March 1, 2004

Sleep Disorders Center Treats
Variety Of Sleep Problems

Tired of not sleeping? You're not alone. Several studies suggest that most Americans don't get enough sleep.

And this is not something to take lightly. Sleep deprivation has been linked to health problems such as high blood pressure, obesity, negative moods, and safety issues in the home, on the job, and on the road.

To help more people experiencing sleep disorders, the Health Center has expanded its capacity to study and treat these problems.

UConn's Sleep Disorders Center brings together experts from specialties including pulmonary medicine, dentistry, neurology, psychiatry, and ear, nose and throat surgery.

Sleep studies are conducted overnight in four private rooms. Patients typically arrive between 8 p.m. and 10 p.m. and are encouraged to bring items from home that make them feel comfortable, such as favorite pajamas, blankets, or pillows.

Once they are settled in, patients are connected to the nocturnal polysomnograph, a tool that measures a variety of activities such as brain activity, eye movement, muscle activity, air movement, breathing, during sleep.

"A sleep study, or polysomnogram, is a critical tool to uncover the root causes of sleep problems or daytime sleepiness," says Dr. Daniel McNally, a diplomate of the American Board of Sleep Medicine and director of the center.

"The sleep lab generates data about each individual's architecture of sleep," he says. A normal sleep pattern involves alternating stages of sleep throughout the night, including deep sleep, and dream sleep, which is marked by rapid eye movement (REM).

McNally analyzes the data to determine the genesis of an individual's sleeping problem. Some common sleep disorders include: sleep apnea (pauses in breathing that obstruct normal airflow during sleep); narcolepsy (a permanent and overwhelming feeling of sleepiness); sleep-walking; insomnia; REM behavioral disorder; periodic limb movement; teeth grinding; and circadian rhythm disorders. Of these, insomnia and obstructive sleep apnea are the two most common serious sleep disorders. "However, many patients have milder problems of inadequate sleep time or poor sleep habits that may lead to daytime sleepiness, but can be improved," says McNally. "The quality and quantity of sleep every night is very important."

He does not recommend treating insomnia with sleeping pills or products designed to take at bedtime. Instead, he advocates a variety of lifestyle and behavioral modifications.

"Insomnia is best treated through a variety of lifestyle changes, as well as changes in the habits and patterns of sleep, to restore a person's natural ability to sleep well," McNally says.

For example, he advises patients to avoid caffeine and alcohol in the evening. Caffeine makes it more difficult to fall asleep. Alcohol may induce sleep to begin with, but disrupt it later in the night.

He also advises against eating, reading, watching TV, or playing with pets in the bedroom. He does, however, urge patients to create a restful environment for sleep.

McNally also recommends lifestyle changes to treat sleep apnea, a disorder characterized by breathing pauses that may disrupt sleep throughout the night. In extreme cases, patients can be aroused dozens of times per hour. And although they are not typically aware of every disruption, they feel the effects the following day with marked daytime sleepiness.

Treatments for obstructive sleep apnea may include quitting smoking and eliminating alcohol intake, caffeine, and exercise before bed-time. Many patients respond well to a special mask that blows air into the throat.

Signs and symptoms of serious sleep disorders may include:

• excessive daytime sleepiness;
• trouble falling or staying asleep;
• depression or reduced sense of well-being;
• lack of energy and motivation;
• leg cramps or a continuous, uncontrollable urge to move the legs;
• anxiety or difficulty learning or concentrating;
• high blood pressure;
• awakening with a choking feeling or gasping for air;
• racing heartbeat during the night.

McNally recommends that anyone experiencing one or more of these symptoms should discuss them with a physician: "A sleep study may be recommended."