| Sleep Disorders
Sleep
disorders affect more than 10% of the population.
Effective treatments are available for some, whereas
the cause and cure for others remain unknown.
1.
Sleep apnea. This periodic interruption of
breathing, characterized by loud, interrupted snoring,
affects more than 5% of adult males and can shorten
lifespan more than smoking a pack of cigarettes a day.
Sleep Apnea causes interrupted snoring. You can listen
to an example of sleep apnea by clicking
here. Sleep
apnea is caused by the excessive relaxation of airway
muscles during sleep. It can be treated by wearing a
mask that pressurizes the airway, a procedure called
CPAP, or continuous positive airway pressure. In mild
cases, weight loss and preventing sufferers from
sleeping on their backs can help.
2.
Insomnia. This is even more common than sleep
apnea. Sleeping pills can be helpful for short-term
insomnia, but may not benefit, and may even have
significant adverse effects, on individuals with
long-term insomnia. Insomnia is more common later in
life, but the cause of this is unclear. One syndrome
that is known to produce a profound insomnia is
“restless legs with periodic movements during
sleep.” "Restless legs" refers to an urge
to move the legs that increases during quiescence.
Periodic movement during sleep, a frequent
accompaniment of restless legs, is a regular
twitching, usually occurring every 5-90 seconds in the
legs during non-REM sleep and can also disturb sleep.
Periodic movement during sleep is present in as much
as 10% of the adult population.
3.
Parasomnias. These events happening during
sleep are particularly common in children. Night
terrors, in which children scream during the night,
sleep walking and bedwetting are some of the most
common and are generally outgrown with age.
Parasomnias include bruxism, a grinding of the teeth
that can be treated by wearing a dental device.
4.
REM sleep behavior disorder. This disorder is
characterized by vigorous movements occurring during
REM sleep as the dreamer acts out his or her dream.
The patient and those sharing the bed can be injured.
Effective drug treatments, often using the
benzodiazepine clonazepam, are available.
5.
Narcolepsy. This disorder is characterized by
excessive daytime sleepiness and sudden loss of muscle
tone in waking called cataplexy. The cause of most
human narcolepsy has been identified in recent studies
in our laboratory and in other laboratories, as a loss
of a chemical called hypocretin. The release of this
chemical by a group of brain cells in a region called
the hypothalamus normally helps maintain muscle tone
and extend the duration of waking periods through its
excitation of monoaminergic neurons and of neurons
containing the neurotransmitter acetylcholine. Joshi
John and Frank Wu in our group have conducted a
successful first test of hypocretin administration as
a treatment for canine narcolepsy. We are hopeful that
this treatment will be useful for human narcolepsy.
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