It seems like everybody I know suffers from insomnia. Now my teenage daughter has it. Is it really that common? How common is common when it comes to sleep disorders like these? Are there others? How do we treat them?

 According to statistics, more than 40 million Americans suffer from one form of sleep disorder or another yearly. Sleep disorders interfere with normal sleep causing sleep deprivation or inadequate sleep. Sleep deprivation, in turn, results in daytime sleepiness, irritability, and inability to concentrate which affects physical and mental functioning.

There are more than a hundred types of identified sleep disorders and to make it easier to identify them, they are categorized into the following:

• Dyssomnias – those that affect the amount and quality of sleep. This includes insomnia, sleep apnea, narcolepsy, restless legs syndrome, hypersomnia, and circadian rhythm sleep disorder.
• Parasomnias – these are abnormalities that occur during sleep stage transitions causing sleep interference. Sleepwalking, sleeptalking, REM sleep behavior disorder, bedwetting, tooth grinding, sleep sex, sleep paralysis, and Sudden Infant Death Syndrome (SIDS).
• Sleep disorders caused by underlying medical and psychiatric conditions like dementia, depression, mood disorders, and alcoholism.

However, there are only four types of sleep disorders that commonly affect us today. I am sure you will agree with me when I say insomnia is one of them. This is followed by sleep apnea, more specifically, obstructive sleep apnea, Restless Legs Syndrome (RLS) and narcolepsy.

Sleep disorder treatments varies according to the type of disorder and its severity. It ranges from over-the-counter medications to regulated drugs to herbal medicine. However, most of these kinds of sleep disorder treatments are not advisable for long-term use. For obstructive sleep apnea, CPAP and surgery are the treatments of choice.

Common pharmacological sleep disorder treatments that are popular today includes Ambien, Dalmane, Halcion and Doral among others for insomnia, Effexor for anxiety that causes sleep disorders, and Strattera for ADHD (attention deficit hyperactivity disorder). Medications such as these should be approved by a physician first since they can have harmful effects when not taken properly.

However, sleep disorder treatments does not only mean drug treatments. For insomnia, stress reduction is the best way to deal with it since stress is the common culprit for insomnia. Relaxation techniques and behavior modification can also prove to be very effective. For sleep apnea, other than CPAP and surgery, behavior modifications such avoidance of sedatives and relaxants and weight loss is also advised. For sleep disorders that have no specific treatment as of the moment, like narcolepsy, counseling may be effective to help the patient cope with the disease.

A good night’s sleep is very essential to help us be more productive and make the most out of each and every day that passes. If we fail to attain the correct amount and quality of sleep that we should be having, everything in our lives is affected: career, family, social life, and our personal health. Getting enough knowledge about sleep disorders and their treatments often helps us prevent the common negative effects that come along with them.

 I think everyone has heard of sleep-talking, there was even a song of it but I can barely remember the exact lyrics, sleepwalking, and other sleep disorders. But did you know that there is another sleep phenomenon which almost led to the demise of a woman because her husband strangled her in his sleep? Yes, and this is an example of a REM sleep behavior disorder (RBD) in action.

REM sleep behavior disorder is actually the acting-out of a dream because of the absence of muscle atonia that normally occurs during the rapid eye movement (REM) stage of sleep. Normally, when we sleep, we go through a series of sleep stages before going into deep sleep or REM stage. This is where dreaming occurs. Our brain, in order to prevent us from potential injuries, sends out a signal to relax our skeletal muscles giving us that temporary paralysis while we sleep.

In REM sleep behavior disorder, the signals, somehow, are intercepted somewhere and it doesn’t reach the muscles. In effect, when the dreaming stage of sleep is attained, the body fails to assume the sleep behavior which is paralysis, and adapts the waking stage instead, which means acting out whatever it is that transpires in the dream. Actions such as mumbling, grunting, shouting, and even violent behaviors such as punching and, yes, strangling, has been documented.

This is a very rare, but very intriguing, disorder and it is thought to be the most studied among other REM sleep parasomnias. In the US, there are only about 0.5% reported cases of REM sleep behavior disorder out of the general population. It could be because most of the cases are reported, not to the doctor, but to family members and significant others.

REM sleep behavior disorder is known to affect men in their 60’s and beyond. In fact, according to research, around 80% – 90% of RBD cases occur in males. However, this disorder can also be found in females and younger generations but not as prevalent as it is in older men.

