 Sleep Disorders and CFIDS   People with FM and CFS do have an abnormality which do interfer with their deep sleep. They have awake brain waves, called alpha waves, in their deep sleep. This shows up in a sleep study as alpha waves intruding in their delta waves (deep sleep brain waves). Scientifically these alpha waves do keep the brain from getting the deep rejuvenating sleep that the body needs to heal any injuries from the wear and tear that occured during the day. With FM and CFS the healing doesn't occur so one theory is that this contributes to the muscle pain and fatigue. (However there are some people who do have alpha waves in their delta sleep who sleep like a log, miss out on the severe storms and other events that may occur at night which everyone is talking about but the person with this abnormality slept through the storm.) There are other sleep problems that people with FM and CFS may also have such as excessive limb movement or sleep apnea. However research has not shown a common sleep disorder that occur in FM and CFS except for the alpha-delta abnormality. People with CFS and FM do often experience excessive daytime sleepiness. Researchers are investigating this. Daytime sleepiness can be caused by a number of things and disorders effecting sleep. Narcolepsy is a common disorder contributed to excessive daytime sleepiness. Sleep quizz Take the quizz and see how you rate with daytime sleepiness. Another sleep disorders quizz Test your knowledge about sleep disorders. Many busy people just don't get enough sleep.  NATIONAL SLEEP FOUNDATION RELEASES NEW STATISTICS ON "SLEEP IN AMERICA" Groggy Workforce, Sleepy "Generation Y" Among Key Poll Findings Are you one of these people? Baby Boomers are guilty of this too. Links to Sleep Disorders Sites  National Sleep Foundation Research, clinical trials, sleep quizz, tips on improving sleep. The Sleep Medicine Home Page Site lists resources regarding all aspects of sleep including, the physiology of sleep, clinical sleep medicine, sleep research, federal and state information, patient information, and business-related groups. National Institute of Neurological Disorders and Stroke Artical "National Institute of Neurological Disorders and Stroke" provides a lot of good information on sleep and sleep disorders. Sleepnet.com "Since 1995 - Everything you wanted to know about sleep but were too tired to ask." Sleep Home Pages Another site with sleep disorders and research information. AMERICAN ACADEMY OF SLEEP MEDICINE Provides information on sleep and sleep disorders as well as research. Loughborough Sleep Reseach Centre Interesting site that includes list of their current research projects Alain Destexhe Site contains movies & articals demonstrating various types of sleep brain waves for the technically minded. Medline Plus Sleep Disorders links to many sites. SleepDisorders.com A resource for sleep disorders, professionals, patients and families. Sleep Channel Site claims "SleepChannel™ is developed and monitored by leading sleep specialists. You can always be assured of finding the most up-to-date, medically accurate information available on the web." THE SLEEP SITE Site contains a lot of information on sleep. Gives overview of sleep problems, links to various sleep disorders, sleep questionnaires, and more information. Site done by the COLUMBUS COMMUNITY HOSPITAL REGIONAL SLEEP DISORDERS CENTER Sleep, Dreams, and Wakefulness You can search over 50,000 documents but must be patient and willing to use the search engine on the site. Sleep Quest Sleep Apnea & Undiagnosed Sleep Disorders and other information pertaining to sleep. IDIOPATHIC HYPERSOMNIA Apparently a new condition just classified for those of us who just either need more sleep or are just sleepy a lot. People with the alpha delta abnormality seen in CFS & FM would fall into this category. Interesting reading by the COLUMBUS COMMUNITY HOSPITAL REGIONAL SLEEP DISORDERS CENTER Accredited by the American Sleep Disorders Association. "This diagnosis can be explained as follows: -One could be chronically sleepy for one or both of the following reasons: 1. There is something wrong with sleep that makes it non-refreshing. 