Consciousness 151SLEEP APNEA Gerald was a snorer. Actually, that’s an understatement. Gerald could
give a jet engine some serious competition. Snoring is fairly common, occurring when
the breathing passages (nose and throat) get blocked. Most people snore only when they
have a cold or some other occasional problem, but some people snore every night and
quite loudly, like Gerald. It is this type of snoring that is often associated with a condition
called sleep apnea, in which the person stops breathing for 10 seconds or more. When
breathing stops, there will be a sudden silence, followed shortly by a gasping sound as
the person struggles to get air into the lungs. Many people do not wake up while this is
happening, but they do not get a good, restful night’s sleep because of the apnea.
Apnea is a serious problem. According to the National Institutes of Health (2011),
from 5 to 25 percent of adults in the United States suffer from apnea (it is difficult to
be precise, as many people are unaware that they have apnea). Apnea can cause heart
problems as well as poor sleep quality and depression (Edwards et al., 2015; Flemons,
2002; National Institute of Neurological Disorders and Stroke, 2015). If a person suspects
the presence of apnea, a visit to a physician is the first step in identifying the disorder
and deciding on a treatment. While some people can benefit from wearing a nasal open-
ing device, losing weight (obesity is often a primary cause of apnea), or using a nasal
spray to shrink the nasal tissues, others must sleep with a device that delivers a continu-
ous stream of air under mild pressure, called a continuous positive airway pressure (CPAP)
device. Still others undergo a simple surgery in which the uvula (the little flap that hangs
down at the back of the throat) and some of the soft tissues surrounding it are removed.
Some very young infants also experience a kind of apnea due to immaturity of the
brain stem. These infants are typically placed on monitors that sound an alarm when
breathing stops, allowing caregivers to help the infant begin breathing again. Although
sleep apnea in infants is often associated with sudden infant death syndrome, or SIDS, it
is not necessarily caused by it: Many infants who die of SIDS were never diagnosed with
sleep apnea (Blackmon et al., 2003).
NARCOLEPSY A disorder affecting 1 in every 2,000 persons, narcolepsy is a kind of
“sleep seizure.” In narcolepsy, the person may slip suddenly into REM sleep during
the day (especially when the person experiences strong emotions). Another symptom
is excessive daytime sleepiness that results in the person falling asleep throughout the
day at inappropriate times and in inappropriate places (Overeem et al., 2001). These
sleep attacks may occur many times and without warning, making the operation of
a car or other machinery very dangerous for the person with narcolepsy. The sudden
REM attacks are especially dangerous because of the symptom of cataplexy, or a sudden
loss of muscle tone. This sleep paralysis may cause injuries if the person is standing
when the attack occurs. The same hypnogogic images that may accompany stage N1
sleep may also occur in the person with narcolepsy. There may be new hope for suffer-
ers of narcolepsy: Researchers have been developing a new drug to treat narcolepsy,
and while still in the stages of animal testing, it looks very promising (Nagahara et al.,
2015). Ta b l e 4. 1 has a more detailed list of known sleep disorders.
Table 4. 1 Sleep Disorders
Name of Disorder Primary Symptoms
Somnambulism Sitting, walking, or performing complex behavior while asleep
Night terrors Extreme fear, agitation, screaming while asleep
Restless leg syndrome Uncomfortable sensations in legs causing movement and loss of sleep
Nocturnal leg cramps Painful cramps in calf or foot muscles
Hypersomnia Excessive daytime sleepiness
Circadian rhythm disorders Disturbances of the sleep–wake cycle such as jet lag and shift work
Enuresis Urinating while asleep in bedsleep apnea
disorder in which the person stops
breathing for 10 seconds or more.narcolepsy
sleep disorder in which a person falls
immediately into REM sleep during the
day without warning.