This post was written based on an appearance by Ram Verma, MD, on the program PBS HealthLine.
Quality sleep is a foundation of overall good health; however, more than 50 million Americans suffer from some form of sleep disorder. In addition to disrupted rest, left untreated, these conditions can contribute to and worsen other serious health issues, including high blood pressure, diabetes, migraines, depression, anxiety and heart disease, leading to poorer mental and physical well-being. Here, we cover some of the most common sleep disorders, their symptoms, how they're diagnosed and two new treatment options.
Sleep apnea
Sleep apnea is a breathing disorder marked by a complete pause in breathing or reduced airflow to the lungs during sleep. The most prevalent type is obstructive sleep apnea, when the airways are entirely or partially blocked. Central sleep apnea, which is less common, happens when the brain has difficulty regulating breathing.
Symptoms include:
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Loud snoring
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Gasping for air during sleep
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Waking frequently
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Daytime sleepiness
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Feeling tired upon waking
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Morning headaches
Monitoring sleep and oxygen levels at home with wearables can provide valuable insights for individuals who are not ready to undergo testing for sleep apnea. Learn more from Dr. Verma about the advantages of tracking this data here.
Narcolepsy
Narcolepsy is a chronic neurological disorder that impacts the brain's ability to regulate sleep-wake cycles. Those with narcolepsy may experience excessive daytime sleepiness and may fall asleep suddenly and without warning, even during activities like driving or eating.
Symptoms include:
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Sleep paralysis
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Cataplexy or sudden loss of muscle tone
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Hallucinations when falling asleep or waking
Insomnia
Insomnia is the most common sleep disorder, affecting approximately one-third of adults worldwide. People with insomnia struggle to fall asleep, stay asleep or achieve quality sleep. The condition can be acute and arise due to a specific event that disrupts sleep. However, if it takes more than 30 minutes to fall asleep or if a person wakes up in the middle of the night more than three times a week for at least three months, it is classified as chronic insomnia.
Symptoms include:
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Waking sooner than intended
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Frequent waking and trouble falling back asleep
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Feeling tired or unrefreshed upon waking
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Feeling irritable, drowsy or anxious during the daytime
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Difficulty paying attention, focusing on tasks or remembering to do things
Many individuals with sleep apnea also present symptoms of insomnia due to frequent waking caused by low oxygen.
Hypersomnia
Hypersomnia refers to excessive daytime sleepiness. Despite sufficient rest, this condition makes staying awake and alert during the day difficult. It can indicate other underlying sleep-related issues, like sleep apnea or narcolepsy, but it can also occur without a specific cause.
Symptoms include:
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Difficulty waking up despite long sleep hours (10+ hours)
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Additional sleep doesn't improve alertness
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Feeling anxious or irritable
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Restlessness
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Slow thinking and speech, difficulty focusing or concentrating, and memory problems.
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Loss of appetite
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Hallucinations
Diagnosing and treating sleep disorders
The gold standard for diagnosing disorders like narcolepsy and sleep apnea is conducting a sleep study in the sleep lab, but technological advancements have made it possible to perform initial testing from the home.
Check out this video with Dr. Devanathan for a closer look at in-home sleep studies here.
Medical providers can often identify insomnia through conversations surrounding an individual's clinical history and daily habits. In cases of chronic insomnia, a sleep study can determine if restlessness is linked to other sleep disorders, underlying medical conditions or poor bedtime practices. Similarly, because idiopathic hypersomnia has no actual cause, diagnosing the condition requires the elimination of different disorders with overlapping symptoms.
CPAP and BiPAP machines
Continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) machines are standard treatments for sleep apnea. These devices help keep airways open during sleep by providing steady airflow. Recent advancements have made these machines and their masks more comfortable and effective. Adjustable settings and updated mask designs give patients more control over the fit and overall experience.
Inspire® therapy
For those who struggle with CPAP or BiPAP, newer treatments like Inspire Therapy offer a promising alternative. Inspire Upper Airway Stimulation (UAS) acts like a pacemaker for the airway. A small device is implanted under the skin and sends signals to the tongue to move forward with each breath, keeping the airway open.
This therapy is particularly beneficial for adults who cannot tolerate CPAP, though candidates must meet certain criteria before placement. The results have been encouraging, with many patients experiencing significant improvements in their sleep quality. Studies are also being conducted for pediatric patients, especially those with Down syndrome, who may find it difficult to use masks.
Read Scott's story about his successful experience with Inspire Therapy here.
Phrenic nerve stimulation
For patients with central sleep apnea, traditional CPAP or BiPAP machines or even adaptive servo-ventilation (ASV) devices may not be effective. In these cases, phrenic nerve stimulation therapy may help. This treatment method involves implanting a device that uses electrical stimulation to help patients breathe by contracting the diaphragm. A cardiologist places the implant, and the settings are managed afterward to ensure proper functioning.
Final thoughts
Although sleep requirements can change with age and vary from person to person, most adults need 7-9 hours of restorative sleep each night. If you're not meeting this target consistently, it may be worth consulting your primary care provider about a referral to PPG—Sleep Medicine for an in-lab or home sleep study.
