Restless legs syndrome

      Heart failure/cardiomyopathy

      Uncontrolled hypertension or diabetes mellitus

      Stroke or recurrent TIAs

      Unexplained nocturia

      Sleep attacks and unexplained syncope

      Unexplained peripheral edema

      Pulmonary hypertension

      Nocturnal angina

      Nocturnal gastro esophageal reflux disease (GERD) symptoms

      Chronic obstructive pulmonary disease (COPD) who may require supplemental oxygen




The most common sleep disorders are listed below...

Insomnia

 

Insomnia is defined by a repeated difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate time and opportunity for sleep and results in some form of daytime impairment.

 

There are three categories of insomnia:

 

•      Adjustment insomnia is usually brought on by excitement or stress, and lasts no longer than four weeks.  

•      Short-term insomnia is any trouble falling or staying asleep that lasts between four weeks and six months. This too is usually brought on by a stressful situation, and once the problem subsides or the sleeper adjusts to it, the insomnia will disappear.

•      Chronic insomnia is anything lasting longer than six months.  


Insomnia may be caused by persistent stress, whether it is relationship problems or trouble at work.  Many lifestyle decisions may contribute as well, such as the misuse of stimulants (caffeine and tobacco), alcohol, or sleeping pills, keeping erratic bedtime hours, and inactive behavior. Often, there are underlying physical or psychiatric problems that are the cause, such as a breathing disorder (Obstructive Sleep Apnea, Central Sleep Apnea), or depression.

 

Narcolepsy

 

Narcolepsy is excessive daytime sleepiness.  Daytime sleepiness is the inability to stay awake and alert during the major waking episodes of the day, resulting in unintended lapses into drowsiness or sleep.

 

Narcolepsy is a chronic neurological disorder caused by the brain's inability to regulate sleep-wake cycles normally. At various times throughout the day, people with narcolepsy experience fleeting urges to sleep. If the urge becomes overwhelming, individuals will fall asleep for periods lasting from a few seconds to several minutes. In rare cases, some people may remain asleep for an hour or longer. In addition to excessive daytime sleepiness (EDS), three other major symptoms frequently characterize narcolepsy: cataplexy, or the sudden loss of voluntary muscle tone; vivid hallucinations during sleep onset or upon awakening; and brief episodes of total paralysis at the beginning or end of sleep.

 

Obstructive Sleep Apnea

 

Obstructive Sleep Apnea (OSA) is a potentially life-threatening disorder linked to irregular heartbeat, high blood pressure and heart failure.  OSA is characterized by repetitive episodes of complete (apnea) or partial upper airway obstruction occurring during sleep. These events often result in reductions in blood oxygen saturation and are usually terminated by brief arousals from sleep.

 

When a person with this syndrome falls asleep, the airway collapses and disrupts normal breathing patterns. This can occur hundreds of times throughout the night, putting a great amount of stress on the vital organs like the heart, lungs as well as interrupting normal sleep cycles.  An apnea is a period of time during which breathing stops or is markedly reduced.  Simply stated, an apnea occurs when a person stops breathing for 10 seconds or more.

Loud snoring is one of the most obvious indicators that OSA may be a problem, especially if the snoring is accompanied by pauses and gasps for air. This suggests that the person has momentarily stopped breathing, or his/her breathing has become shallow enough to cause sleep disruption.

Excessive Daytime Sleepiness is also a warning sign. The brief awakenings at night can cause a person to fall asleep throughout the day, particularly if the OSA is severe.  Other signs include trouble concentrating during the day, irritability, morning headaches, or nausea upon awakening, and frequent urinations at night.

 

Restless Leg Syndrome

 

Restless Legs Syndrome (RLS) is a disorder characterized by a complaint of a strong nearly irresistible, urge to move the legs.  Patients may complain of involuntary jerking or twitching movements of the legs while sitting or lying awake.

 

Restless Legs Syndrome is an uncontrollable urge and uncomfortable sensation in the legs (or possibly arms) that can only be relieved by stretching or moving them.  It has been described as a creepy, crawly feeling, and most often occurs when a person is lying or sitting still in the evening. This continuous need to stretch or move can cause insomnia or delay sleep onset, which in turn leads to excessive daytime sleepiness and the inability to function optimally during the day. The irritable sensations can lead to anxiety and depression.

Periodic Limb Movements of Sleep (PLMS)

Periodic Limb Movement Disorder is similar to RLS, but occurs while a person is asleep. It is an involuntary movement of a section of the limbs that occurs at least four times in a row. This includes anything from an extension of the big toe to a flex of the knee or hip in some cases. The intervals between each movement are usually regular (20-40 seconds), and these movements usually cluster at the beginning of the night.  Because a certain number of limb movements per night are considered normal, a diagnosis of PLMD is not made unless the patient has symptoms of restless legs syndrome.

Rapid Eye Movement

 

REM sleep behavior disorder is characterized by abnormal behaviors emerging during sleep that causes injury or sleep disruption. The main symptom is dream-enacting behaviors, sometimes violent, causing self-injury or injury to the bed partner.

 

Rapid Eye Movement (REM) sleep behavior disorder (RBD) is a manifested by vivid, often frightening dreams during REM sleep.  Patients appear to "act out their dreams," in which the exhibited behaviors mirror the content of the dreams.  The dream-enacting behaviors are usually non-directed and may include punching, kicking, leaping, or jumping from bed while still asleep. The person may be awakened or may wake spontaneously during the attack and vividly recall the dream that corresponds to the physical activity.

Diseases that affect your sleep

(1)   Obesity

(2)   Hypertension

(3)   Diabetes

(4)   Stroke

(5)   Depression