Sleep Medicine Unit

Sleep Medicine is the medical specialty that deals with the study, investigation, diagnosis and treatment of sleep disorders.

About 30% of the population has some sleep disorder. The main symptoms are difficulty initiating or maintaining sleep, excessive sleepiness, discomfort in the legs when lying down, sudden and frequent movements during sleep, and even more complex behaviors during sleep, such as walking.

These disorders affect the rest and quality of life of the people who suffer from them, and may even favor the development of certain diseases (e.g. cardiovascular).

Sleep Medicine includes these disorders:

Insomnia

It is defined by the difficulty to initiate and/or maintain sleep. As a consequence of the lack of sleep, difficulties appear to develop the usual activities during the day. It occurs at any age, sometimes related to stressful life events.

Its prevalence is higher in women, especially after menopause, due to the hormonal changes that occur at this stage. There are several effective treatments for its management, the most effective being cognitive-behavioral therapy, carried out by the specialist psychologist of our Unit.

Obstructive sleep apnea-hypopnea syndrome (OSAHS)

It is manifested by the presence of snoring and airway obstructions during sleep. Consequently, sleep is not restorative, and patients present daytime sleepiness.

OSAS increases the risk of presenting acute cardiovascular events in the future (myocardial infarction and stroke), hence the importance of early detection and treatment. It is more frequent in obese patients, and in those with upper airway problems that reduce the caliber of the upper airway (e.g. nasal septum deviation, turbinate hypertrophy, tonsillar hypertrophy).Hospital Ruber Internacional (from April 2019).

Restless legs syndrome

It consists of the presence of unpleasant sensations in the legs, which appear at rest and worsen in the evening. They are associated with an irresistible need to move the legs, and improvement of these discomforts when moving them.

It affects 12-15% of the population and often has a familial component. Given its predominance at night and with rest, it causes difficulties in falling and staying asleep.

Narcolepsy

It is characterized by the presence of irresistible sleep attacks during the day, a very disturbed nocturnal sleep, with the presence of hallucinations on awakening or falling asleep, and episodes of sleep paralysis on awakening. It may be associated with episodes of cataplexy, consisting of loss of muscle tone triggered by positive or negative emotions.

It is a rare disease of multifactorial origin, with genetic and autoimmune factors involved, causing the loss of hypocretin-secreting neurons.

Parasomnias

These are disorders of the transition between wakefulness and sleep, which cause abnormal sensations and/or behaviors during sleep. Some are more frequent in childhood, such as night terrors and sleepwalking.

In adulthood, somniloquy, head-burst syndrome or nightmares predominate. From the age of 50 years onwards, REM (rapid eye movement) behavioral disorder may appear.

Circadian rhythm disorders

The suprachiasmatic nucleus is the brain structure responsible for our sleep rhythm, functioning as an “internal clock”.

When difficulties appear in aligning our intrinsic sleep rhythm to the circadian rhythm of light and dark, circadian rhythm disorders appear.

In the syndrome due to phase advancement , sleep appears very early and ends very early, as occurs in early risers, or “larks”. On the contrary, in the syndrome due to phase delay, sleep appears very late, as in those late night people, or “owls”.

Jet lag (rapid time zone change syndrome or jet lag disorders) occurs when we travel, and we must adapt our internal clock to a new time zone.