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Guide to SLEEP DISORDERS

Symptoms, Treatment, and Solutions
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You Don’t Have to Live
With a Sleep Disorder
According to the National Institute of Neurological Disorders and Stroke,
chronic sleep disorders affect at least 40 million Americans each year. Left
untreated, sleep disorders – and the resulting sleep deprivation – can inter-
fere with your work, driving, and social activities. Over time, sleep disorders
can even have negative effects on your physical and mental well-being.

You don’t have to suffer from the effects of a sleep disorder. New treatments
and solutions have been developed for the wide range of sleep disorders
affecting millions of Americans today. This guide provides you with
important information about sleep disorders, their symptoms, and available
treatments, to help guide conversations with your health care professional.

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What Is a SLEEP DISORDER?
A sleep disorder (somnipathy) is any disruption in the sleep patterns of an
individual. While some sleep disorders may leave you feeling unrefreshed, a
number of symptoms are more severe including excessive sleepiness, snor-
ing, difficulty falling asleep during normal sleeping hours and abnormal be-
haviors such as restless leg syndrome. There are even disorders that cause
you to get too much sleep.

Particular behaviors during normal daytime Each type of sleep disorder has its own
activities are telltale signs of sleep deprivation. particular symptoms, but each results in
If you are experiencing one or more of the fol- some of the above signs of sleep deprivation.
lowing symptoms during the day, you may not
If you suspect that you are not getting enough
be getting enough restful sleep at night, and
sleep or that you might have a sleep disorder,
you may even have a sleep disorder.
speak to your physician or a sleep specialist. If
Do you: your health care professional feels that
• Feel irritable or sleepy during the day? you may have a sleep disorder they may
• Have difficulty staying awake when sitting ask that you keep a sleep diary, or they may
still, such as when watching television even have you stay overnight at a sleep
or reading? center for observation.
• Occasionally fall asleep while driving?
• Have difficulty paying attention or concen-
trating at work, school, or home?
• Perform below your potential in work,
school, or sports?
• Often hear that you look tired?
• Have difficulty with your memory?
• Have emotional outbursts?
• Feel tired enough to require a nap almost
every day?
• Require caffeinated beverages to keep
yourself awake?

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Evaluating and Diagnosing
Your Sleep Disorder
If you suspect you have a sleep disorder, a sleep specialist can confirm if
your suspicions are correct – and he or she can make a careful and de-
tailed medical evaluation to find the source of your sleep problem.

If you suspect you have a sleep disorder, a
sleep specialist can confirm if your suspicions
are correct – and make a careful and detailed
medical evaluation to find the source of your
sleep problem.
A doctor or a sleep specialist can diagnose
your sleep disorder based on a number of
factors, including:
• A description of your symptoms
• Your age
• Your gender
• Your psychological history
• Your medical history
• A partner’s or loved one’s observation
of your sleep patterns
Keeping a Sleep Diary
Keeping a sleep diary may be helpful in discussing
your daily patterns with your doctor or sleep
specialist. The information in your diary gives
your health care professional clues about what
is causing your problem and how to correct it.
A sleep diary records information about your
sleep routine and daily life activities that can
affect your sleep. Your doctor can give you a
diary, or there are several free sleep diaries
that you can download off the Internet.
Whichever version you choose to use, a sleep
diary should track:
• What time you went to bed each night
• What time you got up in the morning
• How many times you woke up during
the night
• Whether you felt rested when you woke up
• If you took naps during the day
• Whether you felt sleepy or rested throughout
the day
Once your doctor or sleep specialist has
reviewed your sleep diary and given you a sleep
questionnaire, he or she may determine that a
sleep study is the most important next step.
Sleep Studies
In a sleep study, sensors are used to monitor
how your body acts while you sleep. Charts are
made of many physical measurements including
your brain waves, heartbeats and breathing.
Your sleep study provides doctors with the
data that can help them find the cause of your
sleep problem.

