Introduction

      We are all generally aware of the personal consequences of inadequate or non-refreshing sleep including decreased motivation and concentration and depressed mood. Although it is difficult to estimate the overall impact of sleep disruption and disorders on our society, many major accidents such as the Challenger Shuttle explosion and the Three-Mile Island Nuclear Power Plant incident have been linked with sleep deprivation in workers. Sleepy drivers are also more likely to have accidents.
     Major categories of sleep-related symptoms include excessive daytime sleepiness (EDS) and insomnia. In general population surveys 5-15 % of respondents report EDS. By far the most common cause of EDS in patients who come to sleep clinics is sleep-disordered breathing or the Obstructive Sleep Apnea Syndrome (OSAS). The hallmark of this condition is loud snoring with recurring pauses in breathing caused by temporary complete blockage of the air passages in the back of the throat. In a widely quoted survey of middle-aged working persons, 35% of men and 28% of women reported habitual snoring. When studied in a sleep laboratory 24% of the men and 9% of the women respectively were found to have some evidence of OSAS. In approximately one third of the men and one half of the women with OSAS the severity was judged sufficient to have adverse health consequences. An increased risk of OSAS is present in persons who are overweight or who have nasal obstruction (e.g. due to allergies). There are many other causes of EDS including a rare hereditary condition called narcolepsy, which causes uncontrollable "sleep attacks". If excessive sleepiness is interfering with normal daily activities, especially driving, it should be evaluated by a qualified health professional.

      Stressful life events, shift work, jet travel and medical conditions can cause temporary difficulty sleeping. Approximately 27% of the general public reports occasional insomnia. However, 9% of respondents in a Gallup poll reported this problem as lasting 6 months or more. Short-term insomnia, which severely interferes with daily activities and chronic insomnia should be evaluated by a health professional. Other primary sleep disorders include the parasomnias such as sleep walking and acting out of dreams (called REM Sleep Behavior Disorder). These conditions usually do not have severe adverse effects, but injuries to the affected individual or his/her bed partner can occur. Finally, disruption of sleep can be associated with many medical conditions and medications. Once recognized simple treatments may result in significant improvement in sleep and sense of well-being.

  Sleep Disorders Clinics at UNC

     Both the Division of Pulmonary Medicine in the Department of Medicine and the Department of Neurology have Sleep clinics which evaluate patients with all types of sleep-related problems. The UNC Hospitals Sleep Disorders Laboratory directed by Dr. Bradley Vaughn, has 4 beds and performs overnight sleep studies Sunday through Friday nights. In 2005, the laboratory performed approximately 700 overnight studies.

      To schedule an appointment to be evaluated by a physician in the Sleep Disorders Clinic of the Division of Pulmonary medicine, please call 966-7933.

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