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Sleep Disorder :
Sleep Disorder involves conditions related to quality, timing and amount of sleep. It affects badly on your health. Do not worry! Read how to treat sleep disorders without taking medicines. You can also ask your queries on Hellodox App and get suggestions from Medical Experts.
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Sleep Apnea

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Overview
Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full night's sleep, you might have sleep apnea.

The main types of sleep apnea are:

Obstructive sleep apnea, the more common form that occurs when throat muscles relax
Central sleep apnea, which occurs when your brain doesn't send proper signals to the muscles that control breathing
Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, which occurs when someone has both obstructive sleep apnea and central sleep apnea
If you think you might have sleep apnea, see your doctor. Treatment can ease your symptoms and might help prevent heart problems and other complications.

Symptoms
The signs and symptoms of obstructive and central sleep apneas overlap, sometimes making it difficult to determine which type you have. The most common signs and symptoms of obstructive and central sleep apneas include:

Loud snoring
Episodes in which you stop breathing during sleep — which would be reported by another person
Gasping for air during sleep
Awakening with a dry mouth
Morning headache
Difficulty staying asleep (insomnia)
Excessive daytime sleepiness (hypersomnia)
Difficulty paying attention while awake
Irritability
When to see a doctor
Loud snoring can indicate a potentially serious problem, but not everyone who has sleep apnea snores. Talk to your doctor if you have signs or symptoms of sleep apnea. Ask your doctor about any sleep problem that leaves you fatigued, sleepy and irritable.

Causes
Obstructive sleep apnea
This occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils, the side walls of the throat and the tongue.

When the muscles relax, your airway narrows or closes as you breathe in. You can't get enough air, which can lower the oxygen level in your blood. Your brain senses your inability to breathe and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don't remember it.

You might snort, choke or gasp. This pattern can repeat itself five to 30 times or more each hour, all night, impairing your ability to reach the deep, restful phases of sleep.

Central sleep apnea
This less common form of sleep apnea occurs when your brain fails to transmit signals to your breathing muscles. This means that you make no effort to breathe for a short period. You might awaken with shortness of breath or have a difficult time getting to sleep or staying asleep.

Risk factors
Sleep apnea can affect anyone, even children. But certain factors increase your risk.

Obstructive sleep apnea
Factors that increase the risk of this form of sleep apnea include:

Excess weight. Obesity greatly increases the risk of sleep apnea. Fat deposits around your upper airway can obstruct your breathing.
Neck circumference. People with thicker necks might have narrower airways.
A narrowed airway. You might have inherited a narrow throat. Tonsils or adenoids also can enlarge and block the airway, particularly in children.
Being male. Men are two to three times more likely to have sleep apnea than are women. However, women increase their risk if they're overweight, and their risk also appears to rise after menopause.
Being older. Sleep apnea occurs significantly more often in older adults.
Family history. Having family members with sleep apnea might increase your risk.
Use of alcohol, sedatives or tranquilizers. These substances relax the muscles in your throat, which can worsen obstructive sleep apnea.
Smoking. Smokers are three times more likely to have obstructive sleep apnea than are people who've never smoked. Smoking can increase the amount of inflammation and fluid retention in the upper airway.
Nasal congestion. If you have difficulty breathing through your nose — whether from an anatomical problem or allergies — you're more likely to develop obstructive sleep apnea.
Central sleep apnea
Risk factors for this form of sleep apnea include:

Being older. Middle-aged and older people have a higher risk of central sleep apnea.
Being male. Central sleep apnea is more common in men than it is in women.
Heart disorders. Having congestive heart failure increases the risk.
Using narcotic pain medications. Opioid medications, especially long-acting ones such as methadone, increase the risk of central sleep apnea.
Stroke. Having had a stroke increases your risk of central sleep apnea or treatment-emergent central sleep apnea.
Complications
Sleep apnea is a serious medical condition. Complications can include:

Daytime fatigue. The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible, making severe daytime drowsiness, fatigue and irritability likely.

You might have difficulty concentrating and find yourself falling asleep at work, while watching TV or even when driving. People with sleep apnea have an increased risk of motor vehicle and workplace accidents.

You might also feel quick-tempered, moody or depressed. Children and adolescents with sleep apnea might perform poorly in school or have behavior problems.

High blood pressure or heart problems. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system. Having obstructive sleep apnea increases your risk of high blood pressure (hypertension).

