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Sleep Disorders
Firstly, a kind note that this website is designed to be as user friendly and informative as possible for you, our clients. Therefore the information provided here is mostly in non-medical terms. Should you be in need of more scientific information, please feel free to contact us at any time.

Sleeping is responsible for a very large and important part of the health of our body and mind. Sleeping is not only there for our bodies to rest, it is also during sleep that our minds store memories and our bodies produce and release various hormones. The following paragraphs will give a brief description of the most common sleep disorders, why it happens and how we test for each kind of disorder.
 
  Sleep Apnea
Sleep apnea simply means to “stop breathing in your sleep”. Sounds scary, doesn’t it? Even more reason for concern is the alarming amount (about 4%) of South Africans with this condition that goes through life undiagnosed and untreated.

What is sleep apnea?
During sleep, the muscles of our body lose their muscle tone and become “floppy”. In some people this may lead to the repeated collapse of their airway, leaving the person unable to breathe for periods of 10 seconds-2 minutes, or even longer. It is not painful and because it happens during sleep, the person is usually unaware of it. In order to open the airway to breathe again, the brain needs to wake up slightly to restore muscle tone to the airway. Each time this happens, the patient’s sleep architecture becomes disrupted, which eventually leads to tiredness during daytime. This disturbance of the sleep architecture, together with the strain of apnea on the heart can explain most of the symptoms listed below:

Signs and Symptoms of Sleep Apnea:

  • Snoring with gasping for air   (Most Common)
  • Daytime Sleepiness              (Most Common)
  • High Blood Pressure
  • Diabetes
  • Depression
  • Decreased Libido and Sexual Dysfunction
  • Decreased Memory and Concentration
  • Heartburn at night
  • Excessive Sweating at night

Are You at Risk for Sleep Apnea?
Answering “yes” to any of the following questions means you may be at increased risk for suffering from sleep apnea and that you should probably attend to it.

  • Do you snore?
  • Do you gasp for air during sleep?
  • Has your partner ever seen you stop breathing during sleep?
  • Do you wake up still feeling tired?
  • Do you become drowsy inappropriately during daytime?
  • Are you overweight?
  • Do you suffer from high blood pressure or diabetes?

How is sleep apnea diagnosed?
The best way to diagnose sleep apnea and determine its effect on the functioning of your body is by means of an Overnight Polysomnogram, more commonly referred to as a sleep study. A proper sleep study should last for about 8 hours of sleep and should measure the following:

  • Brainwave activity      (to determine the disturbance in the sleep architecture)
  • Eye movement
  • Snoring                    (an indicator of airway instability) 
  • Muscle tone
  • ECG                         (evaluates the heartbeat)
  • Leg movements         (refer to the segment for Periodic Leg Movements)
  • Airflow at the nose     (to monitor breathing)
  • Respiratory effort at the chest
  • Respiratory effort at the abdomen
  • Oxygen saturation
  • Body position

By measuring all of these parameters we can determine if a person has sleep apnea, how severe it is, the type of sleep apnea (which determines the treatment) and the influence on the sleep architecture which in turn effects your health as a whole.

For more information on Sleep Apnea or to book a Sleep Study appointment, please Contact Us.

How can sleep apnea be treated?

Sleep apnea can be treated very efficiently with Continuous Positive Airway Pressure or CPAP therapy. This is a small bedside device that delivers a constant column of air to the person, through a mask that fits over the nose. This column of air then keeps the airway open while you sleep, thus preventing sleep apnea and also at the same time eliminates snoring. Once the sleep apnea is taken care of, your body can restore its necessary sleep, restore various hormone levels and often improve blood pressure levels. New technology allows these devices to be small, noise free (about 23dB) and relatively easy to use. Overall, this treatment is not much effort on a sleep apnea sufferer’s behalf, if one considers the increased quality of life that it restores.


