Hypersomnia: How to Manage Excessive Daytime Sleepiness

November 8, 2023Sleep Management,Sleep Disorders

Hypersomnia is a sleep disorder characterized by excessive daytime sleepiness, even with adequate nighttime sleep. The condition can significantly impact daily functioning and overall well-being.

As the disorder has various potential underlying causes, it’s crucial to understand them to identify the kind of problem you are dealing with and find the right treatment methods.

In this article, we will learn about hypersomnia, its symptoms, potential causes, methods of diagnosis, and available treatment options.

What is hypersomnia?

The definition of hypersomnia is excessive daytime sleepiness (EDS), often referred to as hypersomnolence or hypersomnolence disorder.

One thing to understand is that hypersomnia is not just simple tiredness or sleepiness. The effects of hypersomnia are usually much more apparent and harder to deal with. Another distinction is that hypersomnia will not go away even with adequate rest, unlike regular sleepiness.

Hypersomnolence is often only a symptom of some other neurological condition or underlying disorder like narcolepsy or Kleine-Levin syndrome, both of which can be categorized as hypersomnias. Hypersomnia can also be a standalone condition with no identifiable underlying cause, in which case, we call it idiopathic hypersomnia. In this article, we will focus on this type.

At first glance, the symptoms might be similar to narcolepsy or other sleep disorders, but the underlying causes and treatment options might vary.

Accurate diagnosis and appropriate treatment are crucial for managing hypersomnia and similar conditions.

Hypersomnia symptoms

The symptoms of hypersomnia might vary slightly depending on the underlying causes. However, excessive daytime sleepiness (EDS) is the hallmark sign of hypersomnia, which is apparent in all forms of the condition.

Other symptoms might include:

• Episodes of excessive sleepiness during daytime, called sleep attacks
• Difficulty remaining awake
• Sleep drunkness after waking up
• Naps are not refreshing
• Need to sleep longer than 10 hours a day
• Low energy levels
• Anxiety, depression, increased stress
• Decreased mental capacity, slow thinking, speaking slowly, problems with memory and concentration
• Headaches
• Hallucinations

It's important to note that regular tiredness might cause similar symptoms. However, hypersomnia produces the same symptoms even when you get an adequate amount of rest, and the symptoms are usually more apparent and harder to deal with.

Hypersomnia causes

Hypersomnia can be the result of various underlying causes.

We can distinguish between primary and secondary hypersomnias based on what causes them.

Primary hypersomnias are standalone medical conditions, while secondary ones are usually the results of some other underlying disease or disorder.

Primary hypersomnias

There are four conditions that fall into this category.

• Narcolepsy type 1 - Caused by low hypocretin levels, this disorder leads to sudden and intense sleep attacks accompanied by the loss of muscle tone and control, called cataplexy.
• Narcolepsy type 2 - Produces similar symptoms to narcolepsy type 1 but without cataplexy. It occurs with normal hypocretin levels, and the causes behind it are not entirely clear yet.
• Klein-Levin syndrome - A rare, long-standing medical condition that leads to episodes of extreme sleepiness and tiredness, each of them lasting for weeks or even months. The causes behind it are unknown, but doctors suspect the malfunction or damage of the hypothalamus.
• Idiopathic hypersomnia - Hypersomnia is the main symptom of the above disorders, so they are all categorized as hypersomnias. But hypersomnia can appear even on its own, without additional symptoms associated with the conditions above. In these cases, the underlying cause is not clear. This is called idiopathic hypersomnia.

Secondary hypersomnia

Hypersomnia can be categorized as secondary when it is a result of some other underlying issue.

Some medications, excessive alcohol consumption, and long-term lack of proper sleep can all lead to developing secondary hypersomnia.

Several diseases and disorders may also have hypersomnia as a symptom. Some of these are:

• Sleep apnea
• Delayed sleep phase syndrome
• Restless leg syndrome 
• Bruxism
• Depression
• Bipolar disorder
• Epilepsy
• Multiple sclerosis
• Tumors
• Central nervous system dysfunctions
• Parkinson's disease
• Hypothyroidism

Diagnosing hypersomnia

When diagnosing hypersomnia or other sleep-related issues, doctors will ask questions about your sleep quality, sleep schedule, and sleeping habits. They might also ask you to keep a sleep diary for a while to help with the diagnosis process.

Various diagnostic tests can help doctors rule out other conditions and underlying issues that might lead to hypersomnia. They might run blood tests for anemia or thyroid problems. CT and MRI scans can help uncover neurological issues, and they might use electroencephalogram (EEG) tests to measure electrical brain activity. Polysomnography is a complex sleep test that could help diagnose or rule out many sleep disorders.