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SleEP DISORDER DIAGNOSIS TESTS
• Epworth Sleepiness Scale – This sleep
questionnaire asks you to rank whether
certain situations make you sleepy and,
if so, how sleepy.
• Nocturnal polysomnogram – This test
measures the electrical activity of your brain
(electroencephalogram) and heart (electrocar-
diogram), and the movement of your muscles
(electromyogram) and eyes (electro-oculo-
gram), and usually requires an overnight stay
at a sleep clinic for observation purposes.
4 Major CaTEGORIES of Sleep Disorders
Dyssomnias Disturbance in the amount, timing, or
quality of sleep. Dyssomnias result
in excessive daytime sleepiness or an
inability to fall asleep or stay asleep.
Dyssomnias can originate from causes
inside or outside the body.
Parasomnias Disorders of partial arousal from
sleep, or disorders that interfere with
sleep stage transitions. Behaviors not
normally associated with sleeping may
occur during sleep.
Sleep disorders due to medical,
neurological, or psychiatric disorders.
Proposed sleep Similar to other classified sleep disorders,
disorders but different enough to be considered
distinct sleep disorders.
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• Daytime Multiple Sleep Latency Test
(MSLT) – This test measures how long it
takes for you to fall asleep during the day, plus
the kind of sleep you get during such a nap.
•R  epeated test of sustained wakefulness
(RTSW) – This test measures how long it
takes for you to fall asleep in a situation that
challenges you to stay awake.
•B  lood test – Depending upon the
description of your symptoms and your
personal and family medical histories, your
sleep specialist may also conduct a blood test.
There are over 100 different types of sleep disorders.
Each has its own causes, symptoms, and treatments.
• Insomnia
• Narcolepsy
• Inability to stay awake (hypersomnia)
• Sleep apnea
• Restless Legs Syndrome (RLS)
• Periodic Limb Movement in Sleep (PLMS)
• Circadian rhythm sleep disorder
• Sleepwalking
• Sleeptalking
• Nightmares
• Sleep terrors / night terrors
• Nocturnal leg cramps
• Sleep paralysis
• Grinding or clenching of the teeth (bruxism)
• Bedwetting
• Sudden Infant Death Syndrome (SIDS)
• Dementia
• Depression
• Alcoholism
• Night sweats
• Short-sleeping
• Long-sleeping
Of these sleep disorders,
the most common are:
Obstructive Sleep Apnea (OSA)
Sleep apnea is characterized by episodes of
cessation of breathing during night time sleep
that can occur as often as several hundred
times in a night. Snoring is a warning that the
sleeper may be a victim of sleep apnea.
Insomnia
Insomnia may mean you have a hard time
going to sleep or that you have a hard time
staying asleep. Usually, you will know if you
are experiencing insomnia because you will
remember tossing and turning or being awake
at night.
Narcolepsy
Narcolepsy is a chronic neurological disorder
which impairs the ability of your central
nervous system to regulate sleep. Because
falling asleep during some activities like
walking, driving, or cooking can have drastic
effects, narcolepsy is a dangerous sleep disorder.
Am I at Risk for Developing
a Sleep Disorder?
Some sleep disorders can be triggered, and conversely,
managed through your behavior and lifestyle. The
following habits and conditions are risk factors for
developing a sleep disorder:
• Poor sleep environment (e.g., too noisy, too
brightly lit, too hot, or too cold)
• Excessive use of caffeine, alcohol, or certain
medications and drugs
• Smoking or chewing tobacco
• Illness
• Obesity
• Anxiety, depression, or another mood disorder
• Stress, such as the death of a loved one or job pressure
• Unhealthy or irregular sleep routine
• Early or late-night bedtimes
• Traveling between time zones
• Daytime napping
• Shift work with a rotating schedule

Restless Leg Syndrome

Restless Legs Syndrome is a neurological disorder
characterized by uncomfortable, tingly, or
creeping sensations in your legs, which create an
uncontrollable urge to keep them moving. RLS is
not necessarily confined to your sleep time.