It is still not clear what causes this phenomenon but experts are looking into it. Possible causes would be tumors, brain injuries, and degenerative disorders. It has also been found that there is a significant link between REM sleep behavior disorder and degenerative disorders. It seems like those who had prior REM sleep behavior disorder has a greater chance of developing Parkinson’s disease. But this is still subject to confirmation.

The leading treatment that most RBD patient’s responds to is clonazepam.  Clonazepam is a benzodiazepine derivative and have been known to be the best drug for suppressing the acting out of dreams, though some research shows that Clonazepam treatment on some users have been discontinued because of it’s side effects.  The second most tried treatment is melatonin and have been effective on treating RBD on some patients.  The reason behind the effectiveness of Melatonin on some cases still remains a mystery.  Other drugs that have been studied but are not widely used because of their side effects are paroxetine,  Rozerem, Seroquel and Xyrem.

Since experts are still on the process of finding out the truth about the causes of this disorder and treatment options still doesn’t work for some cases, safety measures are encouraged for those who have this REM sleep behavior disorder. Practices like putting extra pillows on the floor beside the bed, removing hard objects including nightstands and clocks, etc., even removing side tables from near the bed, would prevent injuries during episodes. Should you feel that you or anyone in the family is exhibiting these sleep behaviors, consulting a sleep doctor wouldn’t hurt.

The reason why so many sleep disorders remain undiagnosed and untreated is because people either don’t recognize or do not want to acknowledge that the constant sleepiness or lack of it is a medical condition. Since sleep is actually one of the most taken for granted necessities of the human body, we don’t take heed when a bolt is loose.

For instance, not many of us know that there is such a thing as hypersomnia; most of us know only insomnia. As its name suggests, it is characterized by excessive sleepiness during the day, hence it is often referred to as somnolence. Somnolence can happen at any time of the day, even while you are driving, and can be very dangerous if left unaddressed.  Statistics show that around 5% of the population has it.

When you sleep more than eight hours every day, have trouble waking, find yourself extremely drowsy during waking moments and then conking out mid-conversation, then you might be suffering from hypersomnia. Your sleep doctor will tell you if you have either idiopathic hypersomnia or recurrent somnolence. You might first need to undergo an overnight study called polysomnogram to make sure you don’t have Sleep Apnea or other sleep disorders that’s making you sleepy. Idiopathic somnolence happens all day every day, while recurrent somnolence can take months before it manifests itself again.

There are many possible treatments for hypersomnia. One is to avoid caffeinated drinks and engage in a healthy, exercise-active lifestyle. Going to bed at the same time every night would also help. For worse cases, however, medications are necessary. The most popular among the hypersomnia drugs is Modafinil (Provigil).

Modafinil (Provigil) is a wake-promoting chemical agent that is also referred to as a eugeroic drug, or an alpha1-adregenic agonist medication. Modafinil (Provigil) is designed to boost the responses of alpha-1 receptors in the brain to noradrenalines, which are responsible for strengthening the memory, and keeping us alert and energized.
 Modafinil (Provigil) was approved for commercial use on hypersomnia in 1988, and then moved on to be used as treatment for sleep apnea, shift work sleep disorder, and excessive sleepiness years after.

Reviews on Modafinil (Provigil) are positive and it seems that there is very minimal to no side effects to its use. Regular sleep drugs have side effects like irritability, palpitations, euphoria, agitation. Past user os Modafinil (Provigil) generally rated the drug 8 out of 10 for effectiveness and ease of use.

Perhaps the reason why Modafinil (Provigil) is void of the usual aches and pains is because it targets very specific areas of the brain that control sleep and wakefulness. In addition, the effects of Modafinil (Provigil) can last for around 15 hours, so although it is comparatively expensive, it’s a practical buy. Other sleep drugs need to be taken three times a day, thereby increasing the patient’s exposure to chemical ingredients and risk of developing other ailments. Modafinil (Provigil) is taken during the morning, once a day.

Of course, Modafinil (Provigil) has its share of critics and dissatisfied users. Some comments on Modafinil (Provigil) on the Internet forums say it causes headaches for the entire duration of the treatment. Some even say that Modafinil (Provigil) does not work, at all. Having seen these, it is safe to say, then that the effects of Modafinil (Provigil) vary from case to case and from person to person. Since we have different make-ups, we can’t say that Modafinil (Provigil) successfully treating the somnolence problem of one is the same for another.

Besides Modafinil (Provigil) other drugs used to treat idiopathic hypersomnia and somnolence include ampethamine and methylphenidate. Ask your doctor which treatment suits you best. Idiopathic hypersomnia is a serious and long-term condition. In addition, Modafinil (Provigil) is a pretty strong drug and must be taken under medical monitoring and supervision. Never attempt to self-medicate.

