Diagnosing Sleep Disorders
In addition to a thorough clincial history, the sleep specialist may request an all-night polysomnograph, requiring the patient to sleep at the lab while equipment records the different stages of sleep which are experienced. This same equipment may be used during the daytime for a multiple sleep latency test (MSLT) in which the patient is given opportunities to nap and the time needed to fall asleep is measured. Whether or not the patient enters REM sleep early is also recorded. Pupillography, which measures the diameter of the pupil of the eye, is also used as an indication of drowsiness.
Categories of Sleep Disorders
The International Classification of Sleep Disorders (ICSD) presently has more than 80 on its list under the following categories:
1. The Dyssomnias
2. The Parasomnias
3. Sleep Disorders Associated With Medical/Psychiatric Conditions
4. Proposed Sleep Disorders
For complete info, see here: http://www.geocities.com/~sleepwake/chart.html
Definition Of Parasomnias
Parasomnias are dysfunctions associated with sleep or partial arousals and may be associated with a specific stage of sleep or related to the transition between sleeping and waking. Patients may not know if they are awake or asleep and thus confuse activities, demonstrating such symptoms as sleepwalking, bedwetting, etc., or suffering sleep-related headaches, abnormal swallowing, painful erection, or head-banging.
Do YOU Have A Sleep Disorder?
If any of the following sounds familiar to you, you MAY have a sleep/wake disorder. Ask your family doctor for a referral to a specialist where you will be able to receive a professional diagnosis.
1. Do you have trouble sleeping, staying awake, or suffer from early morning headaches?
2. Does your spouse/family complain about your loud snoring at night?
3. Have you lost a job because you can?t get to work on time, or can?t stay awake during the day?
4. Do you fall asleep in class or have difficulty concentrating?
5. Is your social calendar empty because you are just too tired to participate?
6. Have friends, teachers, or co-workers labelled you as disinterested, inattentive, or unmotivated?
7. Have you become wary of driving because you doze off at the wheel?
8. Do you lose muscle control - perhaps even collapse - when you laugh, get angry, or show other strong emotions?
9. Have you been delegated to the couch because you have a tendency to act out your dreams?
10. Do you ever get a crawling sensation in your legs?
11. Are your bedclothes in disarray each morning, even though you believe you?ve had a restful sleep?
12. Are you a shiftworker who wants to sleep when you can?t, and then can?t when you should?
13. Are you often depressed because you don?t have the energy to complete an everyday routine?
14. Does your family think you have lost interest in them?
Sleep Disorder Symptoms
Symptoms of a sleep disorder include:
1. Excessive Daytime Sleepiness (EDS): can manifest itself as sleep attacks (irresistible sleepiness and/or an unusual, susceptibility to drowsiness.
2. Sleep Apnea: involves frequent cessations of breathing during a sleep period. Loud snoring usually accompanies each resumption of breathing. Awake, respiration is normal; asleep, the sufferer is unaware of breathing irregularities.
3. Cataplexy: a rapidly occuring loss of voluntary muscle tone, usually triggered by emotions such as laughter, anger, elation or surprise. A cataplectic attack can range from a brief experience of partial muscle weakness to an almost complete loss of muscle control lasting several minutes; the victim is conscious, but cannot move.
4. Disrupted Night-Time Sleep: multiple awakenings during each sleep period, often accompanied by a craving for food.
5. Hypnagogic Hallucinations: intense, vivid, sometimes terrifying experiences which occur at the beginning or end of a sleep period. Any or all of the normal senses may be involved and the experience is often very difficult to distinguish from reality.
6. Night Terrors (not to be confused with nightmares): usually affect young children who awaken in panic and confusion within an hour of falling asleep. Tghe pulse races and there is disorientation, but no memory of dreaming. Nightmares are not a disorder, but a natural dream phenomenon; only if they are recurrent and deeply disturbing is help necessary.
7. Automatic Behaviour refers to doing things (usually of a routine nature) with greatly reduced awareness of and intelligent control over the activities involved. One is generally unable to recall the specific details of one?s activities.
8. Sleep Paralysis is an awareness of one?s ability to move despite the desire to do so. It occurs as a person is falling asleep or waking up.
9. Sleepwalking (somnambulism) episodes occur occasionally in children, typically before the age of 10 and stopping by age 15. Frequent sleepwalking in adults is more serious, begins later in life, occurs more frequently, shows no family history, and is often related to major stress. Although sleepwalkers can avoid objects, they are clumsier than when awake and speech is usually unintelligible.
10. Bedwetting (enuresis) is found in about 10% of girls and 15% of boys at age five. Cases in older age groups may be related to physical disorders, congenitally small bladders or infections, or may be a result of generalized anxiety.
Self-Help Groups
Those with sleep disorders can often derive much comfort from self-help groups. Many people, through no fault of their own, are unable to help themselves. They hold down full-time jbs, look after a family, and try to keep relations with those they love together, despite the fact that many can?t even drive. Demonstrating their great need to interact with others who can understand them, they use their last bit of energy to attend self-help meetings where they share their hopes and dreams for the future, their problems, the pain of loneliness, and the lack of understanding by family and friends.
Diagnosis Is Important
Prompt and proper diagnosis of a sleep/wake disorder can save you and your family years of unnecessary suffering and emotional stress. If you suspect that you or someone in your family may have a sleep/wake disorder, ask your family doctor for a referral to a specialist.