There are numerous disorders of sleeping and waking that can interfere with your life. These disorders not only affect the quality of life, but can also endanger public safety because of their role in traffic accidents and industrial accidents. These disorders include insomnia, narcolepsy, sleepwalking, sleep terrors, restless legs syndrome and bedwetting.
The following are common sleep disorders:
Transient insomnia - normally brought about by stress or excitement, and typically ceases after a few nights of disturbed sleep
Short-term insomnia - will affect sleep for less than six months and subsides when a stressful situation is over or the person becomes accustomed to the situation
Chronic insomnia - results in poor sleep every night or most evenings; while most insomniacs believe their trouble with sleep is caused by worrying, more than half of persistent insomnia is caused by disorders of breathing or muscle activity
One in three American adults suffer from insomnia - the inability to fall asleep or stay asleep. This sleep disorder will not only affect the quantity of sleep, but also the quality. Sleepiness and fatigue will often occur in people suffering from this disorder. Unlike other sleep disorders, insomnia affects people of all ages.
The following are types of insomnia:
There are a number of factors that could cause insomnia including:
|Vulnerability to insomnia
||Persistent stress |
||Use of stimulants |
|Use of alcohol
||Erratic sleeping hours |
||Circadian rhythm disturbance|
|Misuse or overuse of sleeping pills
||Breathing disorders |
|Restless leg movements
|You should consider seeking help from a healthcare professional if your sleep is disturbed for more than a month or if lack of sleep begins to interfere with the way you feel or function during the day. |
Excessive drowsiness during the day or the tendency to fall asleep at inappropriate times is the hallmark symptom of narcolepsy. Narcolepsy is a disorder of the part of the central nervous system that controls sleep and wakefulness. This disorder is not caused by psychiatric or psychological problems. Although narcolepsy is an uncommon disorder, its effects can be debilitating if they are not recognized and treated appropriately.
The four most common symptoms of narcolepsy are:
Although there is no cure for narcolepsy, its symptoms can be controlled through a combination of medication, behavior treatment and environment management.
- Excessive daytime sleepiness - experiencing sleepiness at inappropriate times
- Cataplexy - a sudden, brief loss of muscle control which occurs during emotional situations
- Sleep paralysis - feelings of an inability to move when falling asleep or waking up
- Hypnagogic hallucinations - occurs when the person is drowsy; these hallucinations are vivid, dreamlike experiences that seem very real
If you feel you suffer from narcolepsy, consult your doctor. He or she will be able to prescribe the most appropriate treatment for your condition or refer you to a sleep specialist.
A tendency to stop breathing during sleep is defined as sleep apnea. This disorder usually causes the sleeper to stop breathing several times during a sleep period. This results in not getting the amount of oxygen the body needs and failing to get a restful night's sleep.
There are three types of sleep apneas:
Common symptoms of sleep apnea are:
- Obstructive sleep apnea (OSA) - caused by structures in the throat blocking the flow of air (the most common type of sleep apnea)
- Central sleep apnea (CSA) - results from the brain not signaling the person to breathe
- Mixed sleep apnea (MSA) - a combination of OSA and CSA
Sleep apnea can be a serious disorder if left untreated. It can lead to other problems such as high blood pressure, stroke or heart disease. A talk with your healthcare provider can determine if you need to visit a sleep lab for testing. The tests can help determine the type of sleep apnea you are suffering from and the best treatment to follow.
- Restless sleep
- Very loud snoring, often interrupted by silence and then gasps
- Excessive daytime somnolence
- Morning headaches
- Loss of energy, fatigue, tired
- Trouble concentrating
- Mood or behavior changes
- Anxiety or depression
The two most effective types of therapies are:
- Continuous Positive Airway Pressure (CPAP) - a continuous flow of air that is applied through a mask that fits over your nose; this air pressure prevents structures in your throat from blocking air movement
- Bi-level Positive Airway Pressure (BiPAP) - BiPAP delivers two different pressure levels; one works with you, helping you to inhale, and the other helps you exhale more freely
Other therapies include weight loss, surgery, positional therapy and dental appliances.
Sleep and mood are often closely linked. The amount and quality of sleep a person gets will affect his or her mood through fatigue and depression. Depression is closely linked to two common sleep disorders - obstructive sleep apnea and insomnia.
Identifying the relationship between sleep and depression becomes an important step in determining the best treatment. Finding and implementing the best ways to cope with difficulties in falling asleep and managing feelings of depression is crucial. Often, treatment for depression will help eliminate the sleep problem.
It is important to talk with your doctor if you feel your sleep is being affected because of depression. Your doctor will determine the most appropriate treatment for you to follow.
