November 29, 2007
Sleepless in Seattle? UW sleep disorders clinic can help
By Dr. Vishesh Kapur and Dr. Nathaniel F. Watson
UW Medicine Sleep Disorders Clinic
If you notice yourself nodding off during meetings, or catching a quick snooze on the bus during your morning commute, you probably aren’t the only one. More than half of us have some difficulty sleeping at night, according to a survey conducted by the National Sleep Foundation in 2004.
Most adults need from seven to nine hours of sleep to be fully alert. The best time for this sleep is during the two periods every night and afternoon when our bodies have a natural tendency to sleep: midnight to 7 a.m. and 1 p.m. to 4 p.m.”
While it’s normal to be tired on occasion, sleepiness is a medical problem when it interferes regularly with daily activities or affects our ability to function.
The best way to diagnose a sleep disorder is through an evaluation by a sleep specialist, which often includes an overnight polysomnogram test at a sleep center. During a polysomnogram, electrodes are placed on your scalp, temple and chin region to monitor brainwaves and eye and muscle movements during sleep. Your heart, breathing and oxygen levels are also monitored, and a sensor is placed on your neck to measure snoring.
- The most common sleep problem is insomnia: difficulty falling asleep, waking up frequently during the night and having difficulty returning to sleep, waking up too early in the morning or waking up unrefreshed. Insomnia has many causes including stress, environmental noise, jet lag and medications. It’s often associated with depression, and it occurs more frequently as we age.
For occasional insomnia, treatment may consist of behavioral changes such as refraining from caffeine, alcohol or tobacco before bedtime, limiting daytime naps and maintaining regular sleep schedules. Short-term use of sleeping pills may also be part of the treatment plan.
With severe insomnia, it’s possible that other sleep disorders such as sleep apnea or restless leg syndrome are involved and an evaluation by a sleep specialist is recommended.
- An estimated 12 million Americans suffer from obstructive sleep apnea, which occurs when your throat collapses briefly during sleep. Each time this happens, your breathing stops or gets very shallow. Common symptoms are loud snoring, choking or gasping during sleep and feeling tired during the day. Many people with sleep apnea are also overweight.
The Sleep Center at Harborview offers expertise in the full spectrum of effective treatments for sleep apnea. The most common treatment for severe sleep apnea is continuous positive airway pressure. With this treatment, pressurized air from a machine flows through a mask worn over your nose to keep your airway open during sleep.
For some patients, surgery may be recommended. As part of our Sleep Center, we have a surgery clinic, which offers a full range of treatments including nose, palate, pharynx, tongue, larynx, facial bones and tracheotomy surgeries. Dental appliances, which are worn in the mouth at night, have also been shown to be effective in treating sleep apnea in some patients. A dentist experienced in this therapy is affiliated with the Sleep Center.
Other treatment recommendations include weight loss, behavioral changes such as avoiding alcohol, tobacco, and medications that make you sleepy (because they also relax your throat muscles) and sleeping on your side.
- Narcolepsy is a serious sleep disorder. Symptoms include excessive sleepiness or falling asleep at inappropriate times and places during the day even after adequate sleep at night. Treatment of narcolepsy can substantially improve symptoms and quality of life.
- Restless leg syndrome involves unpleasant sensations (creeping, crawling, tingling, pulling or pain) in the legs, especially in the evening and night. This syndrome is often accompanied by frequent and involuntary leg movements while asleep. For this condition, an evaluation for iron deficiency is helpful since lack of iron may cause the problem. There are effective medications that can be prescribed by your doctor to treat this condition.
Drs. Vishesh Kapur and Nathaniel Watson are co-directors of the UW Medicine Sleep Disorders Center at Harborview. For more information, call 206-744-4999 or go to www.harborview.org.
