• Sleep Disorders
  • General Symptoms
  • Sleep Apnea
  • Restless Leg Syndrome
  • Periodic Limb Movement Disorder
  • Insomnia
  • Parasomnias
  • Narcolepsy
  • Sleep-Wake Disorders
  • Circadian Rhythm Disorders

Sleep Disorders

Gwinnett Sleep offers comprehensive care for sleep disorders and related conditions by leveraging state-of-the-art technology and physicians/staff that pay attention to patient needs. Both of our Georgia locations are ready to help Atlanta-area residents get the rest they deserve and desire.

General Symptoms

Gwinnett Sleep not only diagnoses and treats specific sleep disorders, but patients that in general, have trouble sleeping. If you suffer from any of the following general symptoms, contact Gwinnett Sleep for a consultation:
  • Difficulty falling asleep
  • Wake up at night and cannot go back to sleep
  • Wake up earlier in the morning and feel tired
  • Early morning headaches
  • Snoring
  • Sweat excessively
  • Wake up suddenly at night gasping for breath
  • Feel sleepy during the day
  • Trouble concentrating
  • Vivid dreams while falling asleep or awakening
  • Leg cramps
  • Excessive daytime fatigue

What is sleep apnea?

Sleep apnea affects as many as one out of 10 Americans. People suffering from
sleep apnea stop breathing for more than 10 seconds at a time during sleep.

Also known as obstructive sleep apnea, sleep apnea is more common in men
than women. It’s also more common in people who are overweight.

More Information on this Disorder

How does it occur?

During normal sleep, throat muscles relax. Your airway can become blocked if there is too little room inside your throat or too much tissue pressing on the outside of your throat. Blockage halts the movement of air, and the amount of oxygen in your blood drops. The drop in oxygen causes the brain to rouse you from sleep so that you can reopen your airway.

If you suffer from sleep apnea, this cycle may repeat 50 or more times an hour, impairing your ability to reach deep, restful sleep.

You may not remember waking up. However, these arousals lead to sleepiness during ensuring days.

Weight gain may cause a narrowing of your airway. Other causes of sleep apnea are:

  • Tobacco
  • Alcohol
  • Lung disease
  • Abnormal sleep patterns due to irregular work schedules
  • Hereditary factors

What are the symptoms?

If you have sleep apnea, your body receives less oxygen when you don’t sleep well. Common symptoms of sleep apnea are:
  • Loud snoring interrupted by pauses in breathing; followed by loud gasps
  • Not feeling rested when you wake up in the morning
  • Morning headaches
  • Daytime tiredness or sleepiness
  • Trouble concentrating
  • Anxiety, irritability, or depression
  • A strong desire to take afternoon naps
  • Sleepiness while driving.
Many people who snore do not have sleep apnea. But nearly everyone who has sleep apnea snores. If you snore and do not enjoy a good night of rest, contact Gwinnett Sleep.

How is it diagnosed? Gwinnett Sleep may:

Inquire about your family’s health history
Examine your throat and nasal passages
Conduct a sleep study at our sleep disorders clinic. Your heart rate, brain
waves, chest movement, and blood oxygen levels will be measured while you
sleep. The study will help to determine if the movement of air slows during
sleep or if your air movement stops completely. It will also show how often this
occurs during sleep.

How is it treated?

It is very important to treat sleep apnea. Untreated sleep apnea can lead to serious, long-term health effects. It may increase your risk of high blood pressure, heart attacks, and sudden death. Effective treatment of sleep apnea may result in normal blood pressure, relief of fatigue, and weight loss.The most common treatment is utilization of a machine that sends pressurized air into your nose and throat at night. How much pressure you need is determined by the sleep study. Your health care provider will carefully supervise your usage of this breathing machine; minor adjustments may need to be made so it works right for you. This treatment is called Continuous Positive Airway Pressure (CPAP).

If you have pressure on your throat because of excess fatty tissue in your throat, your health care provider may suggest a
weight-loss program.

It may be hard for you to lose weight because you are extremely tired and lack energy to exercise. Use of the breathing machine may help you rest well enough to initiate diet changes and increase physical activity.

Surgery may be an option if you cannot use the breathing machine regularly and properly. This procedure may include improving the air passage in the nose, removing the tonsils, or moving the back of the tongue forward.

Experimental treatments include:
Medication that increases muscle tone during sleep
Pacemakers that sense when blockages are occurring during sleep and
stimulate throat muscles to open up the throat before you wake up.
It is too early to determine if these experimental treatments will become acceptable treatments of sleep apnea.

