The Battalion
?dnesday • February 4, 1998
Sleeping with the Enemy
udents lear ghttin slee< habits may have serious medical explanations
Rhonda Reinhart
Staff writer
3 ark circles under the eyes, sluggish be
havior and incessant yawning are all signs
that a person has had disrupted sleep,
l or college students, occasional all-nighters
id sleepless nights attributed to ingesting in-
11u amounts of Dr Pepper or cappuccino are
11 ly common.
lint for some people, disturbed sleep is a
i >1 >lem that can invade their lives daily and for
Inch they can find no relief.
I )r. David Earnest, an associate professor at
h College of Medicine, said as the aging
[roc ess progresses, the risk of developing a
cop disorder increases.
If you look at the statistics, sleep disorders
i one of the leading causes of insfitutional-
iiiion in the United States,” he said. "Almost
h third of people 65 or older have some sort
l sleep disturbance.”
I lie “International Classification of Sleep
isorders” (ICSD), published by the American
p Disorders Association, divides sleep dis-
ders into four main categories: (1) dyssom-
lis, (2) parasomnias, (3) sleep disorders asso-
i iied with medical and/or psychiatric
• oditions and (4) proposed sleep disorders.
I he first category, dyssomnias, includes in-
minia (difficulty sleeping) and apnea (theces-
11 ion of airflow during sleep).
I he authors of “The Concise Guide to Evalu-
lion and Management of Sleep Disorders” di-
ide insomnia into three groups: transient in-
unnias, which last for several days; short-term
isomnias, which can last up to three weeks; and
hionic insomnias, which continue for more
han three weeks.
Martin Reite, John Ruddy and Kim Nagel,
a lical doctors involved with the diagnosis and
i ratment of sleep disorders, write that transient
nsomnias may be related to stress, high alti-
udes or changes in sleeping patterns, related to
hilt working and jet lag.
l amest said students who engage in late-
night socializing or studying also may experience
transient insomnia because the body cannot stay
in sync with the dramatic shifts in schedule.
“While most people don’t have truly biologi
cally-based sleep disorders,” he said, “many peo
ple develop abnormal sleep-wake patterns that
are disruptive.”
The more prolonged short-term insomnias
are caused by severe stress, such as major
surgery, serious family or relationship problems
and significant loss.
Unlike transient and short-term insomnias,
the causes of chronic insomnia are more evasive.
"The differential diagnosis and effective treat
ment of chronic insomnia can challenge the
most skilled clinician,” Reite, Ruddy and Nagel
write.
“With chronic insomnia ... the primary cause
is rarely immediately apparent, and the likeli
hood of more than one cause is significant.”
If left untreated, sufferers of chronic insom
nias may begin to experience chronic fatigue,
impaired daytime performance and excessive
daytime sleepiness.
Earnest said lack of sleep can cause a signifi
cant drop in a person’s mental performance.
“The main result of sleep deprivation is that
normal, physical and mental activity becomes
less and less optimal,” he said.
Earnest said people who return to sleep after
having been deprived will experience REM
(rapid eye movement) rebound, which means
they will go immediately into REM sleep. Nor
mally, REM sleep lasts only a short amount of
time and is one of the later stages of sleep.
To treat insomnia, doctors often prescribe
medication and encourage good sleep hygiene,
which includes establishing a regular sleep pat
tern and avoiding poorly-timed alcohol and caf
feine consumption.
Another common sleep disorder in the dys-
somnia family is apnea, which is characterized
by persistent sleepiness and fatigue.
Robert L. Williams, Ismet Karacan and Con
stance A. Moore, authors of “Sleep Disorders: Di
agnosis and Treatment,” divide apnea into three
categories.
Central apnea is the cessation of airflow last
ing 10 seconds or longer.
In obstructive apnea, airflow ceases despite
persistent respiratory effort, and mixed apnea is
a combination of the other types of apnea.
This disorder is defined as the cessation of
airflow and respiratory effort at the beginning
of the episode, followed by resumption of respi
ratory effort, but not airflow in the latter part of
the episode.
Williams, Karacan and Moore write that ap
nea patients often complain of deteriorating
memory, personality changes, morning
headaches and morning nausea.
“A patient’s daytime activities can be severely
impaired by irresistible urges to sleep, which re
sult in occupational or driving accidents ...,”
they write.
“Family members report that obstructive
sleep apnea patients snore loudly at night.”
Treatments for sleep apnea include weight
loss, drug therapy, surgery of the upper airway
and continuous positive airway pressure (CRAP).
CPAP requires the patient, during sleep, to
wear a mask that maintains a column of air op
posing the passive collapse of the walls of the
upper airway.
Williams, Karacan and Moore write that be
cause sleep apnea syndromes are the result of
abnormal events during sleep, it is mandatory
that patients be studied during sleep.
“It may be easy to diagnose sleep apnea in se
vere cases,” they write, “but evaluating its po
tential risk to the patient is difficult without all-
night monitoring.”
The second category of sleep disorders, para
somnias, includes sleepwalking, sleep talking
and sleep paralysis.
According to Reite, Ruddy and Nagel, sleep
walking is more common in children, but adult
experiences with sleepwalking do occur.
“Surveys have estimated that 0.5 percent to
2.5 percent of adults sleepwalk,” they write.
“Childhood somnambulists usually grow out of
the condition by adolescence.”
Sleepwalking is highly hereditary. “The Con
cise Guide to Evaluation and Management of
Sleep Disorders” reports a child who has two
parents who sleepwalk has a 60 percent chance
of developing the disorder.
Sleepwalkers should protect themselves by
installing appropriate locks on doors and win
dows and by sleeping on the first floor.
More severe cases of sleepwalking may require
psychotherapy, behavior therapy or hypnosis.
For people with potentially dangerous sleep
walking, medication is the suggested treatment.
Another parasomnia disorder is sleep paraly
sis, which Reite, Ruddy and Nagel define as a
transient period of awakening from sleep during
which the subject is unable to move or speak.
Please see Sleep on Page 4.
By Quatro
SURE, IT'S DEGRADING THAT THEY MAKE US
DO THIS INSIDE.,. BUT AT LEAST WE'VE GOT REAPING MATERIAL.
®Jt;|('!f|ill jp
TMs Week^ tp change something about
Texas A&M. what would it be and whv?
If I could change anything about A&M, it would be the bus
system. They’re never on time, they’re always overcrowded
and they’re very inconsistent.”
• *
— Kelli Thorinburg
Sophomore speech communications
imel & Lewis
By Hell Ewe Hall
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Thursday, Feb. 5th • 7:30 p.m.
Room 159 Wehner Bldg.
For more information go to http://aggienet.tamu.edu/cctr
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