Sleep Awareness Quiz

Do you have a sleep problem?

If you find that you can answer yes to two of more of the questions listed above, you are a prime candidate for a sleep study evaluation and should speak with your doctor. Please see the information provided below in response to your selections to learn why you may have a sleep problem, what it means, and how a visit to The Center for Sleep Disorders at Saint Barnabas Medical Center can help.

Often, keeping a "Sleep Diary" to record your sleep habits and experiences will reveal facts and patterns in the way that you sleep. Completing a Sleep Diary records, in a simple and easy to use format, previously un-tracked conditions that may well be interfering with your ability to get a good night's sleep. The Sleep Diary will give your doctor the information he or she needs to recommend a simple and successful therapy for you.
Click here to download the Sleep Diary worksheet. (86kb pdf)

Loud snoring

Snoring is a breathing noise that occurs during sleep. It is a common problem among all ages and both genders, and it affects approximately 90 million American adults — 37 million on a regular basis. Persons most at risk are males and those who are overweight, and it usually becomes more serious as people age. Snoring can cause disruptions to your bed partner's sleep and is also associated with cardiovascular problems such as high blood pressure, headaches and diabetes.

While breathing in, the air passage between the upper soft palate, or uvula, and the throat or base of the tongue may open and close. During sleep, the muscles surrounding these structures relax and the air passage may narrow or close — causing a blockage of the airway. Air cannot flow through easily and may need to be drawn between these structures. The tissues then vibrate — resulting in the familiar sound of snoring.

Snoring represents abnormal breathing during sleep. The loudness and tone of the noise is affected by how much air is going through the passage. The greater the obstruction, the greater is the effort to draw air and the louder the noise.

As it becomes harder to breath and snoring becomes worse, you may actually stop breathing. This is a sign of a serious condition called apnea (meaning "want of breath"), which requires medical attention and may lead to other serious conditions.

A diagnosis of sleep apnea can be made through a sleep study at The Center for Sleep Disorders at Saint Barnabas Medical Center. The general treatment is a specialized sleep mask that applies pressure to the airways. A weight loss program and possible referral to an ear, nose and throat specialist may be recommended, depending on the severity of the condition. To make an appointment, please call 973-322-9800.

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You or other have observed that you stop breathing or gasp for breath during sleep

When there is a partial or complete obstruction of air flowing through the throat into the lungs during sleep, breathing may be interrupted or stop. These pauses, which may last from 10-60 seconds and are usually accompanied by snoring, are symptoms of a serious, life-threatening condition called apnea.

During an "apneic event," which can occur as often as 20-60 times per hour, you are unable to breathe, causing the following: Oxygen levels drop -- alerts the brain to wake up the body -- an arousal occurs to tighten the throat muscles and clear the air passage -- breathing resumes.

As breathing starts up again, there is a loud snort or gasp. These disruptions in sleep cause fragmented, insufficient sleep leaving you at risk for daytime sleepiness, depression, headaches, mental impairment and decreased interest in activities. They put a strain on your lungs, heart and other organs, which can lead to hypertension, heart disease and stroke.

As many as 18 million Americans suffer from sleep apnea although it is more common among men and those who snore, are overweight, have high blood pressure or physical abnormalities in their upper airways. Sleep apnea, which will not go away on its own, has serious consequences for your health and quality of life.

A diagnosis of sleep apnea can be made through a sleep study at The Center for Sleep Disorders at Saint Barnabas Medical Center. The general treatment is a specialized sleep mask that applies pressure to the airways. A weight loss program and possible referral to an ear, nose and throat specialist may be recommended, depending on the severity of the condition. To make an appointment, please call 973-322-9800.

Talk to your doctor — sleep apnea can be prevented and is treatable.

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Feel sleepy or doze off while watching TV, reading, driving or engaged in daily activities

The drive to sleep or the likelihood that you will actually doze off during the day while doing these activities is a serious problem and sign that you may be suffering from sleep deprivation or a sleep disorder. To determine your level of daytime sleepiness, you can take the Epworth Sleepiness Test, a simple eight-question test, and get immediate results. Fewer than 1/3 of American adults get the recommended eight hours of sleep each night, which leaves them at risk for difficulties performing daily activities, driving drowsy, injury and illness.

Over 100,000 sleep-related crashes occur annually, and an increasing number of accidents at work result from untreated sleep problems. It could be due to poor sleep habits, interruption in sleep and/or a serious sleep disorder such as sleep apnea or narcolepsy.

A person who has sleep apnea has "apneic events" or pauses in breathing that can occur as often as 20-30 times per hour and disrupt sleep. The lack of enough sleep, or fragmented sleep, leads to daytime sleepiness. Associated consequences include depression, difficulty concentrating and remembering, moodiness and decreased interest in activities.

The most dominant symptom of narcolepsy is excessive sleepiness with unwanted sleep attacks that occur during normal daily activities — even when you have sufficient sleep at night. About 65-70% of persons with narcolepsy also experience cataplexy, a sudden loss of muscle tone in response to a strong emotion. Other symptoms may include sleep paralysis prior to sleep and upon awakening, sleep-onset hallucinations and automatic behavior (when a person performs an activity without awareness).

A diagnosis of narcolepsy can be made through a sleep study at The Center for Sleep Disorders at Saint Barnabas Medical Center. Narcolepsy is treatable with lifestyle changes and medications. To make an appointment, please call 973-322-9800.

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Have difficulty sleeping three nights a week or more

Having trouble falling asleep, frequent awakenings during the night, waking too early and inability to get back to sleep, or waking feeling unrefreshed are not normal sleep patterns. All are symptoms of insomnia, the inadequate or poor-quality sleep experienced by over one-half of American adults — more often in women and the elderly — a few nights a week or more. Keeping a sleep diary can help you report these symptoms to your doctor.