How long will the effects of sleep apnea last?

Sleep apnea can be cured if it is caused by a reversible problem such as weight gain; or it can be treated with surgery. For most people, however, sleep apnea will always be a problem, and the CPAP machine will need to be utilized regularly to maintain quality sleep and prevent serious complications of sleep apnea.

Restless Leg Syndrome / Periodic Limb Movement Disorder

What is restless legs syndrome (RLS)?

Restless Legs Syndrome (RLS) is a cause of insomnia (trouble sleeping) for
many people. RLS sufferers experience aching, twitching, tingling, burning, or
prickling sensations in the lower leg muscles when they lie in bed or sit down.
The discomfort is relieved by standing or walking.

How does Restless Legs Syndrome occur?

The exact cause of RLS is unknown. It tends to run in families. RLS is more common after middle age and occurs more frequently in women. Many people with RLS can recall “growing pains” in their legs during childhood. It may be that a nerve malfunction is involved. RLS has also been linked with alcohol dependence, smoking, too much caffeine (usually from drinking coffee), rheumatoid arthritis, anemia, and diabetes. Some medicines may worsen symptoms.


What are the symptoms of Restless Legs Syndrome?

Symptoms may include:
  • Aching
  • Twitching
  • Tingling
  • Burning
  • Prickling in the lower leg when you are lying down or sitting.
  • relief from the symptoms when you stand up or walk around.

How is Restless Legs Syndrome diagnosed?

The diagnosis of RLS is based on your medical history. Your health care provider will examine you and may order blood tests or other tests to check for underlying medical problems, including anemia, rheumatoid arthritis, or diabetes.

How is it treated?

Your health care provider can prescribe medicine to relieve the symptoms and improve sleep. Levodopa (Sinemet), a drug usually used for Parkinson’s disease, is often prescribed.

What is Insomnia?

Having insomnia means you often have trouble falling or staying asleep or going back to sleep if you awaken. Insomnia can be either a short-term or a long-term problem.
Insomnia affects 1 in 3 adults every year in the US.

How does it occur?

Having insomnia means you often have trouble falling or staying asleep or going back to sleep if you awaken. Insomnia can be either a short-term or a long-term problem.

Stress such as a big deadline at work, a financial problem,

Being overweight

Depression, anxiety, or other mental health problems

Medical problems such as sleep apnea or hyperthyroidism

Restless leg syndrome (muscles in your lower legs twitch

Use of caffeine or other stimulants

Use of alcohol, other depressants, or sedatives, which can relax you but lead to shallow sleep that starts and stops, especially if you use these drugs for a long time

Medicines, such as those used to treat asthma

Pain and other discomfort caused by an illness such as

Shortness of breath caused by chronic obstructive

Poor sleep habits, including going to bed at different
times or in a noisy environment, or eating or working in

Changes in sleep patterns because of different work
hours or travel (jet lag).

Insomnia may be temporary (called situational insomnia) or ongoing (chronic insomnia).

Situational insomnia occurs with a stressful event. It is often caused by noise, pain, worry, or family, work, financial, or school
problems. It lasts 3 weeks or less. This kind of insomnia generally goes away when the stressful event is over or resolved.

Chronic insomnia can be caused by irregular sleep-wake patterns resulting from shift work, drug dependency (including long-term
use of sleeping pills or alcohol), stress, illness, or mental health problems such as anxiety or depression. It lasts longer than 3 weeks and requires treatment of the underlying problem.

What are the symptoms? Symptoms include:

  • Trouble falling asleep (taking longer than 45 minutes)
  • Awakening often in the night
  • Waking up early in the morning and being unable to go back to sleep
  • Not feeling rested in the morning or feeling tired during the day
  • Restlessness or anxiety as bedtime approaches.

How is it diagnosed? Your health care provider will ask you about:

  • Your sleep patterns
  • Use of caffeine, alcohol, medicine, and other drugs
  • Eating and exercise habits
  • Your mental and physical condition
  • Your medical and mental health history, and your family’s history
  • Your job and travel patterns.

Your health care provider may also ask your spouse, bed partner, or other family members about your sleep habits. After talking with
you, your health care provider may give you a physical exam. A blood sample may be taken for lab tests.

Your health care provider may ask you to take notes each morning about:

How long you were in bed

How much time you think you actually slept

How many times and what times you woke up

What time you got up in the morning

Your thoughts about the quality of your sleep

Whether anything unusual happened.