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Obstructive Sleep Apnea (OSA)
Sleep apnea is a sleep disorder characterized
by pauses in breathing during sleep. These
episodes, called apneas (literally, “without
breath”), each last long enough so one or more
breaths are missed, and occur repeatedly
throughout sleep. Sleep apnea is diagnosed with
an overnight sleep test called a polysomnogram.
The individual with sleep apnea is rarely aware
of having difficulty breathing, even upon
awakening. Sleep apnea is recognized as a
problem by others witnessing the individual
during episodes or is suspected because of its
effects on the body. Symptoms may be present
for years or even decades without identification,
during which time the sufferer may become
conditioned to the daytime sleepiness and
fatigue associated with significant levels of
sleep disturbance.

Symptoms of Sleep Apnea

Loud snoring. This can indicate breathing problems or blocked air passages.

Cessation of breathing or In severe cases, this can occur over fifty times an hour with each spell
choking spells in the lasting as long as ten seconds.
night.
Excessive daytime Daytime sleepiness can become so excessive that working becomes difficult and
sleepiness. driving is dangerous.

Frequent visits to the Individuals with sleep apnea often find that they require repeated trips to the
bathroom. bathroom throughout the night.

Severe mood swings. Sleep deprivation can affect mental health, often causing moods to shift rapidly
from depression to irritability to anger.

Obesity. Although some slim people do suffer from sleep apnea, the majority
are overweight or obese.

Low sex drive and a Because individuals with sleep apnea suffer from sleep deprivation, they often
general lack of energy. find they lack the energy to perform daily activities, and even lose interest in sex.

Dry mouth and sore Because individuals with sleep apnea suffer from sleep deprivation, they often
throat in the morning. find they lack the energy to perform daily activities, and even lose interest in sex.

Lack of concentration Sleep deprivation affects motor skills and memory.

and forgetfulness.

Morning headaches. Lack of sufficient air throughout the night can cause headaches.

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Causes of Sleep Apnea
Sleep apnea causes the throat to collapse during
sleep, blocking the airway and preventing air
from getting to the lungs. Generally, your throat
muscles keep the throat and airway open.
Causes of an obstructed airway include:
• Shape of head and neck – some head and neck
shapes can create a smaller than normal airway.
• Large tonsils or adenoids – this or other
anatomical differences such as a deviated
septum, enlarged tongue, or receding chin can
also create difficulties breathing during sleep.
• Excess weight or obesity – although slim
people can suffer from sleep apnea, obesity is a
risk factor for sleep apnea.
• Abnormally relaxed throat muscles and tongue
– this can be due to alcohol or sedative use
before bedtime.
Other risk factors for sleep apnea include:
• Irregular sleep hours
• Snoring
• Smoking or exposure to secondhand smoke
• Nasal congestion, nasal blockages, and
nasal irritants
• Family history of sleep apnea
Other physical conditions, such as immune
system abnormalities, severe heartburn or
acid reflux and high blood pressure are also
