John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Insomnia, the inability to
sleep, is all too common in our society. Many
people have transient sleep disturbances and treat them with over-the-counter
medications, while others turn to their healthcare provider for prescription
medications - and there are plenty of choices for medications. Each has its
benefits and risks, indications, and side effects, and these medications are not
interchangeable. More importantly, they aren't safe to use together.
Regardless of the mechanism of action of sleeping pills, they are all
"downers." They depress brain function, and if too many are taken or if they are
mixed with alcohol or other drugs, the breathing centers of the brain can be
depressed to the point that the body stops breathing, and the person dies.
One prescription sleep medication is
zolpidem (Ambien). Ambien is a sedative drug that
works quickly; but as with any sleeping pill, it needs to be used in a wise
manner.
Insomnia is difficulty in falling or staying asleep,
the absence of restful sleep, or poor quality of sleep.
Insomnia is a symptom and not a disease. The most common
causes of insomnia are:
Insomnia can also be caused by poor
sleeping habits such as excessive daytime naps or caffeine
consumption and poor sleep hygiene.
The National Center for Sleep Disorders Research at the National Institutes
of Health estimates 30%-40% of adults report some symptoms of insomnia each
year, and about 10%-15% report they have chronic insomnia.
Insomnia may be classified by how long the symptoms are
present.
Transient insomnia usually is due to situational
changes such as travel, extreme climate changes, and stressful events. It lasts for
less than a week or until the stressful event is resolved.
Short-term insomnia usually is due to ongoing stressful lifestyle
or events,
medication side effects or medical conditions and lasts for one to three weeks.
Chronic insomnia (long-term insomnia) often results from
depression, digestive problems, sleep disorders, or substance abuse and continues for more than three weeks.
Transient insomnia may progress to short-term insomnia and without adequate treatment,
and short-term
insomnia may become chronic insomnia.
Among the medications and substances that can contribute
to insomnia are:
caffeine and coffee,
tobacco,
alcohol,
decongestants (for example, pseudoephedrine),
diuretics (for example, furosemide
[Lasix],
hydrochlorothiazide
[Dyazide]) especially if taken in the evening or at
bedtime,
Night sweats are severe hot flashes that occur at night and result in a drenching sweat. In order to distinguish night sweats that arise from medical causes from those that occur because one's surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment.
Restless leg syndrome (RLS or restless legs syndrome) is a common cause for painful legs that typically eases with motion, and becomes worse and more noticeable at rest. This characteristic nighttime worsening can frequently lead to insomnia. Treatment of the symptoms of restless leg syndrome is generally with medication as well as treating any underlying condition causing restless leg syndrome.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. Not getting enough sleep can hurt memory performance, health, and your mood.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Narcolepsy, a chronic disease of the central nervous system causes have not been fully determined. Some theories include abnormalities in hypocretin neurons in the brain or an autoimmune disorder. Symptoms of narcolepsy include excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, sleep paralysis, disturbed nocturnal sleep, and automatic behavior. Diagnosis of narcolepsy is based on a clinical evaluation, specific questionnaires, sleep logs or diaries, and the results of sleep laboratory tests. Treatments of narcolepsy symptoms include medication and lifestyle changes.
Sleepwalking is a condition in which an individual walks or does other activities while asleep. Factors associated with sleepwalking include genetic, environmental, and physiological. Episodes of sleepwalking may include quiet walking to agitated running. Conditions that may have similar symptoms of sleepwalking, but are not include night terrors, confusional arousals, and nocturnal seizures. Treatment of sleepwalking generally include preventative measures. Medication may be prescribed if necessary.
Hypersomnia is a condition where a person has excessive daytime sleepiness and trouble staying awake during the day. Treatment for hypersomnia includes medication, CPAP machines, and lifestyle changes.
Caring for a loved one or patient with Alzheimer's can become a difficult and overwhelming task at times. This guide helps caregivers of individual's with Alzheimer's deal with communicating, bathing, and dressing; as well as problem solving with incontinence, sleeping, wandering; and coping with difficulties Alzheimer's patients present.
Periodic limb movement disorder (PLMD) is a sleep disorder characterized by rhythmic movements of the limbs during sleep. The movements typically involve the legs, but upper extremity movements may also occur. Movements occur periodically throughout the night and can fluctuate in severity from one night to the next. They tend to cluster in episodes that last anywhere from a few minutes to several hours. These movements are very different from the normal spasms, called hypnic myoclonia, that we often experience initially while trying to fall asleep.
When sleepiness interferes with daily routines and activities, or reduces the ability to function, it is called "problem sleepiness." A person can have problem sleepiness without realizing it. Symptoms of problem sleepiness include: consistently don't get enough sleep, or poor quality sleep, fall asleep while driving, struggle to stay awake when inactive (like watching TV or reading), have difficulty paying attention or concentrating at work, school, or home, have poor performance problems at work or school, have difficulty remembering things, have slowed responses, have difficulty controlling your emotions, and/or if you have to take naps on most days.
Sleep needs in children and teenagers depends on the age of the child. Sleep disorders in children such as sleep apnea, parasomnias, confusional arousals, night terrors, nightmares, narcolepsy, and sleepwalking can effect a child's or teen's sleep. Healthy sleep habits and good sleep hygiene can help your infant, toddler, preschooler, tween, or teenager get a good night's sleep.
Periodic limb movement disorder (PLMD) is a sleep disorder characterized by rhythmic movements of the limbs during sleep. The movements typically involve the legs, but upper extremity movements may also occur. Movements occur periodically throughout the night and can fluctuate in severity from one night to the next. They tend to cluster in episodes that last anywhere from a few minutes to several hours. These movements are very different from the normal spasms, called hypnic myoclonia, that we often experience initially while trying to fall asleep.
What Causes PLMD?
The causes of PLMD are unknown. However recent research has shown that people with a variety of medical problems, including Parkinson's disease and narcolepsy, may have frequent periodic limb movements in sleep.
PLMD may be caused by medications, most notably, antidepressants.