Your health care provider may suggest that you sleep overnight in a sleep center. At the sleep center you may have a continuous,
all-night recording of your breathing, eye movements, muscle tone, blood oxygen levels, heart rate and rhythm, and brain waves.

How is it treated?

When appropriate, your health care provider will prescribe treatment for underlying problems that are causing the insomnia. For
example, if you have depression, medicine used to treat depression should help the insomnia. If drug or alcohol abuse is the cause of
your insomnia, the treatment is to help you to stop using these substances. If you have chronic insomnia, it must be treated with
management of the underlying problem.

In some cases of temporary insomnia, your health care provider may prescribe medicine to help you sleep until the stressful event is
over or resolved. Counseling may also help you deal with psychological problems or reduce stress that may cause or contribute to
your insomnia.

Some sleeping medicine can be addictive. Your health care provider will work with you to choose the right medicine for short-term or
long-term use.

Your health care provider may recommend relaxation techniques, changes in diet, cutting out caffeine, and a healthy lifestyle that
includes exercise. Your provider also will probably discuss good sleep habits and a regular sleep routine.

How long will the effects last?

Often insomnia lasts for just a few nights. If you cannot sleep almost every night for 2 weeks, tell your health care provider. Insomnia
that lasts this long usually continues until the cause is identified and treated.

How can I help prevent insomnia?

Having insomnia means you often have trouble falling or staying asleep or going back to sleep if you awaken. Insomnia can be either
a short-term or a long-term problem.
  • Establish a regular bedtime and wake-up time and stick to them even on weekends.
  • Avoid taking naps.
  • Exercise regularly during the day. Avoid exercising in the evening.
  • Keep light levels very low after sunset and keep the bedroom very dark.
  • Keep the bedroom at a cool temperature.
  • Use the bed only for sleep and sex, not for reading or watching television.
  • Go to bed when you are drowsy and get up when you are wide awake.
  • Avoid caffeine, other stimulants, cigarettes, and alcohol. Do not drink alcohol within 6 hours of bedtime. If you smoke, try to quit smoking entirely. Cutting back on smoking without quitting may lead to nicotine withdrawal in the middle of the night that awakens you.
  • Eat lightly at the evening meal and avoid snacks after supper.
  • Lose weight if you are overweight.
  • Learn to use relaxation exercises.
  • Meditate for 20 minutes before you go to bed.
  • Read something light or entertaining just before you go to bed, to get your mind off the day’s troubles.
  • Consider having white noise in the background, such as a fan blowing.
  • Try not to focus on falling asleep. For example, don’t keep checking the clock and worry about why you are not asleep yet. If you are awake for more than 20 minutes, leave the bed and do not go back to bed until you feel ready to sleep.
  • Try to reduce stress in your life by changing the things that cause stress.
  • Keep a “to do” journal. Before you go to bed, write down all the things you are worrying about. Then write down what you can do tomorrow. Mark the other things as things to do later in the week. This will help clear your mind of worry.

What are Parasomnias?

Parasomnia refers to all the abnormal things that occurs to people while they sleep — excluding sleep apnea. Some examples are sleep-related eating disorders, sleepwalking, night terrors, sleep paralysis, REM sleep behavior disorder, and sleep aggression. Parasomnias can have negative effects on people during the daytime, including sleepiness.

When do parasomnias occur?

Parasomnias can occur as a person is falling asleep or at any point in the sleep cycle. If they occur while falling asleep, a person may experience disturbing hallucinations or sleep paralysis (the body is unable to move for several seconds or minutes). Sleep paralysis can be quite frightening, especially when it occurs with hallucinations.

Parasomnias that occur during sleep, such as REM Sleep Behavior Disorder (RBD), often involve vigorous and harmful dream-enacting behaviors. RBD is a brain disorder that usually occurs in men over 50 years of age, but can affect people of any age who are taking certain medications such as antidepressants and people with neurologic disorders such as Parkinson’s disease, narcolepsy or stroke. Other parasomnias that occur during sleep include nightmares and sleep-related groaning, which can be loud and prevent a person’s bed partner or roommate from sleeping.

In addition, there are parasomnias that occur when a person has abrupt, partial awakenings such as confusional arousals,
sleepwalking, sleep terrors, and a sleep-related eating disorder. Sleep-related hallucinations may also occur as a person is waking up.

What causes a parasomnia?

