Sleeping Disorders
 
    There are ceaseless nights of tossing and turning, and opportunities deprived in slothful slumber. Sleep disorders are a major underlying condition in the United States in adults, adolescents, and children. Some are temporary and mild, others are terminal and tortuous, and the rest seem to fall somewhere in-between. Sleep Disorders can stem from inside the body or from conditions in the external environment (Fritz). There are four basic categories that the different sleeping disorders fit into: extrinsic, intrinsic, circadian, and parasomnias (Zammit).
    Extrinsic disorders are those that originate outside of the body. Removal of these factor will result in a cure. Things like alcohol-related problems and diet-related problems fall within this category. Sleep disorders that develop within the body or arise from causes within the body are intrinsic. Narcolepsy, sleep apnea, restless legs syndrome, and certain forms of insomnia are intrinsic. Circadian sleeping disorders disrupt the “biological clock” reach to include jet lag and shift work sleep disorder. Parasomnias are clinical disorders that are not abnormalities for the processes related to sleep. These include things like REM behavior disorder, sleepwalking, and night terrors (Zammit).
     Two of the more mild disorders are called Delayed Sleep Phase Syndrome (DSPS) and Advanced Sleep Phase Syndrome (ASPS). These syndromes are caused when the normal circadian sleep rhythm is out of alignment with the day (Harvey). The word circadian comes from a Latin word meaning “about a day,” and it refers to a persons synchronization of a 24-hour day (Fritz). People with ASPS have their circadian rhythm or their biological clock, set too early. They will often fall asleep too early in the evening, but they will wake up in the early hours of the morning around 3:00A.M.-4:00A.M. With DSPS, the sleep cycle is too late, and affected persons can not fall asleep until the early morning where they will sleep the normal seven or eight hours (Harvey). These syndromes are frequently found in the elderly, non-social types that spend a lot of time indoors, and shift-workers (Fritz). Treatments can come in the form of medicine aimed at setting a normal sleep schedule and rhythm, or a light technique where bright bulbs are replaced in the house to “trick” the brain into distinguishing daytime. The easiest, and least invasive method of treatment is turning the patients clock backward or forward by three hours every two days until a more normal sleep cycle develops (this usually requires temporary sleep loss) (Albert).
    Nocturnal myoclonus, or periodic limb movements in sleep (PLMS), is a sudden, brief, shock-like involuntary movement caused by active muscular contractions. These are jerking movements that can occur every 20 seconds during the night. The incessant kicking may cause the patient to develop insomnia, but more frequently the spouse is the victim of insomnia (Wilson). Dopamine agonists and opiates are medications used in sever cases only, but prove to diminish the muscle spasms significantly so the patient has less muscle contractions that are less severe (Fritz).
     Narcolepsy is an infamous neurological disease that is often chaffed at because of its peculiarity. Narcolepsy is caused by a brain abnormality that affects the neurotransmitters in the central nervous system (Fritz) that is likely genetically inherited (Harvey). This disease involves a paralysis that causes the narcoleptic to steep into a REM sleep at any given moment. Narcolepsy is marked by the sudden weakness of the face, neck, and sometimes body causing the person to crash to the floor. The attack can include an inability to move for several minutes, along with vivid and strange dreams. The attacks are seemingly random, but strong positive and negative emotions may trigger this paralysis (Harvey). The American Narcolepsy Association estimates that approximately one in a thousand people are affected with narcolepsy. Treatment is usually stimulant drugs and methamphetamines, however speed addicts are known to fake symptoms of narcolepsy to get access to these drugs, so it is very difficult for patients to get these prescriptions and the treatment they need (Fritz).
    Restless Legs Syndrome (RLS) sounds like something that might be fun to have on the weekend, but in reality it can be an extremely painful experience. This syndrome is vastly misunderstood and most physicians don’t know how to diagnose it. Wittmaack-Ekbom Syndrome, as it is also called, has different levels of severity in each patient and in each attack (Wilson). A symptom of RLS is dysesthesia, a medical term used for a feeling that can’t be described. Some say it is a sort of creeping or crawling in the legs, others say it is a prickling or sharp prodding sensation; this can result in extremely painful tormenting. To relieve the pain people will jump, run, or walk around. When experiencing an attack a patient can become dangerously irrational in an attempt to stop the sensation – like jumping off a tall building or an urge to jump out of a moving vehicle. RLS is an important cause of severe insomnia because attacks often happen during the night in bed and patients are forced to move about losing sleep, which is why RLS is frequently called the sleep thief (Wilson).
    “Sometimes people who are polite and normally well controlled during the day become aggressive and violent during the night because of REM behavior disorder,” John R. Harvey. REM Behavior Disorder is a subtle defect in the brain that normally causes paralysis during the dreams of REM sleep (Harvey). Sleepwalking to the extreme, a patient may act out the content of the dream causing harm to themselves and to others. REM Behavioral Disorder can often happen in children between the ages of four and twelve, however it is more frequent among men and can be treated with the drug Clonazepam® to help “ground” (Fritz).
        Sleep apnea is a common condition in America that can sometimes require a major surgery. It is a transient cessation of breathing during the night (Harvey). This means that there a frequent episodes of stopped breathing that conclude with a large intake of breath. Sleep apnea is recognizable by loud snoring and wheezing or gasping sounds. This can repeat several hundred times throughout the night causing loss of sleep and insomnia. This could be caused by a malfunction in the part of the brain that controls breathing during sleep, but direct causes of apnea include obstruction of the airway due to enlarged tonsils and fat or extra tissue in the throat. Individuals with sleep apnea are likely to be overweight with high blood pressure, and sleep apnea puts a tremendous strain on the heart thus increasing risk of death due to stroke or heart attack (Harvey). Weight loss and avoiding sleeping on the back are two techniques that can eliminate mild forms of sleep apnea. However some need surgery to enlarge the airways. To do this, patients use a machine that uses air pressure to hold open air passages in the nose and throat (Fritz).
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