commonly associated with sleep apnea. It isn’t
clear whether these conditions are among causes
or merely the result of sleep apnea.
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Disorders and syndromes
associated with sleep apnea
• Hypothyroidism
• Acromegaly
• Amyloidosis
• Vocal cord paralysis
• Post-polio syndrome
• Neuromuscular disorders
• Marfan’s syndrome
• Down Syndrome
How Sleep Apnea is Diagnosed
Speak with your health care professional if you
suspect you might have sleep apnea or any other
sleep disorder. You will most likely be asked to
keep a sleep diary for a few nights. .
If necessary, your health care professional may
schedule a sleep test overnight in a sleep center.
Sleep centers are set up much like hotels, with
private rooms and baths. You will be observed
while sleeping – using cameras as well as
monitors attached to your body.
Treatments for Sleep Apnea
Sleep apnea is highly treatable, and most
individuals find that they experience relief from
employing one or sometimes a combination of
treatments. Mild to moderate sleep apnea can often
be treated with behavioral modification, but most
cases of sleep apnea require a physician’s assistance
to find the most effective treatment.
The following treatments are for informational
purposes only. Sleep apnea is a serious condition
– it’s important to consult with your physician to
find the treatment that is best for you.
Behavioral Treatments for Sleep Apnea
Weight loss
Reduce consumption of alcohol,
tobacco, and sedatives such as
sleeping pills
Sleep on your side
Establish a regular sleep routine
Medical Treatments for Sleep Apnea
Continuous Positive
Airway Pressure (CPAP)
Bilevel Positive Airway Pressure
(BiPAP)
Oral Devices
Surgery
Oxygen Administration
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Losing even 10% of your weight can reduce sleep apnea
incidents and dramatically improve the quality of your sleep
Avoiding the use of stimulants and depressants can reduce
the likelihood of airway closure during the night
Some individuals with sleep apnea find that they experience
temporary relief when sleeping on the side, rather than the
back
Irregular sleep hours can throw off your sleep cycles and
lead to breathing problems during the most important sleep
stages
A CPAP machine blows pressurized air into a mask worn
over the nose to keep the patient’s airway open during
sleep. This is the most common long-term treatment for
severe sleep apnea.
An electronic circuit monitors the patient’s breathing and
provides two different pressures: one for inhalation and
one for exhalation. This treatment is sometimes used for
patients who find breathing out against increased pressure
to be uncomfortable or disruptive to their sleep.
Oral devices such as dental appliances open the patient’s
airway by bringing the lower jaw or tongue forward during
sleep. Two common oral devices are the Mandibular Res-
positioning Device and the Tongue Retaining Device.
Surgically removing tissue such as tonsils, adenoids, or
excess tissue at the back of the throat or inside the nose
increases the size of the patient’s airway, allowing better
airflow during sleep.
Oxygen is provided to the patient via a small tube that fits
inside the nose. This treatment is rarely used, although it is
occasionally employed in conjunction with CPAP.
Insomnia