If doctors can't find any underlying causes behind your hypersomnia symptoms, that might lead them to a diagnosis of idiopathic hypersomnia.

Hypersomnia treatments

In the case of secondary hypersomnia, when the underlying cause of your hypersomnia is clear, doctors usually focus on fixing that first, which, in turn, should ease the symptoms of hypersomnia as well.

This might include medical treatment for some other disease or disorder, a change of medications if hypersomnia occurs as a side effect of those, reducing alcohol and caffeine consumption, or some other lifestyle changes.

Idiopathic hypersomnia treatment is a bit less straightforward. Since the cause is unknown, there is no clear-cut cure for it. Treatment focuses on easing the symptoms and restoring your ability to function during the day.

Medications

Doctors might recommend medications to help you stay awake and focused during the day.

• Non-stimulant wake-promoting drugs - modafinil, armodafinil, pitolisant, solriamfetol
• Psychostimulants - amphetamine, methylphenidate, dextroamphetamine
• Other options - sodium oxybate, flumazenil, clarithromycin

These medications might have some unwanted side effects, though. And some of them can be highly addictive.

Other treatment methods

In some cases, doctors might advise different approaches or combine them with medications.

Cognitive behavior therapy can be helpful in dealing with the stress and anxiety caused by hypersomnia, and it might also help you get better sleep by reducing stress levels.

Changing your diet might also alleviate the symptoms of hypersomnia to some degree. Reducing caffeine and alcohol intake could be beneficial, and maintaining a healthy and balanced diet can also improve your overall well-being.

Taking measures to improve your sleep quality might also be a good idea. These things might help you get better rest during the night:

• Maintain a steady sleep schedule
• Avoid night-shift work
• Keep your room dark during the night
• Use white noise to improve your sleep
• Try sleep patches
• Stay active physically
• Avoid stimulating activities before bedtime
• Make sure you address any other sleep disorders that you might have
• Try sleep-promoting herbal teas, like chamomile

by Super Patch Team

Coping with Sleep Apnea: Causes and Diagnosis Explained

November 8, 2023Sleep Management,Sleep Disorders

Sleep apnea is a sleep disorder that causes interruptions in breathing during sleep, leading to decreased sleep quality and potential daytime fatigue.

The condition can disrupt sleep patterns and cause long-term discomfort in many areas of life. Understanding sleep apnea, its types, potential underlying causes, and available treatment options can help alleviate the symptoms and manage the disorder effectively.

In the following article, we will learn all about sleep apnea. If you are ready to claim back your sleep, keep reading.

What is sleep apnea?

Sleep apnea - or sleep apnoea - is a sleep disorder that causes breathing to stop for short periods during the night.

These episodes cause oxygen deficiency, which fires a survival reflex that wakes you up and restarts your breathing. Sleep apnea can interrupt healthy sleeping patterns, decrease sleep quality significantly, and cause other problems.

Types of sleep apnea

There are two main types of sleep apnea, each with a different underlying cause.

Obstructive sleep apnea (OSA)

Obstructive sleep apnea - or OSA - happens when your airways are blocked, causing you to lose breath. The reason is usually a dysfunction in the throat or neck muscles.

Central sleep apnea (CSA)

With central sleep apnea - or CSA - your brain fails to send signals related to breathing, causing episodes of breathlessness associated with sleep apnea. CSA is less common than OSA.

Treatment-emergent CSA

A third type of sleep apnea can appear when OSA treatments lead to the development of CSA. This condition is also known as complex sleep apnea.

Sleep apnea symptoms

The main symptom of sleep apnea is a sudden stop in breathing while asleep, causing a feeling of breathlessness, followed by a brief moment of waking up and breathing returning to normal.

Not everyone experiences sleep apnea in the same way. Some remember these episodes, while others do not.

However, there are some other signs of sleep apnea that might help identify the condition.

• Waking up tired in the morning
• Excessive daytime sleepiness
• Snoring or unusual breathing patterns during the night
• Shortness of breath or choking during sleep
• Depression, anxiety, and mood changes
• Insomnia
• Sexual dysfunction
• Headaches
• Slower thinking or memory problems
• Night sweats
• Children with sleep apnea might also wet their bed or display symptoms similar to ADHD

Not everyone experiences all of these symptoms. If you experience some of the above, you might want to consult your healthcare provider, who could order a comprehensive sleep test to determine if you have sleep apnea or some other sleep disorder.

