If you’re one of the millions of Americans suffering with sleep problems, we know how frustrating that can be. And the consequences go far beyond feeling tired the next day. Narcolepsy, for instance, is dangerous because people fall asleep in an instant, even while they’re driving. With sleep apnea, your organs are deprived of oxygen and slow down. And chronic insomnia can often bring anxiety or depression and may indicate a more serious underlying medical problem.

The sleep medicine experts at Central Maine Healthcare’s are here to help. Our board-certified pulmonologists and other specialists will get to the bottom of what’s keeping you up, and work with you to find the right treatment, whether that’s medication, a state-of-the-art sleeping device, minimally invasive procedure or another solution. Together, we can improve your sleep and overall health and wellness.

• Sleep Apnea: When you have sleep apnea, it means your airway is obstructed while you sleep and you’re depriving your brain and other organs of oxygen. Snoring is the clearest symptom, but apnea affects all of your body’s systems; you might feel colder than other people, or your hair might be thinning, you’re tired, or you can’t lose weight. In short, your internal motor isn’t running up to par. Some apnea patients even wake up during the night, gasping for air, which can be terrifying. But rest easy—we can help you control apnea with a variety of treatments, including a CPAP machine.
• Insomnia: If it’s hard for you to fall asleep, or you wake up during the night and can’t fall asleep again, you have insomnia. That happens to everyone occasionally and can be resolved by changing the parts of your life that affect sleep — your bedtime, or diet and exercise. But when it happens repeatedly, you have chronic insomnia that should be treated. We’ll make sure you don’t have an underlying health problem, then create a personalized program that fits your lifestyle.
• Narcolepsy: If you’ve been diagnosed with narcolepsy, you probably can’t make firm plans — especially if you have to drive — because you never know when you’ll suddenly fall asleep. We start with specialized testing to confirm the diagnosis, then custom-design a program to get you through your days with energy. We’ll co-create a regular sleep, meal and exercise schedule, and possibly prescribe new medications to help you sleep better at night.
• Restless Leg Syndrome: We consider this ailment a sleep disorder because it usually happens at night and keeps you from getting enough rest. If you feel an urge to move your legs when you lie down, or if you feel a twitching, “pulling” or strange ache in your legs, you may have restless leg syndrome. We use a number of treatments for this disorder, including medications to boost the dopamine levels in your brain—it’s a chemical that sends messages to your nerves, telling them to relax—and a variety of muscle relaxants and sleep medications.

Insomnia

Defining insomnia isn’t complicated; it means you have difficulty falling or staying asleep. Conquering insomnia, however, isn’t quite so easy because it can be traced to a long list of medical or lifestyle causes. Insomnia is a widespread sleep disorder: the National Institutes of Health says 30 percent of American adults experience some sleep disruption on a regular basis.

If you’re not getting the sleep you need for your healthiest and most productive life, the experts at Central Maine Healthcare can help. Our board-certified pulmonologists specialize in diagnosing and treating insomnia, and will work with you to create a personal plan to help put your sleep problems to bed.

Understanding Insomnia

The symptoms of insomnia are obvious: you’re tired during the day, you’re irritable and your performance at work or school is suffering. What most people don’t realize is, there are two types of insomnia:

• Acute insomnia sounds more severe, but the opposite is true; here it means “temporary,” caused by some life circumstance. You’re likely to get acute insomnia, for instance, the night before a big exam or job interview, or when you’ve had an argument with a friend. Acute insomnia resolves itself after a few days without any treatment.
• Chronic insomnia is ongoing—meaning, it happens at least three times a week, for at least three months. It can be caused by a change in your environment (moving to a new house or a different city), working the night shift or split shifts, another illness or medications. It also can be linked to another medical or psychological disorder.

