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We are all generally
aware of the personal consequences of inadequate or non-refreshing sleep including decreased motivation and concentration
and depressed mood. Although it is difficult to estimate the overall impact of sleep disruption and disorders on our society,
many major accidents such as the Challenger Shuttle explosion and the Three-Mile Island Nuclear Power Plant incident have
been linked with sleep deprivation in workers. Sleepy drivers are also more likely to have accidents.
Major
categories of sleep-related symptoms include excessive daytime sleepiness (EDS) and insomnia. In general population surveys
5-15 % of respondents report EDS. By far the most common cause of EDS in patients who come to sleep clinics is sleep-disordered
breathing or the Obstructive Sleep Apnea Syndrome (OSAS). The hallmark of this condition is loud snoring with recurring pauses
in breathing caused by temporary complete blockage of the air passages in the back of the throat. In a widely quoted survey
of middle-aged working persons, 35% of men and 28% of women reported habitual snoring. When studied in a sleep laboratory
24% of the men and 9% of the women respectively were found to have some evidence of OSAS. In approximately one third of the
men and one half of the women with OSAS the severity was judged sufficient to have adverse health consequences. An increased
risk of OSAS is present in persons who are overweight or who have nasal obstruction (e.g. due to allergies). There are many
other causes of EDS including a rare hereditary condition called narcolepsy, which causes uncontrollable "sleep attacks".
If excessive sleepiness is interfering with normal daily activities, especially driving, it should be evaluated by a qualified
health professional.
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Stressful life events, shift work, jet travel and medical conditions can cause temporary difficulty
sleeping. Approximately 27% of the general public reports occasional insomnia. However, 9% of respondents in a Gallup poll
reported this problem as lasting 6 months or more. Short-term insomnia, which severely interferes with daily activities and
chronic insomnia should be evaluated by a health professional. Other primary sleep disorders include the parasomnias such
as sleep walking and acting out of dreams (called REM Sleep Behavior Disorder). These conditions usually do not have severe
adverse effects, but injuries to the affected individual or his/her bed partner can occur. Finally, disruption of sleep can
be associated with many medical conditions and medications. Once recognized simple treatments may result in significant improvement
in sleep and sense of well-being.
SLEEP APNEA
RESTLESS LEG SYNDROME (RLS)
NARCOLEPSY
INSOMNIA
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