The dangers of sleep apnea

A common question when it comes to sleep apnea is: "Can sleep apnea kill you?"

While it is very unlikely that one would die because of breathing cessation, the dangers of sleep apnea are still something to be aware of.

Chronic sleep apnea can increase your risk of sudden death during sleep, especially at an older age. It can also increase the risk of developing other medical conditions, such as high blood pressure, diabetes, and heart disease.

Doctors define severe sleep apnea as having more than 30 episodes of breath cessation per hour.

Sleep apnea causes

The underlying causes of sleep apnea can vary depending on which type of the condition you have.

What causes OSA?

Obstructive sleep apnea is a result of a blockage in the airways. This usually happens due to the muscles in your throat getting relaxed. While this happens with everyone during sleep, some people have narrower airways, or their muscles become looser, causing an abnormal obstruction in the airflow.

As a result, your oxygen levels get lower, and you might wake up choking or gasping for air. Your breathing usually corrects almost instantly with one or two breaths, so you might not even remember these episodes at all.

With OSA, these sleep obstructions can happen 5-30+ times per hour, leading to restless sleep.

What causes CSA?

Central sleep apnea can have various underlying causes.

Cheyne-Stokes breathing is an abnormal pattern of quick, deep breaths followed by a long pause in breathing, potentially leading to apnea. It's often associated with various heart conditions.

CSA can also result from something affecting your brain's ability to control breathing. This might be due to some form of brain damage, a disease, or a side effect of medications.

The oxygen concentration of the air is lower at higher altitudes, which can also lead to CSA.

While rare, CSA can also develop as a side effect of OSA treatments using positive airway pressure therapy.

Diagnosing sleep apnea

The most reliable way to diagnose sleep apnea is an overnight polysomnography, a sleep study conducted in a specialized sleep center. Doctors monitor various parameters during the test, such as eye movements, muscle tone, blood pressure, breathing patterns, airflow, blood oxygen levels, heart rate, and brain activity. From these data points, doctors can diagnose sleep apnea and any other underlying sleep disorders you might have.

At-home sleep apnea testing kits are also available, but they don't measure brain activity and are less reliable in diagnosing central sleep apnea.

Doctors might also use a questionnaire called STOP-Bang to diagnose obstructive sleep apnea.

Sleep apnea treatments

There is currently no known cure for sleep apnea, but various treatment methods can ease the symptoms significantly.

Positive Airway Pressure therapy

Positive airway pressure (PAP) therapy is the most effective treatment method for sleep apnea. Using a PAP machine, pressurized air is pumped into the lungs through a mask. This helps with the episodes of breathlessness associated with sleep apnea and keeps oxygen levels constant during sleep.

There are various forms of positive airway pressure therapy, like CPAP, APAP, and BiPAP, which we explain further in our PAP therapies article.

Lifestyle changes for sleep apnea

In mild cases of obstructive sleep apnea, minor lifestyle changes could help alleviate the symptoms to some extent.

• Keeping a healthy weight can lower your risk of severe OSA.
• Maintaining a strict sleep schedule and a quiet environment can promote better sleep quality.
• Sleeping on your side might provide relief for OSA. You can use special sleep apnea pillows to help with this.
• Taking sleeping pills, alcohol, and smoking can worsen your sleep apnea symptoms, so it's best to avoid them.
• Some medications might cause sleep apnea symptoms. If you suspect that this might be the case, consult your healthcare provider about alternative medications.

Surgery for sleep apnea

Surgical approaches can help in severe cases of obstructive sleep apnea. There are several options, like tissue removal, tissue shrinkage, implants, or jaw repositioning, but doctors usually only recommend these when other treatment methods have failed.

Other treatment methods

There are some other methods that doctors might recommend on a case-to-case basis.

• Oral appliance for sleep apnea - Special mouth guards and repositioning mouthpieces can help keep your mouth in a position during sleep that doesn't obstruct airflow.
• Orofacial therapy - Orofacial therapy strengthens the muscles in your mouth and face through various exercises. It helps by repositioning the tongue, giving a better way for airflow.

Nerve stimulators - These machines send a mild electrical current through certain nerve endings to keep some muscles in a position that helps you breathe better.

by Super Patch Team

Restless Leg Syndrome: Causes, Symptoms, and Treatment

November 8, 2023Sleep Management,Sleep Disorders

Restless leg syndrome (RLS) is a neurological disorder that causes uncomfortable sensations in the legs and an irresistible urge to move them, often disrupting sleep and causing daytime sleepiness or leg problems.

