Sleep Disorders
I sleepwalk, is there a treatment for it?
We don't have a treatment for sleepwalking, but we know it exists, we know it has potential dangers, and if you sleepwalk, you ought to put in the necessary measures so that if you get up at night, you're not going to cause yourself an injury.
Why do we yawn?
I'm not sure if anybody's absolutely certain as to why we Yawn, but it does seem that it is a necessity for oxygen inhalation, and when you are particularly tired, it seems that gradually respiratory rate slows down. It comes to a stage where the brain seems to want a sudden input of oxygen, and therefore induces this reaction of a wide opening of the mouth with a sudden inhalation, in order to try and ingest a higher dose of oxygen fairly quickly.
Are yawns contagious?
Well, we do know that yawns happen in groups of people. Now, we don't know whether there is a source of not contagious because there is an infectious element to it. But we don't know if it get transmitted in one way or another or simply, that the circumstances as such, that the people might be going into a deeper relaxation, slowing the respiratory rate, enhance the bodies demanding an inhalation of oxygen in order to relief a slightly load oxygen level.
How much sleep do we really need?
Well, the sleep that we need is extremely variable, because different people need different amounts of sleep. As we grow older, we need less sleep. Certainly, older patients sometimes sleep very little. The importance of the amount of sleep that we need is that we should have had sufficient sleep in order to feel rested the following day. Normally, this averages out to about eight hours in an adult. It can vary between seven and nine, and still be considered fairly normal. Having said that, some adults sleep five or six hours and feel perfectly rested the following day, in which case, it's not something that we attempt to change. We accept it, and the important symptom is whether they feel rested the following day or not.
I am always snoring, can I get help for this?
If you're snoring, we need to try and look at the reasons why you're snoring. Snoring is much more common in obese people or people who are overweight than in people who are of a normal weight. So, we would look at your weight and decide whether we would need to ask you to lose weight or not. And that would be the simplest measure to do about snoring. If you're snoring and you're of a normal weight, we would want to look to see whether the tissues within your nasal passages have grown too much in such a way that they have narrowed the passages and therefore, causing snoring. Or we would need to look at the softer tissues at the back part of your palette to see whether they are a little bit too thick, and hence, causing snoring as well. Once we have pinpointed the cause of your snoring, then we would advise you as to whether you can be subjected to some medical treatment to try and relieve the occasional thickening or whether you need to be subjected to surgery in one form or another depending on the area which is affected.
Is there a cure for insomnia?
Insomnia has no cure, really. But insomnia is approached by trying to analyze its causes. First we would have to define whether you are suffering from insomnia or not. That means that if you just sleep little but feel rested the following day, then we wouldn't classify that as insomnia, because your body is getting enough sleep for what it needs. However, if the amount that you sleep leaves you very tired the following day and possibly not able to carry out your usual tasks or an inability to concentrate the following day, then we would consider it insomnia and we would have to look at the causes. The commonest is anxiety, anxiety is probably the commonest cause for keeping people awake at night because they keep thinking about their concerns, their fears, their worries. Other causes are drinking too many stimulants in the latter half of the day—coffees, teas or caffeine-containing drinks. But of course, despite that, there are other causes of insomnia. Snoring, for example, can wake you up at night and you might have difficulty falling back asleep again. That's yet another cause for insomnia. One would need to run through quite a long list of causes and therefore trying to pinpoint the best approach. At the end of the day, if nothing can be found, one might want to look at sleeping pills or other sleep inducing pills. However, any pill which is taken on a regular basis, which has sleep inducing properties, has the potential to cause addiction and therefore we would treat that with caution and obviously not want to prescribe that very easily.
What is the danger of taking sleeping pills?
The danger of taking sleeping pills is that sleeping pills, in the vast majority, are habit forming, and that means that they cause a number of things. For a start, after a certain time of use, the affect that you receive from that pill is diminished if you maintain the same dosage. So in order to achieve the same effect, we would need to increase the dose, and by doing that, we could continue to increase the dose to unacceptable levels. That is something that we call "tolerance", and can happen with sleeping pills. Other problems with sleeping pills are that they can, in the long term, cause a certain amount of memory loss, and, therefore, we are hesitant to keep patients on sleeping pills for prolonged periods of time. And, maybe, my final concern with sleeping pills is, particularly in elderly patients who want to take a sleeping pill to achieve a better night's sleep, if they happen to get up in the middle of the night to go to the toilet, which is extremely common, they might feel woozy or drowsy as a result of the sleeping pill, and, therefore, be at a greater risk of falling over and fracturing a hip or sustaining other types of injuries.
What is chronic fatigue syndrome (CFS)?
Chronic fatigue syndrome is a condition which expresses itself as an extreme tiredness, often associated with various muscle pains, headaches, lack of concentration, and in some instances symptoms of depression. It is a poorly defined disease concept because the symptoms are very non-specific, that is to say it is very difficult to make the diagnosis. Patients will often spend a number of months or years complaining of symptoms without reaching a specific diagnosis.
What is narcolepsy?
Narcolepsy is a condition whereby the patient suffers an excessive amount of sleepiness, just as with hypersomnia. And despite having had a full night's sleep, and feeling rested, under certain circumstances during the day, simply by just sitting down, the patient could fall asleep. It is a rare condition, however for those patients who suffer it, it can be very debilitating. Because driving can be potentially dangerous and therefore, they would not be allowed to drive. And in a lot of every day situations, it would prevent them from carrying out normal tasks such as sitting in front of a computer and carrying out some work without falling asleep.
