Posts for category: Health
Many people think of insomnia as one specific problem with one treatment. However, just as any type of pain can represent different causes in different people, insomnia has different causes in different people.
First of all, insomnia is often a symptom of some other disorder. Insomnia is defined as any one of 4 basic symptoms – difficulty falling asleep, waking up during the night and having difficulty getting back to sleep, early morning awakening insomnia and nonrestorative sleep insomnia. People can experience more than one of these symptoms.
Insomnia can occur for many reasons. It is often due to another undiagnosed sleep disorder, such as a circadian rhythm disorder (sleeping on a different clock, such as shift work or being on call or circadian rhythm delayed sleep phase, being a natural night owl), sleep apnea/sleep disordered breathing, periodic limb movement disorder but can also be due to mood disorders (it can herald the onset of depression or anxiety disorder or a substance abuse disorder) or be a residual effect of a previous episode of a mood disorder. It can be due to medications or pain issues as well. Unlike other fields of medicine, patients with sleep disorders often have more than one underlying sleep disorder, and all of them need to be treated.
In order to clearly understand insomnia, we need to take a very thorough history of the predisposing factors (“Why me?”) such as genetic insomnia tendency or mood disorders, the precipitating factors (“What got it started?”) such as abuse issues leading to hypervigilance, transitions including parenthood, stressors, shift work in the past, etc., and the perpetuating factors (“Why is insomnia STILL happening?”).
Our goal during our consultation is to isolate all of the possible perpetuating factors and put together a plan to diagnose and treat these factors. This may involve further testing or other treatment protocols that we approach and apply in a systematic manner.
Once the above has been addressed, many patients have a conditioned insomnia, in which the brain has been conditioned to have awakenings or arousals. The brain then needs to be retrained on how to sleep again because the coping mechanisms that people adopt for insomnia usually worsen the insomnia – for example, sleeping late because they “did not get a wink all night”, getting up to do relaxing activities or work during the night, “because since I can’t sleep, I might as well do something”, etc.
Many patients ask about using sleeping pills. There are no medical studies that show that the use of long term sleeping pills are either recommended or helpful in insomnia except in certain rare cases, such as after severe traumatic brain injury or other similar conditions. However, sleeping pills may be considered for brief periods if indicated due to particular stressors. The chronic use of sleeping pills is associated with multiple risks, including dementia and fall risks. Some sleeping pills can also be addictive and can cause a rebound insomnia, which can cause a more severe insomnia if the pills are discontinued.
More importantly, sleeping pills do not actually cure insomnia. A person can take sleeping pills for decades, and at the end of it, they will still have insomnia. The pills have only masked the insomnia. Masking the insomnia problem with pills is not the same as curing the insomnia. Proper treatment of insomnia requires thorough consultation and treatment of all perpetuating causes as well as more detailed treatments such as Cognitive Behavioral Therapy for Insomnia (CBTI).
Insomnia treatment can be challenging. A nice introduction to insomnia treatment that we sometimes recommend is a book called "Say Goodnight to Insomnia" which outlines some of the strategies that are used in Cognitive Behavioral Therapy for Insomnia.
For a thorough evaluation for your sleep problems, we recommend that you contact us at our Portland or Astoria location and schedule a consultation.
Find out why your feet feel so restless at night and what you can do about it.
Restless leg syndrome (RLS) is a condition that causes sensations within the legs that make you feel the urge to move. These symptoms most often appear in the afternoon and evening hours when you are sitting down or lying in bed. Unfortunately, a lot of people with RLS find that they can’t get the proper sleep that they need because these unpleasant sensations in their legs are keeping them up or causing them to toss and turn. If this sounds like you, our Portland and Astoria, OR, sleep medicine specialists Dr. Gerald Rich, Dr. Radhika Breaden and Dr. Gregory Clark are here to help.
What are the symptoms of restless leg syndrome?
As we mentioned above, there are sensations within the legs that make it difficult to sit still. These sensations can range from a creeping, crawling feeling to a feeling of “pins and needles”. Lying down will usually exacerbate these symptoms and it may cause sleep disturbances throughout the night.
What causes restless leg syndrome?
