Sleep Disorders

Diagnosing Sleep Disorders in Taree & Surrounds

A Heading About Motor Mechanics

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The Different Sleep Disorders

There are many different sleep disorders, ranging from Obstructive and Central Sleep Apnoea to snoring, Insomnia and Restless Legs or Period Leg Movement Disorder. Over time, disturbed sleep can increase the chances of later suffering a range of health issues, such as heart disease, stroke, hypertension, depression, diabetes and dementia.

Obstructive Sleep Apnoea

Obstructive Sleep Apnoea (OSA) can be a serious condition, which occurs during sleep, when breathing repeatedly stops and starts. OSA occurs when the walls of your throat collapse and obstruct or block your airway, so no air can get through to your lungs. When this happens your body senses that you have stopped breathing and a control centre in your brain wakes you up just long enough to gasp and take a breath before falling back to sleep. This cycle may be repeated many times per hour throughout the night, placing an immense strain on your heart and major organs. You will wake in the morning feeling unrefreshed with ongoing and excessive daytime sleepiness, poor concentration and work performance.

Signs and symptoms of OSA may include:

Daytime fatigue
Loud, repetitive snoring
Choking or gasping during sleep
Waking up drowsy
Frequent bathroom visits at night (Nocturia)
Morning headaches
Impaired concentration

Risks factors for OSA include:

Males
Post-menopausal females
Obesity, a body mass index greater than 33
People with a large neck circumference (+43cm in men, 40cm in women)
Family history of snoring or sleep apnoea
Physical abnormalities of the nose, throat or upper airway
Consumption of alcohol or sedatives
Diabetes
Enlarged tonsils or adenoids

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What Causes OSA?

Obstructive Sleep Apnoea is a common and serious sleep disorder that causes you to stop breathing during sleep. The airway repeatedly becomes blocked, limiting the amount of air that reaches your lungs. When this happens, you may snore loudly or make choking noises. Your brain and body become oxygen-deprived, and you may wake up. This can happen a few times a night or, in more severe cases, several hundred times.

In many cases, the tissue in the back of the throat collapsing causes an apnoea. The muscles of the upper airway relax when you fall asleep. If you sleep on your back, gravity can cause the tongue to fall back. This narrows the airway, which reduces the amount of air that can reach your lungs. The narrowed airway causes snoring by making the tissue in the back of the throat vibrate as you breathe. There are many people with sleep apnoea who have not been diagnosed or received treatment.

A sleep specialist can diagnose OSA using an in-laboratory sleep study or a home sleep test. The “gold standard” treatment for Obstructive Sleep Apnoeas is Continuous Positive Airway Pressure (CPAP) and is recommended as the first option when needing to control OSA.

At Mid North Coast Sleep Clinic, we conduct home sleep studies. If you require any more information, please contact us.

Central Sleep Apnoea

Central Sleep Apnoea (CSA) is when your brain doesn’t tell your muscles to take in air while you sleep. Whereas OSA is when your breathing is physically blocked by something. You can have both types, which is called mixed sleep apnoea. CSA generally happens due to a serious illness, especially one that affects your lower brainstem which controls breathing. CSA can cause pauses in breathing that last 20 seconds.

The Symptoms of Central Sleep Apnoea

The most common symptom of CSA is pauses in breathing. Other symptoms include:

Being extremely tired during the day
Difficulty concentrating
Headaches in the morning
Waking up often during the night
Memory & mood problems
Not being able to exercise like you normally would

The Risk Factors of Central Sleep Apnoea

Conditions that might be linked to CSA include:

Kidney failure
Hypothyroid disease
Congestive heart failure
Neurological diseases (including Parkinson’s disease & Alzheimer’s disease)
Damaged brainstem from swelling (encephalitis), stroke or injury

Diagnosis of Central Sleep Apnoea

Generally, people find they might have CSA when a bed partner notices they stop breathing while asleep. To diagnose sleep apnoea, you can undertake a sleep study or medical review of your sleep history with your GP or specialist doctor.

