100 Questions & Answers About Sleep and Sleep Disorders

by Sudhansu Chokroverty

Overview

Nearly 32 million Americans have insomnia and over 12 million suffer from sleep apnea .Whether you're a newly diagnosed patient with a sleep disorder, or are a friend or relative of someone suffering from a sleep disorder, this book offers help. The only text available to provide both the doctor's and patient's views, 100 Questions & Answers About Sleep and Sleep Disorders gives you authoritative, practical answers to your questions. Written by an expert on the subject, with

Product Details

ISBN-13:	9780763741204
Publisher:	Jones & Bartlett Learning
Publication date:	12/13/2007
Series:	100 Questions & Answers about
Edition description:	2E
Pages:	188
Product dimensions:	0.43(w) x 6.00(h) x 9.00(d)

About the Author

Sudhansu Chokroverty, MD, FRCP, FACP, is currently Co-Chair of Neurology for Clinical Neurophysiology and Sleep Medicine, and Program Director of Clinical Neurophysiology at the New Jersey Neuroscience Institute at JFK Medical Center, Edison, NJ. He is also Professor of Neuroscience at Seton Hall University School of Graduate Medical Education, South Orange, NJ, and Clinical Professor of Neurology at Robert Wood Johnson University Medical School, New Brunswick, NJ. After graduating with a degree in Medicine from Medical College, Calcutta and University of Calcutta, India, Dr. Chokroverty had post-graduate training in internal medicine and neurology in hospitals in the Unit ed Kingdom (UK). After being certified in Internal Medicine, he became a Member of the Royal College of Physicians (MRCP) of UK. He performed residency training in neurology and fellowship training in neurophysiology at Northwestern University Medical School, Chicago, IL, and Hines VA Hospital, IL. Dr. Chokroverty is board certified in neurology, electrodiagnostic medicine, sleep medicine, and clinical neurophysiology. He has examined for the American Board of Psychiatry and Neurology, the American Board of Sleep Medicine, the American Board of Clinical Neurophysiology, and the American Board of Electrodiagnostic Medicine. Dr. Chokroverty is currently President of the World Association of Sleep Medicine, an international organization devoted to promoting sleep health throughout the world. He is also on the Medical Advisory Board of the International Restless Legs Syndrome Study Group. He was the Founding Chair of the Sleep Section of the American Academy of Neurology, a member of the Advisory Board of the National Center of Sleep Disorders Research of the National Institutes of Health (NIH), and the Chair of the Sleep Science Award Subcommittee of the American Academy of Neurology. Dr. Chokroverty is the Founding Editor-in-Chief of the journal Sleep Medicine, an international journal dealing with clinical sleep disorders. He is also the Section Editor of Sleep Disorders for Current Treatment Options in Neurology. He was associate editor for three sections (Sleep, Clinical Neurophysiology, and Autonomic Disorders) for the Encyclopedia of the Neurological Sciences. He has been on the editorial boards of five scientific journals and has been an ad-hoc reviewer for twenty national and international journals. He has been an ad-hoc grant reviewer for NIH/SBIR Grant Review; NINDS-NSPA Review Committee; BC Health Research Foundation, Canada; Veterans Administrations Merit Review; and Comitato Promotore Telethon, Rome, Italy. He has participated in numerous national and international conferences as lecturer, session chair, continuing medical education course director and faculty member, and grand round speaker. He is the author or editor of ten published books and four books in press, including six books dealing with sleep medicine, one on management of epilepsy, one on movement disorders, and another on magnetic stimulation in clinical neurophysiology. He has been published extensively in both national and international scientific journals, producing over 450 papers, book chapters, and abstracts, and has made over 225 presentations at national and international conferences. Dr. Chokroverty’s recent research interest has focused on sleep and movement disorders; restless legs syndrome; sleep disordered breathing in neuromuscular disorders; autonomic failure and neurodegenerative diseases; and Actigraphy in Insomnia diagnosis and management.

