9.3 Other Sleep Disorders

Obstructive Sleep Apnea

The diagnostic criteria for sleep apnea—also referred to as sleep-disordered breathing—is that a person stops breathing for a period of at least 10 seconds at least five times per hour while sleeping. In severe cases, it can occur up to 100 times or more per hour. Among adults ages 30 to 70 years, approximately 13% of men and 6% of women experience obstructive sleep apnea (Peppard et al., 2013).

In people with obstructive sleep apnea, the airway narrows and becomes constricted, leading to reduced oxygen in the blood. This decreases the oxygen saturation of the blood, and when the brain is deprived of oxygen, it alarms the body to wake up, repeatedly disrupting sleep and leads to chronic sleep deprivation. The lapse in breathing often causes choking, gasping, or snorting sounds and usually loud snoring, although not everyone who snores has sleep apnea and not everyone with sleep apnea snores. Additional symptoms include: needing to urinate frequently throughout the night, waking up with a dry mouth, feeling unrefreshed upon waking, and feeling sleepy during the daytime. People with sleep apnea generally suffer from decreased attention, concentration, and memory, and are at an increased risk for clinical depression, diabetes, hypertension, and long-term cardiovascular problems.

Restless Leg Syndrome

Key characteristic of restless legs syndrome is an unpleasant sensation in the legs, such as a creepy-crawly feeling, pulling, deep itching, or other abnormal sensations known as paresthesias. The severity of these sensations can range from an annoying discomfort to pain. Moving or otherwise stimulating the legs—through massage or stretching, for example—is typically the only thing that temporarily relieves the sensation. Restless legs syndrome affects about 10-15% of Americans (Ohayon et al., 2012).

The reason restless legs syndrome is considered a sleep disorder is because the sensations begin during periods of rest or inactivity and are worse when sleepy and lying down. The discomfort or pain caused by these abnormal sensations and the subsequent need to move seriously disrupts sleep quality and duration. Restless legs syndrome is a cause of chronic insomnia (Ohayon et al., 2012).

Narcolepsy

Narcolepsy is a neurological disorder associated with REM sleep dysfunction and involves blurred boundaries between sleep and wakefulness. The hallmarks of narcolepsy are excessive daytime sleepiness, hallucinations, and sleep paralysis. People with narcolepsy often experience some form of cataplexy, a sudden and uncontrollable muscle weakness during wakefulness, sometimes triggered by strong emotions or vigorous activity (Longstreth et al., 2007). Additionally, those living with narcolepsy often experience very disturbed sleep throughout the night (Roth et al., 2013). Researchers estimate the prevalence of narcolepsy to be between 25 and 50 people per 100,000, but because of the symptoms, narcolepsy is often misdiagnosed as stroke, multiple sclerosis, schizophrenia, epilepsy, panic attacks, or as a side effect to medication (Longstreth et al., 2007).