Understanding RLS is essential to managing the condition, alleviating uncomfortable symptoms, and improving sleep quality.

In this article, you can learn about restless leg syndrome, its symptoms, potential underlying causes, and available treatment options.

What is restless leg syndrome?

Restless legs syndrome is both a neurological disorder and a sleep disorder. It causes uncomfortable sensations in the legs, leading to uncontrollable and involuntary leg movements.

These episodes often occur during nighttime, disrupting sleep and making it hard to fall asleep. RLS can lead to decreased sleep quality, tiredness during the day, general anxiety, stress, and other problems.

Movement usually eases the symptoms for a while, but they might return or become more intense when you rest your legs. Restless legs syndrome is a chronic condition with no known cure, so treatment focuses on easing the symptoms and their effects on your everyday life.

The condition is also known as Willis-Ekborm disease.

Restless leg syndrome symptoms

The hallmark symptom of RLS is discomfort in the legs. It might be a crawling, pulling, throbbing, itching, or aching sensation. Cramps in the legs might also occur. These symptoms are usually felt inside the legs, not on the skin, and they are often triggered when resting the limbs.

Due to these sensations, one will feel the urge to move the legs, which usually eases the symptoms to some degree. This leads to leg twitching, involuntary movement of the legs, and a general feeling of restlessness.

Restless leg symptoms are more apparent in the late afternoon or the evening, especially when one goes to bed. As a result, one might experience difficulty falling asleep, twitchy legs, leg sweating, and waking up in the middle of the night. The decreased quality of sleep leads to further problems associated with RLS.

General fatigue, daytime sleepiness, mood changes, depression, and anxiety are all common symptoms among RLS patients.

Restless leg syndrome can play a role in the onset of other sleep disorders, such as hypersomnia. It may also develop as a secondary condition related to neuropathy, sleep apnea, and other medical conditions.

Another disorder that causes similar symptoms is periodic limb movement of sleep (PLMS), which leads to involuntary jerking of the limbs during sleep. RLS and PLMS are easy to differentiate, as PLMS doesn't cause symptoms during the day, while RLS does.

Restless leg syndrome causes

What causes restless leg syndrome is not entirely clear yet.

Genetics might be at play in some cases since RLS can be inherited. Experts suspect that the condition might result from dysfunction in the basal ganglia, the part of the brain responsible for movement. The basal ganglia need dopamine to fulfill its function, and low dopamine levels might lead to the onset of RLS. Iron deficiency in the brain can also be linked to restless leg syndrome, even when iron levels appear normal in the bloodstream.

Restless legs syndrome might also appear as a result of some other conditions. In this case, doctors refer to it as secondary RLS. Diabetes, kidney diseases, anemia, Parkinson's disease, and neuropathy could all lead to secondary RLS.

Some medications like antihistamines, antidepressants, and antinausea medications might also lead to the development of RLS or make the symptoms of an existing condition worse.

Restless leg syndrome and pregnancy might also be linked since the condition is more common among pregnant women. RLS occurring during pregnancy often goes into remission after giving birth, but sometimes the symptoms remain.

RLS can affect people of any age, including children, but it's more common in people over 50.

Diagnosing restless leg syndrome

There are no exact tests for restless legs syndrome, so doctors will try to rule out other possible conditions to diagnose it.

First, they will perform a physical exam, ask about your medical history, and if RLS was present in your family.

Differential diagnosis focuses on ruling out other conditions which might present similar symptoms. Doctors usually perform neurological exams, blood tests, and sleep studies.

The following criteria must be met to make the diagnosis for RLS:

• Uncomfortable sensations in the legs, even during daytime
• The urge to move the legs
• Symptoms get worse during rest, and movement relieves them
• Symptoms are more apparent in the evening or night
• No other underlying condition is responsible for the symptoms

Sometimes, restless leg syndrome can result from some other underlying condition. In these cases, doctors usually make the diagnosis of secondary RLS.

Diagnosing RLS in children is more complicated because it might be difficult for them to describe their symptoms. Another factor is that RLS shares similar symptoms with ADHD and growing pains, all common conditions among children.

Restless leg syndrome treatments

Restless leg syndrome is a chronic condition that has no known cure yet. However, it's possible to manage symptoms, and in some cases, RLS can go into remission without symptoms.

When one has secondary RLS caused by some other condition, doctors will treat the underlying condition, which usually lessens RLS symptoms as well.

Lifestyle changes for restless leg syndrome

If restless legs syndrome only presents milder symptoms, doctors usually recommend some lifestyle changes first.