Obstructive sleep apnea might also increase your risk of recurrent heart attack, stroke and abnormal heartbeats, such as atrial fibrillation. If you have heart disease, multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from an irregular heartbeat.

Type 2 diabetes. Having sleep apnea increases your risk of developing insulin resistance and type 2 diabetes.
Metabolic syndrome. This disorder, which includes high blood pressure, abnormal cholesterol levels, high blood sugar, and increased waist circumference, is linked to a higher risk of heart disease.
Complications with medications and surgery. Obstructive sleep apnea is also a concern with certain medications and general anesthesia. People with sleep apnea might be more likely to have complications after major surgery because they're prone to breathing problems, especially when sedated and lying on their backs.

Before you have surgery, tell your doctor about your sleep apnea and how it's being treated.

Liver problems. People with sleep apnea are more likely to have abnormal results on liver function tests, and their livers are more likely to show signs of scarring (nonalcoholic fatty liver disease).
Sleep-deprived partners. Loud snoring can keep anyone who sleeps near you from getting good rest. It's not uncommon for a partner to have to go to another room, or even to another floor of the house, to be able to sleep.

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Restless Leg Syndrome

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Restless Legs Syndrome
Restless legs syndrome (RLS) is a disorder of the part of the nervous system that causes an urge to move the legs. Because it usually interferes with sleep, it also is considered a sleep disorder.

Symptoms of Restless Legs Syndrome
People with restless legs syndrome have uncomfortable sensations in their legs (and sometimes arms or other parts of the body) and an irresistible urge to move their legs to relieve the sensations. The condition causes an uncomfortable, "itchy," "pins and needles," or "creepy-crawly" feeling in the legs. The sensations are usually worse at rest, especially when lying or sitting.

The severity of RLS symptoms ranges from mild to intolerable. Symptoms can come and go and severity can also vary. The symptoms are generally worse in the evening and at night. For some people, symptoms may cause severe nightly sleep disruption that can significantly impair their quality of life.

Who Gets Restless Legs Syndrome?
Restless legs syndrome may affect up to 10% of the U.S. population. It affects both sexes, but is more common in women and may begin at any age, even in young children. Most people who are affected severely are middle-aged or older.

RLS is often unrecognized or misdiagnosed. This is especially true if the symptoms are intermittent or mild. Once correctly diagnosed, RLS can often be treated successfully.

Causes of Restless Legs Syndrome
In most cases, doctors do not know the cause of restless legs syndrome; however, they suspect that genes play a role. Nearly half of people with RLS also have a family member with the condition.

Other factors associated with the development or worsening of restless legs syndrome include:

Chronic diseases. Certain chronic diseases and medical conditions, including iron deficiency, Parkinson’s disease, kidney failure, diabetes, and peripheral neuropathy often include symptoms of RLS. Treating these conditions often gives some relief from RLS symptoms.
Medications. Some types of medications, including antinausea drugs, antipsychotic drugs, some antidepressants, and cold and allergy medications containing sedating antihistamines, may worsen symptoms.
Pregnancy. Some women experience RLS during pregnancy, especially in the last trimester. Symptoms usually go away within a month after delivery.
Other factors, including alcohol use and sleep deprivation, may trigger symptoms or make them worse. Improving sleep or eliminating alcohol use in these cases may relieve symptoms.

Diagnosis of Restless Legs Syndrome
There is no medical test to diagnose RLS; however, doctors may use blood tests and other exams to rule out other conditions. The diagnosis of RLS is based on a patient’s symptoms and answers to questions concerning family history of similar symptoms, medication use, the presence of other symptoms or medical conditions, or problems with daytime sleepiness.

Treatment for Restless Legs Syndrome
Treatment for RLS is targeted at easing symptoms. In people with mild to moderate restless legs syndrome, lifestyle changes, such as beginning a regular exercise program, establishing regular sleep patterns, and eliminating or decreasing the use of caffeine, alcohol, and tobacco, may be helpful. Treatment of an RLS-associated condition also may provide relief of symptoms.

Other non-drug RLS treatments may include:

Leg massages
Hot baths or heating pads or ice packs applied to the legs
Good sleep habits
A vibrating pad called Relaxis
Medications may be helpful as RLS treatments, but the same drugs are not helpful for everyone. In fact, a drug that relieves symptoms in one person may worsen them in another. In other cases, a drug that works for a while may lose its effectiveness over time.