Parasomnias refer to a wide array of disruptive sleep-related events. These experiences are normally infrequent and mild, but at times, the conditions may become bothersome enough to seek medical attention.
The most common parasomnias are disorders of arousal including confusional arousal, sleepwalking and sleep terrors.
Confusional arousal may begin with crying and thrashing around in bed. Although the person appears to be awake and seems to be confused and upset, he or she resists attempts to comfort and console. It is difficult to awaken a person in confusional arousal. These episodes can last up to half an hour, and usually end when the agitation subsides and the sleeper awakens briefly, wanting to return to sleep.
Sleepwalking can range from simply getting out of bed and walking around, to performing complex actions. In most cases, treatment is not necessary. These events rarely indicate a serious medical problem and tend to decrease with age.
Sleep terrors are the most extreme of the arousal disorders and the most distressful to witnesses. These episodes often begin with screaming and signs that suggest extreme terror such as sweating, rapid breathing and agitation. Although these episodes can be frightening, the sleeper usually has no conscious awareness of the event.
These disorders typically occur when the person is in a mixed state, both asleep and awake. During these parasomnic episodes, the person is usually able to act out complex behaviors but unable to remember his or her actions.
Parasomnias are most common in young children, and although bothersome, do not pose significant psychiatric or psychological problems. These types of disorders are often hereditary and can become more pronounced if a child is sick or overly tired.
Seeking help from a medical professional should be considered if you or your child's disturbed sleep causes:
Since these disorders are uncommon after childhood, you should seek a medical evaluation if you are an adult suffering from any of these disorders.
- Potentially dangerous behavior
- Extreme disturbance of other household members
- Excessive sleepiness during the day
Restless Legs Syndrome and Periodic Limb Movement Disorder
People experience restless legs syndrome in many different ways, but most describe it as a very unpleasant creepy, crawly sensation in the legs. This disorder occurs most commonly when awake, but can also affect the ability to sleep because of the constant need to stretch or move the legs to relieve the uncomfortable feelings.
Restless legs syndrome is most common in adults. Approximately 30 percent of these cases have a hereditary cause. In these cases, symptoms are often more severe and more difficult to treat. In the remaining 70 percent of RLS cases, the causes are not clearly known.
The following are situations and factors that can trigger RLS:
RLS has unique symptoms that can help a healthcare professional diagnose the disorder. These symptoms may include creepy, crawly, pulling and gnawing sensations in the affected limbs. These feelings create an almost irresistible need to move the affected limbs. Medical history and a physical examination can help determine if you have RLS and can also exclude other problems that may be mistaken for RLS.
- Poor blood circulation in the legs
- Nerve problems
- Muscle disorders
- Kidney disease
- Excessive alcohol intake
- Vitamin or mineral deficiencies
- Stopping or starting certain medications
- Excessive caffeine consumption
- A very warm environment
- Prolonged exposure to cold temperatures
When treating RLS, the first step is to determine if there is an underlying cause contributing to the limb movements. If symptoms persist after diagnosis and treatment, there are a number of home remedies that may prove effective in bringing relief. Some of these remedies include hot baths, leg massages, use of heat, ice packs, regular exercise and eliminating caffeine.
Periodic limb movement disorder (PLMD) is another limb disorder that can have serious affects on sleep, as well as the ability to function in the day. These movements, unlike restless legs syndrome, occur involuntarily, usually during sleep. Typically, these movements occur at periodic intervals, most often in clusters in the first half of the night.
When leg movements occur five times or more during each hour of sleep, they should be considered serious enough to represent this disorder. Limb movement may result in various complaints including difficulty falling asleep, trouble staying asleep or excessive daytime sleepiness.
PLMD is rare in people under 30 years of age. The disorder becomes more common as people grow older and affects men and women equally.
Causes of this disorder are unclear, but periodic limb movements are more common in people suffering from kidney disease or narcolepsy. Some antidepressant medications may also increase the frequency of this disorder.
People with PLMD often need nighttime sleep observation to discover the cause of their problem.
This central nervous system disorder causes a person to feel excessively tired throughout the day. Unlike people with narcolepsy, people suffering from idiopathic sleepiness do not find themselves refreshed after naps. In fact, people with this disorder will likely find they are just as tired after a nap as they were before the nap.
This disorder can be disabling if not treated. To help discover the causes of idiopathic sleepiness, the sleeper is asked to keep a diary of his or her sleep habits for at least a week. Through the diary and other tests in a sleep lab, a treatment recommendation can be made. Treatments can include developing good sleep habits or in some cases, taking medication.