Obstructive Sleep Apnea versus Central Sleep Apnea
Obstructive sleep apnea is when the airwaybecomes narrowed or obstructed and you're making the effort to breathe but we do notsee any flow in air movement coming from your nose or mouth. Where central sleep apnea occurswhere your brain forgets to tell your body to breathe. If we're looking at it from avery simplistic term and so we do not see the drive to breathe. So the first step isto come into the and be seen by one of our physicians in the sleep medicine .We'll go through a questionnaire and try to determine what risk factors we think you havefor sleep apnea such as obesity, snoring, daytime sleepiness and then if we think thatyou have a high risk for meeting those criteria
then we would set you up for a sleep studyeither in your home to do an overnight sleep study or in our laboratory, depending on yoursituation. The CPAP can be used to treat both conditions and, in some patients, that isenough. However, there are some patients that have more complex types of central sleep apneathat require more complicated types of machines to treat that condition. Obstructive sleepapnea actually has been linked to a lot of other problems such as high blood pressureand then, you know, difficulty functioning during the day. If it goes untreated for along period of time there's an increased risk of early heart problems and those types ofthings.
Restless Legs Syndrome and Sleep Diagnosis and Treatments
Hi, my name is Charlene Gamaldo. I'm a Johns Hopkins neurology sleep faculty member and I'mthe medical director of the Howard County Sleep Disorders Center. My name is Rachel Salas. I'm a sleep neurologist board certified in both specialties. So, restless leg syndrome, that has alsorecently been coined WillisEkbom disorder is a alsleep disorder. It requires four essential criteria
that involves a person who hasuncomfortable sensations in their legs that is associated with an urge to move. This urge to move usually comes on at restand it peaks at night and for that reasonbecause it peaks at night and they want to move it causes disruption in their ability togo to sleep. And for that reason they often show upin a sleep because it causes problems with
ability to go to sleep and causesproblems with daytime functioning as a result. Restless leg syndrome can occur in anyone. There tends to be more of a femalepredominance but again it can occur in anyone. Even children can have it. There tends tobe a hereditary component there. People that have iron deficiencyanemia are more at risk. People that have kidney disease,particularly endstage renal disease.
it can put them at higher risk probablybecause of the iron. Patients with peripheral neuropathy particularly those that suffer fromdiabetes can be at higher risk. There's certain things.certainother disorders that increase the risk for restless legsyndrome, but then again it could also be you know, sporadic.people could justdevelop it. So, treatment strategies for restlessleg syndrome
is number one educate them about itbecause there are exacerbaters out there herparticularly overthecounter medications, anythingwith antihistamines are big culprits for essentially kicking people into you know, these flares of restless legsyndrome. Medications are actually very good forpatients with restless leg syndrome. It can actually improve theirquality of life There's different classes the FDAapproved dopamine agonists
are available. If the patient has restless leg syndrome we'll always check aniron panel to see what their iron status is and if that'sdeficient or even low normal.a lot of times we'll try treating just with iron first and that may be all patients need. For the more severe types, and these are typically what we see, you know, becausepeople are coming to Hopkins you know,
Periodic Limb Movements of Sleep
MUSIC Periodic limbmovements of sleep. Perodic Limb Movementsof Sleep or PLMS is a sleep disordercharacterized by uncontrolled, repeated movements inthe lower limbs during sleep. While these movements usuallyoccur in the big toe and at the ankle,it can also effect the arms. The movements interfere withdeep sleep, though the person
may not be aware of it, andsimply feel tired the next day. Often the only symptom of PLMSis complaints from the sleep partner being kicked. PLMS may cause serioussleep disturbance for both individuals. PLMS is equally dividedbetween men and women. Up to 44% of people overthe age of 65 may have it. It is rarely seen in peopleunder the age of 30.
PLMS is often mistaken insomeone with obstructive sleep apnea, because it can causesimilar leg movements. Additionally, as manyas 80% of people with restless leg syndrome,RLS, also have PLMS. Symptoms of PeriodicLimb Movements of Sleep. If you have PLMS, or sleepwith someone who does, you may describe the movements asflexing or jerking the big toe, bending the ankle or knee,or twitching the hip.
The movements can lastfrom 1 to 5 seconds, occur about every 20 to40 seconds, and cluster into episodes that last froma few minutes to several hours. Individuals with PLMS oftencomplain of daytime sleepiness and an unpleasant crawling, creeping orpainful sensation in the legs. Some have a hard time fallingasleep or staying asleep. This may be related tochronic insomnia or
restless leg syndrome. Occasionally, PLMS is a signof a serious medical problem, such as diabetes,kidney disease or anemia. Diagnosing Periodic LimbMovements of Sleep. To diagnose PLMS,a health care provider will ask many questions about yourfamily and medical history, as well as your sleep habits. You will be asked aboutyour caffeine, tobacco, and
alcohol use. Bring a list of allthe medicines you take. Be sure to includeboth prescription, and over the counter pills andvitamins. All of these may affect PLMS. Various tests, includingan overnight sleep study, may be ordered to helpidentify the limb movements. Treatment for PeriodicLimb Movements of Sleep.