Drugs used to treat RLS include:

Dopaminergic drugs, which act on the neurotransmitter dopamine in the brain. Mirapex, Neupro, and Requip are FDA-approved for the treatment of moderate to severe RLS. Others, such as levodopa, may also be prescribed.
Benzodiazepines, a class of sedative medications, may be used to help with sleep, but they can cause daytime drowsiness.
Narcotic pain relievers may be used for severe pain.
Anticonvulsants, or antiseizure drugs, such as Tegretol, Lyrica, Neurontin, and Horizant.
Although there is no cure for restless legs syndrome, current treatments can help control the condition, decrease symptoms, and improve sleep.

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Narcolepsy

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Overview
Narcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep. People with narcolepsy often find it difficult to stay awake for long periods of time, regardless of the circumstances. Narcolepsy can cause serious disruptions in your daily routine.

Sometimes, narcolepsy can be accompanied by a sudden loss of muscle tone (cataplexy), which can be triggered by strong emotion. Narcolepsy that occurs with cataplexy is called type 1 narcolepsy. Narcolepsy that occurs without cataplexy is known as type 2 narcolepsy.

Narcolepsy is a chronic condition for which there's no cure. However, medications and lifestyle changes can help you manage the symptoms. Support from others — family, friends, employers, teachers — can help you cope with narcolepsy.

Symptoms
The signs and symptoms of narcolepsy may worsen for the first few years and then continue for life. They include:

Excessive daytime sleepiness. People with narcolepsy fall asleep without warning, anywhere, anytime. For example, you may be working or talking with friends and suddenly you nod off, sleeping for a few minutes up to a half-hour. When you awaken, you feel refreshed, but eventually you get sleepy again.

You may also experience decreased alertness and focus throughout the day. Excessive daytime sleepiness usually is the first symptom to appear and is often the most troublesome, making it difficult for you to concentrate and fully function.

Sudden loss of muscle tone. This condition, called cataplexy (KAT-uh-plek-see), can cause a number of physical changes, from slurred speech to complete weakness of most muscles, and may last up to a few minutes.

Cataplexy is uncontrollable and is triggered by intense emotions, usually positive ones such as laughter or excitement, but sometimes fear, surprise or anger. For example, when you laugh, your head may droop uncontrollably or your knees may suddenly buckle.

Some people with narcolepsy experience only one or two episodes of cataplexy a year, while others have numerous episodes daily. Not everyone with narcolepsy experiences cataplexy.

Sleep paralysis. People with narcolepsy often experience a temporary inability to move or speak while falling asleep or upon waking. These episodes are usually brief — lasting a few seconds or minutes — but can be frightening. You may be aware of the condition and have no difficulty recalling it afterward, even if you had no control over what was happening to you.

This sleep paralysis mimics the type of temporary paralysis that normally occurs during a period of sleep called rapid eye movement (REM) sleep. This temporary immobility during REM sleep may prevent your body from acting out dream activity.

Not everyone with sleep paralysis has narcolepsy, however. Many people without narcolepsy experience some episodes of sleep paralysis.

Changes in rapid eye movement (REM) sleep. REM sleep is typically when most dreaming happens. REM sleep can occur at any time of the day in people with narcolepsy. People with narcolepsy often transition quickly to REM sleep, usually within 15 minutes of falling asleep.
Hallucinations. These hallucinations are called hypnagogic hallucinations if they happen as you fall asleep and hypnopompic hallucinations if they occur upon waking. An example is feeling as if there is a stranger in your bedroom. These hallucinations may be particularly vivid and frightening because you may not be fully asleep when you begin dreaming and you experience your dreams as reality.
Other characteristics
People with narcolepsy may have other sleep disorders, such as obstructive sleep apnea — a condition in which breathing starts and stops throughout the night — restless legs syndrome and even insomnia.

Some people with narcolepsy experience automatic behavior during brief episodes of narcolepsy. For example, you may fall asleep while performing a task you normally perform, such as writing, typing or driving, and you continue to perform that task while asleep. When you awaken, you can't remember what you did, and you probably didn't do it well.

When to see a doctor
See your doctor if you experience excessive daytime sleepiness that disrupts your personal or professional life.

