Because many factors influence the sleep-wake cycle, treatment must be individualized according to the patient's specific symptoms and findings from the patient's evaluation. Several generalizations are possible.
Implementation of good sleep habits and daily physical activity should help create an environment conducive to restorative sleep. Even if poor sleep habits are not responsible for insomnia, elimination of such habits can minimize their perpetuating influence.
Daily exercise and exposure to daylight can help reinforce the circadian cycle. These measures have the greatest potential for improving the quality of sleep in elderly persons. Exposure to bright light for 30 to 60 minutes in the evening may benefit patients with early bedtimes who complain of early-morning awakening.
Patients may be advised to avoid going to bed until they feel as though they can easily fall asleep. An extended wakeful time in bed (e.g., more than 30 minutes) should be avoided to minimize further reinforcement of hyperarousal. In addition, patients should plan relaxing nighttime activities before bedtime.
Low dosages of sedating antidepressants are especially helpful in patients with depressive symptoms. While potentially valuable in offering relief of insomnia, hypnotic agents should not be regarded as the ultimate solution to a sleep problem.
They should be used under limited circumstances, following evaluation of the patient's symptoms and in the context of good sleep habits. Consultation with a sleep disorders specialist should be considered in patients with marked daytime sleepiness, because this symptom can be dangerous.
Guidance regarding the management of chronic insomnia and sleep-related behavioral problems also may be obtained from a sleep disorders specialist. Formal sleep studies are appropriate when a primary sleep disorder is suspected.
Showing posts with label Disorders. Show all posts
Showing posts with label Disorders. Show all posts
Monday, November 5, 2007
Sleep Disorders
Sleep is absolutely essential for normal, healthy function. Scientists and medical professionals do not fully understand this complicated, necessary, physiological phenomenon. According to the National Institute of Neurological Disorders and Stroke, about 40 million people in the United States suffer from chronic long-term sleep disorders each year and an additional 20 million people suffer occasional sleep problems.
There are more than 70 different sleep disorders that are generally classified into one of three categories:
In most cases, sleep disorders can be easily managed once they are properly diagnosed. Insomnia is the most common sleep disorder. It occurs more often in women and in the elderly.
The amount of sleep that a person needs to function normally depends on several factors (e.g., age). Infants sleep most of the day (about 16 hours); teenagers usually need about 9 hours a day; and adults need an average of 7 to 8 hours a day. Although elderly adults require about as much sleep as young adults, they usually sleep for shorter periods and spend less time in deep stages of sleep. About 50% of adults over the age of 65 have some type of sleep disorder, although it is not clear whether this is a normal part of aging or a result of medications that older people commonly use.
Falling asleep and waking up are controlled by various chemical changes in the brain and in the blood. Foods and medicines that alter the balance of these chemicals also affect how well we sleep. Caffeine, for example, can cause insomnia (lack of sleep). Antidepressants can cause a loss of REM (rapid eye movement) sleep, as can smoking and alcohol. Smoking and alcohol also can result in a loss of deep sleep. Both REM and deep sleep are essential parts of the normal sleep cycle.
There are more than 70 different sleep disorders that are generally classified into one of three categories:
- lack of sleep (e.g., insomnia),
- disturbed sleep (e.g., obstructive sleep apnea), and
- excessive sleep (e.g., narcolepsy).
In most cases, sleep disorders can be easily managed once they are properly diagnosed. Insomnia is the most common sleep disorder. It occurs more often in women and in the elderly.
The amount of sleep that a person needs to function normally depends on several factors (e.g., age). Infants sleep most of the day (about 16 hours); teenagers usually need about 9 hours a day; and adults need an average of 7 to 8 hours a day. Although elderly adults require about as much sleep as young adults, they usually sleep for shorter periods and spend less time in deep stages of sleep. About 50% of adults over the age of 65 have some type of sleep disorder, although it is not clear whether this is a normal part of aging or a result of medications that older people commonly use.
Falling asleep and waking up are controlled by various chemical changes in the brain and in the blood. Foods and medicines that alter the balance of these chemicals also affect how well we sleep. Caffeine, for example, can cause insomnia (lack of sleep). Antidepressants can cause a loss of REM (rapid eye movement) sleep, as can smoking and alcohol. Smoking and alcohol also can result in a loss of deep sleep. Both REM and deep sleep are essential parts of the normal sleep cycle.
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