• Avoid stimulants like alcohol, nicotine, and caffeine, especially before bedtime.
• Keep a strict sleep schedule.
• Sleep in a dark and silent environment. Use blackout curtains, white noise, or earplugs if needed.
• Dedicate time for relaxation before bedtime.
• Try herbal teas or sleep patches.
• Try massages, hot baths, or stretching during episodes of discomfort to ease the symptoms.

Medications for restless leg syndrome

In some severe cases, the above methods might not prove enough, so doctors may prescribe medications to ease your symptoms.

• Dopamine agonists, such as ropinirole, pramipexole, and rotigotine, can help increase dopamine levels in the brain and ease the symptoms of RLS.
• Painkillers can lessen the discomfort and leg pain associated with RLS.
• Hyptonics like zopiclone or zolpidem can promote more restful sleep, but these sleeping pills are usually only recommended for short-term use.
• Anti-seizure medicines, such as gabapentin enacarbil or pregabalin, can ease sensory discomfort in the legs.

Benzodiazepines, like clonazepam or lorazepam, can remedy anxiety, insomnia symptoms, and muscle problems.

by Super Patch Team

Living with Narcolepsy: Symptoms, Causes, and Effective Treatment

November 8, 2023Sleep Management,Sleep Disorders

Narcolepsy is a complex neurological disorder marked by sudden, uncontrollable sleepiness during the daytime, often accompanied by muscle weakness. Having narcolepsy can dramatically disrupt one's daily life and well-being and potentially cause dangerous situations.

Since narcolepsy is not just simple sleepiness, it's crucial to understand the disorder. Below, we will learn about what narcolepsy is, its symptoms, similar medical conditions, and potential causes, and explore available treatment options.

What is narcolepsy?

To completely understand narcolepsy, we have to start with what narcolepsy is not. Narcolepsy and similar sleep disorders like hypersomnia are often confused for plain old sleepiness. However, this is not the case.

One of the definitive characteristics of narcolepsy - compared to regular tiredness - is that you can't fix it by simply sleeping more. Another hallmark sign of narcolepsy is that it's different from just being tired, as it causes actual sleep attacks where it's almost impossible to stay awake and function normally.

Types of narcolepsy

We can distinguish two types of narcolepsy. It's crucial to get a proper diagnosis to determine which type you have because underlying causes and treatment options are different for the two.

Narcolepsy Type 1

Type 1 narcolepsy is more common. It's sometimes referred to as narcolepsy with cataplexy. Cataplexy is the sudden loss of muscle tone while one is awake. It causes muscle weakness and the inability to control one's muscles. Episodes of cataplexy could be triggered by strong emotions like laughter or anger, but they might also occur randomly. These episodes might last from a couple of seconds to a few minutes. Other signs of type 1 narcolepsy might be sleep paralysis, hallucinations, insomnia, and sleep drunkness.

Type 1 narcolepsy is often associated with low levels of hypocretin - also known as orexin - a protein that helps regulate sleep.

Narcolepsy Type 2

Type 2 narcolepsy is more rare and more challenging to diagnose. The main reason behind this is that while it has similar symptoms to type 1, cataplexy is not one of them, which makes the condition less apparent. Another difference is that type 2 narcolepsy might appear even with normal hypocretin levels, which leads scientists to believe that it might be related to how this protein travels in the brain instead of its deficiency. However, the causes behind type 2 narcolepsy are not entirely clear yet.

While this form of narcolepsy might have similar symptoms, like sleep paralysis, hallucinations, insomnia, and sleep drunkness, they usually occur less frequently. On the other hand, excessive daytime sleepiness might cause the same amount of discomfort in both cases.

Secondary narcolepsy

The third type of narcolepsy is relatively rare, and - as the name suggests - it's always caused by some other underlying condition, like a brain injury, a tumor, inflammation, or multiple sclerosis.

Narcolepsy symptoms

Narcolepsy symptoms in adults are typically similar across both types of narcolepsy. With narcolepsy type 2, these are usually milder and less frequent. One notable difference is cataplexy, as type 1 causes cataplexy while type 2 does not.

