Friday, July 24, 2009

Sleep Walking in Detail

Sleepwalking Overview

Sleepwalking has been described in medical literature dating before Hippocrates (460 BC-370 BC). In Shakespeare's tragic play, Macbeth, Lady Macbeth's famous sleepwalking scene ("out, damned spot") is ascribed to her guilt and resulting insanity as a consequence of her involvement in the murder of her father-in-law.

Sleepwalking is characterized by complex behavior (walking) accomplished while asleep. Occasionally nonsensical talking may occur while sleepwalking. The person's eyes are commonly open but have a characteristic glassy "look right through you" character. This activity most commonly occurs during middle childhood and young adolescence. Approximately 15% of children between 4-12 years of age will experience sleepwalking. Generally sleepwalking behaviors are resolved by late adolescence; however, approximately 10% of all sleepwalkers begin their behavior as teens. A genetic tendency has been noted.

There are five stages of sleep. Stages 1, 2, 3, and 4 are characterized as non-rapid eye movement (NREM) sleep. REM (rapid eye movement) sleep is the sleep cycle associated with dreaming as well as surges of important hormones essential for proper growth and metabolism. Each sleep cycle (stages 1,2,3,4, and REM) lasts about 90-100 minutes and repeats throughout the night. Thus the average person experiences 4-5 complete sleep cycles per night. Sleepwalking characteristically occurs during the first or second sleep cycle during stages 3 and 4. Due to the short time frame involved, sleepwalking tends not to occur during naps. Upon waking, the sleepwalker has no memory of his behaviors.

Sleepwalking Causes

Genetic factors

Sleepwalking occurs more frequently in identical twins, and is 10 times more likely to occur if a first-degree relative has a history of sleepwalking.

Environmental factors

Sleep deprivation, chaotic sleep schedules, fever, stress, magnesium deficiency, and alcohol intoxication can trigger sleepwalking.

Drugs, for example, sedative/hypnotics (drugs that promote sleep), neuroleptics (drugs used to treat psychosis), minor tranquilizers (drugs that produce a calming effect), stimulants (drugs that increase activity), and antihistamines (drugs used to treat symptoms of allergy) can cause sleepwalking.

Physiologic factors

* The length and depth of slow wave sleep, which is greater in young children, may be a factor in the increased frequency of sleepwalking in children.

* Conditions, such as pregnancy and menstruation, are known to increase the frequency of sleepwalking.

Associated medical conditions

* Arrhythmias (abnormal heart rhythms)

* Fever

* Gastroesophageal reflux (food or liquid regurgitating from the stomach into the food tube or esophagus)

* Nighttime asthma

* Nighttime seizures (convulsions)

* Obstructive sleep apnea (a condition in which breathing stops temporarily while sleeping)

* Psychiatric disorders, for example, posttraumatic stress disorder, panic attack, or dissociative states (for example, multiple personality disorder)

Sleepwalking Symptoms

* Episodes range from quiet walking about the room to agitated running or attempts to "escape." Patients may appear clumsy and dazed in their behaviors.

* Typically, the eyes are open with a glassy, staring appearance as the person quietly roams the house. They do not, however, walk with their arms extended in front of them as is inaccurately depicted in movies.

* On questioning, responses are slow with simple thoughts, contain non-sense phraseology, or are absent. If the person is returned to bed without awakening, the person usually does not remember the event.

* Older children, who may awaken more easily at the end of an episode, often are embarrassed by the behavior (especially if it was inappropriate). In lieu of walking, some children perform repeated behaviors (for example, straightening their pajamas). Bedwetting may also occur.

* Sleepwalking is not associated with previous sleep problems, sleeping alone in a room or with others, achluophobia (fear of the dark), or anger outbursts.

* Some studies suggest that children who sleepwalk may have been more restless sleepers when aged 4-5 years, and more restless with more frequent awakenings during the first year of life.

When to Seek Medical Care for SleepWalking

For children and adults, sleepwalking is usually a sign of lack of sleep, intense emotional problems, stress, or fever. As these conditions resolve, sleepwalking incidences disappear.