Table of Contents

Acknowledgments     v
Introduction     vii
The Basics     1
Provide background information for understanding sleep and sleep disorders, covering such topics as
What is sleep?     2
Why do we sleep?     5
What is my sleep requirement?     6
How does sunrise or sunset control when we sleep and wake up?     6
Why do some people go to sleep earlier and others go to sleep later?     9
Why do people sleep at night and not in the daytime? Does a person need to sleep at certain times of the day and night?     10
Why do we dream?     11
How common are sleep problems?     14
What are common sleep problems?     16
Are sleep disorders serious problems?     17
Is the sleep pattern different in normal elderly people?     18
How does sleep change from birth to old age?     18
What are some sleep problems in old age?     20
As we grow older, cells in different body organs, including the brain, progressively decay. If the brain controls sleep, then why is the sleep requirement not decreased in old age?     21
Why is it bad to perform physical exercise close to bedtime? Conversely, performing yoga, meditation, or relaxation exercises close to bedtime is conducive to sleep. Why?     23
Is there a relationshipbetween certain foods and drinks and sleep?     24
How does a warm bath promote a good night's sleep?     25
Does a relationship exist among sleep, the bed and pillows, and environmental light, sound, temperature, and humidity?     25
Risk/Prevention/Epidemiology     27
Discuss, among other topics, causes and risk factors of sleep disorders
What causes temporary and long-standing sleeplessness?     28
Why does pain cause sleeplessness?     30
Can medications cause excessive sleepiness or sleeplessness?     32
Can certain medications cause excessive dreams?     33
Do frequent dreams interfere with sleep?     33
What causes narcolepsy? Can narcolepsy run in the family?     33
How common is Restless Leg Syndrome (RLS)?     34
Does RLS run in the family?     35
What is the cause of RLS?     35
How is RLS treated?     37
Can sleep apnea run in the family?     39
Why does snoring become worse after I drink alcohol?     40
Why do women have sleep disturbances immediately before and after their menstrual cycles?     40
Why do pregnant women and women who have just given birth suffer from sleep disturbances?     41
Do night shift workers suffer from physical illness?     43
I have heard that people often have heart attacks, stroke, or even die in their sleep during the early hours of the morning. Is this true and, if so, why?     44
Diagnosis     47
Deal with diagnosing and evaluating sleep disorders
How does a sleep specialist diagnose a sleep problem?     48
What are some important laboratory tests for evaluating sleep problems?     50
What is an overnight sleep study?     51
What is a multiple daytime sleep study?     55
What is sleep apnea?     56
How is narcolepsy diagnosed?     60
I am a 60-year-old man who falls asleep in the daytime in inappropriate places and under inappropriate circumstances. I have almost been in two car accidents because of this problem. Should I see my primary physician or a sleep specialist?     61
Since adolescence, I have been falling asleep at class, at work, and while driving. My primary care physician told me I may have narcolepsy. What is narcolepsy?     62
I suffer from irresistible sleep attacks. Also, on hearing a joke, I tend to go limp momentarily without loss of consciousness. My doctor told me I may have cataplexy. What is cataplexy?     64
I am a 65-year-old man. I have terrible feelings in my legs when I am in bed preparing to go to sleep. I must keep moving my legs or get out of bed and walk around to get relief. This condition is driving me crazy and preventing me from getting to sleep. Some doctors told me that it is psychological. Is that true?     65
My husband tells me that I keep moving my legs during sleep. In the daytime, I feel tired and irritable. I do not seem to have quality sleep at night. Do I have RLS?     71
My husband, aged 65, is a perfect gentleman in the daytime. Lately, however, he has begun to behave in an obnoxious manner in the middle to late part of the night. He will kick me, thrash about in bed, and scream loudly. Is he developing a dreadful psychiatric illness?     73
My 12-year-old daughter falls asleep normally. Approximately 45 to 60 minutes later, she sits up in bed with a vacant and confused appearance. She then stands up in bed and screams loudly. Sometimes, she exhibits thrashing movements of her limbs. Does my daughter suffer from an epileptic seizure or an abnormal sleep disorder?     75
I am a 40-year-old single woman. I can fall asleep easily but wake up between 3:00 and 4:00 A.M. and cannot get back to sleep again. What should I do?     77
I toss and turn in bed and it takes me two to three hours to go to sleep. In the daytime, I feel irritable and tired. What is happening to me?     78
Why do I feel bad for days after flying from New York City to Hong Kong and then back to New York City? Can anything be done to help me?     79
All my life, I have experienced difficulty getting to sleep. I go to sleep between 3:00 and 5:00 A.M. and wake up between 10:00 A.M. and 1:00 P.M. If I have to wake up early, I cannot function adequately. Why is my sleep pattern different from that of the average person?     82
Is sudden infant death syndrome (crib death) a special type of sleep-related breathing disorder?     83
Treatment     85
Give an overview of various treatment options for sleep disorders
What can I do for my sleeplessness?     86
Should I take over-the-counter sleeping pills for my sleeplessness?     90
Should I take melatonin for my sleep problem?     91
Are there any common-sense measures that I can follow for my sleep problem?     92
My friend has been using herbal products for sleeplessness. Should I use alternative medicines such as ginkoba, valerian root, and other herbal products?     94
Why can't I use sleeping medications for sleeplessness for a long time?     96
My sleep specialist diagnosed sleep apnea for my daytime sleepiness and snoring, and suggested that I use a nasal mask, which will deliver air from the outside to keep my upper airway passage open. What is this device supposed to do?     98
What are some problems associated with the use of a CPAP machine and a mask delivering air from outside continuously to keep my airway passage open?     101
Do I have options other than a mask treatment (CPAP) for my sleep apnea problem?     103
