Most patients come to the sleep center either because they are having trouble staying awake during the day (excessive daytime sleepiness, or EDS) or because they can’t fall asleep or maintain sleep at night. A smaller group suffers from parasomnias, or abnormal sleep behaviors. Some patients are urged to seek help by their bedmates, whose sleep is being disturbed.

Trouble Staying Awake

The most frequently diagnosed cause of excessive daytime sleepiness is sleep apnea. It occurs when a person stops breathing again and again while sleeping, limiting restful sleep. When left untreated, sleep apnea can have serious health consequences, including high blood pressure and even heart attack or stroke. Heavy snoring can be a symptom of sleep apnea.

Excessive daytime sleepiness may also be caused by a condition called narcolepsy, a neurologic disorder of control of sleep. Many patients with narcolepsy will have cataplexy, which is muscular weakness when angry, surprised or amused.

Trouble Initiating or Maintaining Sleep

Insomnia, or difficulty initiating or maintaining sleep, can be transient, intermittent or chronic. It is more common in women and the elderly. It has many causes, including specific sleep disorders, anxiety, depression, stress, medical problems and other factors. A condition called restless legs syndrome can prevent people from getting proper sleep.

Parasomnias

Parasomnias are abnormal behaviors occurring during sleep. Rapid eye movement sleep behavior disorder causes dream-enacting behaviors during sleep including thrashing and other purposeful movements. Sleepwalking is seen occasionally in children and usually disappears by the time they reach the age of 15. If it begins later in life or persists into adulthood and occurs frequently, it may indicate a more serious sleep disorder. It may be related to major life stress.