In most cases, no treatment is necessary because sleepwalking rarely indicates any serious underlying medical or psychiatric problem.

In most children, sleepwalking disappears at puberty. However, it can occasionally persist into adulthood or may even begin in adulthood.

Consult a sleep specialist if the person is having frequent episodes, injuring himself or herself, or showing violent behavior.

Differential Diagnosis

Sleepwalking, night terrors, and confusional arousals are all common non-REM sleep disorders that tend to overlap in some of their symptoms. Approximately 15%-20% of young children through mid adolescence will experience some or all of these behaviors.

* Night terrors: Like sleepwalking, night terrors tend to occur during the first half of a night's sleep, often within 30-90 minutes from falling asleep. Also, like sleepwalking, night terrors occur during stage 3 and 4 sleep. However, unlike sleepwalking, an individual with night terrors will portray a sudden and often agitated arousal that may appear to parents as violent and terrified behaviors. Night terrors often start during the toddler years with a peak incidence between 5–7 years of age. During these times, evidence of a surge in autonomic nervous system activity is evident. Accelerated heart and respiratory rates, dilated pupils, and sweating are characteristic. Triggers for night terrors may include sleep deprivation, stress, or medications (stimulants, sedatives, antihistamines, etc.). Unlike sleepwalking, episodes of night terrors may recur for several weeks in a row, abate completely, and later return.

* Confusional arousals: Similar to night terrors, confusional arousals are characterized by a sudden and violent arousal from sleep with behaviors described as agitated and semi-purposeful in pattern. Speech is generally coherent (unlike in sleepwalking). A distinguishing point between night terrors and confusional arousals is the lack of autonomic nervous system phenomena in the latter. Confusional arousals tend to occur during the first half of a night's sleep (during stages 3 and 4). They are characteristically short-lived, lasting only 5 - 30 minutes in duration. Affected individuals typically have no memory of the event.

* Nocturnal seizures: Several important differential points help delineate the above three sleep behaviors from seizure activity that occurs at night. Seizures by their nature are very brief, lasting often only a few minutes. In addition, seizure events likely to be confused with the above are characterized by a series of repeated, stereotypical, and frequent behaviors occurring in clusters. Importantly, seizures more commonly occur in the second half of the night's sleep. Patients often with have post-ictal (post-seizure) issues including headache, extreme grogginess, being hard to arouse, as well as incontinence of urine and stool. To assist in establishing a correct diagnosis a neurologist may perform a video-EEG study to help clarify the issue.

Sleepwalking Treatment

Self-Care at Home

The following measures can be taken by a person who has a sleepwalking disorder:

* Get adequate sleep.

* Meditate or do relaxation exercises.

* Avoid any kind of stimuli (auditory or visual) prior to bedtime.

* Keep a safe sleeping environment free of harmful or sharp objects.

* Sleep in a bedroom on the ground floor if possible. To prevent a fall, avoid bunk beds.

* Lock the doors and windows.

* Remove obstacles in the room. Tripping over toys or objects is a potential hazard.

* Cover glass windows with heavy drapes.

* Place an alarm or bell on the bedroom door and if necessary, on any windows.

Medical Treatment

If sleepwalking is caused by underlying medical conditions, for example, gastroesophageal reflux, obstructive sleep apnea, periodic leg movements (restless legs syndrome), or seizures, the underlying medical condition should be treated.

Medications for the treatment of sleepwalking disorder may be necessary in the following situations:

* The possibility of injury is real.

* Continued behaviors are causing significant family disruption or excessive daytime sleepiness.

* Other measures have proven to be inadequate.

Medications

Benzodiazepines, such as estazolam (ProSom), or tricyclic antidepressants, such as trazodone (Desyrel), have been shown to be useful. Clonazepam (Klonopin) in low doses before bedtime and continued for 3-6 weeks is also usually effective.

Medication can often be discontinued after 3-5 weeks without recurrence of symptoms. Occasionally, the frequency of episodes increases briefly after discontinuing the medication.

Other Therapy

Relaxation techniques, mental imagery, and anticipatory awakenings are preferred for long-term treatment of persons with sleepwalking disorder.