Common signs of narcolepsy are:

• Excessive daytime sleepiness - Also referred to as hypersomnia, this symptom often manifests as episodes of extreme tiredness, called sleep attacks, during the day, hindering everyday function and making it hard to stay awake even in situations where maintaining focus is essential.
• Cataplexy - As mentioned above, cataplexy means the sudden loss of muscle tone and sometimes muscle control. It is the hallmark symptom of narcolepsy type 1, but it never appears with type 2.
• Restless sleep - Various sleep problems often go hand in hand with narcolepsy. People with narcolepsy might experience sleep paralysis, automatic movements during sleep, and changes in their REM sleep pattern. These all lead to restless nights and difficulty staying asleep.
• Decreased mental capacity - The tiredness associated with narcolepsy may lead to slower thinking, memory problems, slow speech, headaches, and other problems that make it harder to function during the day.
• Hallucinations - Sometimes narcolepsy is accompanied by hallucinations. These most often occur around falling asleep or right before waking up.
• Sleep drunkenness - Waking up in the morning is usually a challenge with narcolepsy, and some people experience sleep drunkness after getting out of bed. During this time, your mind is not fully awake yet, even tho your body seems like it is.
• Automatic behavior - People with narcolepsy may experience being half awake, talking, and walking like normal but having no memories of events during this time. Automatic behavior can occur during the day or even when you're asleep at night.
• Mental health problems - Narcolepsy may cause a lot of stress in your daily life, and being tired all the time can hinder your ability to function. These might lead to various mental health issues ranging from anxiety to irritability, depression, and more.

These symptoms might vary from person to person, and not everyone experiences all of them. Furthermore, narcolepsy can appear in tandem with other sleep disorders, making it harder to identify the symptoms.

Narcolepsy causes

The causes of narcolepsy are not entirely clear yet.

Type 1 narcolepsy is associated with low hypocretin levels, but the exact reason behind this is unknown. Some research points to an autoimmune condition destroying hypocretin-producing cells, and there might also be some connection to the swine flu virus.

However, people with type 2 narcolepsy have normal hypocretin levels and still experience narcolepsy symptoms, except cataplexy.

Genetics might also be a risk factor for narcolepsy, but only to a small degree.

Diagnosing narcolepsy

Diagnosing narcolepsy is a multiple-step process, as it shares similar symptoms with many other conditions, like sleep apnea, epilepsy, depression, and hypothyroidism.

First, doctors will ask you about your symptoms and family history. They might also ask you to complete an Epworth sleepiness questionnaire or to keep a sleep diary for a few weeks before your appointment. These could help them assess your sleeping habits and how sleepy you get during various daily activities.

Physical examinations and blood tests can help rule out other possible conditions.

During the diagnosis process, doctors might order a sleep test called polysomnography. This comprehensive test is performed at a sleep center during an overnight stay. Doctors will measure various factors, such as brainwaves, eye movements, airflow, blood oxygen levels, heart rate, blood pressure, muscle tone, etc. In addition, a multiple sleep latency test might help determine how quickly you can fall asleep and enter REM sleep, a hallmark symptom of narcolepsy.

Doctors might also measure hypocretin levels or look for a genetic marker associated with narcolepsy.

Narcolepsy treatments

Narcolepsy is a chronic condition that has no known cure yet. Treatment usually focuses on alleviating the symptoms and lessening their effects on patients' everyday lives.

There are two main approaches to treating narcolepsy: medicine-based methods and lifestyle changes.

Medications for narcolepsy

Doctors might recommend one of the following medications, depending on the severity of your narcolepsy, if you have other medical conditions, and how effective they prove to be in your individual case.

• Modafinil - Modafinil and armodafinil are commonly used to treat narcolepsy. These are stimulants that affect the central nervous system, improve focus, and reduce sleepiness. Doctors recommend it because they are less addictive than other alternatives and have fewer side effects.
• More potent stimulants - When other stimulants don't work, doctors might prescribe stronger ones like methylphenidate or amphetamines. Adderall is a well-known example of these medications. While these pills are potent stimulants that may help you focus, they can also be very addictive.
• Medications for cataplexy - To counter episodes of cataplexy, doctors might prescribe one of the following medications: venlafaxine, fluoxetine, sertraline, tricyclic antidepressants like protriptyline, imipramine, and clomipramine, sodium oxybate, oxybate salts, or the stimulant pitolisant.

It's important to note that some of these medications might have side effects such as sleepwalking, bed-wetting, heart problems, or nausea. Some of them, like amphetamine-like medications, might also lead to addiction.

Lifestyle changes and alternative remedies for narcolepsy

In addition to taking the prescribed medications, doctors might also recommend making some lifestyle changes that might help alleviate the symptoms of narcolepsy.

