Types

There are 9 main types of sleep disorders that can affect you. If you suffer from any of these types of sleep disorder breathing, please do not hesitate to contact us.

SNORING

Snoring is a common sleep disorder that can affect people at any age, although it occurs more frequently in men and people who are overweight. Snoring has a tendency to worsen with age. Forty-five percent of adults occasionally snore, while 25% are considered habitual snorers. The habitual snorer not only disrupts the sleep patterns of those close to him, he also disturbs his own. Habitual snorers snore whenever they sleep and are often tired after a night of what seems like quality rest. Medical assistance is usually needed for habitual snorers to get a good nights sleep. Snoring may be associated with problems such as:

• Morning headaches    • Hypertension    • High blood pressure    • Diabetes
• Fatigue    • Difficulty concentrating    • Reduced work performance

The loudness and tone of the snoring noise is affected by how much air is going through the passage. The obstruction, the greater is the effort to draw air and the louder the noise. As it becomes harder to breath and becomes worse, you may actually stop breathing. This can be a sign of a serious condition called apnea (meaning “want of breath”). However, not everyone who snores suffers from sleep apnea.

UPPER AIRWAY RESISTANCE SYNDROM (UARS)

Upper Airway Resistance Syndrome (UARS) is a chronic daytime sleepiness that is often accompanied by snoring, brief yet frequent arousals, and only slightly abnormal breathing. Unlike snoring and obstructive sleep apnea, UARS is often more prevalent among women than men. Symptoms may include:

• Sleep on-set insomnia • Headaches • Rhinitis • Depression
• Bruxism • Gastroesophageal reflux • Hypothyroidism • Asthma

People who suffer from UARS lack the typical findings of apnea, hypopnea and nighttime oxygen desaturation on polysomnography (diagnostic sleep studies). As a result, UARS is often not diagnosed by physicians. However arousals and sleep fragmentation related to an increased effort to breathe can be diagnosed by measurement of pressure changes in the esophagus.

INSOMNIA

“Insomnia” originates from the latin words “in” (meaning “no”) and “somnus” (meaning “sleep”), so it literally means “no sleep” or the inability to sleep. Insomnia can be transient (lasting for several days), intermittent (when transient insomnia) or chronic (lasting for more than a month). Insomnia is often characterized by one or more of the following sleep complaints:

• Difficulty initiating sleep • Difficulty maintaining sleep • Waking too early in the morning

In 2002, the National Sleep Foundation (NSF) took a “Sleep in America” poll, which revealed that 58% of adults in the U.S. experience symptoms of insomnia a few nights a week or more. People experiencing insomnia might begin examining their sleep habits to see if their sleeplessness is connected with diet, exercise patterns, or sleeping environment. If these factors do not alleviate the insomnia symptoms, consult a dentist certified in dental sleep medicine or your family physician.

OBSTRUCTIVE SLEEP APNEA

Obstructive Sleep Apnea occurs when air cannot flow out of the person’s nose or mouth, although efforts to breathe continue. In a given night, the number of involuntary breathing pauses-or “apneic events” may be a high as 20 to 60 or more per hour. Snoring and choking between apneic events is common, although not everyone that snores has Obstructive Sleep Apnea. The frequent interruptions of deep restorative sleep often lead to excessive daytime sleepiness and may be associated with early morning headache. OSA occurs in all age groups and both sexes but is more common in men (it may be underdiagnosed in women and possibly young African Americans). Early recognition and treatment is important because OSA may be associated with irregular heartbeat, high blood pressure, heart attack, and stroke. Once diagnosed, OSA is often managed through the use of Continuous Positive Airway Pressure (CPAP). Dental appliances that reposition the lower jaw and the tongue have proven to be effective as well.