While restless leg syndrome can affect anyone, it’s more common in women than men. While there is still a lot that we do not know about this condition it is believed that genetics plays a role in who develops restless leg syndrome. After all, the majority of those with RLS have a family member who also has this same condition.
Of course, there are certain factors that can make RLS symptoms worse such as:
- Chronic health problems (e.g. diabetes; peripheral neuropathy)
- Certain medications (e.g. antidepressants; anti-nausea medication)
Alcohol and lack of sleep are other factors that can also aggravate your RLS symptoms.
What are my treatment options if I have restless leg syndrome?
Since there isn’t a treatment available to get rid of restless leg syndrome, our goal as your Portland, OR, sleep doctor is to determine the best ways to reduce the severity and frequency of your symptoms. This can often be managed through:
Medication: Anti-seizure medications are becoming the most common medication prescribed to those with RLS and it can be effective for handling moderate-to-severe cases.
Lifestyle changes: You may find some relief from your symptoms once you avoid or limit the use of nicotine, caffeine or alcohol. It’s also important to get regular exercise to boost blood flow to the legs. You may also massage your legs everyday or take a warm bath to ease symptoms.
Here at Pacific Sleep Program in Portland and Astoria, OR, we are dedicated to making sure that you get the quality sleep you deserve. No matter whether you have been diagnosed with restless leg syndrome or you think you might have this condition, it’s the perfect time to turn to our sleep doctors for the answers you’re looking for.
Narcolepsy affects up to 200,000 Americans according to the National Institute of Neurological Disorders and Stroke. It is a neurological condition that prevents many people from living normal lives. It’s difficult for patients to conduct daily work, social, or personal activities when they’re prone to falling asleep at inopportune moments. A doctor at Pacific Sleep Program in Astoria and Portland, OR, can assist you with your case of narcolepsy.
What Is Narcolepsy?
Narcolepsy is a chronic sleep disorder that causes patients to fall asleep throughout the day—sometimes without even knowing it. The symptoms often start in childhood and the cause of this neurological problem isn’t clear. It could be related to an issue with the immune system or a brain injury. This may be a challenging and possibly dangerous condition to manage because the patient could fall asleep while working or when driving a car.
Besides the obvious symptom of narcolepsy of excessive daytime sleepiness, there are a few other symptoms that may lead to a diagnosis of narcolepsy. Talk to your sleep doctor if you have any of these issues:
- A desire to take frequent naps throughout the day.
- Muscle weakness (cataplexy) with laughter or strong emotion.
- Sleep paralysis (inability to move or wake up)
- Seeing visions or hearing sounds as you are falling asleep or waking up (hypnagogic or hypnopompic hallucinations)
- Fragmented or poor quality sleep during the night.
- Microsleep episodes (performing automatic actions or being on "autopiilot" without being consciously aware).
Treating Patients with Narcolepsy in Astoria and Portland
Narcolepsy can be treated by a sleep specialist at the Pacific Sleep Program and requires specific testing. Talk to your doctor about the appropriate testing for you.
Possible treatment options include:
- Medication to stimulate the nervous system and make you more alert throughout the day.
- Nighttime sedative.
- Taking scheduled naps throughout the day and committing to going to bed at the same time every night.
Getting Back to Normal
A sleep doctor at Pacific Sleep Program in Astoria and Portland, OR, can help you get back to a normal routine if you struggle with narcolepsy. Call (503) 325-3126 or (503) 228-4414 today to schedule a consultation with Dr. Radhika Breaden, Dr. Jennifer Kim, Debra White NP or Mariah Franclemont, PA.
Have loved ones told you that you snore---loudly and constantly? Snoring is more than a nuisance noise. When it becomes chronic, it impacts interpersonal relationships and overall health. At Pacific Sleep Program in Portland and Astoria, OR, Dr. Gerald Rich, Dr. Gregory Clark, Dr. Jennifer Kim, and Dr. Radhika Breaden provide sleep medicine solutions for chronic snoring and other sleep disorders such as insomnia and Restless Leg Syndrome. Don't ignore snoring, but let the experts help you control it for better health.
Why people snore
We all do occasionally when we have congested nasal passages because of a cold or allergies. Maybe the bedroom air is too dry, or we fall asleep exhausted after a hard day and just stay in an open-mouth position.