* Relaxation and mental imagery should be undertaken only with the help of an experienced behavioral therapist or hypnotist.

* Anticipatory awakenings consist of waking the child or person approximately 15-20 minutes before the usual time of an event, and then keeping him awake through the time during which the episodes usually occur.

Prevention

* Limit stress

* Avoid alcohol intake

* Avoid sleep deprivation

Outlook

The outlook for resolution of the disorder is excellent.

* Sleepwalking is not a serious disorder, although children can be injured by objects or falls during sleepwalking.

* Although disruptive and frightening for parents over the short term, sleepwalking is not associated with long-term complications.

* Prolonged disturbed sleep may be associated with school and behavioral issues.

Insomnia

Insomnia, the most common sleep complaint, is the feeling that you have not slept well or long enough. It occurs in many different forms. Most often it is characterized by difficulty falling asleep (taking more than 30 to 45 minutes), awakening frequently during the night, or waking up early and being unable to get back to sleep.

With rare exceptions, insomnia is a symptom of a problem, and not the problem itself. Good sleep is a sign of health. Poor sleep is often a sign of some malfunctioning and may signal either minor or serious medical or psychiatric disorders. Insomnia can begin at any age. And, it can last for a few days (transient insomnia), a few weeks (short-term insomnia), or indefinitely (long-term insomnia).

Transient insomnia may be triggered by stress-- a hospitalization for surgery, a final exam, a cold, headache, toothache, bruised muscles, backache, indigestion, or itchy rash. It can also be caused by jet travel that involves rapid time-zone change.

Short-term insomnia, lasting up to 3 weeks, may result from anxiety, nervousness, and physical and mental tension. Typical are worries about money, the death of a loved one, marital problems, divorce, looking for or losing a job, weight loss, excessive concern about health, or plain boredom, social isolation, or physical confinement.

Long-lasting distress over lack of sleep is sometimes caused by the environment, such as living near an airport or on a noisy street. Working a night shift can also cause problems: sleeping during the day may be difficult on weekdays, especially when the person sleeps at night on weekends. But more often, long-term insomnia stems from such medical conditions as heart disease, arthritis, diabetes, asthma, chronic sinusitis, epilepsy, or ulcers. Long-term impaired sleep can also be brought on by chronic drug or alcohol use, as well as by excessive use of beverages containing caffeine and abuse of sleeping pills.

Many patients with long-term insomnia may be suffering from an underlying psychiatric condition, such as depression or schizophrenia. Depression, in particular, is often accompanied by sleep problems (which usually disappear when the depression is treated). People with phobias, anxiety, obsessions, or compulsions are often awakened by their fears and worries, sometimes by nightmares and feelings of sadness, conflict, and guilt.

Insomnia is a complex problem, not given to simple solutions. Most experts agree that treatment should start with assessing and correcting sleep hygiene and habits.

Exercise
Regular exercise tends to benefit sleep, but not right at bedtime. Vigorous exercise, especially just before sleep, can cause arousal and delay sleep. You cannot force sleep on a given night by exercising excessively during the day. Exercise in the morning also has little beneficial effect on sleep. The best time to exercise is in the afternoon or early evening. But, even then, it probably won't help you sleep unless you exercise on a regular schedule.

Trying Too Hard
Trouble falling asleep, the most common form of sleep disturbance, may be brought on simply by going to bed too early. Sleep cannot be forced. You should not go to sleep until you are sleepy. If you turn in too early--even if you do fall asleep--you could experience a disturbed night's rest or could wake early without feeling refreshed. If you go to bed when you feel sleepy but find that you can't fall asleep, don't stay in bed brooding about being awake. It is best to get out of bed. Leave the bedroom. Read, sew, watch TV, take a warm bath, or find some other way to relax before slipping between the sheets once more.

Naps
Laboratory tests have shown that daytime naps disrupt normal nighttime sleep. Although many people feel like napping between 2 and 4 p.m. (siesta time), most sleep better if they don't nap during the day. Naps should not be used as a substitute for poor sleep at night. However, there are exceptions to this general rule. Many older people, in particular, do. sleep better at night when they take daytime naps. But if you are a napper who sleeps poorly at night, your nighttime sleep might improve if you skip the naps.

