The Bukowski Agency - Can't Sleep, Can't Stay Awake - Excerpt
Can't Sleep, Can't Stay Awake
A Doctor's Guide to Recognizing and Treating Women's Sleep Disorders

by Dr. Meir Kryger


The Case of Mrs. R.

I WAS HAVING lunch in the hospital cafeteria when one of my colleagues asked me whether it would be worthwhile to have his wife evaluated for a sleep disorder because she had not been sleeping properly for approximately thirty years. He was sceptical whether anything could be done for her as she had had this problem for so long. I suggested that it was something worth pursuing.

When I saw Mrs. R, she told me a story that was similar to many I had heard before. During her third and last pregnancy, thirty years ago, she developed an irresistible urge to move her legs when she tried to go to sleep. She couldn’t stop moving. She tossed and turned and found the only way she could alleviate this discomfort, if only temporarily, was to get up out of bed and walk around. Consequently, she had severe difficulty in falling asleep and staying asleep. She no longer slept in bed with her husband because the tossing and turning and recurrent awakenings were disturbing him. She had little or no energy in the daytime and frequently fell asleep when inconvenient. She did not want to start on sleeping pills and believed that nothing could be done to help her. After interviewing and examining her, I ordered a couple of simple blood tests, and then after receiving the results started her on treatment. Three months later, after suffering for thirty years, the doctor’s wife’s problem was gone.

The sleep disorder that had such an effect on Mrs. R. is called RLS or Restless Leg Syndrome. The abnormal and excessive movements of restless legs syndrome can interfere with normal sleep and it has been called the most common medical problem you never heard of. Though the disorder affects 15% of the general adult population and 10% of the female population and is the second most common sleep disorder, it is hardly ever diagnosed by doctors. Amongst seniors, it is much more common, affecting 30 to 40%. It is very likely that you or someone you know has this syndrome. The disorder seems to run in some families. Sometimes RLS may be caused by other medical conditions but in many cases the cause is never found.

Mrs R. had iron deficiency related anemia, which was easy to prove because her ferritin level was very low. She did not need a sleep test because her clinical history was so typical. Her husband, who was a doctor, could not and would not believe that taking an iron preparation would solve her problem. It did. Three months later her RLS symptoms were completely resolved and her sleep was normal. This case illustrates that doctors don't know enough and don't ask enough about women's sleep disorders, even if the patient is a relative.



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