How is narcolepsy treated?     105
I wake up with terrible leg cramps in the middle of the night. What should I do?     107
Living with a Sleep Disorder     109
Are concerned with issues that arise from living with a sleep disorder and what it can do to your quality of life
What happens if I am sleep deprived?     110
Can sleeplessness cause adverse physical and mental effects?     111
Can a person either become sick or die after complete sleep deprivation?     112
Is it harmful if someone sleeps more than his or her usual requirement of sleep? In other words, does an excessive amount of sleep cause any adverse effects on the human mind and body?     113
Is snoring related to any physical defect, and can snoring cause any physical illness or memory impairment?     114
Does sleep disturbance affect organs in the body?     116
My friend told me that sleep apnea is a serious condition, which may cause stroke, heart disease, and high blood pressure. Is my friend correct?     117
I have heard that people with sleep apnea may die suddenly in the middle of the night. Is this true?     117
Can sleeplessness lead to psychological or psychiatric problems, cause someone to develop a psychopathic personality, or even lead a person to commit murder or practice other violent behaviors?     118
Can one perform complex acts and behave violently or even commit murder during sleepwalking episodes?     119
Normal vs. Abnormal Sleep Behaviors-Which is Which?     123
Deal with sleep behaviors
Is snoring a nuisance or a problem?     124
My bed partner snores loudly, driving me crazy. He makes noises like a freight train. He also feels sleepy in the daytime. Should he use a snore guard or see a doctor?     126
I am a 20-year-old woman. I wake up in the middle of the night to eat and drink. Is this behavior abnormal?     126
My daughter, aged 15, grinds her teeth at night. Is that normal?     128
My son, aged 10 years, wakes up approximately 45 to 60 minutes after going to sleep. He looks confused and then attempts to get out of bed, sometimes walking toward the door and going to the living room. Is sleepwalking normal for his age?     129
I am concerned about my son, aged 1, who has head banging and rocking movements of his body during sleep.
Is this an abnormal sleep disorder?     131
I am a 22-year-old man. On some nights, especially if I had a stressful day, I get sudden jerking movements of the legs with a sensation of falling as I am about to go to sleep. I am concerned about these symptoms. Am I having a nocturnal seizure or developing a serious neurological illness?     132
I am having episodes where I cannot move one side of my entire body, arm, or leg at sleep onset or on awakening. These episodes last only a few minutes. I am frightened. Are these events forerunners of a sinister neurological illness?     133
Sleep Disorders and Other Illnesses     135
Focus on how other illnesses can alter sleep and what can be done to help
I have difficulty getting to sleep, and, many times, I wake up in the middle of the night. I am an anxious-type of person and periodically become depressed. Can anxiety and depression cause sleep problems?     136
I am a 30-year-old woman who has been suffering from depression for a long time. This depression is particularly notable during the winter; during the summer, I feel fine. I have terrible sleep problems during the winter. What can I do?     139
Are sleep and physical illness related? In other words, do fever and other illnesses alter sleep and, if so, what is the mechanism involved?     140
My father has angina and heart failure. His sleep at night is very disturbed. Can it be due to heart problems?     141
I have acid regurgitation, which wakes me up frequently at night, disturbing my sleep. What shall I do?     142
I have been excessively sleepy in the daytime. I wake up frequently at night. My doctor took a blood test and told me that I had low functioning of the thyroid gland. Can my excessive sleepiness be due to thyroid problems and, if so, can it be treated?     143
I always feel tired and fatigued. I also suffer from aches and pains all over my body and certain spots are tender to touch. I have difficulty sleeping. My friend has heard of conditions called fibromyalgia and chronic fatigue syndrome. Is it possible that I have fibromyalgia or chronic fatigue syndrome, and do these conditions cause sleep disturbance?     145
I suffer from emphysema and chronic bronchitis. I have been experiencing sleep problems lately. Can my sleep problems be due to my lung disease?     147
I suffer from allergy and bronchial asthma. Can these conditions be responsible for my sleep difficulty?     148
I have Lyme disease. Can it cause sleep disturbances?     149
I had paralytic poliomyelitis as a young adult and made a reasonably good recovery from my paralysis. Now at the age of 60, I am again experiencing weakness of my previously paralyzed leg and am also feeling some weakness in other extremities. In addition, I have aches and pains and sleep problems. Am I developing postpolio syndrome?     150
My friend suffers from Lou Gehrig's disease. He is having lots of sleep and breathing difficulties. Should he see a sleep specialist?     151
I have been told that stroke may cause sleep disorder and sleep apnea. Is this true?     152
I am a diabetic and am experiencing tingling and numbness in my legs. My doctor told me that I have nerve disease related to uncontrollable diabetes mellitus. Can this condition be responsible for my disturbed sleep?     153
I have Parkinson's disease and am taking medications for this condition. Lately, I have been experiencing sleep difficulties. Can my sleep problem be due to Parkinson's disease or the medications used to treat Parkinson's disease?     154
My father, who is 71, suffers from Alzheimer's disease. At night, he is agitated and screams and shouts later at night. Is this problem due to Alzheimer's disease, related dementia or is he developing another disorder?     157
My cousin, aged 30, has been suffering from a muscle disorder since the age of 20. Now, he is always sleeping in the daytime. Can muscle disease cause sleep problems?     159
My mother has been diagnosed with depression and takes a variety of medications. She is always falling asleep in the daytime. Can these medications cause sleep problems?     161
Does menopause interfere with sleep and, if so, how and why?     162
Resources     165
Glossary     169
Index     177