Sleep Disorders

Quality sleep affects every system in the body, and disturbed sleep can both signal and cause illness. Sleep medicine looks at three groups of problems: disorders of sleep itself, conditions that arise during sleep and impair daytime function, and waking conditions that interfere with sleep. In practice this means snoring and sleep apnea, insomnia, excessive daytime sleepiness and narcolepsy, restless legs and periodic limb movements, disorders of the body clock such as shift-work and jet-lag patterns, and unusual behaviours during sleep. Because sleep touches breathing, the heart, mood, hormones and the nervous system, the centre is led by chest and lung medicine together with neurology and works closely with ear nose and throat, cardiology, psychiatry, endocrinology and internal medicine, so each person is assessed from every relevant angle.

Obstructive sleep apnea, in which the throat narrows and breathing repeatedly stops during sleep, is the condition most people come to be assessed for. Typical signs include loud snoring, pauses in breathing that a bed partner notices, waking with a sense of choking, waking unrefreshed despite a full night in bed, morning headache and heavy daytime sleepiness. The risk is higher with excess weight, a crowded airway and increasing age, and apnea is more common in people with high blood pressure that is hard to control, heart rhythm problems or a history of stroke. Because the consequences build silently over years, recognising these signs and confirming the diagnosis is the first and most important step.

The overnight sleep study, or polysomnography, is the gold standard for diagnosis and is carried out in a quiet laboratory room under the watch of a technician. Soft sensors placed on the skin record how deeply and through which stages the person sleeps, the airflow and effort of breathing, oxygen and pulse, heart rhythm, body position and leg movements through the night, with no needles and no pain. This recording of roughly six to eight hours is then scored by the sleep team and turned into a report. A first night shows whether there is a breathing disorder during sleep and how severe it is; when a breathing device is needed, a second night is sometimes used to fit and fine-tune the mask and pressure so that treatment starts on the right setting.

Treatment is matched to the cause and severity, and many people improve a great deal. For moderate to severe sleep apnea, positive airway pressure therapy, known as CPAP, gently splints the airway open with a flow of air through a mask and is the most effective treatment; it is started and adjusted at the centre and then followed over time. Where weight is a major factor, structured weight loss and lifestyle change help, and a clear anatomical narrowing may be assessed by an ear nose and throat specialist for surgery. For milder disease or those who cannot tolerate a mask, a custom oral appliance can hold the lower jaw forward to keep the airway open, and where apnea depends on sleeping position, simple positional measures help. Insomnia is treated with sleep-focused behavioural therapy and good sleep habits, while restless legs and related movement disorders are managed with neurology.

Sleep is not idle time; it is when the body repairs itself, consolidates memory and keeps the immune and hormonal systems in balance. Untreated sleep apnea, with its repeated drops in oxygen, drives excessive daytime sleepiness that raises the risk of traffic and workplace accidents, and over years contributes to high blood pressure that resists treatment, heart rhythm disturbance and other cardiovascular problems. Persistent insomnia wears down mood, concentration and quality of life. Because these harms accumulate quietly, anyone with loud snoring, witnessed pauses in breathing or stubborn daytime sleepiness is wise to be assessed, since diagnosis and treatment protect both daily life and long-term health.