Family history is likely a factor with parasomnias. Brain disorders may also be responsible, including REM Sleep Behavior Disorder.
Parasomnias may also be triggered by other sleep disorders such as obstructive sleep apnea and various medications.

Who is at risk for parasomnias?

Parasomnias affect one out of 10 Americans. They occur in people of all ages, but are more common in children. Children are
particularly vulnerable because of brain immaturity. The good news? Parasomnias are not associated with negative health
consequences and disappear as children mature.

Should a person be awakened during a parasomnia episode?

Trying to awaken a “parasomniac in action” — especially by shaking or shouting — may trigger an irritable, aggressive
or violent response. Instead, gently redirect the person back to bed by guiding him/her by the elbow, while speaking softly.

How can a parasomnia sufferer be protected?

  • A person who suffers from parasomnias should not sleep on a top bunk or next to a window
  • Remove sharp objects from the bedside area
  • Make sure household members are aware of diagnosis and know how to react
  • During an episode, it’s safe to awaken a parasomnia sufferer with a door alarm

How are parasomnias treated and at what point should someone with a parasomnia seek evaluation and possible treatment?

Many people who suffer with parasomnias enjoy improvements by adjusting sleep habits. Good sleep habits include keeping a
regular sleep schedule, managing stress, having a relaxing bedtime routine, and getting enough sleep. Also, drug therapies control
symptoms.

A person should seek treatment for parasomnia whenever there is risk for injury. It’s also important to seek treatment if parasomnia
disrupts a person’s own sleep or the sleep of the bed partner/roommate, if there is distress about the symptoms (e.g., nightmares),
or if the frequency is high or escalating. An overnight sleep lab study may be needed.

It is important to keep in mind that no matter how weird, bizarre, or violent, parasomnia behavior is rarely linked to psychiatric
disorders. However, people who suffer from parasomnias may endure ridicule, confusion, and/or shame.

What is Narcolepsy?

Narcolepsy is a neurological disorder caused by the brain’s inability to regulate
sleep-wake cycles. The main features of narcolepsy are excessive daytime
sleepiness and cataplexy. The disease is often associated with sudden sleep
attacks, insomnia, dream-like hallucinations, and a condition called sleep
paralysis. Its prevalence in the developed world is approximately the same as
that of multiple sclerosis or Parkinson’s disease.

How does it occur?

In order to understand the basics of narcolepsy, it is important to review the features of “normal sleep.” Sleep happens in cycles.
When we fall asleep, we initially enter a light stage of sleep and progress into increasingly deeper stages. Both light and deep sleep
stages are called non-REM (rapid eye movement) sleep. After about 90 minutes, we enter the first stage of REM sleep, which is the
dreaming portion of sleep. Throughout the night, we alternate between stages of REM and non-REM sleep. For people with
narcolepsy, sleep begins almost immediately with REM sleep and fragments of REM occur involuntarily throughout the waking hours.

During REM sleep, our muscles are paralyzed and dreaming occurs, so it’s not surprising that narcolepsy is associated with paralysis,
hallucinations, and other dream-like and dramatically debilitating symptoms.

Despite the perception that people with narcolepsy are perpetually sleepy, they do not typically sleep more than the average person.
Narcolepsy is considered a “state boundary” control abnormality. That is, narcolepsy patients sleep a normal amount, but cannot
control the timing of sleep.

Narcolepsy affects both sexes equally and develops with age; symptoms typically develop in adolescence or young adulthood and
may remain unrecognized as they gradually develop. The instance of a familial connection with narcolepsy is quite small, but a
combination of genetic and environmental factors may be at the root of this sleep disorder.

Narcolepsy patients typically endure many years of daytime sleepiness before seeking treatment because to most people,
sleepiness is not indicative of disease. Yet the devastating potential of this disorder is reflected in studies showing narcoleptic
patients are more accident-prone and have difficulty forming or maintaining interpersonal relationships.

Researchers believe that narcolepsy may be caused by a deficiency in hypocretin production in the brain. The results of one recent
study —hypocretin was directly administered to the brain — suggest that hypocretin derivatives may be an effective way to prevent
cataplexy and improve wakefulness.