• Follow a sleep schedule - Going to bed and waking up at the same time, even on weekends, can help your brain adapt to a strict schedule, making it easier to fall asleep and improving the quality of your sleep.
• Optimize your environment - Sleeping in an optimal environment may improve your sleep quality significantly. You can use blackout curtains to make the room darker and white noise to drown out outside noises.
• Avoid certain substances - Nicotine, alcohol, and caffeine can disturb your sleep patterns and worsen the symptoms of narcolepsy, especially when consumed before bedtime.
• Stay active during the day - Daily physical activity can help you sleep better at night, among many other benefits. You don't necessarily have to hit the gym. Even just walking for 20 minutes a day might do the trick.
• Take naps if you need to - Siesta naps can be beneficial for anyone, but they may be especially useful for narcolepsy patients. Taking 20-30 minute naps may reduce the daytime sleepiness associated with narcolepsy.
• Try alternative treatment methods - Alongside medications, alternative remedies like herbal teas, sleep patches, or meditation may help ease your symptoms and improve your sleep quality.

by Super Patch Team

Bruxism: Causes, Symptoms, and Treatment Options

November 8, 2023Sleep Management,Sleep Disorders

Bruxism, commonly known as teeth grinding, is a condition that involves the involuntary clenching and grinding of teeth, often occurring during sleep.

The grinding of teeth can be a mild annoyance or a risk to your dental health in more severe cases.

This article will provide an in-depth understanding of bruxism, including its symptoms, underlying causes, methods of diagnosis, and available treatment options.

What is bruxism?

Bruxism, also known as bruxia, refers to the repetitive action of grinding or clenching one's teeth, commonly occurring during sleep or unconsciously throughout the day.

During episodes of bruxism, teeth are tightly pressed together and move back and forth, causing a distinct grinding sound. At first glance, bruxism seems like just a bad habit. However, it isn't merely a simple habit; it represents a significant medical condition. Although occasional teeth grinding is normal, chronic and severe bruxism can cause several issues.

In severe cases, this involuntary motion of the jaws is more than just an auditory annoyance. Left untreated, bruxism can trigger a range of severe consequences, particularly affecting dental health. These encompass an increased likelihood of tooth damage, heightened tooth sensitivity, loss of teeth, and a greater risk of fractures. Additionally, the condition might cause discomfort and dysfunction in the jaw, temporomandibular joints, neck muscles, and even potential alterations in facial structure.

Types of bruxism

Bruxism is an involuntary action, and while the teeth grinding is the same, bruxism might refer to two separate conditions.

Sleep bruxism

Sleep bruxism occurs when you grind your teeth in your sleep. This form of bruxia is more harmful because one might not be aware of it at all. And even if you know you grind your teeth in your sleep, you will have no idea how strong the grinding and clenching of the jaws is. So it is hard to estimate the damage. The human bite is especially strong, so extensive clenching of your jaw muscles might lead to jaw pain, headaches, and tooth damage.

Awake bruxism

Another form of bruxism is when you grind your teeth during the day. While awake bruxism is an involuntary reaction as well, one might catch it and adjust. With some self-awareness, concentration, and the right stress management techniques, one could get rid of the bad habit, or at least lessen the damage.

Bruxism symptoms

The most prominent symptom of bruxism is the act of grinding teeth. However, since this typically occurs unconsciously, it might be challenging to recognize without external observation. There are several other symptoms that might result from bruxism and could signal the condition.

• Headaches, especially in the temples
• Pain in the jaws, neck, or TMJs
• Clicking or popping sounds in the jaw
• Teeth pain, fracture, or sensitivity
• Locking of the jaw
• Pain while eating
• Intense facial pain in the morning that gets better during the day
• Aching ears, not related to actual ear issues
• Loose teeth
• Not getting enough rest while sleeping

If you are dealing with sleep bruxism, these symptoms might be more apparent after waking up, but some of them might even cause long-term damage.

Bruxism causes

The most common cause of bruxism is general stress. This might mean anger, frustration, anxiety, pain, frustration, or a stressful lifestyle. Chronic stress might lead to muscle tension throughout the body, including the jaw. As a result, the grinding of teeth becomes a subconscious outlet for releasing this tension. Individuals who experience emotional stress might unconsciously channel these emotions into the act of teeth grinding during sleep.

An imbalance in brain neurotransmitters might also lead to the development of bruxism. These chemical messengers play a critical role in regulating mood, emotions, and stress responses. Disruptions in neurotransmitter levels can impact the brain's ability to regulate muscle activity, potentially contributing to teeth grinding. Certain antidepressants, known as selective serotonin reuptake inhibitors (SSRIs), might be associated with an increased risk of teeth grinding as a side effect.

Bruxism is more common among children than adults. For children, stress is not the most common cause thought. Instead, factors such as allergies, mouth irritation, teeth problems, and sleep apnea might all contribute to teeth grinding. It's crucial to identify and address these factors early on to prevent long-term dental complications in children.

