The importance of sleep
Getting sufficient sleep is crucial for maintaining good health. Our bodies devote about one-third of our lives to sleeping. During this time, our bodies enter a state of reduced awareness and responsiveness to the environment, allowing for much-needed rest and repair. Sleep consists of two main types: Non-rapid eye movement sleep (NREM) and Rapid eye movement sleep (REM). While we sleep, our bodies undergo various physiological changes that differ from when we are awake. These changes include:
Frequent Sleep Problems:
1. Sleep apnea, which has two types:
Obstructive sleep apnea (OSA), where the tissue around the throat, particularly the base of the tongue, collapses and blocks the airway during sleep, making it difficult for the patient to breathe, even when attempting to do so. If there is some airflow, snoring may be heard. When air is severely restricted, the brain may trigger the patient to wake up slightly, but not fully, which is known as an arousal. Central sleep apnea (CSA) occurs when the brain fails to signal breathing during sleep. As a result, there is no movement of the respiratory muscles during the apneic period. Patients with CSA may need to wake up multiple times to breathe, resulting in poor quality sleep. Furthermore, frequent arousal from sleep due to either OSA or CSA can result in high blood pressure, as the autonomic nervous system is not able to rest, and the alternating periods of oxygen deprivation and reoxygenation can produce harmful free radicals that can lead to atherosclerosis, a condition that narrows and hardens the arteries, and can lead to heart disease and stroke.
2. Sleep-related abnormal movement and parasomnia include Restless Leg Syndrome (RLS), Periodic Limb Movement in Sleep (PLMS), Bruxism, and Sleepwalking.
Restless Leg Syndrome causes significant distress for patients, as many describe feelings of discomfort in their legs, such as an urge to move or a crawling sensation that persists even after movement. Symptoms often occur when the patient is still or before bedtime, and can severely disrupt sleep, leading to frustration and affecting mental well-being. RLS is often associated with iron deficiency in the brain.
Periodic Limb Movement in Sleep is characterized by jerking movements of the legs during sleep that the patient is often unaware of. These movements can disrupt sleep, resulting in shallow and insufficient sleep, and leaving the patient feeling tired and unrefreshed. Without proper diagnosis, PLMS can go unnoticed.
Bruxism is the habit of grinding or clenching teeth during sleep, often resulting in symptoms such as jaw pain, headaches, or tooth sensitivity. Bed partners may also hear grinding or gnashing sounds during the night.
Sleepwalking is a parasomnia that is commonly seen in children but may persist into adulthood. It is important to investigate the underlying cause of sleepwalking if it occurs in adults. Severe parasomnias, such as REM Sleep Behavior Disorder (RBD), where the patient acts out dreams and may cause harm to themselves or others, may be indicative of a neurodegenerative disorder such as Parkinson's disease.
3. Circadian rhythm disorder refers to a condition where the body's internal clock is disrupted, beyond just insufficient sleep and poor sleep quality. Sleeping at appropriate times can ensure efficient functioning of various organs in the body.
Symptoms of sleep disorders may include:
Diagnosis of sleep disorders can be done using a standard method called Polysomnography. This involves placing several biological sensors on the body to monitor various bodily functions during sleep, such as brain waves, eye movements, muscle activity, breathing, heart rate, sleep position, and video recording. Trained specialists observe the sleep study to detect any abnormalities and provide appropriate treatment.
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