Sleep Medicine

Facts about sleep disorders

Loss of sleep can cause problems at home or on the job. It can lead to serious or even fatal accidents. The National Sleep Foundation notes that:

• Between 50 and 70 million U.S. adults have some type of sleep or wakefulness disorder.
• Sleep problems often get worse as you get older.
• Poor sleep costs billions of dollars a year. This is from health care expenses and lost productivity.
• About 20% of motor vehicle crashes are linked to drowsy driving, with a total of about 300,000 police-reported crashes, over 100,000 injuries, and as many as 6,400 deaths each year.

Types of sleep disorders

There are many types of sleep disorders. They can affect health and quality of life. The disorders include:

• Insomnia.
• Sleep apnea.
• Sleepwalking.
• Bed-wetting.
• Nightmares.
• Night terror.
• Restless legs syndrome.
• Snoring.
• Narcolepsy.

Why is sleep important?

Sleep is not just resting or taking a break from busy routines. Sleep is a key part of good health. Getting enough sleep may help the body recover from illness and injury. Not getting enough sleep over a period of time is linked to health problems. They include obesity, diabetes, and heart disease.

The mental benefits of sleep are also important. Sleep problems can make daily life feel more stressful and less productive. Some people with chronic trouble sleeping (insomnia) are more likely to have mental health problems. Sleep problems are also tied to depression. And people with insomnia may have trouble doing tasks that use memory and learning.

How much sleep do you need?

Sleep needs vary from person to person, and your needs change over the course of your life. But most healthy adults need about 7 to 9 hours of sleep a night. You may need more or better sleep if you:

• Have trouble staying alert during quiet activities.
• Are irritable with coworkers, family, or friends.
• Have trouble focusing or remembering facts.
• Have trouble falling asleep or staying asleep, or you wake up early and can't get back to sleep.

Getting treatment for a sleep disorder

For those who suffer from sleep disorders, help is available from many sources. Sleep problems can be treated or managed by different kinds of doctors. You may be treated by a doctor who specializes in:

• Internal medicine.
• Gerontology.
• Pediatrics.
• Family practice.
• Pulmonary medicine.
• Neurology.
• Psychiatry or psychology.
• Otolaryngology.

You can also find a doctor who is certified in sleep medicine by the American Board of Sleep Medicine. Talk with your doctor about finding a sleep disorder program.

When you're struggling to sleep or suffering from sleepiness during the day, many factors could be at play. You may be drinking too much caffeine or staying up too late. Or perhaps you have a medical condition or sleep disorder that's causing this extreme tiredness (fatigue).

To find out the cause of your sleep problems, you may need many tests. These may confirm or rule out various health conditions and other problems.

Hematocrit and hemoglobin test

You may need a hematocrit/hemoglobin blood test to measure the levels of these substances in your blood. If you have low levels of either of them, or both, you have anemia. This is a blood disorder that can cause you to be tired and sleepy during the day. It can also lead to restless legs syndrome. Abnormal levels of hemoglobin may also mean you have an iron deficiency, chronic illness, or lung disease. All of these can contribute to sleep problems.

Arterial blood gases test

An arterial blood gas test measures the levels of gases, including oxygen, and carbon dioxide, in the blood. The test is done by drawing blood from an artery in the wrist. This takes only a few minutes. The test can diagnose or rule out many conditions, including problems with breathing. Trouble breathing, shortness of breath, and sleep apnea can affect sleep.

Thyroid function test

Thyroid function can be assessed by checking the levels of thyroid hormones in the blood. These hormones help regulate the body's metabolic processes. A thyroid function test may signal an underactive thyroid gland. This is called hypothyroidism and it may cause fatigue and lethargy. Or it may show an overactive thyroid, a condition called hyperthyroidism. This can cause insomnia or fatigue. Either of these conditions can play a part in sleep problems.

Drug and alcohol toxicology screening

Testing for drugs and alcohol in the blood can help find out if they are the cause of sleep disorders, such as insomnia. People may use drugs or alcohol as sleep aids. But doing so can backfire. For instance, a glass of wine before bed can lead to drowsiness, so falling asleep is easy. But the alcohol can then cause middle-of-the-night wakefulness, resulting in insufficient sleep. You may give a blood or pee (urine) sample in either a doctor's office or a lab.

Epworth sleepiness score

This test is a questionnaire that helps assess how sleepy you are during the day. It also looks at how likely you are to fall asleep during daytime hours and during certain activities, such as watching TV or sitting in a car. Chronic daytime sleepiness may mean that you have a sleep disorder.

Beck depression index

This test asks questions to check for depression. The questions are about feelings of sadness, guilt, self-criticism, fatigue, sleep problems, and other symptoms that often signal depression. Depression and some of the medicine used to treat it are commonly linked to insomnia and other sleep disorders.

Electrooculogram

In sleep medicine, the EOG (electrooculogram) is used to find different types of eye movements during sleep. Electrodes that measure electrical signals based on eye movements are placed on the sides of the eyes. These let the doctor identify different stages of sleep, including rapid eye movement sleep. It's used as part of the polysomnogram.

Chin and leg electromyogram

The electromyogram test, or EMG, measures the electrical activity of the nerves in the chin and the legs. It's often done in a sleep clinic during a sleep study. It involves attaching electrodes to the skin on the legs and chin to record the activity of the muscles. The nerve activity can show increased activity of muscles during sleep.

Polysomnogram

A polysomnography test may be done to check the patterns of brain waves and other physical functions during sleep. The test is often done in a sleep clinic overnight to look at the body's activity during sleep. The test measures heart rate, respiration, muscle activity, blood pressure, brain activity, and eye movement. The test can show whether you are asleep and whether you have any problems in the sleep pattern. This test often includes an electroencephalogram (EEG), EOG, and EMG. The EEG measures brain activity.

Actigraphy

Actigraphy measures rest and activity cycles. It uses a wristwatch-type sensor that measures your body movements day and night over 1 to 2 weeks.