During sleep, people can experience episodes where they stop breathing, called apnoeas. Anything less than five episodes per hour is considered normal. However, in CSA, the apnoeas are longer-lasting and more frequent. The body doesn’t try to breathe during these apnoeas, which differs from Obstructive Sleep Apnoea, where patients struggle to breathe against a blocked airway. For patients with CSA, the airway is not blocked, instead there’s a pause in breathing efforts. Loud snoring is not common in CSA.

Snoring

Snoring occurs when the soft tissue in the back of your throat relaxes too much and starts to vibrate. The sound from this vibration can become loud and disruptive. Chronic loud snoring can be an indication of a more serious sleep problem, such as Obstructive Sleep Apnoea. If you snore loudly with episodes of stopping breathing and frequent sleep arousals, you may have OSA.

You are more likely to snore if you are:

Overweight or obese. Carrying extra fatty tissue, especially around the neck area, can increase the restriction of your airway when the muscles in your throat relax.
A male. Men are at higher risk of OSA than women. Middle-aged men often carry more weight, which can accumulate around the neck and jaw, putting added pressure on the airway during sleep.
Older. As we grow older, we tend to lose muscle tone, including in the upper airway.
Drinking alcohol. Alcohol is a muscle relaxant, so while you are sleeping this will increase the length and noise of your snoring. Taking sleeping tablets or sedatives to help you sleep. Sleeping tablets can also make snoring worse as the medication will relax the muscles in the back of your airway even more.
Going through menopause. As women go through menopause the level of oestrogen drops, which results in poorer muscle tone, including in the upper airway. Thereby it increases the incidence of snoring.

To see alternative treatments for OSA, click here. Read more about snoring here.

Insomnia

Insomnia is a common and distressing sleep disorder which can become chronic if untreated. If you regularly find it hard to fall asleep or stay asleep, then this can be your first sign of insomnia. It is usually associated with daytime tiredness and distress. If these symptoms last more than a month, you may have chronic insomnia.

Where can I find out more?

https://www.sleepfoundation.org/insomnia
https://www.tuck.com/best-online-cbt-programs/

A Mindful Way is an Australian, six-week digital online self-help program that teaches mindfulness and cognitive-behavioural skills for sleep improvement at a cost. A Monash University randomised control pilot study showed completion of the program led to significant improvement in measures of insomnia. (This link is provided for information only and is not an endorsement of their products and services)

Leg Movement Disorders

What is PLMS?

Periodic Limb Movements of Sleep (PLMS) is the movement of legs or arms every 10 to 60 seconds while the patient is asleep. It is out of your control and mainly appears during the deepest type of sleep in the first third of the night. PLMS can happen in several ways, including flexing toes or feet, bending ankles or knees and twitching the hip. It tends to reoccur as well.

Often, the way people discover that they have PLMS is when their bed partner complains of being kicked or the blankets are jumbled in the morning. In some cases, PLMS can disrupt the sleep of the patient or that of their bed partner. If it’s a problem, we recommend treatment.

Where can I get further information?

https://www.emedicinehealth.com/periodic_limb_movement_disorder/article_em.htm

https://sleepeducation.org/sleep-disorders/periodic-limb-movements/

What is RLS?

RLS is where you experience significant discomfort in your limbs. People describe it as tingling, itching, prickly and painful sensations. It generally affects the legs more than the arms. When it happens, you’ll feel a strong or irresistible urge to move the affected limbs.

RLS can occur when sitting for long periods, such as at a desk, travelling in a vehicle or plane and watching a movie. It may also affect you when you lie down to sleep. RLS is worse in the evenings, making it difficult to fall asleep. If you do get to sleep, you might wake up multiple times during the night. Eventually, you can feel irritable, anxious and depressed.

Where can I get further information?
https://www.helpguide.org/articles/sleep/restless-leg-syndrome-rls.htm

https://www.helpguide.org/