Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

Most of us have drifted off to sleep, only to awaken with a sudden start. This is a benign occurrence known as a hypnic jerk.

There is a similar condition in which people awaken suddenly because they hear a loud noise in their head. They usually describe it as a loud bang or an explosion. In fact, this phenomenon is called exploding head syndrome.

Like hypnic jerks (or sleep starts), this is a completely benign condition. A hypnic jerk can accompany the clash of cymbals that people hear. Even though benign, it can be very disturbing to experience, and people often think that they are having a stroke.
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Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

It is frustrating, to both patients and doctors, that modern medical science often lacks understanding of or treatment for common, everyday ailments.

One such ailment, leg cramps, is very common and yet poorly understood. It often plagues people at night, and therefore “sleep-related leg cramps” is recognized as a bona fide sleep disorder by the International Classification of Sleep Disorders.

Most people have had a “charley horse” and know that leg cramps can be quite painful. Leg cramps result from the sudden, intense and involuntary contraction of a muscle or muscle group. They usually occur in the calf muscle or the small muscles of the feet.
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Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays (or this week, on Wednesday) on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

The recent heat wave across many parts of the country has been disturbing the sleep of many people who are not fortunate enough to have air conditioning.

This makes perfect sense because sleep is associated with a steady decline in our core body temperature. It should reach its lowest point approximately three hours before we wake.

Therefore, when we are overheated and this natural temperature drop is impeded, then sleep is disrupted.

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Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

It seems that the public is just as fascinated with REM sleep. So are sleep physicians and researchers. But fascination often leads to confusion and controversy, and a lot of both surround the subject of REM sleep.

First, to give a brief history lesson, it is important to understand that REM, or rapid eye movement sleep, was discovered and described only in 1953, so it makes sense that there is still much to learn.

One key aspect of REM sleep is that all physical characteristics studied to date are different in REM when compared with non-REM. In fact, REM sleep more closely resembles the waking state. That is likely why people are more alert when they are awakened out of REM compared with other sleep stages.

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Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

We were supposed to be talking about Kathy’s insomnia, but, as is often the case, she was wanted to tell me about a loved one’s sleep problem, in this case, her grand-daughter’s.

“She is banging her head up and down every night, sometimes hitting the headboard. It is scaring her parents to death because, well, it is kind of creepy, and they are afraid that she has psychiatric problems, not to mention, they are worried she could hurt herself.”
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Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

Henry was 80 years old and “tired all the time.” His primary care doc had done a thorough work up. I tested for every sleep disorder known to man and god and found no underlying problem with his sleep quality.

At our initial visit, I had expressed my concern that his hypnotic medication, Clonazepam, could be part of the problem, especially because his dose of 2 mg was rather high for a man his age. He had been reluctant to make any changes to a medication that, from his point of view, had worked so well for him over the years. Now, with all other explanations ruled out, he was ready to try to get off it in order to feel less groggy in the morning.
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Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

Susan was young, healthy and appeared very well rested. Why was she in my sleep clinic? “I am studying abroad for a year and I have to share a room so the noises I make at night are going to be a problem.”

Noises? “My family tells me that I groan in my sleep, every night, very loudly. Have you heard of this? Can you help me?” I thought to myself, in typical doctor fashion, Yes, I have heard of this and maybe I can help.

Catathrenia, which means sleep-related groaning, is a rare disorder in the sleep clinic, but may be more prevalent in the population than previously thought. It is marked by loud, groaning that typically starts in adolescence or young adulthood and, if not treated, is usually chronic and occurs most, if not every, night.

Patients usually only present with this problem when it becomes an issue for bed partners, family members, or roommates. The patients themselves rarely report a problem with disturbed sleep or impaired daytime alertness. However, the social impact should not be underestimated.
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Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.
I have a patient who is a man in his mid-30s who had a headache almost every day of his life for the 10 years before he came to my clinic.  We found that he had significant sleep apnea and the treatment for it has been nothing short of a miracle for him.

Sleep apnea is the most common sleep disorder to present with a complaint of morning headache.  The International Classification of Headache Disorders now has a separate classification for sleep apnea headache.  By definition, the headache is present upon awakening and resolves on its own in 30 minutes or less, and is not better described by another headache disorder.

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Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.
Poor sleep is such a common complaint during pregnancy that probably many women and even their doctors think it's is a normal part of pregnancy.
While it is true that pregnancy has a significant impact on the quantity and quality of sleep, it is also true that many of the sleep problems that arise during pregnancy can be treated or ameliorated.

It is common for women to feel extreme sleepiness and fatigue in the first trimester, which is assumed to be secondary to rising progesterone levels because progesterone is known to have a hypnotic affect. Progesterone levels continue to rise throughout pregnancy yet in the second trimester most women report feeling more daytime alertness and they feel that their sleep quality is improved compared with the first trimester.

The third trimester ushers in a host of problems that are mostly connected to the increased girth. During the later months, women often experience shortness of breath and reflux because  their diaphragm is elevated, pressing on the lungs and the stomach. They also have to urinate frequently during the night. That alone is quite a disruption to sleep.

These are normal problems encountered during pregnancy and there is not a lot a doctor can do about it. However, there are other sleep problems that represent the emergence of a bona fide sleep disorder and these can be treated.
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Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.
A frazzled, 45-year-old woman came into my office the other day complaining of longstanding, intermittent bouts of insomnia.

“The frustrating thing is I watch my husband take his melatonin and ‘poof’ it’s like the sandman flew in through the window and sprinkled sand in his eyes. He is out. Me? Nothing. I lie there for hours even if I take two or three pills.”

I hear this lot. Melatonin works remarkably well for some people and has no affect on others.

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