Bedtime Snacks
If hunger keeps you awake, a light snack might help you sleep, unless it causes problems with digestion. Avoid heavy meals, alcohol, and caffeine-containing coffee, tea, and cola. For those who. can tolerate milk, that old, time-tested remedy may work best.

Smoking At Bedtime
Nicotine stimulates the nervous system and can interfere with sleep. In one sleep laboratory study, smokers experienced greater difficulty than nonsmokers. Sleep patterns also improved significantly among chronic smokers when they abstained from smoking.

Alcohol
The effect of alcohol is deceiving. It may induce sleep, but chances are it will be a fragmented sleep. The sleeper will probably wake up in the middle of the night when the alcohol's relaxing effect wears off.

Regular Bedtime
The best way to sleep better is to keep a regular schedule for sleeping. Go to bed at about the same time every night, but only when you are tired. Set your alarm clock to awaken you about the same time every morning--including weekends and regardless of the amount of sleep you have had. If you have a poor night's sleep, don't linger in bed or oversleep the next day. If you awaken before it is time to rise, get out of bed and start your day. Most insomniacs stay in bed too long and get up too late in the morning. By establishing a regular wakeup time, you help solidify the biological rhythms that establish your periods of peak efficiency during the 24-hour day.

Sleeping Pills: A Temporary Solution
All brands of prescribed sleeping pills are hypnotics--that is, drugs that depress the central nervous system and put users to sleep. A variety of hypnotics are now on the market, including barbiturates, benzodiazepines, and several classes of drugs generally referred to as the nonbarbiturates/nonbenzodiazepines.

The benzodiazepines are very toxic when taken in combination with alcohol. Benzodiazepine drugs sometimes can aid sleep for up to 30 days. The benzodiazepines are not all alike, though. Some work faster than others, some produce effects that last longer, and some are eliminated from the body sooner.

When taken for a brief period and under a doctor's guidance, prescription sleeping pills may help you sleep better. But insomnia cannot be corrected with pills. At best, sleeping pills have only limited usefulness. They provide a temporary solution to insomnia. Thus, only when a person's health, safety, and well-being are threatened should drugs be sleep-promoting considered and then only after the doctor takes a medical history and does a physical examination. He or she might identify conditions that should not be treated with sleeping pills and weigh other risks drug treatment.

Although temporarily helpful, sleep promoting medications can eventually cause disturbed sleep, side effects, a sleep "hangover" during the day, and dependence on the drug. Further more, once the drugs are stopped, sleep problems return, at least temporarily, and may be even more severe than they were before the medication was first taken.

Sleeping pills can be fatal when taken in combination with alcohol or other drugs. Even when not fatal, combining drugs and alcohol can be perilous to driving and the use of other machinery. Long-acting sleeping pills, by themselves, may also impair driving performance the day after they are taken. People who are taking sleeping pills should never drink for a couple of days afterward.

Anxiety, Depression, And Sleep

In a recent national survey, 47 percent of those reporting severe insomnia reported a high level of emotional distress. Psychological factors, such as fears, phobias, and compulsions, can so occupy the mind that sleep is delayed, disturbed, or shortened. Chronically tense people are frequently so restless, hyperactive, and apprehensive that they expect not to sleep when they go to bed.

In depressed people, an overwhelming feeling of sadness, hopelessness, worthlessness, or guilt can be associated with abnormal sleep patterns. Often, the depressed person awakens early and cannot return to sleep. Yet, sometimes, just the opposite is true. Some depressed people find relief in sleeping, denying or escaping from the problems of living by sleeping. The loss of a sense of purpose in life may be associated with an overwhelming urge to sleep, a constant feeling of tiredness, or nighttime sleep marked by an irregular sleep/wake pattern.

Many depressed people complain of insomnia without recognizing they are depressed. If you have lost interest in activities you used to enjoy, or if you have feelings of hopelessness or suicidal thoughts, you may be one of them. You should discuss the problem with your physician, who may recommend psychiatric consultation. While the complaint may be insomnia, the underlying depression, not the insomnia, must be treated. Antidepressant medications and/or psychotherapy can produce remarkable improvement, both in mood and sleep patterns.