Insomnia is a sleep disorder characterized by
an inability to sleep and/or inability to remain
asleep for a reasonable period. Insomniacs
typically complain of being unable to close their
eyes or “rest their mind” for more than a few
minutes at a time.
Insomnia can be caused by fear, stress, anxiety,
medications, herbs, caffeine, depression, or
other mental conditions and sometimes occurs
for no apparent reason. An overactive mind
or physical pain may also be causes. Finding
the underlying cause of insomnia is usually
necessary to cure it.

Symptoms of Insomnia

Difficulty getting to sleep This symptom continues night after night for a month or more in cases of
and staying asleep. chronic insomnia.

Waking up unrefreshed. Individuals with insomnia often feel like they haven’t slept at all.

Morning headaches. This is often called the hangover effect, when, in fact, the person did no
drinking the night before.

Difficulty concentrating. Sleep deprivation affects motor skills and memory.

Irritability. Sleep deprivation can affect mental health, often causing moods to shift rapidly
from depression to irritability to anger.

Bloodshot eyes. Insufficient oxygen to the cornea causes small blood vessels in the eyes to
become inflamed. Fatigue can cause your eyes to become bloodshot.

Daytime sleepiness. Daytime sleepiness can become so excessive that working becomes difficult
and driving is dangerous.

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Causes of Insomnia
There are many possible causes of insomnia.
Sometimes there is one main cause, but often
several factors interacting together will cause a
sleep disturbance.
Possible causes of insomnia include:
•P
 sychological or mental health issues – issues
such as stress, fear, anxiety, depression, or
even more serious conditions such as bipolar
disorder can adversely affect sleep cycles.
•F
 ood and drug consumption – consuming
stimulants such as caffeine can disrupt
sleep. In addition, drinking alcohol or using
nicotine, herbal supplements, recreational
drugs, or some medications can cause
insomnia.
•L
 ifestyle – Working shifts, traveling, napping
during the day, or even exercising just before
bedtime can interfere with sleep.
•M
 edical or physical conditions – Pain,
disease, or sleep disorders such as sleep
apnea can often cause insomnia.
Insomnia Statistics
• According to the U.S. Department of Health
and Human Services, approximately 60
million Americans suffer from insomnia.
• Insomnia is more likely to affect women
– about 40 percent of sufferers are women,
as opposed to 30 percent of men.
Insomnia is a serious condition that can
have negative affects your health and well-
being, particularly if you have a chronic sleep
problem. Surveys report that people with
severe insomnia experience a quality of life
similar to those who have chronic conditions
such as heart failure.
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Effects of insomnia
• Poor health and diminished quality of life
• Impaired social functioning
• Increased impatience and irritability
• Diminished mental alertness and memory
• Slower reaction times and impaired concentration
• Increased risk of disorders such as major depression,
anxiety disorder, and substance abuse
• Increased likelihood of automobile, home,
and workplace accidents
• Poor job performance, missed work days,
and school absences
How Insomnia is Diagnosed
Speak with your health care professional or a
sleep specialist if you have trouble sleeping for a
week or more.
If your insomnia is severe, your doctor may
recommend a visit to a sleep center where a team
of sleep specialists will use the latest technology
to monitor you while you sleep. A sleep center can
also provide you with equipment to monitor your
activities (awake and asleep) at home.
Treatments for Insomnia
Insomnia can be treated through behavioral
modification, medication, sleep aids, or a
combination of treatments. It is a serious disorder
that can affect all aspects of your life – mental,
physical, and social.
The treatments outlined below are for
informational purposes only. It is important to
consult with your physician to find the treatment
that is best for you.
Behavioral Treatments for Insomnia

Progressive Muscle Relaxation This relaxation technique is practiced by tensing certain

(PMR) muscle groups and then totally relaxing them.

Autogenic training A relaxation method that calls for an individual to repeat a

set of visualizations to induce a state of relaxation.

Meditation Concentration on an object of thought or awareness that

can calm and relax the body and mind.

Stress management Being aware of and managing the amount of stress in your
life can allow you to more easily relax at night when it’s
time to sleep.

Stimulus control Stimulus Control therapy reassociates the bed and bed-
room with sleeping by limiting the amount of time spent in
the bedroom for non-sleep activities.

Diet management Reducing the use of stimulants and depressants and avoid-
ing big meals just before bed can help reduce the risk of
insomnia episodes.

Acupuncture, acupressure, These alternative treatments can have an extremely

and massage calming effect on your nervous system.

Medicinal Treatments for Insomnia

Benzodiazepines The most commonly-used class of drugs prescribed for

insomnia. Includes drugs such as temazepam, diazepam,
lorazepam, and midazolam.

Non-benzodiazepine Includes drugs such as Ambien and Lunesta. These drugs

prescription drugs have a cleaner side effect profile than benzodiazepines
but do appear to cause psychological dependence and
physical dependence.

Melatonin A hormone that has proved effective for some insomniacs

in regulating the sleep/waking cycle.

Over-the-counter sleep aids Many of these sleep aids use the antihistamine diphen-
hydramine. The effectiveness of these aids often decrease
over time and next-day sedation is common.

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Narcolepsy

Narcolepsy is a chronic neurological condition
which impairs the ability of your central
nervous system to regulate sleep. Individuals
with narcolepsy typically experience disturbed
nocturnal sleep (often confused with insomnia)
and abnormal rapid eye movement (REM) sleep.
Narcolepsy affects about 1 in 2,000 people.
Most individuals experience their first symptoms
between the ages of 10 and 25. Evidence
suggests that the condition is genetic, and while
it is a lifelong condition, it does not usually get
progressively worse. However, narcolepsy is a
serious disorder with potential physical, mental,
and social consequences.

Symptoms of Narcolepsy

Excessive daytime Narcoleptics may find it impossible to stay awake and often have
sleepiness. uncontrollable episodes of sleep during the day.