Narcolepsy is an illness characterized by sudden sleep attacks that could occur at any time and place due to excessive daytime sleepiness. It is often accompanied by muscle weakness and paralysis, vivid dreaming and trance-like behavior. This is a neurologic disorder and a lot of people have been affected with this disorder. The United States alone has about 1 case in every 2000 Americans.  

This disorder affects almost 200,000 Americans but very few are properly diagnosed and given treatment, probably because research on narcolepsy treatment is still ongoing. In fact, extensive research on narcolepsy and what causes it is keeping experts busy. Once a definite cause has been pinpointed, treatment would follow.

According to Stanford University School for Narcolepsy, the second leading cause of excessive daytime drowsiness following obstructive sleep apnea is narcolepsy. This is probably one of the most debilitating illnesses one could ever have. Not to mention that this is incurable. At least not right now. Research on narcolepsy would prove to be a very big help not only to the individuals affected with the disease but to the other members of the family as well who are suffering with them.

Research on narcolepsy was pioneered by Stanford University Sleep Clinic, the first medical clinic to specialize in sleep disorders. They were the first to find out that hypocretin has everything to do with narcolepsy. They found out that there is a marked decrease in hypocretin brain cells in narcoleptics compared to normal ones. Instead of hypocretin cells, researchers found scar tissue, which could suggest that narcolepsy may not be hereditary.

Researchers are making use of brains donated by narcoleptics. It was through this method that the hypocretin-narcolepsy link was found out. There is a National Brain Bank where these brains used in narcolepsy research are being kept. They are also encouraging narcoleptics to donate their brains at their demise to help further the ongoing research. Now, this may sound a bit morbid, but if we consider the amount of help it would give to narcoleptics in generations to come, donating a brain would be tantamount to heroism.

Currently, research on narcolepsy is focused in determining what causes this hypocretin depletion. It could be autoimmunity, it could be ingested toxins, or it could also be due to environmental factors. A lot of possibilities are at play and with the advancement of research on narcolepsy, we expect more to come. Decades of research have been devoted to finding the exact cause of narcolepsy but the current data gathered is not enough to determine the proper treatment. But with the help of today’s technology, we’re expecting results. And fast.

Here’s this one question about narcolepsy that researchers are taking a long time to provide an answer to. Is narcolepsy hereditary? For about a hundred years since cases of narcolepsy have been reported, no definite causative factor has been identified. It has always been thought to be hereditary but many are not convinced.

Several studies suggest that genetics may have something to do with the development of this disorder, that the defective gene could be transmitted though heredity in an autosomal dominant fashion. It means an individual has a higher risk of developing narcolepsy himself if a close relative is affected with the disorder. However, only about 5% to 10% of documented narcoleptics report having a close relative with narcolepsy. Is narcolepsy hereditary then? Maybe not.

One of the symptoms of narcolepsy is excessive daytime drowsiness, so excessive that you are talking to a narcoleptic one second, and another second, he’s slumped on the table, snoring! Other distinct symptoms of this disorder are cataplexy (sudden loss of muscle tone), hypnagogic hallucinations (vivid dreaming), sleep paralysis, and automatic behavior. Narcolepsy, in laymen’s terms, is sudden sleep attacks at inappropriate times and places, i.e. while eating, driving, or in the middle of a conversation. This is often triggered by intense emotions like sadness, surprise, fear, happiness, etc.

Normally, when we sleep, we go through a series of sleep stages (non-REM stages) before going to the REM stage of sleep, or deep sleep, where dreaming occurs. It usually takes 90 minutes of non REM sleep stages before going to deep sleep. In narcolepsy, the non REM stage is shorter, and in most cases, the REM stage of sleep is immediately achieved. In other words, when the drowsiness becomes uncontrollable, the body immediately goes into deep sleep regardless of time, place or situation.

It was found out that this anomaly is due to the failure of the brain neurons and neurotransmitters to send the proper signals from the brain to the body. The hypothalamus is the part of our brain that regulates sleep and it produces a substance called hypocretin (or orexin). This substance is responsible for stabilizing the activity of the neurons involved in transmitting the signals to the body when it is time to wake or sleep, or when it is time to relax the skeletal muscles in preparation for the dream stage of sleep. Simply put, hypocretin controls our sleep patterns.

