Common Sleep Disorders, Insomnia, Narcolepsy Essay
People who suffer from the most common sleep disorder, insomnia, have difficulty falling or staying asleep. Sleepiness caused by insomnia reduces concentration and slows reaction time during waking hours, leading to reduced productivity and accidents. One in three adults experiences some degree of insomnia at one time or another, especially during periods of stress. Longer-lasting cases of insomnia, called chronic insomnia, are less common and may be caused by a number of factors in addition to stress, including imbalances in body chemistry or other medical conditions.
Taken under the guidance of a qualified physician, sleeping pills are an effective treatment for temporary insomnia and may help some chronic insomnia patients. In some cases of insomnia, psychological treatments and physical exercise programs help patients identify or manage stress, enabling them to sleep better. Recent work has suggested that melatonin, a hormone naturally released into the bloodstream during the hours of darkness, may play a role in synchronizing sleep to a 24-hour cycle. Results from studies of the effects of melatonin on human sleep have been inconsistent. However, some evidence suggests that supplements of this hormone combat insomnia in older people who are melatonin deficient.
Narcolepsy is a sleep disorder that affects both NREM sleep and REM sleep mechanisms. Narcoleptics are persistently sleepy and experience periodic losses of muscle tone called cataplexy. During cataplectic attacks, the narcoleptic's muscles weaken, and if the attack is severe, the narcoleptic falls to the ground. Cataplectic attacks are triggered by sudden strong emotional reactions, such as laughter. A related symptom, called sleep paralysis, can occur when the narcoleptic is lying down, prior to falling asleep or just after awakening. At these times the person may lose muscle tone, resulting in an apparent paralysis, while remaining fully awake. Sleep paralysis can be terrifying if the narcoleptic does not realize that it is not life threatening. Animal studies have shown that the loss of muscle tone experienced by narcoleptics in waking results from an activation of the REM sleep-active and an inactivation of the REM sleep-inactive systems that normally function to reduce muscle tone in REM sleep. Narcoleptics are treated with stimulants to block sleepiness and with REM sleep suppressants to block cataplexy.
Children often experience one of several sleep disorders. Nocturnal enuresis, commonly known as bedwetting, typically occurs during NREM sleep. Sleep talking and sleepwalking also usually occur during NREM sleep (see Somnambulism). Night terrors, typically marked by a scream and a terrified, confused awakening, affect many children. These disorders do not indicate any serious neurological or behavioral problem. Children suffering from them usually outgrow them by puberty, although sleep talking and sleepwalking may persist into adulthood.
In another common disorder, sleep apnea, relaxation of the muscles of the tongue and the soft palate at the base of the throat, allows the breathing passage to collapse in individuals with a narrow airway. Although chest movements may continue, no air flows into the lungs and oxygen levels in the blood decrease. When blood oxygen levels fall too low, the person briefly wakes to take a breath. This gasping breath can produce a loud, characteristic snort. The cycle of sleeping, airway collapsing, waking, and sleeping repeats, often hundreds of times in a night. Individuals with sleep apnea do not remember these brief awakenings and believe they slept through the night. However, the interrupted sleep leaves the individual exhausted in the morning and sleepy throughout the day. If left untreated, sleep apnea may also cause cardiovascular problems and greatly shorten life span. Effective treatments are available at medical centers specializing in sleep disorders. One treatment, called continuous-positive-airway-pressure (CPAP), uses a mask to deliver a stream of air through the nose, preventing airway collapse, restoring normal sleep. Sometimes surgical treatments that enlarge the airway can be effective.
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