Abnormal REM sleep. People with narcolepsy enter the REM, or dream, phase of sleep right after falling
asleep, whereas most people take about 90 minutes to enter the REM phase.

Hypnagogic hallucinations. Some people with narcolepsy experience vivid, sometimes frightening, visual or
auditory sensations while falling asleep or upon awakening.

Cataplexy. People with narcolepsy often have a sudden loss of muscle control while awake,
usually experienced during strong emotion such as anger, grief, or while laughing.

Sleep paralysis. Sleep paralysis is the inability to move or talk at the beginning or end of sleep.
About 25 to 50% of narcolepsy sufferers experience sleep paralysis.

Nighttime wakefulness. People with narcolepsy may have periods of wakefulness at night. This
disrupted nighttime sleep adds to daytime sleepiness.

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Causes of Narcolepsy
Researchers continue to seek out the root
cause of narcolepsy. Currently, the general
consensus is that genetics, accompanied by an
environmental trigger of some sort – a virus,
for example – may affect brain chemicals and
contribute to the disorder.
Scientists have recently discovered that people
with narcolepsy are lacking in hypocretin
(also called orexin), a chemical in the brain
that activates arousal and regulates sleep.
Narcoleptics generally do not have as many
Hcrt cells or neurons that secrete hypocretin,
inhibiting their ability to fully control their
alertness and sleep cycles.
Heredity appears to be a factor in narcolepsy,
but environmental triggers also play a strong
role. Research is also investigating these triggers.
Narcolepsy affect
MANY AREAS of life:
• Physical well-being and safety
• Mental health
• Social and professional relationships
• Intimate relationships
• Memory and attention
How Narcolepsy is Diagnosed
Narcolepsy is often misdiagnosed or
undiagnosed. The most common and
sometimes the only symptom of narcolepsy is
excessive daytime sleepiness. Because excessive behavioral changes.
daytime sleepiness is a symptom of other sleep
disorders and of depression, narcolepsy can be
difficult to diagnose.
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Diagnosis of narcolepsy can take a very long
time, sometimes more than one year, or even up
to several decades.
Tests used to diagnose narcolepsy
•E pworth Sleepiness Scale – This sleep
questionnaire asks you to rank whether
certain situations make you sleepy and, if so,
how sleepy.
•N octurnal polysomnogram – This test
will measure the electrical activity of your
brain (electroencephalogram) and heart
(electrocardiogram), and the movement of
your muscles (electromyogram) and eyes
(electro-oculogram), and usually requires
an overnight stay at a sleep clinic for
observation purposes.
•M ultiple sleep latency test (MSLT) – This
test measures how long it takes for you to fall
asleep during the day. People with narcolepsy
tend to fall asleep very quickly.
• Spinal
 fluid analysis – The lack of
hypocretin in the cerebrospinal fluid may be
a marker for narcolepsy. Examining spinal
fluid is a new diagnostic test for narcolepsy.
Treatments for Narcolepsy
Although no cure yet exists for narcolepsy,
a combination of treatments can control the
symptoms. The most commonly recommended
treatment for narcolepsy includes a
combination of counseling, medication, and
The following treatments are for informational
purposes only. Narcolepsy is a serious condition
– it’s important to consult with your physician
to find the treatment that is best for you.
 Behavioral Treatments for Narcolepsy

Schedule sleep periods Individuals with narcolepsy find that a few brief,
scheduled naps (no longer than 15 minutes at a time)
during the day can prevent unplanned lapses into sleep
during the daytime.

Avoid caffeine, alcohol, Stimulants and depressants can interfere with sleep cycles
and nicotine during your normal sleeping hours.

Exercise on a regular basis Exercise can make you feel more awake during the day
and stimulate normal sleep patterns at night.

Wear a medical alert bracelet A medical ID is useful to alert others to your condition
or necklace if you suddenly fall asleep or become unable to move
or speak.

Medicinal and Herbal Treatments for Insomnia

Methylphenidate (such as Ritalin) Effective in treating narcolepsy but can have strong side ef-
and various amphetamines fects and can be addictive.