Causes
The exact cause of narcolepsy is unknown. People with type 1 narcolepsy have low levels of the chemical hypocretin (hi-poe-KREE-tin). Hypocretin is an important neurochemical in your brain that helps regulate wakefulness and REM sleep.

Hypocretin levels are particularly low in those who experience cataplexy. Exactly what causes the loss of hypocretin-producing cells in the brain isn't known, but experts suspect it's due to an autoimmune reaction.

It's also likely that genetics play a role in the development of narcolepsy. But the risk of a parent passing this disorder to a child is very low — only about 1 percent.

Research also indicates a possible association with exposure to the swine flu (H1N1 flu) virus and a certain form of H1N1 vaccine that's currently administered in Europe, though it's not yet clear why.

Normal sleep pattern vs. narcolepsy
The normal process of falling asleep begins with a phase called non-rapid eye movement (NREM) sleep. During this phase, your brain waves slow considerably. After an hour or so of NREM sleep, your brain activity changes, and REM sleep begins. Most dreaming occurs during REM sleep.

In narcolepsy, however, you may suddenly enter into REM sleep without first experiencing NREM sleep, both at night and during the day. Some of the characteristics of narcolepsy — such as cataplexy, sleep paralysis and hallucinations — are similar to changes that occur in REM sleep, but occur during wakefulness or drowsiness.

Risk factors
There are only a few known risk factors for narcolepsy, including:

Age. Narcolepsy typically begins in people between 10 and 30 years old.
Family history. Your risk of narcolepsy is 20 to 40 times higher if you have a family member who has narcolepsy.
Complications
Public misunderstanding of the condition. Narcolepsy may cause serious problems for you professionally and personally. Others might see you as lazy or lethargic. Your performance may suffer at school or work.
Interference with intimate relationships. Intense feelings, such as anger or joy, can trigger signs of narcolepsy such as cataplexy, causing affected people to withdraw from emotional interactions.
Physical harm. Sleep attacks may result in physical harm to people with narcolepsy. You're at increased risk of a car accident if you have an attack while driving. Your risk of cuts and burns is greater if you fall asleep while preparing food.
Obesity. People with narcolepsy are more likely to be overweight. The weight gain may be related to a low metabolism.

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Insomnia

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Definition of insomnia
Insomnia is a type of sleep disorder. Individuals with insomnia find it difficult to fall asleep, stay asleep, or both.

People with insomnia often don’t feel refreshed when they wake up from sleeping, either. This can lead to fatigue and other symptoms.

Insomnia is the most common of all sleep disorders, according to the American Psychiatric Association (APA). In fact, the APA states that about one-third of all adults report insomnia symptoms. But between 6 to 10 percent of all adults have symptoms severe enough for them to be diagnosed with insomnia disorder.

The APA defines insomnia as a disorder in which people have trouble falling asleep or staying asleep. Doctors make a clinical diagnosis of insomnia if both of these criteria apply:

Sleep difficulties occurring at least three nights a week for a minimum of three months.
Sleep difficulties creating major distress or functional difficulties in a person’s life.
Keep reading to learn all about the symptoms, causes, and types of insomnia.

Insomnia causes
The causes of your insomnia will depend on the type of sleeplessness you experience.

Short-term insomnia may be caused by stress, an upsetting or traumatic event, or changes to your sleep habits.

Chronic insomnia lasts for at least three months and is usually secondary to another problem or a combination of problems, including:

medical conditions which make it harder to sleep, such as arthritis or back pain
psychological issues, such as anxiety or depression
substance use
Risk factors for insomnia
Insomnia can occur at any age and is more likely to affect women than men.


Treating insomnia
There are both pharmaceutical and nonpharmaceutical treatments for insomnia.

Your doctor can talk to you about what treatments might be appropriate. You may need to try a number of different treatments before finding the one that’s most effective for you.

The American College of Physicians (ACP) recommends cognitive behavioral therapy (CBT) as a first-line treatment for chronic insomnia in adults.

Sleep hygiene training may also be recommended. Sometimes, behaviors that interfere with sleep cause insomnia. Sleep hygiene training can help you change some of these disruptive behaviors.

Suggested changes may include:

avoiding caffeinated beverages near bedtime
avoiding exercise near bedtime
minimizing time spent on your bed when you’re not specifically intending to sleep, such as watching TV or surfing the web on your phone
If there’s an underlying psychological or medical disorder contributing to your insomnia, getting appropriate treatment for it can alleviate sleep difficulties. Discover more treatments for insomnia.

