"About one-third of the planet's population has some kind of sleep disorder," said Dr. Muhammad Sayed, medical director of Cascade Valley Sleep Disorders Center in Arlington.
He has spent many waking hours studying sleep.
Disorders involve more than an occasional night of tossing and turning. The American Academy of Sleep Medicine lists 81 official sleep disorders.
Insomniacs can't sleep at night. Narcoleptics can't stay awake during the day. Restless leggers can't stop kicking. With sleep apnea, there are pauses in breathing.
Those are the main ones. There's also a lot of grinding, biting, walking and talking that happens behind closed eyes.
Often there is another issue lurking.
"It's a preventative branch of medicine," Sayed said. "It's more than just treating sleep disorders. You are preventing further complications.
"Two-thirds of stroke patients have sleep apnea, untreated. Two-thirds of heart failure patients have untreated sleep apnea."
Sleep disorders are also increasingly linked to auto accidents, plane crashes, workplace accidents and learning problems.
Diagnosis is the first step. It can be as simple as an office visit.
Some patients get sent packing for an overnight sleep study.
The Arlington center combines hotel-like ambience with clinical testing.
"I tell my patients, 'Just bring your PJs,' " Sayed said. "They can bring their own blanket and pillow. If they like the noise of their fan, they can bring it with them. And that nice book that is so boring you fall asleep in 10 minutes."
The patient is tethered to machines as if in an intensive care unit. Technicians monitor and record it all from a command center across the hall.
Sayed knows what's it's like to be the lab rat.
"When I started in sleep medicine, I said, 'Can someone really sleep with all these wires?' So I had the technologist hook me up."
Sayed slept until breakfast.
Insomnia is the leading sleep disorder, followed by sleep apnea and restless leg syndrome.
Restless leg is a neurological condition of irresistible kicking urges, deep pain and quirky sensations. Patients often trace their symptoms to childhood when they were told, "Stop wiggling so much" or "Those are growing pains."
Restless leg is the only sleep disorder that also happens when people are awake.
"Patients say, 'My bed partner said I kick, but I also have weird feelings like ants or spiders crawling up my leg,' " Sayed said.
"I had a patient recently who had more than 700 kicks. If someone woke you up 700 times in a night, how would you feel?"
Because they are asleep, many patients are unaware of the extent of their disorders. The bed mate is often the tattle-tale.
"I had a nice lady whose dog diagnosed her with sleep apnea. She said, 'Doctor, he gets crazy and he wakes me up in the middle of the night,' " Sayed said.
"When she stops breathing, he thinks something happened to her, so he wakes her up at 2 a.m. She knows he's not that kind of dog and said, 'Maybe something is happening to me when I am sleeping.' Sure enough, it was sleep apnea."
Want a good night's sleep?
Forget the eight-hour rule.
"Sleep until you feel you are OK. If you sleep, say, five hours or eight hours in 24 hours and wake up in the morning and are fully functioning and can stay up to 9 p.m., then this is what you need," he said.
"Bill Gates and Bill Clinton sleep only 4 ˝ hours in 24 hours. And Winston Churchill slept 8 ˝ hours."
Calvin Coolidge slept 12 hours a night, and even took an afternoon nap.
Sayed sleeps 6 hours a night, but he doesn't have time for naps.
He did his residency in neurology at Georgetown University Hospital, conducted a stroke study at University at Buffalo, State University of New York, and spent a year on a research health committee with Sen. Ted Kennedy in Washington, D.C.
After completing a fellowship in sleep disorders at Cleveland Clinic, he hoped to return to the D.C. area.
"There was an ad for a sleep doctor in Arlington," he said.
To his surprise, it was an Arlington on the other side of the country.
Still, he and his family moved here eight years ago.
And they've slept happily ever after.
Why count sheep when you can count sleep disorders? Here's the list from the International Classification of Sleep Disorders, Second Edition:
• Adjustment Insomnia
• Advanced Sleep Phase
• Behavioral Insomnia of Childhood
• Behaviorally Induced Insufficient Sleep Syndrome
• Central Sleep Apnea
• Circadian Rhythm Sleep Disorder Due to Drug or Substance
• Circadian Rhythm Sleep Disorder Due to Medical Condition
• Circadian Rhythm Sleep Disorder, Other
• Confusional Arousals
• Congenital Central Alveolar Hypoventilation Syndrome
• Delayed Sleep Phase
• Dissociative Disorders
• Eating Disorder
• Environmental Sleep Disorder
• Excessive Fragmentary Myoclonus
• Exploding Head Syndrome
• Fatal Familial Insomnia
• Free-Running (Nonentrained) Type
• Grinding Teeth (Bruxism)
• Hypersomnia Due to Drug or Substance
• Hypersomnia Due to Medical Condition
• Hypoventilation/Hypoxemia Due to Lower Airways Obstruction
• Hypoventilation/Hypoxemia Due to Neuromuscular and Chest Wall Disorders
• Hypoventilation/Hypoxemia Due to Pulmonary Parenchymal or Vascular Pathology
• Idiopathic Hypersomnia with Long Sleep Time
• Idiopathic Hypersomnia without Long Sleep Time
• Idiopathic Insomnia
• Inadequate Sleep Hygiene
• Insomnia Due to Drug or Substance
• Insomnia Due to Medical Condition
• Insomnia Due to Mental Disorder
• Insomnia Nonorganic, Unspecified
• Insomnia Organic, Unspecified
• Irregular Sleep-Wake Rhythm
• Jet Lag
• Leg Cramps
• Long Sleeper
• Movement Disorder Due to Drug or Substance
• Movement Disorder Due to Medical Condition
• Movement Disorder, Unspecified
• Narcolepsy Due to Medical Condition
• Narcolepsy, Unspecified
• Non-Obstructive Alveolar Hypoventilation, Idiopathic
• Obstructive Sleep Apnea
• Obstructive Sleep Apnea in Children
• Paradoxical Insomnia
• Parasomnia Due to Drug, Substance or Medical Condition
• Periodic Limb Movements
• Primary Sleep Apnea of Infancy
• Propriospinal Myoclonus of Sleep Onset
• Psychophysiological Insomnia
• Recurrent Hypersomnia
• REM Sleep Behavior Disorder
• Restless Legs
• Rhythmic Movement
• Shift Work
• Short Sleeper
• Sleep Apnea/Sleep Related Breathing Disorder, Unspecified
• Sleep Paralysis
• Sleep Starts
• Sleep Talking
• Sleep Terrors
Source: American Academy of Sleep Medicine
To learn more
• Cascade Valley Hospital and Clinics
• Restless Leg Syndrome
• National Sleep Foundation
• American Academy of Sleep Medicine
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