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Sleep Disorders

Insomnia
Sleep apnea
Restless legs syndrome
Narcolepsy
Bruxism (teeth grinding)
Insomnia
Insomnia is a common complaint causing people to toss and turn in bed for hours before being able to fall asleep or preventing them from going back to sleep after waking up at night. During the day, insomniacs feel sleepy and may have trouble concentrating. Sleepiness during the day is not only irritating; it may cause serious accidents. Being sleepy while driving a car is just as dangerous as driving with a high alcohol level.

30% of the adult population report occasional sleep problems. In 10%, insomnia becomes chronic.
In many cases, insomnia is short-lasting and due to temporary stress or illness. However, if sleep problems last longer, they may become chronic. You may then start worrying about your sleep, feel reluctant to go to bed, or stay in bed longer in the morning to make up for lost sleep. Soon, you can get into a vicious circle that is hard to break without help.

Treatment of insomnia
Unfortunately, when suffering from long-lasting insomnia, people tend to use sleep medication or to take a nightcap. For short-lasting, stress-related insomnia, sleep medication can be helpful. However, if insomnia is long-lasting, sleep medication does not resolve the problem and may even cause additional problems. The longer you are using the medication, the more its effects will diminish, so that you will need a higher dose to achieve the same effects. Furthermore, when you use sleep medication for longer periods of time, there is a high risk of becoming addicted. Alcohol may help to relax and fall asleep more easily but disturbs sleep later during the night.

A large number of studies in high-ranking scientific journals demonstrate that a cognitive behavioral therapy is most effective in treating chronic insomnia. Such a sleep therapy involves
  • analyzing your sleep problem,
  • working on specific assignments aimed at improving your sleep pattern,
  • identifying irrational, sleep-hindering thoughts and replacing them by more rational or sleep-promoting thoughts,
  • learning various techniques that can promote sleep and reduce rumination. Throughout the treatment your personal sleep consultant will guide and motivate you, continuously monitor your progress and give feedback. Your consultant will tailor the therapy to your specific needs.


Somnio offers a cognitive behavioral sleep therapy via internet. You can follow the therapy in the comfort of your own home and at the time that suits you best. Behavioral treatment is also offered at a number of sleep clinics. However, their waiting lists are often long.

Useful links:
Free Sleep Test and Profile: Do you have a sleep disorder?
Somnio Online Sleep Therapy for insomnia: Insomnia Treatment
American Academy of Sleep Medicine: "Insomnia" article on Sleepeducation.com
American Academy of Sleep Medicine: "Insomnia Cures" article on Sleepeducation.com
Sleep apnea
People suffering from sleep apnea frequently stop breathing during sleep. The most common form of sleep apnea is the Obstructive Sleep Apnea Syndrome (OSAS). The breathing cessations (called ‘apneas’) cause serious sleep disruption as patients wake up very often or pass from deeper to lighter sleep states. As a consequence, patients feel sleepy and tired during the day. Some do not realize that their sleepiness is caused by sleep disruptions, as they cannot remember waking up during the night. Loud snoring may possibly, but not necessarily, be a symptom of sleep apnea. About 30% of the adult population snore, whereas only 4% actually suffer from sleep apnea. Your bed partner may notice that besides the snoring there are also breathing cessations. Note that the continuation of breathing is often accompanied by a loud snore and sometimes a change of position.

Other symptoms that may be associated with apnea are: the feeling to suffocate, sweating at night, waking up with a headache or a dry mouth.

Various factors may contribute to apnea. The shape of the jaw or fat formation in the throat can narrow the cavity behind the tong and uvula. As the muscles that keep the pharynx open when lying down get weak during sleep, the pharynx may prolapse and block the throat entirely.

OSAS does not only cause sleepiness during the day, it is also associated with various other health risks. High blood pressure and heart problems are often associated with serious apnea. Complications may, however, be prevented by an early diagnosis. Clinics with experience in apnea diagnostics use specialized sleep registration methods to arrive at a proper diagnosis.

Treatment of sleep apnea
Most commonly, OSAS is treated by means of CPAP (continuous positive airway pressure) during the night. The patient wears a mask, which is connected to a pump. The pump provides air flowing in the pharynx with continuous slight positive pressure. This prevents the pharynx from collapsing. There are various types of CPAP appliances. Together with your physician, you need to determine which type suits you best. In some cases, surgery may be considered for treatment. That involves removing part of the uvula, tonsils and a small part of the soft palate with a laser technique. The pharynx is thereby enlarged, so that the air can pass through more easily. Another treatment possibility involves wearing an oral appliance called mandibular reposition apparatus (MRA) that stays positioned on the teeth at night. Specialized dentists create an individually fitted MRA for each particular patient.

Furthermore, it is important that apnea treatment is accompanied by careful education, including, among other things, the following major points. Apnea patients are often overweight. Overweight, as well as drinking large amounts of alcohol in the evening and smoking may aggravate apnea. Moreover, using muscle-relaxing medication, such as benzodiazepines (often described as sleep medication) should be avoided.