CENTRAL SLEEP APNEA

Central Sleep Apnea is the second of two main types of sleep apnea. Central Sleep Apnea appears to be related to a malfunction of the brain’s normal signal to breathe. It is less common than “Obstructive Sleep Apnea” which is the cessation of breathing due to a mechanical blockage of the airway. Prompt and proper diagnosis is an important first step to treating any and all forms of sleep apnea. Problems associated with untreated sleep apnea include:

• Hypertension • Coronary artery disease • Myocardial infraction • Stroke • Psychiatric problems
• Impotence • Cognitive dysfunction • Memory loss • Death

SLEEP BRUXISM

Sleep Bruxism is the gnashing, clenching, or grinding of the teeth during sleep. It is the third most prevalent sleep disorder, after sleep talking and primary snoring. Tooth grinding or tooth-clenching during sleep may cause:

• Abnormal wear of the teeth • Jaw muscle discomfort
• Sounds associated with bruxism (About as pleasant as fingernails on a chalkboard).

Some people have episodes of SB that occur less than nightly with no evidence of dental injury or impairment of psychosocial functioning. Others experience nightly episodes with evidence of mild impairment of psychosocial functioning. Yet others have nightly episodes with evidence of dental injury, temporomandibular joint (jaw) disorders or moderate or severe impairment of psychosocial functioning.

SLEEP DISORDERS THAT INVOLVE DREAMING

Sleep disorders that involve dreaming include nightmares, sleep terrors and REM sleep behaviors. Nightmares are dreams with vivid and disturbing content. They are common in children during REM sleep. They usually involve immediate awakening and good recall of the dream content.
Sleep terrors are often described as extreme nightmares. Like nightmares, they most often occur during childhood however they typically take place during non-REM sleep. The child appears terrified, screams, and is usually inconsolable for several minutes, after which he or she relaxes and return to sleep. Sleep terrors usually take place early in the night and may be combined with sleepwalking. The child typically does not remember or has only a vague memory of the terrifying events. Characteristics of a sleep terror include:

• Arousal • Agitation • Large pupils
• Sweating • Increased blood pressure

REM sleep behaviors are similar to sleep terrors, but more common in adults. Patients are usually middle aged or elderly, and about one third have an associated neurological disease and should consult their doctor; sleep disorders can often be treated. Patients with REM sleep behaviors may complain of:

• Sleep disruption • Unpleasant and vivid dreams.
• Violent behavior with injuries to themselves or to their bed partner

LIMB MOVEMENTS (PLMS)

Limb Movements (PLMS)are defined as repetitive movements that most typically occur in the lower limbs, every 20-40 seconds. If you have PLMS or sleep with someone who has PLMS also referred to as PLMD (periodic limb movement disorder), you may recognize these movements as:

• Brief muscle twitches • Jerking movements
• An upward flexing of the feet that cluster into episodes lasting several minutes or longer

People with PLMS are often not aware of these movements, and often complain of several symptoms, including insomnia, excessive daytime sleepiness, frequent awakenings from sleep, or unrefreshed sleep. While often not indicative of a serious medical condition, PLMS may be a contributing factor in chronic insomnia and/or daytime fatigue because they may cause awakenings during the night. Occasionally, PLMS may be an indicator of a serious medical condition such as kidney disease, diabetes or anemia, which is why you should seek the advice of your family physician or a sleep medicine specialist.

RESTLESS LEG SYNDROM (RLS)

Restless Leg Syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest, in an effort to relieve these feelings. The most distinctive or unusual aspect of RLS is that lying down and trying to relax activates the symptoms. As a result, most people with RLS have difficulty falling asleep and staying asleep. Left untreated, the condition causes exhaustion and daytime fatigue.
The cause of RLS is still unknown, but the symptoms tend to worsen over the years and becomes more severe in middle to-old age. The fact that is occurs 3x-5x more frequently is first-degree relatives of people with RLS than in people without RLS suggests that heredity may be involved. Pregnancy or hormonal changes may temporarily worsen symptoms. Stress, diet or other environmental factors may also play a role.