Narcolepsy or Sleep Attacks

A sleepy feeling during the day could be caused by insufficient, inadequate, or fragmented sleep, by insomnia, or by boredom, social isolation, physical confinement, or depression. But, if you continually experience excessive daily daytime sleepiness--sometimes expressed as tiredness, lack of energy, and/or irresistible sleepiness--you could be suffering from another little-known, chronic sleep disorder called narcolepsy.

According to the American Narcolepsy Association, 1 out of every 100 Americans is afflicted with this disorder. Yet, between 50 and 80 percent of them remain undiagnosed. People with narcolepsy suffer from sleep apnea more often than the general population, although apnea is not a core feature of the disorder.

During a narcoleptic attack, the person may find it physically impossible to stay awake and sleeps for periods ranging from a few seconds to a half hour. An attack can occur while watching TV, reading, or listening to a lecture. More surprising, these sudden attacks of sleep can also strike while walking, eating, riding a bike, or carrying on a conversation.

Usually, narcolepsy starts in the early teen years, but it can strike anyone at any age. At first, the symptoms are rather mild. Gradually, over a period of years, they increase in severity.

Narcolepsy With Cataplexy

Besides the presence of excessive sleepiness, which usually is the first symptom noted, the person suffering from narcolepsy may experience a sudden weakness of the muscles called cataplexy. A cataplectic attack is usually triggered by such emotions as laughter, anger, elation, or surprise. It may be experienced as partial muscle weakness lasting a few seconds or as almost complete loss of muscle control lasting for 1 to 2 minutes. During this period, the victim may be in a state of nearly total physical collapse, unable to move or speak, but still conscious and at least/ partially aware of activity in the immediate environment.

Sometimes, narcolepsy is misdiagnosed as epilepsy. But while epilepsy is often accompanied by loss of bladder and bowel control and tongue biting, narcolepsy is not. More often, the symptoms of narcolepsy are attributed to laziness, malingering, or psychiatric disorder. Job and home life usually suffer when narcolepsy goes untreated.

Narcolepsy, believed to be caused by a defect in the central nervous system, has no known cure. However, after proper diagnosis, the disorder can be effectively managed with drugs.

People who have narcolepsy but don't know it represent a serious safety hazard to themselves and others when they drive. They may doze off while waiting for a traffic signal to change, or they may drive to destination and be completely unable to recall how they got there. At least one in every 500 drivers is estimated to be suffering from narcolepsy.

Tragically, many of the drivers may not survive to be diagnosed or counted among the sufferers. Yet, narcolepsy is a major traffic safety problem with a low-cost and easy solution: proper diagnosis and medical care. Diagnosed patients who understand their symptoms appear to be very safe drivers, and their driving can be coordinated with the use of medication.

Sleep Walking

Is a Sleep Disorder characterized by walking or other activity while seemingly still asleep. Sleepwalking (Somnambulism) is a series of complex behaviors that are initiated during slow wave sleep and result in walking during sleep. Sleepwalking is a rapid eye movement (REM) behavior disorder occurring in the dream stage of sleep. During this phase, the body releases a chemical that paralyzes the body. However, those who sleepwalk do not have this chemical trigger, hence the behavior.

Symptoms and Features:

Ambulation (walking or moving about) that occurs during sleep. The onset typically occurs in pre-pubertal children.
amnesia following an episode
polysomnographic monitoring demonstrates the onset of an episode during stage 3 or 4 sleep
other medical and psychiatric disorders can be present but do not account for the symptom
the ambulation is not due to other sleep disorders such as REM sleep behavior disorder or sleep terrors.
Fatigue (which is not the same as drowsiness),
stress and
anxiety

The normal sleep cycle involves distinct stages from light drowsiness to deep sleep. Rapid eye movement (REM) sleep is a different type of sleep, in which the eyes move rapidly and vivid dreaming is most common. During a night, there will be several cycles of non-REM and REM sleep. Sleep walking (somnambulism) most often occurs during deep non-REM sleep (stage 3 or stage 4 sleep) early in the night. It can occur during REM sleep near morning.