2. There is a problem with the brain mechanisms which normally should keep one alert (whether caused by primary problems within the brain or its chemistry, or by other factors (such as sedating medications or thyroid problems). The most common causes of severe sleepiness beginning or progressively worsening in adults are SLEEP APNEA and RELATED BREATHING DISORDERS DURING SLEEP. If the problem instead is a primary disorder of brain chemistry, NARCOLEPSY is the leading diagnosis. As outlined elsewhere on this web site, people with narcolepsy are diagnosed either by a clear-cut history of their having had cataplexy, or via their demonstrating REM sleep in two or more daytime naps on a Multiple Sleep Latency Test. (The latter test is not 100% reliable, since some patients with classic narcolepsy may not demonstrate REM sleep during any of the naps on a given day, simply by chance). -Idiopathic CNS hypersomnia (or hypersomnolence. as it has been called) is a diagnosis applied to people who are excessively sleepy--but not because there is anything apparently wrong with their sleep, and not because of narcolepsy or any other identifiable cause. It is basically a diagnosis of exclusion: one that is made by excluding all other possible diagnoses. -Idiopathic is a more dignified way of saying that we don't know exactly what causes the problem. -Hypersomnia is not the commonest diagnosis...but it is not rarely made, either. -Hypersomnia does not appear to be one single entity. Various abnormalities of brain chemistry have been suggested in studies of such patients or suspected as being potential causes. The brain is complex to the point that there would be many different possible ways to impair alertness. What are three common features of patients diagnosed with idiopathic hypersomnia? 1. People given this diagnosis are likely to sleep for long periods of time without feeling refreshed. They often do not feel any better after taking naps. It has been said that a history of not feeling refreshed after sleep will reliably differentiate sleep apnea and hypersomnia from narcolepsy, but I personally don't believe it. I have a number of patients with definite narcolepsy who find naps unrefreshing, and who also wake up feeling groggy and exhausted in the morning. 2. People with idiopathic CNS hypersomnia often have family histories of this same sort of problem, of true narcolepsy or of both entities. Not infrequently, hypersomnia seems hereditary. 3. For the most part, patients diagnosed as having hypersomnia report that their sleepiness began late in childhood, during their teen years, or in their early twenties. Hypersomnolence resembles narcolepsy in its typical age of onset. For this reason, I am hesitant to make this diagnosis in people who develop sleepiness later in life. There is a greater possibility that people with late onset of sleepiness instead suffer from a specific underlying cause: one that should be identified and managed with specific treatment. They deserve a thorough evaluation. Narcolepsy Network Site contains newsletters containing research articals as well as humorous cartoons. MYSTERY OF HUMAN NARCOLEPSY SOLVED By Dr. Jerome Siegel Research found a significant decrease in the number of hypocretin cells located in the hypothalamus which is located at the base of the brain. Artical in newsletter of Narcolepsy Network. (unfortunately the link to the artical is gone.) Stanford University Center for Narcolepsy Overview, symptoms, research and treatment. Click the links on left side to see different catagories. BRINGING SECRETS OF THE NIGHT TO THE LIGHT OF DAY... Understanding the symptoms of sleep disorders. NARCOLEPSY "Narcolepsy involves both "brain sleepiness" (IMPAIRED BRAIN MECHANISMS THAT NORMALLY SHOULD KEEP ONE AWAKE. In such cases, even if sleep were perfect, the individual would still be too sleepy.) and disturbances of REM sleep (a tendency for it to occur too rapidly after sleep onset and for its component parts to intrude into wakefulness--with distressing symptoms). Resulting possible symptoms: --Dreaming in brief naps. --Dream fragments occurring either prior to falling asleep or persisting after awakening (hypnagogic and hypnopompic hallucinations). --Sleep paralysis. --Cataplexy. Only cataplexy is diagnostic of narcolepsy, and not all narcoleptics suffer from cataplexy. How is narcolepsy diagnosed? -A careful history, followed by specific sleep center studies (both an overnight sleep monitoring and a multiple sleep latency test). Who develops narcolepsy? -Narcolepsy can occur in people of both sexes. Symptoms--particularly sleepiness--usually begin in late childhood, the teen years or the early twenties. Narcolepsy can begin after age 30: but such is relatively uncommon. In contrast, while sleep apnea can develop in childhood, it more often becomes a significant and progressive problem later in life. HENCE,TWO VALUABLE CLUES TO THE POSSIBLE DIAGNOSIS OF NARCOLEPSY IN A SLEEPY PERSON: --Indications of cataplexy. --Onset of sleepiness early in life, particularly if no severe snoring was noted then. For example, falling asleep more frequently in school than one's classmates, taking naps after school, and in some cases, hyperactive behavior (which in children, can be a manifestation of impaired alertness). What causes narcolepsy? -The usual cause appears to be a problem with the chemical "neurotransmitters" that regulate