SPECIAL INTEREST IN SLEEP DISORDERS
My work in sleep disorders goes back almost 20 years working in hospitals, with specialists such as neurologists and paediatricians doing neurophysiology testing, running a sleep laboratory as well as lecturing and training students in sleep medicine for many years gave me the edge on assessing most sleep disorders. Most sleep disorders require medical intervention resulting in my work being in collaboration with other practitioners and sleep specialists. I was privileged to do a mini-fellowship in insomnia at Penn University, Philadelphia, USA with Professor Michael Perlis and colleagues in 2010. I have been strongly influenced by a handful of mentors and specialists working in sleep disorders in South Africa and continue to collaborate with them and their sleep laboratories.
I gained a lot of experience in Sleep Apnoea but in doing so began to realise how neglected the other sleep disorders were from a clinical evaluation and treatment perspective. So I started to attend sleep conferences all over the world and through the years under the tuition of many beloved mentors gained some experience and understanding of how to assess and treat all the sleep disorders. I work with all sleep disorders as a starting point to assess and identify the sleep problem. From there some clients stay with me and/or are referred to other practitioners. Some examples of sleep disorders are: Insomnia, Circadian Rhythm Disorders, Obstructive Sleep Apnoea, Restless Leg Syndrome, Periodic Limb Movement Disorder, Parasomnias e.g. Nightmares, Sleep Walking, teeth grinding, REM Behaviour Disorder etc. I also assist parents to train their babies and children to sleep when they are not sleeping well.
Insomnia, the inability to get to sleep, or stay asleep or both, is a sleep disorder that can present on its own after a precipitating event but is often associated with other complex problems such as a head injury, concussion and/or a stress response e.g. Post Traumatic Stress Disorder. Insomnia can be related to family system events such as the birth of a baby, marital disputes and/or safety issues. It is often related to hormonal change such as pregnancy, child birth, menopause etc. These cases require long-term therapy, a multidisciplinary team approach and monitoring over time to improve quality of life.
Obstructive Sleep Apnoea is a sleep disorder related to snoring and breathing problems during sleep affecting oxygen supply to the body. This disorder has risk factors for many conditions such as hypertension, stroke and metabolic disorder.
Types of sleep disorders
There are several types of sleep disorders, including:
- Insomnia - The inability to fall asleep or to remain asleep. This sleep disorder can be caused by stress and anxiety, hormones, digestive problems or jetlag. It may have an adverse effect on your quality of life, as it causes depression, difficulty concentrating, irritability, weight gain, and impaired performance at work or in school.
- Sleep Apnoea - This is a serious medical condition that is characterised by pauses in breath during sleep.
- Parasomnias - This causes abnormal movements and behaviours during sleep, such as sleepwalking, sleep talking, groaning, nightmares and bedwetting.
- Restless Leg Syndrome - This is an overwhelming need to continuously move the legs at night.
- Narcolepsy - This is characterised by “sleep attacks” that occur during the day.
- Circadian rhythm disorders such as jet lag, phase delay and phase advance syndrome.
Sleep Disorders Symptoms
A sleep disorder is a common condition that affects the ability to sleep well on a regular basis. Most people experience sleeping problems due to stress, hectic schedules and outside influences. However, when these problems present itself more frequently and interfere with daily life, they may indicate a sleeping disorder.
Symptoms of sleep disorders can differ depending on the severity and the type of disorder. They may also differ when sleep disorders are caused by other conditions, such as medication or stress.
However, the general symptoms of sleep disorders include:
- Excessive Daytime Sleepiness
- Mood alteration such as weepiness, irritability, anger outbursts, anxiety or depression
- Difficulty falling or staying asleep
- Daytime fatigue
- A strong urge to take naps during the day
- Irritability or anxiety
- Lack of concentration