In children, the cause is usually unknown but may also be related to fatigue, prior sleep loss, or anxiety. In adults, sleep walking is usually associated with a disorder of the mind but may also be seen with reactions to drugs and/or medications and alcohol, and medical conditions such as partial complex seizures. In the elderly, sleep walking may be a symptom of an organic brain syndrome or REM behavior disorders.

The sleep walking activity may include simply sitting up and appearing awake while actually asleep, getting up and walking around, or complex activities such as moving furniture, going to the bathroom, dressing and undressing, and similar activities. Some people even drive a car while actually asleep. The episode can be very brief (a few seconds or minutes) or can last for 30 minutes or longer.

One common misconception is that a sleep walker should not be awakened. It is not dangerous to awaken a sleep walker, although it is common for the person to be confused or disoriented for a short time on awakening. Another misconception is that a person cannot be injured when sleep walking. Actually, injuries caused by such things as tripping and loss of balance are common for sleep walkers.

Sleep walking occurs at any age, but it occurs most often in children aged 6 to 12 years old. It may occur in younger children, in adults, or in the elderly, and it appears to run in families. Sleepwalking (somnambulism) is fairly common, especially among children. An estimated 15 percent of all children between the ages of 5 and 12 have walked in their sleep at least once, and most outgrow the disorder. Typically, the child (or adult) sleepwalker sits up, gets out of bed, and moves about in an uncoordinated manner. Less frequently, the sleepwalker may dress, open doors, eat, or go to the bathroom without incident and usually will avoid obstacles. But sleepwalkers don't always make their rounds in safety. They sometimes hurt themselves, stumbling against furniture and losing their balance, going through windows, or falling down stairs.

In children, sleepwalking is not believed to be influenced by psychological factors.
In adults, it could indicate a personality disturbance.

Usually, it is enough for parents of sleepwalkers to provide their children with emotional support. They should also lock windows and doors and make sure the child does not sleep near stairways and potentially dangerous objects. For severe cases, a doctor may prescribe drugs.

Medical reports show that about 18% of the population are prone to sleepwalking. It is more common in children than in adolescents and adults. Boys are more likely to sleepwalk than girls. The highest prevalence of sleepwalking was 16.7% at age 11 to 12 years of age. Sleepwalking can have a genetic tendency. If a child begins to sleepwalk at the age of 9, it often lasts into adulthood.

For some, the episodes of sleepwalking occur less than once per month and do not result in harm to the patient or others. Others experience episodes more than once per month, but not nightly, and do not result in harm to the patient or others. In its most severe form, the episodes occur almost nightly or are associated with physical injury. The sleepwalker may feel embarrassment, shame, guilt, anxiety and confusion when they are told about their sleepwalking behavior.

Amnesia is another danger that usually follows a sleepwalking episode. Sleepwalkers usually remember little to nothing. But there are times sleepwalkers have a vague memory of an episode where they think they were being burned, buried alive, caught under a roof or trying to escape a dangerous situation. Sleepwalking primarily occurs in young children and is more prevalent in boys than girls.

Sleepwalking episodes can range from sitting up in bed to walking, and can even lead to frantic attempts to escape as if threatened or fleeing. During an episode, a sleepwalker exhibits behaviors such as sitting up with glassy eyes, picking at the blankets, making body movements and walking around the house. Sleepwalkers may also urinate, defecate or avoid looking at another person who attempts to communicate with them. Exiting through a window is not an uncommon practice, either.

Homicide or suicide during sleepwalking has rarely been reported when a person has tried to awaken a sleepwalker.

Sleepwalking can be treated with drugs, but hypnosis has also proven to be successful on a short-term basis.

An important component in dealing with this disorder is to make the environment as safe as possible, such as having sleepwalker's bedroom on the ground floor, removing hazardous items from the house, locking windows and placing an alarm on the bedroom door.

It is very important that if the sleepwalker exits the house, or is having frequent episodes and injuries are occurring -- DO NOT delay, it is time to seek professional help.

In a few instances, sleepwalking can result in violent behavior. It is very important that a chronic sleepwalker seek professional help.

