Sleep Disorders Polysomnography Causes Diagnosis and Treatment

Sleep Disorders

  • Disturbed sleep is one of the most common health problems.

  • Average requirement of sleep is 7-8 hours per night.

     

    • States and stages of sleep are defined by character­istic patterns in EEG (electro-encephalogram), EOG (Electrooculogram), EMG (Electromyogram) measured on the chin and neck.
  • Polysomnography

    • The continuous recording of electrophysiologic param­eters of sleep and wakefulness is termed poly­somnography.

Sleep Disorders

Sleep Disorders Polysomnography Causes Diagnosis and Treatment


There are two states of sleep:

  • Rapid Eye Movement Sleep (REM)
  • A Non Rapi Eye Movement Sleep (NREM) There are 4 stages of NREM sleep.
  • After onset of sleep there is NREM sleep stages 1 to 4 in one hour. NREM stages 3 and 4 continue for 1/3rd of the night.
  • First REM sleep occurs in the 2nd hour of sleep.

  • Sleep-wake cycle is affected by

     

    • endocrine, ther­moregulatory, cardiac, pulmonary, renal, gastrointes­tinal and neural functions.
    • This follows a circadian rhythm.
  • Narcolepsy

    • Sudden weakness of muscles, hallucinations and sleep paralysis
  • Sleep apnea

    • There is occlusion of airway, or absence of respira­tory effort.
  • Somnambulism

    • Patients leave the bed and walk about and even do certain activities.

  • Aruxism

     

    • There is involuntary grinding of teeth.

  • sleep enuresis

     

    • Bed-wetting.

Sleep disorders are  :

  • Obstructive sleep apnea
  • Narcolepsy-Cataplexy syndrome .y Periodic limb movements
  • Insomnia.
  • The narcolepsy tetrad consists of excessive day time sleepiness, loss of muscle tone without loss of con­sciousness (cataplexy), hallucinations, sleep paraly­sis on awakening.

Obstructive sleep apnea syndrome (OSAS) and Cardiovascular disease:

  • Snoring is a loud sound produced during sleep due to vibration of colla sible art of airwa between poste­rior c onae and the e i lottis articularl oro..eha­ryngeal isthumus. Extreme cases of snoring associ­a ed with apnea and h 0 neas are described as sleep
  • Isor er breathin or OSAS.
  • OSAS has a high prevalence in the cardiovascular dis­ease patients.
  • OSAS affects as many s 30% of coronary artery dis­ease patients, 50% of congestive heart failure pa­tients, 60% of stroke patients, 80% of drug resistant hypertensive patients. OSAS has been associated with’ an almost 5 fold increase in risk of development of cardiovascular disease independent of age, body mass index, systolic blood pressure, diastolic blood pres-‘ sure and smoking. ‘

Clinical features of Sleep Disorders :

  • Patient is usually obese
  • Snoring
  • Hypertension
  • Hallucinations
  • Restless legs syndrome
  • Renal failure
  • Anaemia and Asthma.

Treatment of Sleep Disorders

  • Continuous positive airway pressure Uvulopalatopharyngoplasty by ENT surgeon Weight loss
  • Clonazepam and Zolpidem.
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