Useful links:
Free Sleep Test: Do you show signs of sleep apnea or other sleep disorders?
American Sleep Apnea Association: www.sleepapnea.org
U.S. Department of Health & Human Services: How are overweight and obesity treated?
Restless legs syndrome
Restless legs syndrome (RLS) is a neurological disorder characterized by an irresistible urge to move your legs, often accompanied by uncomfortable itching or creeping sensations deep inside your legs. These bothersome symptoms emerge only during rest and diminish when moving the legs. Symptoms occur mainly in the evening or at night, thereby disrupting sleep.

Although its exact origin is not clear, yet, RLS appears to be related to a disturbance in the dopamine metabolism of certain nerve cells in the motor areas of the brain, which are responsible for planning, executing and controlling movements. Dopamine is a chemical substance involved in transmitting information between nerve cells.

Certain diseases as diabetes, kidney problems, or rheumatism may increase the risk of getting RLS. But also pregnancy or a low blood-iron-level, as present in anemia, are risk factors.

People suffering from RLS often also suffer from periodic limb movements disorder (PLMD). Periodic limb movements occur every 20-30 seconds during sleep.

Treatment of the restless legs syndrome (RLS)
A behavioral treatment approach can reduce RLS symptoms. Behavioral treatment includes:
  • avoiding alcohol and caffeine
  • proper sleep hygiene, e.g. an appropriate sleep environment and regular bed times
  • regular physical activity (moderate amount and intensity)
  • a warm or cold bath, warm or cold compresses, massages


Currently, there is no actual cure for RLS. However, some medicine may reduce symptoms. Unfortunately, such medication often brings about bothersome side effects. If a vitamine of iron deficiency is causing RLS, iron, vitamine B12 or folate nutrition supplements can help. Other substances prescribed to reduce RLS symptoms include:

All of these drugs have more or less severe side effects. Therefore, the severity of RLS symptoms and the risk of bothersome side effects should be considered carefully.

Useful links:
Free Sleep Disorders Test: Do you have symptoms of RLS or other sleep disorders?
Restless Legs Syndrome Foundation: www.rls.org
American Academy of Sleep Medicine: "Restless legs" article on Sleepeducation.com
U.S. Department of Health & Human Services: What is Restless Legs Syndrome?
Narcolepsy
Narcolepsy is a chronic neurological disorder. Main symptoms include sleep attacks during the day and cataplexy, that is, a sudden short-lasting loss of voluntary muscle tone triggered by emotional situations, such as laughing or being angry. Another symptom may be sleep paralysis: waking up with the feeling that you are unable to move your arms and legs. Furthermore, dream-like experiences may occur while you fall asleep but when waking up. These experiences can be frightening, as they may seem very realistic. Besides these symptoms, problems with maintaining sleep are common.

The first symptoms of narcolepsy often emerge between age 15 and 30. Many people suffering from narcolepsy are accused of being lazy or uninterested. Narcolepsy often has serious consequences for daytime functioning, causing problems during study and work as well as in personal relations. Unfortunately, it sometimes may take a long time before a patient is diagnosed correctly with narcolepsy.

Treatment of narcolepsy
There is no cure for narcolepsy, yet. The serious sleepiness during the day is usually treated with stimulating drugs, such as Ritalin or Provigil (modafinil). For the loss of muscle tone antidepressants are often described. Furthermore, proper education about coping with narcolepsy is essential. Certain life style regulations, such as avoiding alcohol and heavy meals as well as spreading sufficient rest periods throughout the day, are very important.

Useful links:
Free Sleep Test: Do you have symptoms of narcolepsy or other sleep disorders?
Narcolepsy Network:
www.narcolepsynetwork.org
American Academy of Sleep Medicine: "Narcolepsy" article on Sleepeducation.com
U.S. Department of Health & Human Services: What is Narcolepsy?
Bruxism (teeth grinding)
Bruxism, or teeth grinding, occurs more often in children (about 30% of all children) than in adults (8%). Bruxism involves an intense contraction of the chewing muscles, while firmly grinding ones teeth of the upper and lower jaw. A special form of bruxism involves clutching the yaws very firmly for long lasting periods of time. A single instance of bruxism cannot do much harm. However, as teeth grinding and clutching goes along with intense muscle contractions, it can lead, in serious cases, to tooth abrasion, headaches, sore ears or jaws. There is not much known, yet, about the causes of bruxism. A number op factors that can aggravate symptoms are: stress, alcohol, smoking, caffeine en sleep apnea.

If you suspect that you are suffering from chronic bruxism, it is best to consult your dentist. Your dentist might advise you to wear a dental guard to prevent grinding or clutching. Moreover, certain exercises can often help.

Useful links:
Free Sleep Test: Do you have a sleep disorder?


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