Your Lifestyle Can Affect Your Sleep

You’ve heard the saying, “you are what you eat.” Food and drink, more than any other factor, can keep you from occasionally getting a good night’s sleep:

• Caffeine—no surprise there—can keep you awake. It’s a stimulant that stays active in your system for eight hours, so if you’re an all-day coffee drinker you should consider cutting yourself off after lunch.
• Nicotine is another stimulant. If you smoke, you’re not resting as well as you might otherwise, even though you think smoking is relaxing you.
• Alcohol can make you tired but can also disturb your sleep later, during the night.
• A big meal close to bedtime can interrupt your sleep because heavy foods make it hard for your body to settle down and relax. Also, spicy food can cause heartburn, keeping you awake even longer.

Medical Causes of Insomnia

A large number of ongoing medical disorders can also cause you to lose sleep:

• Nasal and sinus allergies or asthma
• Lower back pain
• Reflux or other gastro problems
• Endocrine disorders
• Arthritis pain
• Depression
• Other sleep disorders, such as restless leg syndrome
• Chronic anxiety, such as a nightly feeling of being overwhelmed by family or work responsibilities.

Helping You Get the Sleep You Need

There’s currently no clear-cut test for diagnosing insomnia. But, by keeping a sleep log, answering targeted questions and a blood test to rule out issues such as thyroid disorders, you and your team at Central Maine can pinpoint the cause of your insomnia and find the right treatment. We may also recommend an overnight sleep study, offered at our full-service sleep center in Lewiston. Once we better understand the problem, your treatment plan may include one or a combination of:

• Relaxation training:Breathing exercises, meditation and mindfulness training all can help immensely with your overall relaxation, helping you to sleep better at night.
• Stimulus control:If you take your laptop to bed with you, pay bills in the bedroom or even watch TV until you go to bed, you’re stimulating your brain when you should be preparing it for rest. You can exercise stimulus control by following three simple rules: (a) don’t go to bed until you’re sleepy; (b) reserve the bedroom for two activities only—sleep and intimacy; and (c) if you’ve been lying in bed for 20 minutes and still can’t fall asleep, get up and do something else.
• Cognitive Behavior Therapy (CBT): A therapist trained in CBT can teach you to eliminate unhealthy fears that keep you awake, or to change other thought patterns to help you rest easier. 
• Over-the-counter or prescription medications: A mild sleeping medication might be necessary to get you in the habit of falling asleep on a regular schedule.

Narcolepsy

Narcolepsy is a neurological disorder that can cause a sudden “sleep attack” during any type of activity or any time of day. It’s relatively rare: only one in 2,000 American adults have been diagnosed. But, it can severely limit your life – people with narcolepsy don’t dare drive, and holding down a job can be challenging, to say the least.

If you or someone in your family drops off to sleep without warning, it’s important to get tested for narcolepsy as soon as possible. The experts at Central Maine Healthcare specialize in diagnosing and treating this condition, helping you find peace of mind and the healthy, routine sleep habits you need.

Understanding Narcolepsy

When you have narcolepsy, it means your brain can’t control your sleep and wake cycles. The disorder usually begins when you’re young—between ages 10 and 25—but diagnosing it can take up to 10 years because so many other disorders show the same symptoms. In fact, it’s estimated that half of people with narcolepsy have not been diagnosed. Symptoms include:

• Excessive Daytime Sleepiness (EDS)—more than “ordinary” fatigue, people with EDS are tired all the time and when they get sleepy, they fall sound asleep, whether they’re driving a car, talking or even standing
• Frightening nightmares, seeming like hallucinations
• “Cataplexy,” a weakening of your muscles when you feel strong emotions of any kind, whether it’s laughter, surprise or anger. Your head will drop, your face will droop, jaws weaken and knees give out. You might even fall down.
• Sleep disruption – you can fall asleep but it’s difficult to wake up.
• Sleep paralysis — you can’t move or speak when you’re falling asleep or waking up. Sometimes you can’t breathe.

Getting You Back to Good Sleep

To diagnose narcolepsy or another sleep disorder, we may recommend a sleep study, available at our nationally accredited sleep center in Lewiston. During your visit, you may undergo two of the gold-standard tests:

• PSG (polysomnography), an overnight exam that measures your brain waves, oxygen levels, heart rate, leg movements and eye movements; and
• MSLT (multiple sleep latency test), which takes place the morning after the PSG and measures daytime sleepiness.

