Many people in Queens struggle with periodic or frequent
insomnia. In most cases, insomnia is due to poor sleep hygiene, or secondary to
depression or anxiety. Difficulty sleeping can often be fixed by avoiding
caffeine late in the day, eliminating noise and other distractions from the
sleeping area, and maintaining a regular sleeping schedule. When insomnia is
largely due to depression or anxiety, treating the underlying psychological
problem can often alleviate the problem. However, there are a few conditions
that cause insomnia that are relatively rare, but can be serious and require
different treatment approaches. Four of the rarer forms of insomnia in Queens
are Periodic Limb Movement Disorder (PLMD), Non-24-Hour Sleep-Wake Disorder
(non-24), Irregular Sleep-Wake Rhythm Disorder, and the rare but very serious
Fatal Familiar Insomnia.
#1: Periodic Limb Movement Disorder
People with Periodic Limb Movement Disorder (PLMD) in Queens
move their limbs involuntarily during sleep. These movements generally occur at
periodic intervals around 20-40 seconds apart during early non-REM sleep
phases, eventually subsiding due to the muscle atonia that accompanies REM
sleep. PLMD can make it very difficult to get to sleep, and to remain asleep
through the night. People with PLMD often experience excessive daytime
sleepiness due to the poor quality of sleep during the night, and may be
unaware of the cause unless a sleeping partner informs them of the limb
movements. A polysomnographic sleep study is generally used to confirm a
diagnosis of PLMD. The exact cause of this condition is not yet known; some of
the risk factors that have been identified include being a shift worker,
snoring, stress, caffeine consumption, and the use of benzodiazepine
medications. There is no known cure for PLMD, although it often responds to
anti-Parkinson medication or anticonvulsants.
#2: Non-24-Hour Sleep-Wake Disorder
Non-24-Hour Sleep-Wake Disorder (Non-24) is a circadian
rhythm disorder, arising when a person’s sleep-wake cycle becomes
desynchronized from the light-dark cycles that normally regulate the person’s
biological “clock”, extending the cycle over more than 24 hours. Most people
who suffer from non-24 in Queens are blind, with the disorder resulting from
the inability to perceive light input; however, it sometimes occurs in sighted
individuals. Non-24 interferes with the regularity of the person’s sleep-wake
cycle, and can impede their ability to function well during the day. Although
insomnia is not necessarily a feature of non-24 in and of itself, it often
occurs when people with non-24 attempt to follow a standard “9-to-5” schedule,
resulting in cognitive dysfunction, low energy, and other symptoms of sleep
deprivation.
#3: Irregular Sleep-Wake Rhythm Disorder
Irregular Sleep-Wake Rhythm Disorder (ISWD) is another
circadian rhythm disorder that can cause insomnia in Queens. People with ISWD
sleep irregularly from day to day, often in the form of several naps during the
day in lieu of continuous nighttime sleep. Insomnia due to ISWD can impair a
person’s occupational functioning and interfere with their ability to maintain
an active social life. It most often occurs in conjunction with other
neurological conditions, such as Alzheimer’s disease, other forms of dementia,
or brain damage. ISWD treatment is often approached with melatonin
supplementation and regular sleep times and meal times.
#4: Fatal Familial Insomnia
Fatal Familial Insomnia (FFI) is a very rare condition that,
fortunately, has never occurred locally in Queens. As the name suggests, it is
serious and often fatal. FFI is a rare autosomal dominant prion disease of the
brain; this means that only one copy of the gene is necessary for a person to
inherit the disorder, which is caused by a mutation to a prion protein. The age
of onset is in adulthood, ranging from as young as 18 to as old as 50, and
death usually occurs 7-36 months later. FFI proceeds in four stages:
·
1. The patient suffers increasing insomnia over
several months.
·
2. Hallucinations and panic attacks, brought on
by the lack of sleep, become noticable.
·
3. Rapid weight loss occurs along with inability
to sleep
·
4. The patient develops dementia.
FFI is an extremely rare disorder; worldwide, only 25
families are known to carry the gene that causes
it.
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