Lifestyle Choices

Persistent bed-wetting, sleep enuresis, is considered a disorder after the age of five. It occurs in all sleep stages, and daytime bladder control can be normal. While the prevalence of bed-wetting in childhood decreases with age, about 3 per cent of adolescents between the ages of twelve and eighteen continue to wet their beds.”

Bed-wetting has a hereditary component. Approximately 77 per cent of children whose parents both wet their beds as children are bed wetters themselves.’ A congenitally small bladder, bladder infections, allergies, obstructive sleep apnoea or metabolic or endocrinologic disorders may be predisposing factors. Contrary to popular belief, bed-wetting is almost never emotionally or psychologically caused; less than 1 per cent of bed^-wetting has an emotional source.”

There are devices on the market that use moisture-sensitiv_emattress covers or underwear with alarms to condition the child over a period of time to wake up in response to a full bladder. If the bed-wetting is due to medical or psychological problems, it may disappear with the successful treatment of the causes. In some instances, medication such as imipramine or desmopressin acetate will be prescribed.”

Some babies are at particular risk:

•  Infants born with low birth weight are five to ten times as likely to die of SIDS.

• Twins and triplets, even at normal birth weight, are twice as likely to die of SIDS, and after one twin dies, the surviving twin also has an increased chance of dying from SIDS.

•  Babies whose previous siblings died of SIDS are two to four times as likely to die of it.

• Six per cent of infants with infant sleep apnoea die of SIDS.

• Black and Eskimo infants are four to six times as likely as all others to die of SIDS.

• SIDS is more common in lower socio-economic groups.”

Sudden Infant Death Syndrome (SIDS)

Sudden infant death syndrome (SIDS), the number one cause of neonatal and infant death, is arguably the most tragic of the sleep disorders. Occurring in 1 or 2 of every 1,000 live births, SIDS is characterized by the unexpected sudden death during assumed sleep of otherwise apparently healthy infants. It has not been unequivocally demonstrated whether the primary cause of death is respiratory or cardiac failure.”

Risk of SIDS is highest between ten and twelve weeks of age. Unfortunately there is no definite way to predict the possible onset of the disorder.

There are a large number of medical and psychiatric disorders that produce problems with sleep and wakefulness. Among these are psychoses (such as schizophrenia), mood disorders (most often depression), anxiety and panic disorders and alcoholism.

Forty-seven per cent of people who experience severe insomnia report a high level of emotional distress. In depressed people, abnormal sleep patterns are often associated with an overwhelming feeling of sadness, hopelessness, or guilt. Some depressed people awaken early and cannot sleep, others sleep too much to avoid daytime stress. Many depressed individuals complain of insomnia without recognizing they are depressed. If you have lost interest in work, family or recreation, or if you have feelings of hopelessness or harbour suicidal thoughts, you may be suffering from depression. Though your complaint may be insomnia, the underlying depression, not the insomnia, must be treated.’

If you .are being treated for a psychosis, a mood, anxiety, or panic disorder or alcoholism, it is suggested that you discuss any sleep problems or daytime sleepiness with your doctor.

Often, medications prescribed for treatment of these disorders will affect your sleep-wake cycle and alertness. Behaviour therapies and new pharmaco-therapies show promise in treating these problems, while at the same time not interfering with the need to get adequate sleep nor with daytime alertness.

When to Call the Sleep Doctor

It’s important to remember that sleep disorders are not rare, and that they can be very serious. If after reading you think that you or someone you know may be suffering from a sleep disorder, contact a doctor who has been trained in sleep medicine.

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