What is it?

There are many diseases and organic conditions that can cause one disturbances of sleep, but there are two main organic etiologies for sleep disorders- narcolepsy and sleep apnea.
Sleep apnea is a p sleep disorder in which breathing repeatedly stops and starts. The main types of sleep apnea are:
- Obstructive sleep apnea: the more common form that occurs when throat muscles relax
- Central sleep apnea: which occurs when the brain doesn't send proper signals to the muscles that control breathing
- Complex sleep apnea syndrome: also known as treatment-emergent central sleep apnea, which occurs when someone has both obstructive sleep apnea and central sleep apnea.
Narcolepsy is a neurological disorder in which there is a decreased ability to regulate sleep- wake cycles. These people tend to have long daytime sleep episodes, and most of them may experience episodes of sudden loss of muscle tone- a phenomenon called cataplexy. The cause of narcolepsy is not yet known. In some cases, there is a family history of the disorder and some may have low levels of orexin neuropeptide- suggesting an autoimmune etiology. In rare cases, it can be caused by traumatic brian injury.

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Additional names

This group contains additional names:
- Congenital Central Alveolar Hypoventilation Syndrome
- Confusional Arousals
- Organic Insomnia
- Sleep Related Bruxism
- Periodic Limb Movement Disorder
- REM Sleep Behavior Disorder

Signs & symptoms

The signs and symptoms of obstructive and central sleep apneas overlap, sometimes making it difficult to determine the type of apnea. The most common signs and symptoms of obstructive and central sleep apneas include: Loud snoring,episodes of stop breathing during sleep, gasping for air during sleep, awakening with a dry mouth, morning headache, difficulty staying asleep , excessive daytime sleepiness (hypersomnia), difficulty paying attention while awake and irritability.
Narcolepsy symptoms may include excessive daytime sleepiness (hypersomnia), sudden loss of muscle tone, sleep paralysis, changes in REM sleep and hallucinations.

Diagnosis

Sleep apnea evaluation often involves overnight monitoring at a sleep center of breathing and other body functions during sleep. Home sleep testing also might be an option. Tests to detect sleep apnea include:
- Nocturnal polysomnography: During this test, equipment that monitors the heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels are connected to the body while sleeping.
- Home sleep tests: simple tests to be used at home to diagnose sleep apnea. These tests usually measure heart rate, blood oxygen level, airflow and breathing patterns.
Narcolepsy evaluation is based on the patient’s symptoms. In addition, there are three tests being used:
-Polysomnography
-The Epworth sleepiness scale- a questionnaire administered to determine likelihood of sleep disorder.
- The multiple sleep latency test which checks for excessive daytime sleepiness by measuring how quickly the patient falls asleep in a quiet environment during the day.

Treatment

For milder cases of sleep apnea, doctors may recommend only lifestyle changes, such as losing weight or quitting smoking. If there are nasal allergies, doctors will recommend treatment for the allergies. If these measures don't improve signs and symptoms or if the apnea is moderate to severe, a number of other treatments are available.Certain devices can help open up a blocked airway. In other cases, surgery might be necessary.
- Continuous positive airway pressure (CPAP): A machine that delivers air pressure through a mask while sleeping.
- Oral appliances: Another option is wearing an oral appliance designed to keep the throat open.
- Supplemental oxygen: Using supplemental oxygen while sleeping might be helpful for central sleep apnea
- Surgery: Usually only an option after other treatments have failed. Generally, at least a three-month trial of other treatment options is suggested before considering surgery. However, for a small number of people with certain jaw structure problems, it's a good first option.
Narcolepsy treatment may include medications such as stimulants (modafinil, sunosi, concerta, ritalin) SSRIs or SNRIs (prozac), tricyclic and sodium oxybate (Xyrem)

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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