Stealthy Insomnia Cause? Upper Airway Resistance Syndrome Subtly Disturbs Breathing in Sleep | Stanford Center for Sleep Sciences and Medicine

February 13, 2015 5:50 PM

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Stealthy Insomnia Cause? Upper Airway Resistance Syndrome Subtly Disturbs Breathing in Sleep | Stanford Center for Sleep Sciences and Medicine

By Gerard Meskill, M.D. A 29-year-old woman presents to the sleep clinic complaining of a chronic history of insomnia. She reports that while she has difficulty going to sleep due to racing thoughts going through her mind, the bigger problem is that she wakes up several times during the night, often occurring at the same times each night. Some of these awakenings involve going to the bathroom. It is increasingly harder to go back to sleep each time. She has tried multiple different sleeping pills, but none seem to solve her problem. She doesn't snore, but frequently when she wakes up, she has a dry mouth, is sweating, and sometimes her heart is racing. Occasionally, she notes that she has been clenching her teeth during sleep. Her husband says that occasionally she talks in her sleep. She also frequently wakes up in the morning with heartburn.

On physical exam, she has unremarkable vital signs and normal body weight. She has normal heart rate and breath sounds, an overbite, mild enamel wear on her front teeth, horizontal mid-level scars on each of her cheeks, teeth indentations on her tongue ("scalloping"), and modestly enlarged (2+) tons...

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