Based on those results, your Central Maine pulmonologist will work with you to create a personal treatment plan, which may include medication and/or lifestyle changes. The first drug treatment usually is a stimulant for the central nervous system, because it’s less addictive than other choices and causes fewer side effects.

If that type of stimulant isn’t effective, your provider may prescribe an amphetamine-like stimulant. These meds are less desirable because they not only can cause unhealthy side effects such as shakiness and heart rhythm fluctuations, they also are potentially easy to abuse.

Simple lifestyle adjustments can also help normalize your sleep patterns: taking short naps, getting on a regular sleep schedule, cutting alcohol and caffeine before bedtime, exercising, stopping smoking and relaxation exercises.

In addition, your provider will make you aware of safety precautions you need to take if you’re diagnosed with narcolepsy. You don’t want to be driving, either alone or with passengers, if your sleep/wake cycles aren’t completely under control.

Restless Leg Syndrome

It couldn’t be more aptly named: if you have Restless Leg Syndrome, it means your legs won’t stay still. Also called Willis-Ekbom Disease, restless leg affects nearly 10 percent of adults in America. It happens at any age, to both men and women, and the discomfort happens more frequently and lasts longer as you get older.

If you feel a strange, “jittery” sensation in your legs, especially in the evening, come see the sleep medicine specialists at Central Maine Healthcare. Our board-certified providers can diagnose the condition and recommend the right treatment to help your legs relax, so you can get some much-needed sleep.

Understanding Restless Legs

Restless leg won’t directly damage your health, but it’s extremely uncomfortable and stops you from getting good sleep (which is never healthy). Like any sleep disorder, the lack of sleep brings on daytime fatigue and sleepiness, sometimes to the point of exhaustion. Because you’re tired, you may not be able concentrate, study or work well—all factors that contribute to depression and anxiety.

People with restless leg describe it, first, as an irresistible urge to move their lower limbs. They say it feels like an aching, throbbing, pulling, crawling, itching or creeping sensation, often with some pain. It begins in late afternoon or evening and is most severe at night. It varies from day to day, usually affecting both legs. It’s considered severe when you feel it more than twice a week and it affects your daily functioning. Moving around can relieve the restlessness, but it often returns.

Causes

We can’t be sure what causes restless leg, but we do know it has a genetic component. It’s also related to low iron in your brain, and low levels of dopamine, a brain chemical needed to produce smooth, purposeful muscle movements — the opposite of what your limbs do when you have restless leg syndrome.

Certain medications aggravate the condition, such as anti-nausea drugs, antipsychotic drugs, some antidepressants and select cold and allergy medicines. Alcohol, nicotine and caffeine can make it worse, so if you have restless leg, you may be able to temper it a bit by cutting back on those substances. Pregnant women are susceptible, as are people with nerve damage (neuropathy).

Helping You Get a Relaxing Sleep

Diagnosing restless leg syndrome isn’t a complex process; it’s one sleep disorder with unique symptoms that your provider will recognize. Your specialist at Central Maine will help you find the right treatment, which may involve lifestyle changes such as cutting alcohol and tobacco use, setting and sticking to a regular sleep pattern and doing moderate exercise, including aerobics and leg stretching.

Iron supplements might also if a blood test shows you’re iron-deficient. Your provider might want to try anti-seizure medications, which increasingly are the first line of defense in treating restless leg.

For non-drug therapies, massaging your legs can soothe and relax your muscles, reducing the discomfort of restless leg. If the idea of massaging appeals to you, ask your provider to look into new devices that wrap around the leg and vibrate, delivering relief to the muscles running down the back of your legs.

It couldn’t be more aptly named: if you have Restless Leg Syndrome, it means your legs won’t stay still. Also called Willis-Ekbom Disease, restless leg affects nearly 10 percent of adults in America. It happens at any age, to both men and women, and the discomfort happens more frequently and lasts longer as you get older.

