From 100,000 car accidents caused by drowsy drivers every year to fatalities from choking in slumber, sleep disorders can turn into a nightmare for sufferers and bed partners.

"Obstructive Sleep Apnea (OSA), the blockage of airways during sleep that causes people to snore, can double the risk of stroke and death," warned Martin C. Johnson II, M.D., Medical Director of the Sleep Disorders Center at the Salem Hospital and a pulmonary specialist.

Sleep-related breathing difficulties are the most widely treated disorders at Salem's two research facilities, the Willamette Sleep Center and the Salem Hospital Sleep Disorders Center.

Each location has eight suites to conduct overnight studies, equipped with TVs and cable and wireless internet. Patients are attached to electrodes that measure brainwaves, eye and muscle movements, heart rhythm and air flow. A sleep technician monitors and records sleepers with infrared cameras and microphones.

"At the end of the night, 1,000 pages of data and notes are produced, reflecting every sleep stage, respiratory events, leg movements, and body positions," Stephen Baughman, Operations Manager at the Willamette Sleep Center, said.

Adults sleep eight hours on average; adolescents nine to ten, and the elderly sleep the least. It is uncertain whether the cause is natural, or stems from illness or side effects of medications, Johnson said.

Not meeting these hours doesn't necessarily mean a person needs medical attention. The symptoms to watch out for are daytime drowsiness, low energy, irritability, inability to concentrate, sleep phobias, chronic insomnia, snoring, restless leg syndrome, narcolepsy, night terrors, recurring nightmares, or any other kind of sleep disturbance that interferes with the person's schedule or life, including using over-the-counter sleep aids (antihistamines) more than occasionally.

"In the area of sleep medicine, there's a lot of denial and a tendency not to assign daytime symptoms to sleep. That's why we encourage bed partners to come with the patient," Johnson said.

Sleep Centers see hypnotics as a last resort.

"We look at lifestyles, sleep hygiene and other factors. We only prescribe sleep aids when those approaches fail," Johnson said.

The standard treatment for OSA is Continuous Positive Airway Pressure (CPAP) air masks, or other devices like mouth guards and Breathe Right Strips. Some people opt for surgery to clear up blockages in the nose or throat.

Psychological traumas can cause sleep deterioration, and once some sleep is lost, people go into REM Sleep Rebound. OSA, nightmares, sleepwalking/talking/eating, and parasomnias are most common during REM sleep.

"We've had patients with broken noses or limbs after their bed partner attacked them in the middle of the night in an effort to fight off demons during a nightmare. REM Sleep Behavior Disorder causes patients to lose the inhibitory reflexes that keep them from acting out their dreams," Johnson said.

When it comes to parasomnias and insomnia, Cognitive Behavioral Therapy (CBT) is usually the best option, so patients are referred to a psychologist to work out the negative associations they have with sleep. "This is time-consuming, and it requires discipline and follow-ups. Many people give up and reach for pills," Johnson said.

Light therapy can also be a helpful technique for various sleep disorders. Melatonin, the relaxing hormone, is released when the pineal gland senses darkness and is suppressed when light hits the eyes.

"Many youth suffer from Delayed Sleep Phase Syndrome (DSPS), the classic modern young adult schedule of going to bed late and sleeping in, which very few lifestyles allow. Older folks sometimes experience Advanced Sleep Phase Syndrome (ASPS), where they wake up and go to sleep extremely early," Baughman said.

Light therapy is applied to DSPS patients in the morning and ASPS patients in the evening to reset their biological clocks.

"Getting a few more hours of sleep can make a big difference in test scores and job performance. It would be nice to have flexible work and school schedules, but it's more realistic to become disciplined in terms of consistent bedtime hour and good sleep habits than to expect a change in the system," Johnson said.

Turning off television and computer monitors is recommended because of their ability to suppress melatonin and elevate adrenaline, along with shutting off the lights (unless a dim light helps with anxiety), reading a boring book, and not worrying over the alarm clock.