Sleep Clinic

The term “sleep disorder” describes a wide variety of conditions affecting an individual’s sleep. In our increasingly busy and complex society, we are having much greater difficulty getting the sleep we need.  Many sleep disorders result from, or are triggered by, other mental illnesses which are often connected with biological problems. It’s also possible that a mental illness can be mistaken for a sleep disorder or vice versa.  Sleep disorders are considered as seriously as any other illness and they may significantly interfere with many important aspects of our lives.

The Royal offers clinical expertise in sleep medicine as well as expertise that are not routinely available in other sleep clinics for patients with very specific sleep problems related to psychiatric illness. The Sleep Disorders Clinic at The Royal includes a state-of-the-art sleep lab where sleep data is collected from a patient and analyzed.

The results are interpreted by a psychiatrist who specializes in sleep medicine and can provide diagnosis and treatment options. Treatment may involve a number of measures including medication and therapy to encourage appropriate behavioural changes and habits to promote good sleep according to each patient’s unique situation.

Sleep issues related to psychiatric illness may require different treatment than other sleep disorders such as obstructive sleep apnea, restless legs syndrome etc., but frequently these problems may be comorbid or even related. For example, unrecognized obstructive sleep apnea might contribute to the development or exacerbation of a mood disorder, or the nightmares/anxiety of patients with post traumatic stress disorder (PTSD).

Services are obtained through referral from your primary care physician, often a family doctor.  Click here for the referral form (PDF) or phone 613.722.6521 ext. 6248.

Your care may include a consultation with sleep specialist, possibly a polysomnogram and further testing afterwards, a results appointment with sleep specialist, then possibly additional tests or therapeutic suggestions.

Information About Sleep And Sleep Disorders
Your physician managing your sleep apnea and the respiratory therapy companies should be the primary sources of information. Further information can be obtained from the following internet sites:

Good Sleep Habits

  • Get up at the same time each morning. Even if you fall asleep very late you should still get up at the same time each morning.
  • Go to bed only when you feel tired.
  • Develop relaxing pre-sleep rituals such as reading, taking a bath, brushing your teeth, letting the cat out, etc.
  • Use the bed only for sleep and sexual activity.
  • To avoid ‘Sunday night insomnia-Monday morning blues’ — don’t stay up late on weekends and then sleep in.
  • Avoid caffeine and alcohol within six hours of bedtime.
  • Don’t smoke at bedtime.
  • Hunger may disturb sleep so you might try a light snack before bed. A glass of milk may be helpful.
  • Exercise regularly. Get vigorous exercise such as jogging either in the morning or afternoon. Get mild exercise such as walking two to three hours before bedtime.

Glossary of common sleep disorders

  • Sleep Apnea involves abnormal breathing during sleep, where people either pause their breathing or breathe significantly less causing them to wake up, sometimes hundreds of times during the night, resulting in severe fatigue during the day.   Snoring is often a symptom of apnea.  People are more likely to suffer from sleep apnea if they are overweight.  Apnea is more common in men and it’s also more likely to occur as we get older.
  • Insomnia is the inability to get to sleep or stay sleep, which leaves people fatigued and interferes with their ability to function during the day. Insomnia is considered chronic when it goes on for longer than six months.
  • Narcolepsy is characterized by excessive daytime sleepiness.  It is a potentially disabling sleep disorder whereby the person may fall asleep uncontrollably in any situation.  People who experience narcolepsy often also have cataplexy, the sudden loss of muscle power at times of emotion such as when laughing.
  • Sleep Paralysis is when a person loses the ability to move when falling asleep or waking up. The paralysis can last from seconds to several minutes. Sometimes dreamlike images (called hypnagogic hallucinations or hypnopompic hallucinations), which are often very frightening, are experienced during sleep paralysis. These may be confused with or misdiagnosed as psychiatric hallucinations, but they are not
    the same.
  • Sleepwalking (somnambulism) occurs during deep sleep when part of the brain becomes awake while the other part remains asleep. Someone who sleepwalks usually doesn’t remember anything about the event.  Sleepwalking is most common in children, who usually outgrow the condition.
  • REM Behaviour Disorder is the acting out of dreams.  Not to be confused with sleep walking, this disorder occurs during REM (rapid eye movement) sleep.  Normally our bodies are paralyzed during REM sleep so that we won’t act out our dreams. With REM Behaviour Disorder, the body is not paralyzed so the person can act out their dreams. People with this disorder often can remember their dream; it usually affects men over the age of 60.
  • Sleep Talking (somniloquy) is most commonly found in children, and is normal.  It’s most likely to occur during brief arousals from the non-REM (NREM) stages of sleep. Sleep Talking can be caused by a number of factors such as stress, illness (fever) or another sleep disorder such as sleep apnea or night terrors.
  • Night Terrors refer to a disorder of partial arousal (like sleepwalking) in which part of the brain wakes up while the other part remains in deep sleep.  The person usually bolts upright in bed and lets out a bloodcurdling scream or shout.  The individual is not aware of the event, he or she eventually returns to sleep and awakes the next day with no memory of the terrors the next and usually no memory of dreaming. This makes night terrors generally more distressing to those who witness them than to those who experience them.  Night terrors are common in children and the condition is usually outgrown.
  • Periodic Limb Movements (PLMs) are sporadic and repetitive contractions of the leg during sleep (the arms my sometimes be affected as well).  As with sleep apnea, these abnormal movements may cause a person to awaken up to hundreds of times during the night and, as a result, they cause fatigue during the day.  They are more likely to occur as one ages.
  • Restless Legs Syndrome occurs at rest, usually in the evening or before falling asleep.  With this disorder, a person’s legs feel uneasy, as though they have itchy, crawly feelings in them. Patients often relieve these sensations by moving the legs, which is why it’s called ‘restless’ legs syndrome, although the arms can also be affected.  Most people with restless legs also have periodic leg movements (PLMs) during sleep.
  • Circadian Rhythm Disorder occurs when the body’s internal clock is offset, such as sleeping at a time when you want to be awake.  Sunlight and other time cues seem to play a role in setting the circadian clock.  Factors such as jet lag and shift work cause our natural rhythms to be upset. Changes in age also affect the timing of our body’s response to time cues.  For example, the elderly have an advanced sleep phase, so they fall asleep early in the evening and wake early in the morning.  Teenagers, on the other hand, have a delayed sleep phase so they are more apt to fall asleep late at night and can sleep until noon.