Risk factors for bruxism

There are some factors that make it more likely to develop bruxism.

• A stressful lifestyle, constant anxiety, or frustration can increase your risks of involuntary teeth grinding.
• Bruxism is more common among children and, in a lot of cases, goes away with age.
• An aggressive, hyperactive, or competitive personality type might increase your risk of developing bruxism.
• Some antidepressants, smoking, alcohol, or drug use might also be a risk factor.
• Sleep bruxism is more common in families with a history of the disease.
• Some other medical conditions might also lead to the development of bruxia. Sleep apnea, ADHD, gastroesophageal reflux disorder, epilepsy, and some other disorders might increase your risks.

Diagnosing bruxism

If you experience any symptoms of bruxism, you might want to consult your GP or dentist.

Doctors will examine your teeth, looking for loose or chipped teeth, wear or damage on the surface, or flattened tips. They might also ask questions about your lifestyle, stress levels, sleep habits, and medications. Tenderness in the jaw muscles, cheeks, or neck might also signal the presence of bruxism.

X-ray scans can help determine the level of damage to the teeth or underlying bones.

In some cases, bruxism might be the symptom of another sleep disorder that needs to be addressed. Doctors might order a sleep study - known as polysomnography - during which they will be monitoring your muscle activity during sleep.

If bruxism is related to anxiety or psychological problems, doctors might recommend therapy.

Bruxism treatments

In milder cases, bruxism might go away on its own. Especially in children who might simply outgrow the issue.

However, if bruxism is severe enough to be a danger to dental health, sleep quality, or mental health, treatment is vital. Doctors might recommend different approaches depending on your medical history, lifestyle, and the underlying causes of the problem.

Managing stress

Stress and anxiety are the major causes of bruxism, so appropriate management of stress levels might help cure the condition.

Reducing outside stressors is not always an option, but adjusting how we react to them is always in our control. Meditation, therapy, and learning healthy coping strategies and relaxation techniques can all help with this.

In severe cases, a therapist might recommend the use of stress-relieving medications, CBD, or other forms of stress management supplements. Magnesium supplements can also help with managing the effects of stress in a natural and healthy way.

Dental approaches

The dental approach to treating bruxism doesn’t stop the condition from occurring but helps reduce damage to the teeth.

Splints or mouth guards are personalized devices that fit your teeth perfectly and can keep them separated during sleep. This will help avoid damage done by grinding.

Another crucial part of the treatment is fixing dental damage that has already occurred. Chipped or loose teeth might cause issues while chewing, and the damaged surface of the teeth will make them sensitive and more prone to further damage. Dentists will use various dental correction methods to fix these issues, but it’s also vital to deal with the source of this damage - bruxism itself.

Medications

Bruxism doesn’t respond well to medication in general. However, in some severe cases, doctors might recommend various medications, especially for short-term treatment.

These might include stress relief medicine, like antidepressants or anti-anxiety pills. Muscle relaxants taken at night might help reduce the effects of bruxism until a more permanent solution is established.

In some cases, other treatment methods might not bring relief, and doctors may recommend botox injections to help with the issue.

Other approaches

There are some alternative methods and approaches that might help reduce the negative effects of bruxia.

Lifestyle factors can impact the frequency and severity of bruxism episodes. With some lifestyle changes, you can reduce your risk and help lessen the effects of existing bruxism. Tobacco, alcohol, and caffeine are all substances that can exacerbate stress and anxiety, which are prominent triggers for bruxism. Minimizing their intake may reduce the likelihood of clenching and grinding.

Behavioral changes also hold potential benefits in managing bruxism. Simple adjustments in jaw positioning during the day can help break the cycle of habitual grinding.

Biofeedback is an emerging technique that empowers individuals to gain control over physiological processes that are typically involuntary, such as muscle tension. In the context of bruxism, biofeedback involves using monitoring devices to provide real-time feedback about muscle activity in the jaw. This heightened awareness enables individuals to consciously relax the jaw muscles.

Bruxism might occur related to other sleep disorders and medical issues, so addressing these underlying problems is a common approach to treatment. Sleep apnea and GERD are two of the most common conditions associated with bruxism. Additionally, maintaining a consistent sleep schedule and engaging in relaxing bedtime rituals can promote better sleep quality, reducing the likelihood of sleep bruxism episodes. Innovative solutions like our REM sleep patches can help restore the quality of sleep without the use of drugs.

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by Super Patch Team