Diagnosis and Treatments
Please visit our Neurology page for more details.
We have all suffered from sleep issues from time to time – and they often have a very clear cause. The teenager who is still snoring at lunchtime is just growing. There are many times you are awake worrying about your job, or even worse, listening to your husband snore. Even it is often a sign that your body is fighting an illness if you find yourself sleeping more than usual.
There are times though when there is a neurological basis to your sleep disturbances – here are some common concerns.
Drowsiness / Somnolence
Drowsiness/Somnolence: a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods called hypersomnia. It has two separate meanings:
- the usual state preceding falling asleep
- a sleep disorder in which a person becomes drowsy, even when they aren’t about to fall asleep.
Fatigue / Malaise
Fatigue and Malaise: Fatigue is a feeling of general discomfort or uneasiness, or being out of sorts, and is often the first indication of an infection or other disease. Malaise is often defined as the “general feeling of being unwell”.
Hypersomnolence: – also known as excessive daytime sleepiness (EDS) without an obvious cause. It can occur on its own or as part of another medical condition. Symptoms often develop slowly during adolescence or young adulthood and may include daytime naps that do not relieve drowsiness, difficulty waking from a long sleep, increased need for sleep during the day, and increased sleep time (up to 14 – 18 hours per day). It is different from narcolepsy in that it does not involve suddenly falling asleep or losing muscle control (cataplexy).
Insomnia: a sleep disorder in which there is an inability to fall asleep or to stay asleep as long as desired. Insomnia is most often thought of as both a medical sign and a symptom that can accompany several sleep, medical, and psychiatric disorders characterized by a persistent difficulty falling asleep and/or staying asleep or sleep of poor quality. Insomnia is typically followed by functional impairment while awake. Insomnia can be short-term or long-term, which can lead to memory problems, depression, irritability and an increased risk of heart disease and automobile-related accidents.
Narcolepsy: also known as hypnolepsy, is a chronic neurological disorder caused by the brain’s inability to regulate sleep-wake cycles normally. People with narcolepsy experience periods of extreme daytime sleepiness and sudden, irresistible bouts of sleep that can strike at any time. These “sleep attacks” usually last a few seconds to several minutes. People with narcolepsy experience various types of day and nighttime sleep problems that are associated with REM sleep disturbances that tend to begin subtly and may change dramatically over time. The most common major symptom, other than excessive daytime sleepiness (EDS), is cataplexy, or a sudden loss of voluntary muscle tone while awake that makes a person go limp or unable to move.
Sleep Apnea: a sleep disorder characterized by one or more pauses in breathing or shallow breaths while a person sleeps. Breathing pauses can last from a few seconds to minutes and may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.
Sleep apnea usually is a chronic condition that disrupts one’s sleep. When the breathing pauses or becomes shallow, a person will often move out of deep sleep and into light sleep. As a result, the quality of sleep is poor, which makes one tired during the day. Sleep apnea is a leading cause of excessive daytime sleepiness.
Sleep Disturbance: a medical disorder of sleep patterns. When a person suffers from difficulty falling asleep and staying asleep with no obvious cause, it is referred to as insomnia. Some sleep disorders are serious enough to interfere with normal physical, mental, social, and emotional functioning. Disruptions in sleep can be caused by a variety of issues, from teeth grinding to night terrors. Dyssomnia refers to a group of sleep disorders with the symptoms of trouble falling asleep or maintaining sleep, which may cause an elevated sense of sleepiness during the day.
Periodic Limb Movement (PLMD)
Periodic Limb Movement (PLMD): also known as nocturnal myoclonus, is a sleep disorder where a person moves limbs involuntarily during sleep and has symptoms or problems related to these movements. PLMD is involuntary and the person is often unaware of the movements. It should not be confused with restless leg syndrome (RLS), which often occurs while awake as well as when asleep, and when awake, there is a voluntary response to the uncomfortable feeling in the legs.