Sleeping Disorders

Sleep Disorders

Sleep disorders are disorders which interfere with one’s pattern of sleep. There are many different sleep disorders, three of the most prominent being insomnia, narcolepsy and sleep apnea. Insomnia is a case of recurring problems in falling or staying asleep and bothers 10 to 15 percent of adults. Narcolepsy is characterized by periodic attacks of uncontrollable, overwhelming sleepiness. People who complain of sleep apnea suffer from temporary cessations of breathing during their sleep and repeated awakenings (Myers, 2006). I have reviewed three articles, one covering each of the three disorders given above.

“Coping with Insomnia” written by Mike Mead was the first article reviewed. It begins with describing the sleep cycle in humans and how it is centrally controlled by a hormone known as melatonin. Melatonin kicks in just before falling asleep, peaks around 2-4am and then is reduced by factors which would normally wake a person such as light or noise. Some statistics on insomnia are given and then Mead goes on to explain how a four-step plan can help in consultations with patients who present with this problem. Step 1 is to understand what exactly the patient’s problem is which is done by asking 6 questions and sometimes suggesting the completion of a sleep diary. The sleep diary notes statistics such as total hours of sleep, number of awakenings, etc. The second step is attempting to identify a cause. Some of the probable causes of insomnia are stress, depression, anxiety or dementia. Mead also points out that research shows 52% of patients with insomnia have a well-defined mental disorder, and 54% report a physical disorder. Step 3 is working with the patient to re-establish a sleep routine. The first thing to do is break any form of anxiety patients may develop due to their insomnia because that just compounds the problem. After that, numerous tips are given to help improve sleep. If the tips fail, the final step is the suggesting of a hypnotic drug. Hypnotic drugs may work but are not an ideal solution because of numerous and common side-affects that they are associated with. They can also lead to withdrawal which is why it is important to assess the patient properly, target any causes identified, and provide as much self-help information as possible.

Like most people, I have heard of insomnia but did not really know exactly what it is. Also, I was not aware that it affected that many people. The article supplied good information, however there were a few steps of the plan that seemed like they had a few holes in them. With step 2, the hole that I found is a rarity, but I am sure it is possible for a patient with insomnia not to have any of the main causes or some sort of retardation. The other hole that I found was within step 3. I understand breaking the anxiety, but I do not understand how you can attempt to get a patient with insomnia on a new sleep cycle. The reason they are complaining is because they can’t fall asleep in the first place.

The second article reviewed, on narcolepsy, was “Sounding the alarm for narcolepsy”, written by Terrilynn Fox Quillen. The article starts with the basics; what narcolepsy is, who it affects and how dangerous it can be. It then goes into detail on how to assess and treat the disorder. Narcolepsy usually begins during or shortly after puberty and is a leading cause of excessive daytime sleepiness. One of the worst aspects of narcolepsy is just how random the sleep attacks are. It can happen during an important interview, a baseball game, or even sexual intercourse. During these sleep attacks sufferers may experience odd bizarre automated behaviors that they can not control. Narcolepsy can also lead to fragmented sleep during the nighttime. Other distinguishing characteristics associated with narcolepsy are cataplexy, sleep paralysis, and hallucinations. Quillen then goes into a series of tests and questionnaires that should be administered in diagnosing narcolepsy. The disorder can not be cured; just controlled by drugs. Originally the treatment was with stimulants for the central nervous system, but was switched over to Provagil due to all of the adverse reactions experience with the CNS stimulants. Ways to support people who suffer from narcolepsy are to teach them about the disease, the medications, and get them into better sleeping habits.

This article provided a great deal of information. It was extremely well written as it gave the reader all they need to know without rambling on for 25 pages that no one wants to read. Another thing that I enjoyed with the article is that it was fun to read, it was not boring at all. The parts that I found most interesting were that the average delay between symptom onset and diagnosis is 10 to 15 years and the circumstances under