Sleep Medicine

Abnormal Sleep Behavior

Abnormal behaviors that occur during sleep are called parasomnias. These include abnormal physical or verbal behaviors that may occur at any age, although some are more common in childhood. Parasomnias may prevent you from getting a good night's sleep and can affect your daily activities.

Abnormal sleep behaviors may be hereditary, or triggered by stress, traumatic episodes, certain medications, alcohol or other sleep disorders. A few abnormal sleep behaviors have been described below.

Sleepwalking: A parasomnia in which one gets out of bed and moves around or performs certain activities in a state of sleep. Sleepwalkers are usually confused and angry when awoken and may respond aggressively if restrained. Sleepwalking can be dangerous as the sleepwalker is unaware of their surroundings and can injure themselves.

Night terrors: The person awakens in a fearful state, confused and unable to communicate as they are not fully awake. They fall asleep again after some time and are unable to remember the event the next day.

Nightmares: Nightmares are unpleasant dreams that one awakens from and experiences feelings of fear and anxiety. The person having a nightmare has difficulty going back to sleep and usually remembers the terrible dream.

Sleep paralysis: Sleep paralysis refers to the temporary inability to move, which happens while going to sleep or upon awakening. During these episodes the person will be unable to move or speak, and may experience hallucinations. Sleep paralysis may last a few seconds or minutes, or may end when someone touches or speaks to the person.

REM sleep behavior disorder: People with REM sleep behavior disorder act-out certain actions and sometimes violent dreams, sometimes hurting themselves or others.

Potentially dangerous parasomnias, or those affecting your health and daily activities require medical attention. A sleep specialist will recommend the maintenance of a diary of the sleep habits and will review symptoms, medical and social history to identify the type of parasomnia and the associated cause. A sleep study such as a polysomnogram is conducted which measures breathing patterns, air flow, blood oxygen levels, electrical activity of the brain, heart rate, muscle activity and eye movements during sleep.

To treat abnormal sleep behavior, the specialist may prescribe medication, or recommend lifestyle changes or behavioral therapy. It is important to maintain certain safety measures to reduce the risk of injury associated with some parasomnias. Treating the underlying sleep disorder may help improve the symptoms of parasomnias.

Snoring and Sleep Apnea

Snoring is a sound produced due to the obstruction of breathing while sleeping. It is caused by vibrations that occur when tissues at the top of the airway strike each other. Snoring is commonly observed in older people and those who are overweight. It may be a sign of a more serious condition known as sleep apnea.

Sleep apnea is a disorder in which breathing is brief and repeatedly interrupted during sleep. It is an involuntary condition and in most cases the person is unaware as the obstruction of breath does not trigger full awakening. As a result, sleep is fragmented and of low quality. Sleep apnea is more common in men than in women.

In children, snoring may be a symptom of a problem related to the tonsils and adenoids. In adults and elderly people, snoring may be due to poor muscle tone in the throat and tongue, excessive throat tissue, long soft palate and uvula or obstructed nasal airways. Chronic snoring is an indicator of sleep apnea and should not be left undiagnosed. As people with sleep apnea are sleep deprived, the untreated condition may lead to difficulty in concentrating and mood changes such as irritability. Children may experience learning deficits and memory loss. Adults may have difficulty concentrating at work and focusing on the road when driving. People with the condition are at risk of developing high blood pressure, weight gain, memory loss, congestive heart failure, stroke, impotence and depression.

Snoring and mild to moderate sleep apnea may be treated by a newly developed device by Oventus called the O2Vent. This is an oral appliance designed to direct air flow to the back of the throat and alleviate any obstruction from the nose, soft palate and tongue. It also advances the mandible forward. Your doctor will obtain impressions of your upper and lower teeth as well as a bite registration. These are then scanned with a 3D scanner and using 3D printing technology the custom-made appliance is designed.

Another oral appliance that promotes better breathing during sleep is the newly introduced SomnoDent, a device by SomnoMed. It is designed to alleviate obstruction by advancing the mandible forward during sleep. The device fits over your teeth like a sports guard. It is custom designed in the SomnoMed laboratory with the oral impressions and bite registrations that your doctor obtains. The device gently advances your lower jaw forward so that your airway remains open and you get a good night's rest.