Patients have described their condition to me in many ways. One man stated, “I have absolutely no energy; sometimes I feel I can barely hold my head up. My boss thinks I’m bored in my job—I’m not. I love my work. But sometimes I just want to curl up on the floor of the office and snooze for the rest of the afternoon.” Another said he was so groggy on rising that he thought he had been drinking the night before, to the point where he couldn’t remember whether he’d drunk or not. A woman said she felt “weary all the time, no matter how much sleep I got the night before.” She assumed she was clinically depressed, because she felt an overpowering urge to crawl into bed and pull the covers over her head. One patient was terrified by the overpowering attacks of sleepiness and muscle paralysis he experienced during moments of emotional arousal. In addition to feeling weary or exhausted, victims of DOES may claim that their sleep is nonrestorative, light, or fragmented. As one patient said, “My batteries just never seem to get recharged the way they used to.” Obviously, these problems, left untreated, can interfere with social, work, and family obligations.
Excessive daytime sleepiness is the major complaint of those people who seek help from sleep-disorder clinics. In one study, 51 percent of patients were diagnosed as suffering from hypersomnia, while 31 percent suffered one of the forms of insomnia described earlier. Each year, sleep-disorder centers report seeing as many as 30,000 new patients with some form of DOES complaint.
Statistically, most cases of daytime sleepiness arise from disordered breathing during the night—the sleep apnea in the context of sleep interruption. According to one study, as many as 43 percent of DOES victims have a breathing abnormality, primarily of the obstructive variety. During the night, these patients experience stoppages of breath lasting 20, 40, even 90 seconds, which in turn cause them to waken to some degree or another. Come morning, apneics feel unrested and lethargic; surprisingly, however, many ‘ of them have no idea that their breathing at night is abnormal, since during the day they experience no breathing difficulty. We will take a closer look at sleep apnea, including the condition known as sudden infant death syndrome, shortly.
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