You May Have a Sleep Disorder If...
Wake up refreshed? Alert throughout the day? If not, you may have a sleep disorder.
Other Sleep Disorders
Restless Leg Syndrome (RLS)
Particularly around bedtime, many people (about 15% of the population)
experience "pins and needles feelings," an "internal itch," or
a "creeping, crawling sensation" in their legs, with a subsequent
irresistible urge to relieve this discomfort by vigorously moving their legs.
This movement totally relieves the discomfort. These symptoms are classic for
restless leg syndrome.RLS makes if difficult to fall asleep and may also
awaken you out of sleep, forcing you to walk around to relieve the discomfort.
Though not considered medically serious, symptoms of RLS can range from
bothersome to having a severe impact on you and your bed partner's lives.
Most people with RLS also have periodic limb movement
disorder (PLMD), repetitive movements of the toe, foot, and sometimes knee
and hip during sleep. They are often recognized as brief muscle twitches,
jerking movements, or an upward flexing of the feet. As with sleep apnea,
sufferers may be unaware that RLS and PLMD disturb sleep and produce symptoms
similar to those noted above. Once again, it is often the bed partner that
brings this to light, as movements awaken him or her throughout the night. It
is important to note that RLS and PLMD are associated with several other
medical conditions, including iron-deficiency anemia. So one should, as always,
seek proper medical attention.
RLS generally responds well to medication, but since it may
occur sporadically with spontaneous remissions, the continuous use of
medications is generally recommended for symptoms occurring at least three
nights per week. Sleep experts use three types or classes of medications for
RLS and PLMD:
- Dopaminergic agents: This class enhances a brain chemical known as
dopamine. Mirapex and Permax have become first-line medication, over older
drugs like L-Dopa with Sinemet.
- Benzodiazepines are generally sleep experts' second-line medication.
They must be used carefully due to the potential for addiction and the negative
impact on sleep. This class includes such drugs as diazepam (Valium, Diastat),
Klonopin, Restoril, and Halcion.
- Opioids represent the third-line of preferred medication generally
and is reserved for those with more severe symptoms. They may be used alone or
in conjunction with other medications. This class includes codeine (active
ingredient in Tylenol #3), oxycodone (active ingredient in Percocet), Darvon,
and methadone (in very severe cases only).
As one would expect, all of these medications are available by
prescription only and should be taken only while under a doctor's care.
Falling asleep spontaneously may indicate the syndrome of narcolepsy.
Excessive daytime sleepiness is typically the first symptom. It's the
overwhelming need to sleep when you prefer to be awake. Narcolepsy is
associated with cataplexy, a sudden weakness or paralysis often
initiated by laughter or other intense feelings, sleep paralysis, an
often frightening situation, where one is half awake yet cannot move, and
hypnagogic hallucinations, intensely vivid and scary dreams occurring at
the onset or end of sleep. One may also experience automatic behavior,
in which one performs routine or boring tasks without full memory later.
There are both behavioral treatments and medications for this
situation, which can make life livable again.
General behavioral measures include:
- Avoiding shift work
- Avoiding heavy meals and alcohol intake
- Regular timing of nighttime sleep
- Strategically timed naps