Sleep disorders affect millions of Americans. Adequate, restful sleep is necessary for both physical and mental well-being.
Studies have shown that sleep is essential for normal functioning of the immune system, the endocrine system and the central nervous system. In addition, adequate sleep is crucial for learning in children and young adults. Numerous studies have shown that interrupted sleep not only gives rise to daytime fatigue and weight gain, but may also be associated with life-threatening conditions such as hypertension, heart disease, diabetes and even Alzheimer’s disease.
Sleep disorders are common. There are 88 different types of sleep disorders and their treatments have advanced significantly in recent years. Obstructive sleep apnea is by far the most common sleep disorder encountered, affecting more than 18 million Americans. Research has shown that treatment with a positive airway pressure device leads to reduction in blood pressure. A recent Johns Hopkins study by Dr. Naresh Punjabi reported that, if left untreated, sleep apnea can increase glucose levels in the body, leading to insulin-resistant diabetes.
Patients with sleep apnea often experience excessive daytime sleepiness, unrefreshing sleep, snoring, frequent nighttime urination, ankle swelling, headaches and memory problems. Treatment options include surgery, oral appliances, and devices like the nasal positive pressure device, to name a few.
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Restless leg syndrome is probably the most common movement disorder encountered in any clinical practice. Patients often complain about the “creeping, crawling sensation” in the legs in the evening interfering with the ability to achieve and maintain sleep. A recent study by Dr. John Winkelman of Harvard University reported a strong association between RLS and risks of cardiovascular disease. He further reported that the higher the frequency and severity of RLS, the stronger the association with risks of cardiovascular disease.
Cutting-edge research tackling this disabling condition has led to the discovery of the cause of RLS, the dysfunction of the dopamine receptor. Treatment includes medications such as Ropinirole, the first Federal Drug Administration-approved drug for RLS. Other medications — Miraprex, Neupro and more recently, Horizant, have been shown to be effective and well tolerated.
Good sleep hygiene practices are essential ingredients for restful sleep. These include maintaining a regular sleep-wake schedule, and avoiding eating and drinking two hours before bedtime, especially caffeinated products. Moderate daily exercise four hours before bedtime would promote deep restful sleep. Last, always reserve the bedroom environment so that it is conducive only for sleep.
Dr. Daniel Lee is a neurologist with Baptist Health Medical Group Neurology in Richmond.