Narcoleptics have been found to have very low levels, and sometimes absence, of hypocretin neurons and neurotransmitters. The reason could be genetic, but another angle that experts are looking into is the possibility of an autoimmune response wherein our body’s defense system is attacking our own cells, in this case the hypocretin cells, mistaking it for a foreign body and destroying it. Now, autoimmunity can also be hereditary. So there’s that question again: Is narcolepsy hereditary? I’m sure you are now confused.

Other factors that can contribute to damage or absence of hypocretin are viral infections like mumps and measles, brain injury, changes in hormones (which could explain why most initial narcolepsy attacks happens during puberty), and stress (narcolepsy also seems to be preceded by a very stressful event like death of a loved one, etc.).

Currently, the consensus is that narcolepsy may be due to genetic factors but ongoing research is underway to prove (or disprove) that. So, if you ask me now, “Is narcolepsy hereditary?” I guess, together, we’ll have to wait a little bit longer for the answer.

Do you know what narcolepsy is? Do you know anyone with narcolepsy? Narcolepsy is a neurological disorder characterized by excessive daytime sleepiness, so excessive that they tend to fall asleep even in the middle of a meal, or a meeting, or a conversation. Here are some narcolepsy facts that you should know about.

Narcolepsy is not a rare disease as thought initially. The United States alone has an estimated 200,000 to 250,000 cases of narcolepsy and there are only about 50,000 of those cases properly diagnosed. It is almost as common in occurrence as Parkinson’s disease, but not as well known. The general public should be made aware of the narcolepsy facts and let them realize that this is not to be ashamed of. Because some of the reasons why most narcoleptics refuse to have themselves diagnosed are denial and their tendency to withdraw because of shame and fear of what they may find out.

Another reason why very few cases are reported is because of failure to recognize the symptoms of narcolepsy. This is one of the most commonly misdiagnosed illnesses. The symptoms of narcolepsy may vary from person to person but the most commonly observed symptom is excessive daytime drowsiness (EDS). This is the first manifestation to be observed in narcoleptics. Other narcolepsy symptoms are cataplexy, hypnagogic hallucinations, sleep paralysis, and automatic behavior. These five symptoms are often referred to as the “narcolepsy pentad”. They may not occur altogether on one narcolepsy patient.

Onset of narcolepsy symptoms often occurs around puberty but it could also occur in adulthood. The first symptom to become noticeable is EDS. The other major symptoms may follow months, or even years, later. This also makes narcolepsy harder to diagnose. And the fact that it occurs in the teenage years where development and learning is crucial, it becomes more devastating, not just for the patient but for the whole family. Not to mention mistaking it for epilepsy or a learning disorder or a mental disorder or brushing it off as plain laziness.

Some narcolepsy facts that some of you out there are probably dying to know are the causes of narcolepsy and whether it is curable or not. At first it was considered to be hereditary, well, it is, but only about 10% to 15% of people with narcolepsy reported having relatives with the same disorder. Another cause could be the decrease of a substance called hypocretin and hypocretin cells in the brain leading to excessive drowsiness. Another theory would be autoimmunity wherein our own immune system is attacking our own cells and destroying these hypocretin cells. There is no cure for narcolepsy as of the moment but the symptoms are certainly manageable.

This is an underdiagnosed disorder but only because there are too few resources for narcolepsy sufferers to gain awareness from. We tend to fear the unknown. But now, you need not to. If you think you are experiencing one or two of the symptoms, have yourself checked. You’ll only be required to have a polysomnogram or a sleep test and a sleep latency test. Remember that this can affect both males and females, it could be you, but I’m certainly hoping not. Try to get as many narcolepsy facts as you can and get educated.

Narcolepsy has been listed as a “Rare Disease” by the National Institutes of Health (NIH) . But would you, readers, consider it rare if 1 in every 1,500 people in America is afflicted with the disease? That’s about 200,000 people suffering from narcolepsy. And less that 50,000 are diagnosed and given proper treatment. Why? One of the reasons would be failure to recognize its clinical manifestations.

Did I get your attention? Narcolepsy, if you are not familiar with it, is a neurological disorder characterized by excessive daytime sleepiness and sudden sleep attacks even when in the middle of an activity. This disorder has something to do with the impaired ability of the central nervous system to communicate signals from the brain to the parts of the body involved in sleep. This is thought to be of genetic causes and is a chronic condition.

The major symptom of narcolepsy is excessive daytime drowsiness (EDS). All narcoleptics exhibit this symptom. This is often accompanied with uncontrollable episodes of sleep during the day and muscle weakness. The patient may appear slack-jawed, unable to speak, or might slump or fall to the ground. The attacks may last from a few seconds to several minutes. Symptoms of narcolepsy usually become noticeable when the patient reaches puberty. But in certain cases, symptoms start to surface in their early 30’s.

