Obstructive Sleep Apnea (OSA)
The most serious sleep disorder, OSA is periodic obstruction of the upper airway during sleep and has a prevalence rate of three to eight percent. Periods of apnea can last up to 90 seconds and may occur several hundred times per night. OSA is the most common medical cause of excessive daytime sleepiness and is more common in men.

Symptoms of OSA include:

  • Daytime fatigue
  • Memory and concentration problems
  • Morning headaches
  • Upper airway abnormalities
  • Frequent napping
  • Nocturnal Angina/Arrhythmias
  • Frequent awakenings
  • Sexual problems
  • Loud, habitual snoring
  • Pauses in breathing during sleep
  • Daytime sleepiness
  • Irritability/Personality changes
  • Obesity
  • Choking/Gasping/snorts during sleep
  • Hypertension
  • Non-refreshing sleep/inability to wake up

Diagnosis for Obstructive Sleep Apnea should be made by pertinent history, physical examination, oximetry and polysomnography. Most people benefit from appropriate evaluation, treatment and follow-up.


Narcolepsy has a prevalence rate of five per 100,000 population.
Symptoms of narcolepsy include:

  • Excessive sleepiness
  • Cataplexy (physical weakness with emotion)
  • Hypnagogic hallucinations
  • Sleep paralysis (occurs upon awakening)
  • Automatic behavior
  • Low concentration
  • Occupational/School problems

Symptoms may appear rapidly or develop slowly over the years. The cause of Narcolepsy is still unknown but shows strong familial clustering.


Periodic Limb Movements (PLM)
PLM is characterized by rhythmic jerking of the feet or legs. Restless Legs Syndrome (RLS) is described as a “creeping, crawling” sensation that creates an urge to move the legs. Its prevalence rate is two to five percent. Symptoms of PLM and RLS include:

  • “Creepy” or “jumpy” legs
  • Unpleasant sensation during sleep
  • Insomnia/Non-refreshing sleep
  • Excessive daytime sleepiness
  • Increased activity
  • Restless sleep

Treatment for Restless Legs Syndrome and Periodic Limb Movements is highly effective for 90 percent of patients seeking help.


In its chronic form, insomnia affects approximately nine percent of the population. It can last for weeks, months, or even years and may be to the following:

  • Worry, anxiety or stress
  • Psychiatric disorders
  • Primary sleep disorders
  • Substance abuse
  • Medical problems
  • Behavioral/Conditional factors

Those with chronic insomnia may experience reduced productivity and accidents as a result of fatigue. Because insomnia is a symptom, the physician must search for the cause. Over 70 percent of insomnia sufferers sleep better after appropriate evaluation and treatment.


Parasomnia refers to a wide variety of disruptive, sleep- events or “disorders of arousal”. These arousal disorders include:

  • Sleep walking
  • Sleep terrors (pavor nocturnes)
  • Nightmares
  • Partial seizures
  • Violent behavior during sleep
  • REM behavior disorder (acting out dreams)

Severe cases may lead to injury, violence, excessive eating, or disturbance of others in the bed or the house. In most cases, Parasomnia can be effectively diagnosed and treated.