Modafinil (Provigil) A stimulant which acts on the central nervous system to

help individuals stay alert and awake during the day. Effec-
tive, with not as many side effects. Chance of addiction is
also lower than with amphetamines.

Antidepressants such as Vivactil, These drugs suppress REM sleep and alleviate the symp-
Prozac, and Zoloft toms of cataplexy, hallucinations, and sleep paralysis.

Sodium oxybate (Xyrem) Controls cataplexy and daytime sleepiness. Has strong
side-effects.

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Restless Legs Syndrome

Restless Legs Syndrome is frequently mis-
diagnosed and often left untreated, yet RLS is
a treatable condition. RLS affects about 10%
of adults in North America and Europe, and
incidence increases with age.
Restless Legs Syndrome (RLS) is a central
nervous system disorder that can interfere
with resting or falling asleep. Many people
describe the feeling of Restless Legs Syndrome
as creeping, crawling, tingling, or pulling
within the leg, along with an overwhelming
need to get up and move around. Although the
symptoms are distinctive, many people dismiss
the feelings as muscle aches or restlessness, and
do not suspect that they have RLS.

Symptoms of Restless Legs Syndrome

Irritating sensations Sensations such as creeping, crawling, tingling or pulling – they can be
in the legs. painful or just uncomfortable.

Overwhelming urge to Getting up and moving around can relieve the discomfort when experiencing
move around. this sensation.

Increased discomfort in Discomfort tends to increase when sitting or lying down and during the
different positions and at evening or night.
different times of the day.

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Causes of Restless Legs Syndrome Effects of Restless Legs Syndrome
Restless Legs Syndrome is a central nervous
system disorder (a disorder based in the brain
or spinal column) which may have a genetic
basis. It is also possible that RLS may be a
brain chemical disorder. Psychiatric conditions
or stress may exacerbate RLS, but they do not
cause RLS.
Restless Legs Syndrome can be brought on
by other conditions, including:
•A  n underlying medical problem – such as
diabetes mellitus, kidney disease, Parkinson’s
Disease, or rheumatoid arthritis.
• I ron deficiency anemia – the way the body
metabolizes iron and certain proteins in the
brain may be related to restless legs syndrome.
•P  regnancy – many women experience RLS
in the last months of pregnancy, possibly as
a result of an iron deficiency. Left untreated,
the symptoms often go away after delivery.
•N  eurologic lesions – people with spinal cord
tumors, peripheral nerve lesions, or spinal
cord injury often report symptoms of RLS.
• Particular medications – medications in-
cluding tricyclic antidepressants, anti-nausea,
and some cold and allergy drugs may increase
or trigger RLS symptoms.
•V  aricose veins – when vein valves fail, the
backward flow of blood pools and stagnates in
the veins, which can lead to aching, throbbing,
cramping and fatigue in the legs.
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• Restlessness – An inability to sit still because
the leg sensations are too annoying or painful
• Insomnia – Difficulty falling asleep or staying
asleep
• Daytime sleepiness – RLS can keep you from
getting a restful night’s sleep, resulting in ex-
haustion during the day
How Restless Legs Syndrome
Syndrome is Diagnosed
Talk to your doctor or sleep specialist to ex-
plore available treatments. To diagnose RLS,
your doctor will request:
• A medical history
• A familial survey to see if anyone else in your
family has similar symptoms
• Interview about other medical conditions
you have
• A blood test for low iron levels
Treatments for Restless
Legs Syndrome
Although no cure exists for Restless Legs
Syndrome, different types of treatment can be
used to manage the condition.
There are three treatment approaches for RLS:
•S
 elf-help – If your symptoms are mild, self-
help may be sufficient treatment.
•M
 edications – For those with severe RLS,
where the disorder disrupts sleep or daily
activities, medications may be the proper
treatment approach.
•T
 reatment of the underlying condition – If
your Restless Legs Syndrome is caused by an
underlying condition, your doctor will treat
that condition.
Behavioral Treatments for Restless Legs Syndrome

Exercise Work with your healthcare professional to determine if there

is an exercise program that relieves your RLS symptoms.