communications between different groups of nerve cells in the brain. Only rare cases have been reported of narcolepsy arising as the consequence of such structural causes as brain tumors, brain infections and head injuries. CT/MRI scans of the brain are normal in the vast majority of cases. -Narcolepsy can "run in families" such that some individuals appear genetically predisposed to develop it. Its onset sometimes follows stressful events, but such does not indicate that it is a psychological disorder. In fact, some breeds of dogs develop narcolepsy on a genetic basis. Is narcolepsy a rare condition? -Not at all! It is roughly as common as MS (multiple sclerosis). How is narcolepsy diagnosed? -A careful history, followed by specific sleep center studies (both an overnight sleep monitoring and a multiple sleep latency test). Can narcolepsy be diagnosed by a "blood test"? -No! Such is a common misimpression that resulted from the discovery that most (but not quite all) narcoleptics share particular HLA types (genetically determined markers on white blood cells that are used to determine tissue compatibility--for example, to assess one's ability to donate a kidney to a possible recipient without high likelihood that the transplanted kidney will be rejected). HLA types are evaluated with a blood test. -There are two reasons why these tests cannot be used to diagnose narcolepsy: --First, some definite narcoleptics who even have cataplexy will come out negative on these tests. --Second, an even greater problem is that up to 25% of the general population will show the same HLA typing that has been associated with narcolepsy! How is narcolepsy treated? -It is best managed with a combination of medications and common sense! Pills alone are not the answer. One should also eliminate aggravating factors that would make the symptoms worse and the prescribed medications less effective. -For example: one does not manage diabetes by giving insulin and then informing the patient that since they now have medicine, they can do whatever they please...such as eating entire pies and cakes and drinking a case of beer every day! It would be illogical to use such a "medications only" approach for any illness--including narcolepsy. -The physician treating the patient with narcolepsy should be experienced in its management and also take the time needed to educate the patient about the condition and factors that can make it worse--empowering the patient and enabling him or her to "outsmart" the disorder as much as possible. Are there other disorders of impaired brain alertness mechanisms beside narcolepsy? -Yes. Even if one excludes causes of their impairment by sedating medications, hormonal imbalances such as hypothyroidism and the like, there are individuals with severe "brain sleepiness" not secondary to problems (such as sleep apnea) occurring during overnight sleep--and who do not have either cataplexy or a tendency to enter REM sleep too rapidly. The term "idiopathic CNS hypersomnolence" has been used to describe such individuals. -Idiopathic CNS hypersomnolence is a diagnosis that is made by excluding other possible causes. CNS means central nervous system, and idiopathic is a polite way of saying that the doctor has no idea what caused the problem!--which does not mean that it cannot be effectively treated. --IT IS IMPORTANT TO KNOW THAT MANY PATIENTS WHO HAVE BEEN DIAGNOSED AS HAVING IDIOPATHIC CNS HYPERSOMNOLENCE IN FACT HAVE UPPER AIRWAY RESISTANCE SYNDROME--WHICH CAN READILY BE MISSED BY CONVENTIONAL SLEEP MONITORING TECHNIQUES. --Upper airway resistance syndrome is treated much differently than idiopathic CNS hypersomnolence--and it is inherently treatable! --Hence, one should not hesitate to ask whether a sleep center is prepared to diagnose upper airway resistance syndrome if it happens to be present." Medicine.net Restless Legs Syndrome: What is restless leg syndrome? What causes restless leg syndrome? Can other conditions mimic restless leg syndrome? What is treatment for restless leg syndrome? NINDS Restless Legs Syndrome Information Page More information on restless legs syndrome including symptoms, treatment, research and organizations focused on restless legs syndrome. Restless Legs Syndrome Foundation Provide research information, online support, newsletters and more. Restless Legs: Treatable, if Recognized THE SLEEP SITE FIBROMYALGIA, CHRONIC PAIN AND SLEEP  The School of Sleep Medicine, Inc. School of Clinical Polysomnography Standford School of Medicine Sleep Well page consists of links to much information on sleep. Also provides links to sleep labs,clinics & center for human sleep research. AASM-Accredited Member Centers and Laboratories Looking for an accrediated sleep lab?   
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