Before treatment with CPAP therapy can start, the correct pressures at which the machine should blow air have to be determined. This is done by repeating the complete sleep study, with the addition of an adjustable CPAP machine (otherwise known as a CPAP titration). The correct pressure is then determined for the home use of the machine. It is important to once again evaluate all the parameters of the first night’s sleep study in order to compare the patient’s condition with and without the CPAP therapy. Furthermore, if the pressure that is set for home use is too low, it will not treat the apnea at all, while if the pressure is too high it has potential side effects and may even worsen the sleep apnea. Repeating the CPAP titration is suggested after every 3-5 years of CPAP use, to ensure that the treatment and CPAP pressure are still optimal. If necessary, adjustments may then be made.

For more information on CPAP therapy or to book a CPAP titration appointment, please Contact Us.

 
  Periodic Leg Movements of Sleep

Periodic Leg Movements of Sleep is also known as Periodic Limb Movements of Sleep and they can both be abbreviated as PLM. As the name suggests, this sleep disorder causes involuntary, small movements of the limbs (usually the legs) while a person is sleeping. If enough of these movements occur, it may disrupt a person’s sleep architecture to cause similar symptoms to that of sleep apnea. The most common symptom of PLM is excessive daytime tiredness, which is also the case in sleep apnea. This is the reason why a proper sleep study should include testing for PLM and sleep apnea at the same time, in order to differentiate between the two disorders. Although PLM and sleep apnea are two different disorders, they may occur simultaneously in the same person. After this disorder has been identified with a sleep study, treatment may vary, but usually involves some medication.

Signs and Symptoms of PLM

  • Excessive daytime sleepiness
  • Decreased memory and concentration

Are you at risk of suffering from PLM?
If you have one or more of the following, you are at increased risk to suffer from this type of sleep disorder. A sleep study may be of value to evaluate the degree to which your sleep is disrupted and to quantify the extent of the problem.

  • Do you wake up feeling unrefreshed?
  • Does your partner complain of your “kicking” at night?
  • Have you ever suffered a lower back injury?
  • Are the Iron levels in your blood within normal limits?
  • Do you suffer from Restless Leg Syndrome?

For more information on PLM or to book a sleep study appointment, please Contact Us.

  Narcolepsy
 

Narcolepsy is a sleep disorder, which may easily be confused with sleep apnea. The reason for this is because both of these disorders share the main symptom of the person falling asleep inappropriately, for example in conversation or while stuck in traffic. Therefore, it may sometimes be difficult to differentiate between narcolepsy and sleep apnea. The correct diagnosis, however, is very important, as the treatment is completely different for the two disorders. Narcolepsy is usually treated with medication and sleep apnea by means of CPAP therapy.

Narcolepsy is essentially a REM-sleep disorder, where the person will spontaneously fall asleep during daytime, starting at the deepest sleep stage or REM-sleep. In order to diagnose narcolepsy, a Multiple Sleep Latency Test (M.S.L.T.) may be requested. During this test, we monitor the person during

daytime to determine by means of his/her brainwave activity, how easily he/she falls asleep and whether the person enters REM-sleep faster than what is expected.

Are you at risk of suffering from Narcolepsy?
If you answer “yes” to one or more of the following, you might be suffering from this disorder. Doing a M.S.L.T. may be of value to help reach a proper diagnosis.

  • Do you sometimes fall asleep inappropriately?
  • Do you sometimes fall down after experiencing sudden emotion? (Cataplexy)
  • Do you sometimes upon waking up in the morning experience the feeling of your mind being awake, but you are unable to move your body? (Sleep paralysis)
  • Do you sometimes when falling asleep or just as you wake up, experience very real, colorful dreams? (Hypnogogic hallucinations)

For more information on Narcolepsy or to book a M.S.L.T. appointment, please Contact Us.

  Insomnia

Insomnia is a very common sleep disorder that can be diagnosed and treated. Insomnia basically boils down to the inability of a person to fall asleep or to stay asleep through the night. This may lead to the person feeling tired in daytime and may also have other consequences, like irritability, decreased concentration/memory and depression.

The origin of insomnia can have many contributing factors. Therefore a sleep study may be recommended to reach a diagnosis, ensuring optimal treatment. The role of a sleep study will then be to include or exclude sleep apnea and leg movements as part of the problem. A sleep study can also provide a quantitative measure of your sleep stages in order to reflect your true sleep efficiency and can also identify spontaneous arousals from sleep.

For more information on Insomnia or to book a Sleep Study appointment, please Contact Us.
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