Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
What are some objective tests to measure sleepiness?
For someone who reports being sleepy during the day, it is sometimes helpful
to measure how sleepy he or she is. Also, after treatment of sleep problems, we
sometimes want to measure improvement in daytime sleepiness.
Sleepiness can be measured with a Multiple Sleep Latency Test (MSLT).
Basically, the MSLT measures how fast someone falls asleep during the day. It
must be done after an overnight sleep study (polysomnography) has documented
adequate opportunity for sleep the night before. The test is composed of four to
five
"naps" that last 20 minutes each and are spaced two hours apart. The person is
instructed to "try to fall asleep." The average time to fall asleep is
calculated for all four or five tests. A normal time would be greater than ten
minutes needed to fall asleep. Excessive sleepiness is defined as falling asleep
in less than five minutes.
The Maintenance of Wakefulness Test (MWT) also measures daytime sleepiness.
The person taking this test is instructed to "try to stay awake." This is
repeated for four 40-minute sessions, two hours apart. Not falling asleep in all
four tests is the strongest objective measure of the absence of daytime
sleepiness.
Some businesses use these tests to ensure that their employees are not
excessively sleepy while at work. Specifically, airline pilots and truck drivers
who experience sleepiness need to have a test to ensure public safety and
productivity at work. Unfortunately, there is no test that will guarantee that
someone will not fall asleep at his or her job or while driving.
What are the treatments for snoring?
The goals for the treatment of surgery may be difficult to determine. The
problem of snoring usually is a problem for the bed partner or roommate.
Therefore, successful treatment should also include the goal of achieving a
successful night's sleep for the bed partner or roommate. This makes treatment
of snoring a difficult challenge. For example, someone may have a successful
treatment if his or her snoring decreases from a jackhammer level to that of a
passing truck. If their bed partner is happy, then the snoring problem is
"cured." However, another person whose snoring decreases from a mild sound to
the level of heavy breathing may still have an unhappy bed partner.
It is wise to look at the "success" reports for various treatments with a
critical eye. If the number of nights that a bed partner has to leave the room
decreases from seven nights per week to one night per week, is that success?
Some would say that it is. However, the bed partner (or snorer) still has to
leave the room one night per week. It is important to know what the expectations
for a "cure" are before considering any treatments.
Sinus infection (sinusitis) signs and symptoms include headache, fever, and facial tenderness, pressure, or pain. Treatments of sinus infections are generally with antibiotics and at times, home remedies.
Restless leg syndrome (RLS or restless legs syndrome) is a common cause for painful legs that typically eases with motion, and becomes worse and more noticeable at rest. This characteristic nighttime worsening can frequently lead to insomnia. Treatment of the symptoms of restless leg syndrome is generally with medication as well as treating any underlying condition causing restless leg syndrome.
Sleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. OSA is caused by the collapse of the airway during sleep. OSA is diagnosed and evaluated through patient history, physical examination and polysomnography. There are many complications related to obstructive sleep apnea. Treatments are surgical and non-surgical.
The common cold (viral upper respiratory tract infection) is a contagious illness that may be caused by various viruses. Symptoms include a stuffy nose, headache, cough, sore throat, and maybe a fever. Antibiotics have no effect upon the common cold, and there is no evidence that zinc and vitamin C are effective treatments.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
It is thought that the tonsils and adenoids assist the body in fighting incoming bacteria and viruses by helping the body form antibodies. This is thought to be important only during the first year of life. Acute tonsillitis, strep throat, mononucleosis (mono), chronic tonsillitis, peritonsillar abscess, and hypertrophic tonsils and adenoids are all common problems involving the tonsils and adenoids. Treatment of tonsillitis and adenoids include antibiotics and other medications depending on the cause. In some cases, a tonsillectomy or adenoidectomy (the removal of the tonsils or adenoids) may be necessary.
Marfan syndrome is hereditary condition affecting connective tissue. A person with Marfan syndrome may exhibit the following symptoms and characteristics: dislocation of one or both lenses of the eye; a protruding or indented breastbone; scoliosis; flat feet; aortic dilatation; dural ectasia; stretch marks; hernia; and lung collapse. Though there is no cure for Marfan syndrome, there are treatments that can minimize and sometimes prevent some complications.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. Not getting enough sleep can hurt memory performance, health, and your mood.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
A deviate septum is a condition in which the bone and cartilage that divide the nasal cavity of the nose in half (nasal septum) is significantly off center or crooked. The causes of a deviated septum can be congenital, or develop after a trauma or injury to the nose. Symptoms of a deviated septum include nasal congestion, recurrent sinus infections, nosebleeds, headache, facial pain, postnasal drip, snoring, and loud breathing. A deviated septum can be relieved with medications, and if necessary surgery, called a septoplasty.
Periodic limb movement disorder (PLMD) is a sleep disorder characterized by rhythmic movements of the limbs during sleep. The movements typically involve the legs, but upper extremity movements may also occur. Movements occur periodically throughout the night and can fluctuate in severity from one night to the next. They tend to cluster in episodes that last anywhere from a few minutes to several hours. These movements are very different from the normal spasms, called hypnic myoclonia, that we often experience initially while trying to fall asleep.
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