Apply compression to your legs Wrap your legs in an ace bandage or wear tight pantyhose.

Take iron supplements For individuals with low iron levels, iron supplements some-
times offer relief. Note that too much iron in your system
is dangerous, so be sure to speak with your health care
professional before starting this type of supplement.

Reduce the use of stimulants and Cut out coffee, chocolate, and caffeinated soda, particularly
depressants in the evening.

Keep a regular sleep schedule Because exhaustion can increase symptoms, a regular
sleep schedule is important to ensuring you get enough rest.

Medical Treatments for Restless Legs Syndrome

Dopaminergic agents The most common treatment for RLS, these drugs increase
(Ropinirole, Pramipexole) the brain chemical dopamine (a neurotransmitter that regu-
lates muscle movements)

Benzodiazepines Sleep medications or central nervous system depressants

which also suppress muscle contractions.

Non-benzodiazepine sedatives Short-acting hypnotic agents or sleeping pills. Helpful in

mild cases of RLS that occur primarily at bedtime.

Opiates/Narcotics Pain killers. These drugs are addictive and should be used
(Darvon, Percodan) only in low dosages.

Anticonvulsants (Neurontin) Drugs normally used to prevent seizures which can reduce
muscle contractions in some individuals.

Hypertensive medications Most often prescribed for high blood pressure, these drugs
can reduce the symptoms of RLS in some individuals.

17 | SleepDisorderAlliance.com
Basic Tips for a Good Night’s Sleep
Whether you suffer from a sleep disorder or would simply like to get a bet-
ter night’s sleep, there are some simple things you can do to increase your
chances of feeling more rested when you wake up in the morning.

Create an Optimal Keep Good Daytime Habits

Sleep Environment •D
 o not nap during the day. If you are having
• Make sure your bed is comfortable. Differ- trouble sleeping at night, try not to nap dur-
ent types of mattresses help with different is- ing the day. If you are feeling especially tired
sues. Some mattresses are made to accommo- and feel as if you absolutely must nap, be sure
date different types bedmates’ sleeping habits to sleep for less than 30 minutes, early in the
and comfort levels. Others are made to adjust day.
to your firmness preferences. In addition, try • L imit caffeine and alcohol. Avoid drinking
therapeutic-shaped foam pillows that cradle caffeinated or alcoholic beverages for several
your neck or extra pillows that help you sleep hours before bedtime.
on your side. Make sure your sheets are com- • D  on’t smoke. Nicotine is a stimulant and can
fortable and clean. make it difficult to fall asleep and stay asleep.
• Ensure your bedroom remains primarily •E
 xpose yourself to bright light/sunlight
a place for sleeping. Don’t use your bed for soon after awakening. This will help to
paying bills, doing work, etc. Help your regulate your body’s natural biological clock.
body recognize that this is a place for rest Likewise, try to keep your bedroom dark
or intimacy. while you are sleeping so that the light will
• Keep your bedroom peaceful and comfort- not interfere with your rest.
able. Make sure your room is well ventilated •E
 xercise early in the day. Twenty to thirty
and the temperature is consistent, and try to minutes of exercise every day can help you
keep it quiet. If you have a problem with out- sleep, but be sure to exercise in the morning
side noise, a fan or a “white noise” machine can or afternoon. Exercise stimulates the body
help block it out. and aerobic activity before bedtime may make
• Hide your clock. A big, illuminated digital falling asleep more difficult.
clock may cause you to focus on the time and • C  heck your iron level. Iron deficient women
make you feel stressed and anxious. Place tend to have more problems sleeping, so if
your clock so you can’t see the time when you your blood is iron poor, a supplement might
are in bed. help your health and your ability to sleep.

18 | SleepDisorderAlliance.com
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