Insomnia medications
Sometimes, medications are used to treat insomnia.

An example of an over-the-counter (OTC) medication that can be used for sleep is an antihistamine, such as diphenhydramine (Benadryl). Medications like this can have side effects, especially long term, so it’s important to talk to a doctor before starting yourself on an OTC medicine for insomnia.

Prescription medications that may be used to treat insomnia include:

eszopiclone (Lunesta)
zolpidem (Ambien)
Talk with your doctor before using any medications or supplements to treat your insomnia.

There might be dangerous side effects or drug interactions. Not every “sleep aid” is appropriate for everyone. Get more information on insomnia medications.

Home remedies for insomnia
Many cases of insomnia can be effectively managed by making lifestyle changes or trying home remedies.

Warm milk, herbal tea, and valerian are just a few of the natural sleep aids you can try.

Meditation
Meditation is a natural, easy, drug-free method for treating insomnia. According to the National Sleep Foundation, meditation can help improve the quality of your sleep, as well as make it easier to fall asleep and stay asleep.

The Mayo Clinic says that meditation can also help with symptoms of conditions that may contribute to insomnia. These include:

stress
anxiety
depression
digestive problems
pain
Many apps and videos are available to help you meditate.

Melatonin
The hormone melatonin is naturally produced by the body during the sleep cycle. People often take melatonin supplements in hopes of improving their sleep.

Studies are inconclusive regarding whether melatonin can actually help treat insomnia in adults. There’s some evidence that supplements may slightly decrease the time it takes you to fall asleep but more research is needed.

Melatonin is generally thought to be safe for a short period of time, but its long-term safety has yet to be confirmed.

It’s always best to work with your doctor when deciding to take melatonin.

Essential oils
Essential oils are strong aromatic liquids made from a variety of plants, flowers, and trees. People treat a variety of conditions by inhaling oils or massaging them into the skin. This practice is called aromatherapy.

Essential oils that are thought to help you sleep include:

Roman chamomile
cedarwood
lavender
sandalwood
neroli, or bitter orange
A review of 12 studies in 2015 found aromatherapy to be beneficial in promoting sleep.

Another study found lavender to be especially useful in promoting and sustaining sleep. The study reported that a mixture of essential oils reduced sleep disturbance and increased well-being in older adults.

Essential oils don’t generally cause side effects when used as directed. Most essential oils have been classified GRAS (generally recognized as safe) by the U.S. Food and Drug Administration (FDA).

However, aromatherapy isn’t regulated by law in the United States, and no license is required for practice. Therefore, it’s important to select practitioners and products carefully.

Find out more about safe and healthy home remedies for insomnia.

According to the National Heart, Lung, and Blood Institute (NHLBI), people with certain risk factors are more likely to have insomnia. These risk factors include:

high levels of stress
emotional disorders, such as depression or distress related to a life event
lower income
traveling to different time zones
sedentary lifestyle
changes in work hours, or working night shifts
Certain medical conditions, such as obesity and cardiovascular disease, can also lead to insomnia. Menopause can lead to insomnia as well. Find out more about the causes of — and risk factors for — insomnia.

Insomnia symptoms
People who experience insomnia usually report at least one of these symptoms:

waking too early in the morning
unrefreshing sleep
trouble falling or staying asleep
These symptoms of insomnia can lead to other symptoms, including:

fatigue
mood changes
irritability
You may also have difficulty concentrating on tasks during the day. Learn more about the effects of insomnia on the body.

Dr. Vishnu Nandedkar
Dr. Vishnu Nandedkar
MBBS, Joint Replacement Surgeon Orthopaedics, 9 yrs, Pune
Dr. Yogeshwar Sanap
Dr. Yogeshwar Sanap
MD - Homeopathy, Family Physician Homeopath, 12 yrs, Pune
Dr. DUSHYANTSINH RAUL
Dr. DUSHYANTSINH RAUL
BDS, Cosmetic and Aesthetic Dentist Dental Surgeon, 5 yrs, Pune
Dr. Sanjay  Babar
Dr. Sanjay Babar
BAMS, Ayurveda General Surgeon, 15 yrs, Pune
Dr. Ashok Lathi
Dr. Ashok Lathi
MS - Allopathy, General Surgeon, 37 yrs, Pune
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