If you feel a strange, “jittery” sensation in your legs, especially in the evening, come see the sleep medicine specialists at Central Maine Healthcare. Our board-certified providers can diagnose the condition and recommend the right treatment to help your legs relax, so you can get some much-needed sleep.

Sleep Apnea

Sleep apnea is a serious disorder in which you stop breathing repeatedly during sleep. If your apnea is severe, you might wake up choking and gasping for breath several times a night, which can be scary. It also means the brain and the rest of the body may not be getting enough oxygen, which can lead to other serious health problems. That’s why it’s important to be seen as soon as possible if you suspect there’s an issue.

At Central Maine Healthcare, our specialists can help you take control of apnea once and for all. We offer overnight sleep studies close to home in Lewiston and a full range of treatment options, including CPAP (Continuous Positive Airway Pressure) machines, so you can get back to the restful night’s sleep you deserve.

Understanding Sleep Apnea

There are two main types of this sleep disorder:

• Obstructive sleep apnea, where your throat muscles relax too much, and your airway literally can close, making it impossible for you to take a breath. You end up with low oxygen levels in your blood, and your organs end up not getting sufficient fuel to work properly.
• Central sleep apnea, when your brain doesn’t send signals to the muscles that control your breathing.

Sleep apnea can affect anyone, but certain factors put you at higher risk:

• Being overweight
• Having a thicker-than-normal neck
• Age
• Family history
• Smoking
• Chronic nasal congestion
• Being a male (men are two-three times more likely to get sleep apnea than women

Additional risk factors associated with the condition include congestive heart failure, taking narcotic pain meds and having suffered a stroke.

Symptoms

The list of sleep apnea symptoms is long, and may include one or a combination of:

• Loud snoring
• You’ve been told you stop breathing while you sleep
• Morning headaches, often with a “pounding” sound in your head
• Choking, snorting or gasping for air during the night
• Dry mouth
• You fall asleep but wake during the night
• Daytime sleepiness
• Difficulty focusing and paying attention
• Irritability
• Nightmares

Take Back Your Sleep – and Health

Sleep apnea affects more than your quality of life. It brings complications far beyond not feeling rested:

• Daytime fatigue and inability to focus can make you feel moody and depressed. Eventually there’s an “emotional fallout” when you feel lousy so much of the time.
• When your heart and other organs don’t get enough oxygen, the outcome can be high blood pressure and heart disease. Even worse, your heartbeat can become irregular, which can result in sudden death.
• Untreated sleep apnea puts you at risk for type 2 diabetes and insulin resistance.
• Sleep apnea can lead to nonalcoholic fatty liver disease.
• Your partner also can develop a range of disorders because your sleep apnea symptoms also stop them from getting good rest.

The good news: Sleep apnea can be effectively managed with the right diagnosis and treatment. At Central Maine Healthcare, we usually start with an overnight sleep study at our nationally accredited sleep center in Lewiston. During the study, our sleep specialists and technicians will monitor your heart, lung and brain activity; arm and leg movements; blood oxygen levels and breathing patterns. Depending on the results, you may be referred to one of our ear, nose and throat (ENT) specialists to rule out a blockage in your nose or throat.

If your sleep apnea is mild, your provider may recommend lifestyle changes, such as losing weight or stopping smoking, to eliminate those possible causes.

Most sleep apnea, though, is treated with the use of a CPAP machine. The CPAP will force your airways open with air while you sleep, so you’ll no longer have an obstructed airway. You can choose to wear a small nose mask or, if you’re a “mouth breather,” a larger face mask. Your provider will adjust the air settings before you take the CPAP home, or might recommend an auto-adjusting BPAP machine instead.

Most of the time, CPAP is a highly effective option, though in rare cases, we may recommend surgery to remove tissue blocking your airway. We’ll work closely with you to the best treatment for your unique needs.