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Sleep Disorders Can Signal Other Trouble
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Sometimes a sleep disorder can point to something more serious. Researchers found the majority of a small sample of people suffering from obstructive sleep apnea or other sleep problems also had a high degree of attention-deficit problems, as well as neuromuscular and psychiatric conditions. The results were to be reported on Oct. 25 at the American College of Chest Physicians meeting in Seattle. The message for doctors seems to be that they may need to look beyond a sleep disorder for underlying problems. "It's not enough to say I treated your sleep apnea," said study author Dr. Clifford G. Risk, director of the Marlborough Center for Sleep Disorders in Massachusetts. However, looking further can be tough in today's managed-care climate. "Part of the difficulty is that clinicians are forced to see people for fewer amounts of time," explained Robert J. Resnick, past president of the American Psychological Association and author of The Hidden Disorder: A Clinician's Guide to Attention-Deficit Hyperactivity Disorder in Adults. "You're supposed to see someone every five to seven minutes. There's no time to go into detail. You treat it symptomatically." Sleep problems can be part and parcel of several different disorders, including bipolar disorder, anxiety, and attention-deficit hyperactivity disorder (ADHD). This study looked at 22 adult patients being evaluated for obstructive sleep apnea, a condition marked by episodes when a person stops breathing while asleep. The researchers assessed the degree of sleep apnea as well as the level of attention impairment. More than half (55 percent) of the participants showed significant attention impairment at the beginning of the study, but improved substantially after receiving continuous positive airway pressure (CPAP) treatment. CPAP requires the individual to wear a facial mask that creates enough pressure to keep the airway open. Another 18 percent of the participants, however, continued to have serious attention-deficit problems even after treatment. These individuals were diagnosed with adult attention-deficit disorder and required medication and skills training. Additional testing showed that many of the patients also suffered from conditions as fibromyalgia, chronic fatigue, depression, and bipolar disorder. "We looked at the spectrum of sleep disorders and asked: 'What is the impact of these several sleep disorders on ADHD and, furthermore, if you treat sleep disorders, does ADHD get better? And if it doesn't, why not?'" Risk said. "The findings have importance for psychologists and psychiatrists because it says if you have a person with an attention-deficit impairment, you've got to do a history that includes the possibility of sleep apnea and the possibility of other sleep disorders," Risk said. "If you don't do that, you may miss the diagnosis." |
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