Most of us have experienced problems with our sleep at some point in life. This could be because of stress, sleeping in a strange bed or drinking too much caffeine or alcohol before going to sleep. However, sometimes people experience chronic sleep deprivation, possibly due to a sleep disorder, which can lead to daytime fatigue, loss of productivity, irritability and a decreased quality of life.

jOKE: Are you a light sleeper?
No, I sleep in the dark!

How can you tell if you have a problem?
There are several signs that can point to the presence of a sleep disorder. One very common indicator, daytime sleepiness, is often ignored and thought of as a consequence of today’s fast paced society. However, excessive sleepiness should not be considered normal if it regularly interferes with daily activities and continues after trying to improve your sleep habits for two weeks.

Ask yourself the following questions.
DO YOU:
• Snore loudly and/or stop breathing temporarily during sleep?
• Have violent movements during your sleep and/or have injured yourself or others?
• Find it hard to stay awake in boring or quiet situations?
• Get drowsy or fall asleep while driving?
• Get sleepy in the daytime in spite of 8 hours in bed every night?
• Get so sleepy in the daytime that you have to lie down for a nap or rest?
• Sometimes get muscle weakness when you are emotional (especially laughter)?
• Get an unpleasant (creeping, crawling) or painful feeling in your legs when you lie down at night?
• Have trouble falling asleep or staying asleep?

All of these are possible indicators of a sleep disorder or underlying medical condition. If you answer yes to any of these statements, you should consider consulting your physician.

Did you know?
If you think you might have a problem it is important to seek medical assistance and receive treatment. Large scale disasters such as Chernobyl (Ukraine), Three Mile Island, Exxon Valdez and Challenger (US) were all officially attributed to errors in judgment induced by sleepiness or fatigue.

Common Sleep Disorders
There are more than 80 medically recognized sleep disorders, some are more common than others. Often sleep disorders are symptoms of underlying medical/health issues, such as insomnia. This article describes 5 of the more common disorders and if you feel that you might have a problem, discuss your concerns with a physician or dentist (in the case of tooth grinding).

Fast Fact
Severe, untreated apnea, which affects about 4% of the adult population, is associated with a 3 times increase in the risk of an automobile accident.

Snoring and Apnea
The noise of snoring is caused by the vibration of soft tissues in the upper airway which relax when we sleep. However, these tissues can sag so much so that they actually block the airway, causing a temporary stoppage of breathing. This is referred to as obstructive sleep apnea. The less common type of apnea is called central sleep apnea. This also involves episodes of stopped breathing but is caused by irregularities in the brain’s signals for breathing during sleep. The most common symptoms of apnea are snoring, witnessed apneas, choking/gasping episodes during sleep and daytime sleepiness. To diagnose this disorder you might be given a portable, home sleep-monitor or visit with your local sleep clinic.

There are four main types of treatments for sleep apnea:
• Behaviour and lifestyle modification, such as weight loss and smoking cessation.
• Continuous Positive Airway Pressure (CPAP) (usually the most effective treatment and consists of a machine that blows pressurized air through a mask, which keeps the airway open).
• Surgery to remove some of the soft tissues from the back of the throat.
• Oral appliance to pull the lower jaw forward.

The Insomnia Continuum
Most people have experienced a restless night or two when you feel like you will never fall asleep. Sufferers of insomnia can also experience feelings of restlessness, irritability, anxiety and inability to concentrate. This acute or short-term insomnia can last from one night to 14 days and is very common. However, sometimes it can last longer and turn into chronic or long-term insomnia. Chronic insomnia is often a symptom of an underlying health issue, such as depression, anxiety, lung disease, arthritis, heartburn or other sleep disorders such as sleep apnea and restless legs syndrome. Psychiatric medications (including some antidepressants) can lead to sleep difficulties; some may make you feel sleepy, but then cause difficulty falling asleep. Other medications such as betablockers used for heart problems can also lead to insomnia as can some nasal decongestants.

Symptoms of insomnia include:
• Difficulty falling asleep.
• Waking up a number of times during the night.
• Waking up earlier than planned and not being able to get back to sleep.
• Daytime sleepiness.

Narcolepsy
Narcolepsy is characterized by excessive daytime sleepiness and sudden, unpredictable “sleep attacks”, in which the person collapses asleep. Many narcoleptics also experience sleep paralysis and sleep related hallucinations. These symptoms can develop with age, appear after a traumatic emotional event, head injury or after a large disruption to the sleep-wake cycle. Narcolepsy is thought to be a sudden switch into a dream state (REM sleep) at inappropriate times. It must be diagnosed and monitored by a physician and while there is no cure, it is possible to manage through various strategies.

Restless Legs Syndrome
Restless legs syndrome is an almost irresistible urge to move the legs, usually while falling asleep. Individuals may experience pain, discomfort, itching, pulling, tingling, or prickling. If the legs are moved, there is partial or complete relief of the sensation. Yet, the symptoms return when the legs stop moving, which leads to difficulty falling asleep and/or staying asleep. The Canadian Medical Association estimates that the disorder affects 3% of the adult population. Often the severity of the syndrome can be reduced through lifestyle modifications, such as physical activity and avoiding stimulants like caffeine. 

Tooth-grinding (Bruxism)
Many people occasionally grind or clench their teeth during sleep. However, according to the Canadian Sleep Society 8% of adults are chronic tooth grinders, which can lead to severe headaches, tooth damage and facial pain associated with jaw joint (TMJ) disorders. Often people are unaware of their tooth grinding and that it may be the cause of their headaches and sore jaw. It can be easily treated with a fitted nighttime retainer, along with relaxation techniques before bed.