In addition to EDS, here are the other four symptoms of narcolepsy that completes the so-called “narcolepsy pentad”. 

• Cataplexy. This often accompanies excessive daytime drowsiness and is present in almost 75% of all narcoleptics. Cataplexy is the sudden episodes of muscle weakness characterized by drooping of the eyelids, slumping of the head, slacked jaw, slurring of speech, weakness of the hands and arms and buckling of the knees. This symptom of narcolepsy may be mild and subtle, or it may be severe and result to sudden falls to the ground. This is triggered by intense emotions such as anger, surprise, sadness, excitement, fear, and amusement. Other contributing factors include stress, fatigue and prior sleeplessness. These episodes often don’t last longer than a few minutes and the patient usually remains conscious throughout the episode.
• Hypnagogic hallucinations. These are actually vivid, and often frightening, dreams experienced during transition from the state of wakefulness to the sleep state. The dream is often accompanied by visual, auditory and tactile hallucinations. Some even reports smell and taste being perceived. Around 50% of patients experience this symptom of narcolepsy. These hallucinations are often very disturbing to patients.
• Sleep paralysis. This is experienced by up to 50% of narcoleptics and is often accompanied with hypnagogic hallucinations. This is the temporary paralysis of the skeletal muscle while in the wakefulness-to-sleep transition or the other way around. It could last from seconds to minutes and the patient remains conscious throughout the episode. The paralysis together with the hallucinations can be quite an experience to narcoleptics.
• Automatic behavior. This symptom of narcolepsy is manifested by almost all narcoleptics. This is the continued performance of activities such as eating, driving, walking, talking, writing, etc, while in a state of sleep. The patient is often unaware that he is fluctuating between states of sleep and wakefulness. When asked about the activities done during the episodes, he would have no recollection of ever doing them.

Judging from the major symptoms of narcolepsy mentioned, I can say that another reason why some narcoleptics refuse to seek the proper diagnosis is because they are afraid to find out the truth. Some narcoleptics report that they are scared that they are going crazy and other people might think so too. But this is not a mental disorder. Narcolepsy is a neurological and a sleep disorder and understanding the symptoms of narcolepsy helps us understand narcoleptics more.

Restless legs syndrome causes are somewhat vague but I will try to go over the possible causes and hopefully enlighten those who are experiencing the symptoms but still don’t know what to make of it.

For starters, restless legs syndrome (RLS), also referred to as “the kicks”, is a neurologic disorder which is characterized by an uncontrollable urge to move the legs in response to the unpleasant sensations caused by sensory and motor dysfunctions. These sensations are often described as pins-and-needles, gnawing, aching, or crawling. Episodes are often triggered by prolonged inactivity especially on long drives, plane rides, and during nighttime.

Now, you might be wondering why a neurologic disorder is included in a sleep blog site. It is because restless legs syndrome causes sleep deprivation due to these constant urges to keep legs in motion in an attempt to relieve the weird sensations felt during an attack. Daytime drowsiness, fatigue, irritability, clumsiness, and depression are often observed in patients with this disorder. Familiar?

There are two types of restless legs syndrome: primary and secondary. Primary RLS is acquired through heredity, an autosomal dominant disorder. This type of RLS is progressive in nature with periods of remissions and exacerbations throughout the patient’s life span.

Other possible restless legs syndrome causes are medications such as antinausea drugs (Compazine, Reglan), antipsychotics (haloperidol, phenothiazines), tricyclic antidepressants, antihistamines, and anticonvulsants (Dilantin); and use and abuse of substances like nicotine, caffeine and alcohol. Restless legs syndrome that is not passed on genetically is called secondary restless legs syndrome.

But sometimes secondary RLS is brought about by an underlying medical condition. Kidney failure, peripheral neuropathy, diabetes mellitus, hypoglycemia, rheumatoid arthritis, thyroid problems, Parkinson’s disease, iron deficiency, varicose veins, and pregnancy are the most common secondary restless legs syndrome causes.

Dealing with the restless legs syndrome causes deals with the disorder itself except in primary RLS. If certain medications trigger the RLS episodes, discontinuing the medication and asking for an alternative from your doctor would take care of the problem. Or if it is caused by another disorder like the ones mentioned above, treatment of that disorder would also treat the RLS.

In cases of primary RLS, staying away from the possible restless legs syndrome causes would limit the recurrence of the episodes. Compression stockings, hot baths, massages and appropriate exercise programs also help deal with the attacks.