Stress such as a big deadline at work, a financial problem,

Being overweight

Depression, anxiety, or other mental health problems

Medical problems such as sleep apnea or hyperthyroidism

Restless leg syndrome (muscles in your lower legs twitch

Use of caffeine or other stimulants

Use of alcohol, other depressants, or sedatives, which can
relax you but lead to shallow sleep that starts and stops,
especially if you use these drugs for a long time

Medicines, such as those used to treat asthma

Pain and other discomfort caused by an illness such as

Shortness of breath caused by chronic obstructive

Poor sleep habits, including going to bed at different
times or in a noisy environment, or eating or working in

Changes in sleep patterns because of different work
hours or travel (jet lag).

What are the symptoms? The main symptoms associated with narcolepsy are:

  • Excessive daytime sleepiness: This is typically the first symptom to appear in people who suffer from narcolepsy. Unless they’re
    being treated for the disorder, the need to sleep can be overwhelming for narcolepsy patients. Someone who has narcolepsy is
    prone to falling asleep while engaged in conversation, driving, eating dinner, or at other inappropriate times. The sleepiness occurs
    in spite of a full night’s sleep and may persist throughout the day.
  • Cataplexy is a sudden loss of muscle tone, usually triggered by emotional stimuli such as laughter, surprise, or anger. It may involve
    all muscles and result in collapse. It may only affect certain muscle groups and result in slurred speech, buckling of the knees, or
    weakness in the arms. Consciousness is maintained throughout the episode, but the patient is usually unable to speak.
  • Hypnogogic hallucinations: During the transition from wakefulness to sleep, the patient has bizarre, often frightening, dream-like
    experiences that incorporate his or her real environment.
  • Sleep paralysis: A temporary inability to move during sleep-wake transitions. Sleep paralysis may last for a few seconds to several
    minutes and may accompany hypnagogic hallucinations.
  • Disturbed nocturnal sleep: Waking up repeatedly throughout the night.
  • Leg jerks, nightmares, and restlessness.

What is Sleep Wake Disorder?

Sleep-Wake Disorders can involve fragmented sleep or frequent awakenings
during the night. Sleep is an important part of the body’s natural healing
process, which is why the recommended hours of sleep a night is so
important. Unfortunately, it’s difficult for those that suffer from Sleep-Wake
Disorders to achieve an entire night of restful sleep. Specialists at Gwinnett
Sleep can evaluate the severity of your Sleep-Wake Disorder and structure
optimal treatment plan unique to your needs.

Circadian Rhythm Disorder / Jet Lag

Individuals who suffer from a Circadian Rhythm Disorder may experience
frequent sleep interruptions. Erratic sleep patterns prevent the body from
achieving optimal rest and recovery levels, which is why seeking treatment for
Circadian Rhythm Disorders from Gwinnett Sleep is extremely important to
prevent other chronic conditions.

What is jet lag

Jet lag is the fatigue you may feel after flying across several time zones. The rapid travel disturbs your normal body rhythms.

How does jet lag occur?

Each person has an internal body clock which determines when sleeping, waking, and hunger occur in a 24-hour period. When you
travel across several time zones, your “day” is longer or shorter than 24 hours. Your body is out of sync with the local time zone.
Your normal body rhythms fails to adjust to this shorter or longer day, resulting in jet lag.

Not all jet lags are the same. Traveling eastward, which shortens your day, is more difficult than flying westward, which lengthens it.

What are the symptoms? The symptoms of jet lag may include:

  • Tiredness
  • Drowsiness during the day
  • Trouble sleeping at night
  • Dulling of mental ability and memory
  • Irritability
  • Headaches
  • Stomach aches
  • Minor coordination problems and reduced physical activity

How long will the effects of jet lag last?

West-to-East Coast trips may require one day of recovery for each time zone crossed. East-to-West Coast journeys may require
one day of recovery for each one and a half time zones crossed. The adjustment can be eased by breaking up a long journey with
a stopover. If you have an important event or meeting to attend at your destination, try to get there 2-3 days early.

What can be done to help prevent jet lag?

What can be done to help prevent jet lag?

  • Drink lots of beverages during the flight, but avoid those containing caffeine or alcohol
  • Eat high-protein, low-calorie meals before, during, and after your flight
  • If you fly eastward, go to bed earlier than usual for a few days before the trip
  • If you fly westward, go to bed later than usual
  • Schedule your arrival at about your usual bedtime, according to the time at your destination, or sleep on the plane and plan to arrive at your usual waking time
  • Set your watch to the destination time when you are halfway through your flight so you can start thinking in terms of the new time zone
  • Spend more time outside at your destination. This exposure to bright outdoor light will help you to adjust faster than if you stay in your hotel room