Did you know that currently there are statistics indicating that 5.3% of men and 3.5% of women have problems with sleep disturbances, snoring, abnormal breathing, and drowsiness during the day, which affects the quality of sleep and increases the risk of cardiovascular and heart diseases, endocrine disorders and accidents, and there is a trend that it will keep increasing. Moreover, some people do not even know that they are at risk of having such problems.

Epilepsy is not far from us

Many may not be familiar with epilepsy, but did you know that this disease is very close to us and its prevalence is likely to continuously increase. It can occur in all genders and ages. In Asia, there are up to 30 million people with epilepsy, and in our country, there are no less than 700,000 people with the condition.

Causes of Epilepsy

Epilepsy can have several causes, such as

• Brain developmental abnormalities, such as malformed cerebral cortex
• Genetics, which can occur from a young age
• Sclerosis in the brain, such as abnormal blood vessels in the brain, brain tumors, brain scars can also lead to seizure episodes

Symptoms of Epilepsy

Characteristics of the disease include

• Absent-minded seizures
• Convulsive seizures, where the patient is unaware and cannot control it, which can occur during sleeping or while awake
• Frequent seizures, which result in decreased cognitive performance, intellect, and memory

What’s even more dangerous is that epilepsy often lurks in patients with diabetes, hypertension, and dementia as well.

Treatment for Epilepsy

Treatment methods for epilepsy include

1. Identifying the origin of the seizure in the brain and the cause of the seizure to decide whether treatment should involve medication, surgery, or electrical stimulation. This depends on the type of epilepsy, as there are several types, which can be diagnosed with modern technologies starting from Electroencephalography combined with Functional magnetic resonance imaging (EEG-fMRI). Patients are placed into a scanner and fitted with EEG equipment to record how the brain functions, helping to more accurately pinpoint the disease location.
2. PET Scan, a technology used to examine abnormal brain cells, can pinpoint the location of abnormalities. Additionally, the EMU (EEG monitoring unit) allows patients to be monitored with video and brainwave recordings, with data displayed on monitors in the Control room, monitored by staff 24 hours a day. If a patient has a seizure, the computer sends an alert immediately. Moreover, doctors can log in from home to view the patient’s condition.
3. The use of nuclear medicine imaging called Ictal SPECT to more accurately diagnose the origin of seizures by injecting a tracer when the patient is having a seizure, allowing administration within 30 – 60 seconds, which is considered fast, thus providing accurate data on the seizure’s origin and helping determine the appropriate treatment.

Abnormal drowsiness, never enough sleep

Abnormal drowsiness can result from various causes, such as

• Sleep deprivation
• Sleep apnea
• Physical or mental illness
• Medication
• A neurological disorder known simply as Narcolepsy
• Lack of a certain neurotransmitter in the brain, which is responsible for separating sleep and wakefulness. People with this condition will experience sleep intrusions during wakefulness and wakefulness intrusions during sleep, like suddenly falling asleep while talking and waking up to continue the conversation moments later. Some might experience sleep paralysis, being unable to move upon waking up on bed, needing a moment to be able to get up. Some may experience hallucinations. Narcolepsy can occur from a young age, and it is a national health issue because some patients are not aware they have it and could potentially cause accidents while driving due to sudden sleepiness.

Identifying the cause of abnormal drowsiness

Specialists may conduct a Sleep Test over 1 day starting with a night test where the patient sleeps as usual to detect abnormalities during sleep followed by a daytime test, requiring the patient to take 5 naps, each 2 hours apart, in a Sleep Lab. Then, it measures how long it takes for the patient to fall asleep after the lights go out. If it’s less than 8 minutes, it’s considered abnormal drowsiness. Some patients can fall asleep within 5 minutes with dreams, which is considered very severe.

Moreover, there’s Actigraphy, using a watch to measure movement, worn on the wrist for 1 – 2 weeks. It measures the intensity and frequency of sleep movements, revealing how many hours the patient sleeps, whether the sleep is continuous, the depth of sleep, and the occurrence of dreams, to assess the quality and efficiency of sleep, contributing to diagnosis and treatment.

Treatment for abnormal drowsiness

The treatment depends on the cause of the excessive drowsiness. Besides addressing the root cause, in some patients, especially those with Narcolepsy, doctors may prescribe stimulant medications in the morning or afternoon to increase alertness. Coupled with napping at intervals during the day, it can help the patient feel more awake. Importantly, understanding from those around is greatly needed. So, if any parent notices their child often napping or feeling lethargic, consider getting them checked because your child might not be simply lazy but could have Narcolepsy.

Snoring is not normal, it could be a sign of Sleep Apnea

If you think snoring is normal, think again. Once snoring starts, it could be a sign of sleep apnea. When you notice you start having abnormal breathing, ask someone who sleeps next to you to observe if you have shallow breathing, stop breathing, or snore along. If so, it indicates that your airway has narrowed more than usual until obstructed. However, if the airway is severely obstructed, the snoring stops. The next symptom is a sudden gasp for air, and then you may or may not be able to continue sleeping. If you manage to sleep and your airway obstructs again, snoring will resume.

The sudden gasp for air is due to the brain becoming alert in response to the stoppage of breath, to resume breathing. Often, low blood oxygen levels are found during the stop breathing or shallow breathing phases. Such brain alertness that frequently occurs during sleep prevents the brain from fully resting. Upon waking, you may feel exhausted as if you didn’t sleep well. If this condition persists, it risks inducing several physical ailments like hypertension, sudden heart muscle death from lack of blood, arrhythmia, high pulmonary blood pressure, stroke, headache, decreased cognitive and memory performance, or even depression.

Men are more likely to develop sleep apnea due to androgen hormones, which reduce the airway stability during sleep. Overweight or obese individuals are also at increased risk due to tissue around the neck and accumulated fat narrowing the upper airway passages. Additionally, every age group can experience sleep apnea, from children to the elderly, which relates to the facial structure, throat, and the upper airway functioning differently in each person.

Treatment for Sleep Apnea

Treatment methods include

1. Medication, if the cause of the breathing stoppage is due to swelling of the nasal and throat airways
2. Using a Positive Airway Pressure device or auxiliary devices to open the throat or nasal passages. The device creates an airflow pressure to expand the airways, preventing obstruction or snoring during sleep, which is an easy and effective method but requires proper air pressure adjustment, determined by a sleep study in a hospital.
3. Surgery may be conducted if the facial structure or the nasal, oral, and throat passages have abnormalities causing the airways to narrow. For example, individuals with large nasal polyps, elongated uvula, large tongue, or in cases of children often presenting with enlarged adenoids or tonsils, causing obstruction in the airways. Surgery has a chance to cure the condition.