Treatment:
There are some things a sleepwalker can do:

Make sure you get plenty of rest; being overtired can trigger a sleepwalking episode.
Develop a calming bedtime ritual. Some people meditate or do relaxation exercises; stress can be another trigger for sleepwalking.
Remove anything from the bedroom that could be hazardous or harmful.
The sleepwalker's bedroom should be on the ground floor of the house. The possibility of the patient opening windows or doors should be eliminated.

An assessment of the sleepwalker should include a careful review of the current medication so that modifications can be made if necessary.

Hypnosis has been found to be helpful for both children and adults.

An accurate psychiatric evaluation could help to decide the need for psychiatric intervention.

Benzodiazepines have been proven to be useful in the treatment of this disorder. A small dose of diazepam or lorazepam eliminates the episodes or considerably reduces them.

Tuesday, July 21, 2009

A Look at the Serious Health Effects of Having Sleep Apnea

Sleep apnea is not a disorder to be taken lightly nor is it something that will go away on its own with time. In fact sleep apnea is classified as being a “progressive disease” which means that just like cancer, diabetes and heart disease it gets worse with time. There is a lot of debate in the medical community about the effect that sleep apnea has on other medical problems. There is a definite connection between sleep apnea and these physical conditions- high blood pressure, diabetes, heart failure, heart attack, kidney failure, pulmonary hypertension and stroke.

More and more research is looking into why the above conditions are related to problems erupting in the upper airways of a person suffering from sleep apnea. It is well known that being overweight, smoking and abusing alcohol plays a role in sleep apnea and in turn leads to a greater chance of developing heart disease and hypertension. However it is not clear while some people who do not have any of these problems regarding their lifestyle still develop sleep apnea.

When there is a cessation of breathing during a sleep apnea episode the bloodstream shows higher levels of carbon dioxide while oxygen levels decrease. As a result of this, a series of chemical and physical events takes place in the body that then increases the risk of other problems arising in the body.

In individuals who suffer from sleep apnea and who are overweight, experts have discovered that they have high levels of immune factors known as tumor necrosis factor-alpha (TNF-alpha) and interleukin 6 (IL-6). High levels of both of these factors can cause serious inflammation in the body which can lead to cell damage, especially in the arteries. In one particular study it was shown that people with elevated levels of TNF-alpha suffered from shortness of breath, excessive tiredness and a “weak heart-pumping action.” However it must be said that to date no “clear causal relationship” between obstructive sleep apnea and heart disease has been scientifically established.

Many studies have been conducted to look at high blood pressure and sleep apnea. A link has been found between the two. To give an example, a study done in 2000 examined patients over a four year period and showed that the more apnea episodes they experienced in the first year, the greater risk was posed for them to develop hypertension by the third or fourth year. Even in those who snored or experienced mild sleep apnea there was a “weak but still higher than normal association with high blood pressure.”

In the past the connection between sleep apnea and hypertension was believed to be strongly linked to obesity. However recent studies are pointing to other findings, which is that hypertension is particularly high in individuals who suffer from sleep apnea no matter what their weight is.

Blood pressure affects sleep apnea because it fluctuates tremendously during repeated sleep apnea episodes. These fluctuations are also related to changes in the form of sudden surges that take place in the sympathetic nervous system. The sympathetic nervous system “controls involuntary muscles, importantly those in the blood vessels and heart.” It is strongly believed that as time passes, these fluctuations could play a significant role in the development of permanent long-term hypertension.

Cure your snoring problem

Friday, July 24, 2009

Sleep Walking in Detail

Sleepwalking Overview

Sleepwalking Causes

Sleepwalking Symptoms

When to Seek Medical Care for SleepWalking

Sleepwalking Treatment

Medical Treatment

Other Therapy

Prevention

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Sleep Walking Dog

Sleep Walking Dog

Sleep Apnea

Sleep Apnea

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All about Insomnia

Insomnia

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What is Narcolepsy or Sleep Attacks

Narcolepsy or Sleep Attacks

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What is Sleep Walking

Sleep Walking

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Tuesday, July 21, 2009

A Look at the Serious Health Effects of Having Sleep Apnea

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