Types of Insomnia

  • Short term or acute insomnia, due to a temporary situation such as stress, jet lag, change or loss in a job or relationship, can last up to one month and is treatable. It is important to address the underlying cause. Effective and safe prescription medications, such as hypnotics, are available.
  • Long-term, chronic or primary insomnia, which is experienced for a month or longer, can be due to many causes such as underlying medical, physical or psychological condition, another sleep disorder or adopting poor sleep habits over time. It is essential to get a medical diagnosis. In addition to an appropriate use of medications, education on behavioral and other techniques as well as good sleep practices can improve sleep.

Consequences of Insomnia
Insomnia is a risk factor for depression and can significantly affect your quality of life. Consequences of not getting enough good sleep can include daytime fatigue, impaired mood, depression and psychological distress, decreased ability to concentrate, problem-solve, make decisions, risk for injury, driving drowsy, and illness.

Good Sleep Practices You Can Use in Managing Your Insomnia
There are many actions you can take that may help you sleep better. Sleep experts recommend the following tips for good sleep.

A relaxing bedtime routine can make it easier to fall asleep:

  • Engage in a relaxing, non-alerting activity such as reading or listening to music. For some people, soaking in a warm bath or a hot tub can be helpful. Avoid job-related work and household chores that are mentally and physically stimulating.
  • Do not eat or drink too much before bedtime.
  • Create a sleep-promoting environment that is quiet, dark, cool and comfortable.

During the day:

  • Consume less or no caffeine.
  • Avoid alcohol and nicotine, especially close to bedtime.
  • Exercise, but not within 3 hours before bedtime.
  • Avoid naps, particularly in the late afternoon or evening.
  • Keep a sleep diary to identify your sleep habits and patterns.

Establish a regular bedtime and get up at the same time every day. Do not stay in bed to make-up for lost sleep or beyond your regular rise time.

Over-the-Counter (OTC) Medications
Non-prescription, over-the-counter sleep aids are often antihistamines prescribed for allergies. They are readily available and may be useful for some individuals in some situations, but you should be aware of side effects like prolonged sleepiness or the possibility of interactions with other medications. It is best to consult a physician for advice on treating your sleep problem.

Seeking Professional Treatment for Insomnia
Working together with your physician or a sleep specialist from The Center for Sleep Disorders at Saint Barnabas Medical Center can help you develop a treatment plan that best meets your needs. To make an appointment, please call 973-322-9800.

Behavioral therapy for insomnia is offered typically by a psychologist, psychiatrist, or other health practitioner or counselor with specialized training. Several visits to the therapist are usually required regardless of the specific behavioral therapy used. Some of the more common behavioral approaches include:

  • Relaxation training often involves reducing tension and muscular relaxation exercises.
  • Cognitive therapy is conducted with a therapist who helps the patient with attitudes and beliefs which may contribute to poor sleep.
  • Stimulus control trains people to use their bed and bedroom for sleep and sex only. Persons with insomnia are encouraged to spend time awake or when having difficulty sleeping in another room engaged in a relaxing activity until they are sleepy and ready to return to bed.

Prescription medications that promote sleep are called hypnotics. All of the hypnotics listed in the following chart have been approved in the U.S. and are safe and effective for treating insomnia. Medications differ by dose and duration of action.

Most individuals take hypnotics a few nights or a few weeks at a time. A few may benefit from long-term use. Research indicates that when used nightly, hypnotics remain effective for at least several weeks and probably longer. The most common side effects include morning sedation, memory problems, headaches and a night or two of poor sleep after stopping the medication.

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Feel unpleasant, tingling, creeping feelings or nervousness in your legs when trying to sleep

These feelings in your legs — sometimes in the arms — can indicate that you may have Restless Leg Syndrome (RLS), a neurological movement disorder characterized by a strong urge to move and difficulty falling and staying asleep. Symptoms are often worse in the evening or early in the night and during periods of inactivity. Persons with RLS also experience motor restlessness such as pacing across the floor or tossing and turning in bed. Of the 12 million Americans with RLS, about 80% may also experience Periodic Limb Movement Disorder, or jerking movements in the legs or arms. Both conditions can result in difficulty sleeping and daytime sleepiness.

A diagnosis of RLS can be made through a sleep study at The Center for Sleep Disorders at Saint Barnabas. RLS is treatable and symptoms can be minimized, initially by diagnosing the associated medical condition, and then with medications and other oral treatments, physical therapy or lifestyle changes. To make an appointment, please call 973-322-9800.

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Interruptions to your sleep

Both the quantity and quality of sleep are compromised when interruptions such as medical conditions, pain or discomfort, stress, a bed partner's sleep problems and environmental factors disrupt or make it uncomfortable to sleep. Older persons, particularly those who have medical problems, and shift workers, particularly those who work the night shift, are more prone to these disruptions.

People who experience uninterrupted sleep and who do not use an alarm clock to be awakened are more likely to get the amount of sleep they need and also reap the benefits of the natural sleep process. As this process occurs and over an eight-hour period, we enter all of the stages of sleep, both NREM (nonrapid eye movement) and REM (rapid eye movement), that includes deep sleep and assures time for the brain and body to relax, hormones to be released, and memory consolidated as body systems are restored — resulting in alertness — so necessary for our performance, safety and health.

It is helpful to identify the causes of your disruptions that keep you from getting a good night's sleep. Check your sleep environment to make sure that it is comfortable, preferably cool, dark and quiet. Report all of your symptoms to your doctor or a sleep specialist at The Center for Sleep Disorders at Saint Barnabas so that any medical conditions can be identified and you get the appropriate diagnosis. To make an appointment, please call 973-322-9800. Keep a sleep diary to record any sleep problems, which can then be discussed with your doctor.

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