However, persistently loud, all-through-the-night snoring is abnormal, and the National Sleep Foundation links it to problems such as:
- Daytime sleepiness
- Irritability and depression
- Poor focus and memory
- Weight gain
- Sexual dysfunction
- Systemic diseases such as diabetes and cardiovascular disease
The National Sleep Foundation also reports that 90 million Americans snore. What can be done about this potentially serious health issue?
Diagnosis and treatment
At the Pacific Sleep Program in Portland and Astoria, our team of highly-trained experts uncovers the causes of snoring and other sleep disorders. Using information from a patient's primary care physician and results from state-of-the-art testing performed in-office our doctors craft individualized sleep medicine care plans to help patients achieve rest and optimal health.
Specifically, the doctors test patients with polysomnography, or tailor-made sleep studies which measure heart rate, blood pressure, respiration, muscular movements, sleep/wake cycles, and other factors. These diagnostics help the doctors pinpoint sleep disorders such as:
- Restless Leg Syndrome (RLS)
- Upper Airway Resistance Syndrome (UARS)
- Central and Obstructive Sleep Apnea (CSA and OSA)
Chronic snoring can be related to UARS, CSA, and OSA. Upper Airway Resistance Syndrome is the most benign of these three sleep disorders because while the airway constricts breathing during sleep, breathing typically does not stop. Sleep apnea, however, does involve breathing cessation-related to airway obstruction or poor communication between the brain and the respiratory system.
Through a carefully selected and monitored sleep study, your doctor at Pacific Sleep Program can determine if you have one of these sleep problems. Treatment varies and usually includes lifestyle changes such as:
- Losing weight
- Avoiding food before bedtime
- Limiting alcohol
- Sleeping on one side rather than on the back
- Having a set bedtime routine
- Elimination of computers, cell phones, and television from the bedroom environment
Medical intervention for sleep apnea and upper airway resistance may include a PAP machine, a bedside apparatus which delivers a steady stream of air through the airway to keep it open. Serious cases may warrant surgery to modify the soft tissues at the back of the throat.
Do you snore?
Don't ignore this problem. Seek help with the team at Pacific Sleep Program. Phone today for an appointment. In Astoria call (503) 325-3126, or in Portland call (503) 228-4414.
Having trouble getting enough sleep? It’s time to turn to a professional.
We can’t always have perfect sleep all the time. Perhaps it was the second glass of wine, or your little one developed a fever in the middle night or your partner was snoring like a freight train. Instances like this happen all the time and can contribute to poor sleep; however, when you are battling with sleeping night after night, it might be time to turn to our Portland and Astoria, Oregon, sleep medicine specialists Dr. Gerald Rich, Dr. Radhika Breaden, and Dr. Gregory Clark for some answers.
If you are dealing with any of these issues then it might be time to turn to our sleep medicine specialists in Portland and Astoria, OR, for help:
- You feel exhausted throughout the day even though you got enough sleep
- You toss and turn throughout the night
- You have difficulty falling asleep
- You wake up early in the morning and have difficulty falling back to sleep
- You snore or your partner complains about your loud or persistent snoring
- You experience restlessness or twitching in your legs at night
If you said yes to one or more of these statements then you could be dealing with a sleep disorder. It’s important that you get an evaluation as soon as possible.
Why should you seek medical attention?
A lot of people find excuses for why they are experiencing bad sleep, but if this is a regular occurrence it’s time to get to the bottom of this, and you’ll need a sleep medicine specialist to help. Even if you don’t think poor sleep is really that big of a deal, conditions that have been linked to untreated sleep disorders include:
- Heart disease
- Hypertension (high blood pressure)
- Extreme fatigue
- Excessive daytime sleepiness
- Heart attack
- Morning headaches and migraines
It can also take a toll on your mental state, increasing your chances of depression, anxiety, irritability, and the like. You may also find that your work or school performance is suffering because you have trouble concentrating.
Don’t lose another night to bad sleep. Pacific Sleep Program has offices in Portland and Astoria, OR, to provide you with the quality care you need to catch those elusive ZZZ's. Schedule an appointment with us today.