Sleep Disorders

23 November 2010

Sleep Expert answers sleep questions

The Sleep Expert answers important questions about insomnia, Restless Leg syndrome, snoring, sleep apnoea and other conditions that are keeping people awake.

The Sleep Expert answers your questions about insomnia, Restless Leg syndrome, snoring, sleep apnoea and other conditions that are keeping people awake, and affecting their health.

Q: Excessive snoring

Good morning, I snore so loudly and excessively that myself and my wife use seperate bedrooms. I wake up three to four times a night and then I can't breathe.  It feels like I'm being suffocated, obviously this is not normal - what can I do?

AYou are quite correct - this is not normal. It sounds like you may be suffering from a condition called Obstructive Sleep Apnoea. This is a common condition, occurring in about 10% of men.

In severe cases there may be a 7 times higher risk of falling asleep at the wheel, and a 23 times higher risk of heart attack, amongst other things. So right, you need it attended to.

You need to get to a sleep doctor, who will arrange for you to have a sleep test. Once this condition has been properly diagnosed, it can be effectively controlled. The treatment will depend on the severity of the condition, and your doctor will be able to discuss alternatives with you. It would be best if you got this attended to as soon as possible.
 

Q: Waking up 4:00am every morning anxious and restless

I have a problem having a full nights sleep without waking. I am on High blood pressure tabs and recently started a Vitamin B Boost, B1 and Calmag-C. I've cut down on HBP tabs by half a dose daily. I wake up at approximately 4am every morning anxious and restless, even with stomach upsets so I have to go to the toilet that time in the morning. My blood pressure also spikes to approximately 140/95 to 150/100, and I also have a cough - I don't smoke. After going to the toilet it returns to normal most times. Please let me know what the problem could be - I was always a great sleeper.

A: Firstly, unless you are malnourished or not having a balanced diet, you probably don't need the supplements. If you are taking them, make sure you take them in the morning - they can keep you awake if taken later in the day.

Early morning waking is typical of anxiety or depression - you might need to see someone about that, and if that does not solve the problem, you will probably need to see a sleep doctor.

Q: Can't fall and stay asleep, suffering from depression

I struggle to fall asleep, even when really tired, tossing and turning non stop.  When I eventually do fall asleep at some ungodly hour in the morning, I wake up at 5am!  During the day I struggle with a lack of energy and battle to concentrate, and usually by 10 or 11am, I just want to lie down and rest, but can't ever sleep during the day.

I am constantly tired and lacking the energy I used to have. I even yawn like mad in the gym! This lack of concentration and energy makes it hard for me to work, focus on studies or research, and of course be the fun dad I should be to my son. I am 44, otherwise in good health, relatively fit, and eat well.

It's been like this for many years, and I've always got around it by taking Valium or the odd stilnox, or even over the counter tabs. And then I would take Bioplus to try get that kick in the day, but that doesn't really help. I just need some good, solid sleep! If I do have a good night, then I am great the next day. Could it be depression, even though I don't think I am depressed?

A: Depression can certainly cause this kind of problem, and you should be checked out for that.

However, a sleep disorder can also cause depression. If you are otherwise in good health, get to a sleep doctor. You should not need the "energy boosters", Valium, etc.  If there is no other cause for it, these problems can usually be sorted out without medication.

Q: Restless legs

I am suffering terribly from restless legs and can't sleep at night. Is this perhaps from an iron deficiency? What medication can I take to ease it or prevent it? It's so frustrating. I do think I have a chemical imbalance as I suffer with panic/anxiety disorder -  could it be from my dopamine levels? Please help.

A: Some people get restless legs from a problem with their iron metabolism. You can ask your doctor to run an iron profile on a blood test. Usually intravenous iron is recommended, but sometimes oral iron will work.

For your anxiety disorder it's important that you see a psychiatrist.

Q: Sleep paralysis question

I have been wanting to ask this - also read your reply to a previous thread regarding sleep paralysis. I've tried finding the answers to these questions, but would appreciate your input:

What contributes to this condition? This happens to me just before I fall asleep and at other times it happens when I'm asleep and it wakes me up. These are my ''symptoms":  I get pins and needles throughout my body, I get very hot, I hear like tinkling (can't describe the sound) and I'm unable to move or talk.  My heart then races (I think that's because I get very scared as I can't explain this).

Is there any research on a possible association with nutrition (lack thereof) and this? Is it actually sleep paralysis, and, if so, what may prevent further occurrences?

A: What you are describing does indeed sound like sleep paralysis.  It has nothing to do with nutrition.

When we go into the dream stage of sleep (so-called REM sleep) our muscles become paralysed. This prevents us from acting out our dreams, in other words sleep-walking. When this paralysis happens at a time it shouldn't, then one gets sleep paralysis. Very frightening, but of no health consequences.

Q: Sleeping tablets and dreams

My doctor prescribed tripilene for cluster headaches and adco solpidem for my sleep problem. I seem to be wide awake at night and can't fall asleep. If I do, I dream a lot and feel tired the next day. I am also using iron tablets, as well as pain tablets during the day due to headaches from the lack of sleep. I have tried Melatone, but it made it worse!  Any suggestions on how to correct this?

A: Sleeping tablets will not work on a long-term basis - your body very rapidly becomes used to them. You need to be assessed by a sleep doctor, who will firstly try to determine the cause of the problem. After that, the best approach is using a technique called cognitive behavioural therapy, which does not involve medication, and which works much better.

Q: Sleepwalking and talking

I have always talked in my sleep but the other night my b/friend said I got up took a torch from next to my bed and went walking around the lounge. I haven't walked in my sleep before (besides once when I was 5). The other night I apparently sat up in bed and was talking/mumbling. What causes this – and should I worry?

A: This generally happens during the dream phase of sleep. At this time the muscles normally become paralysed - to stop you acting out your dreams. For some reason this didn't happen.

It is only a problem if you start walking about, when it could be dangerous, for example if you were to walk through a glass door. Then we would want to put you onto medication to stop it happening.

Q: Narcolepsy

My 9-year-old went through some tests, including an EEG - we all thought she was suffering with ADHD or epilepsy as she falls asleep sometimes 3-4 times a day the moment she's relaxed or over-exited. She has a loss in muscle strength for a few minutes. But, in the end the diagnosis seems to be narcolepsy. She is very bight and talented  -  she's been put on Concerta 36mg (18 mg was not enough). She is 85% better during the daytime but we still have difficult nights as she dreams the moment she falls asleep and wakes up with a shock and beating heart 5 - 10 min later. Now she is sleeping through app 3 - 4 nights a week.
What can I do from my side to help - will she need more medications as she gets older - can I do something to prevent her needing more medication in the future?

A:  There are other medications which can help the loss of muscle tone during the day, and which may also help to reduce the dreaming a bit. We often use a group of chemicals called the tricyclics - discuss this with your doctor.

Also, if she can learn to have naps at pre-determined times of day, this often helps to reduce the amount of Concerta she may need.

Visit the Sleep Centre

Sleep disorders

http://www.health24.com/medical/Condition_centres/777-792-3529.asp

(Joanne Hart, Health24, November 2010)

 

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Ask the Expert

Sleep disorders expert

Neera Bhikha is a Neurophysiologist at SandtonMedi Clinic in Johannesburg. She specialises in Neurodiagnostic testing which includes EEG (routine and long term monitoring sleep studies), Polysomnograms, Nerve conduction studies/EMG studies.

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