What is sleep before going into the details regarding sleep disorders?
It is considered as one of the essential needs of the human beings to survive in the daily busy routines.
However, many individuals experience sleep disorders at least once in their lifetime. Sleep deprivation results in various medical conditions which lead to reduced lifespan.
Each one of us might have experienced the bad night sleep, but if you face consistent issues regarding sleep patterns, then it might be indicated as sleep disorder which needs your attention.
What are sleep disorders?
A sleep disorder is described as a condition where it affects your ability to sleep well and achieve good quality sleep.
It is normal to have consistent problems while sleeping at night, to feel sleepy at work or feel exhausted. About 70 million Americans experience sleep disorders.
However, regular sleeping issues result in a debilitating and frustrating experience. Sleep disorders result in damaging effects on your physical health, affecting your mood, efficiency, energy and ability to manage stress.
Ignoring sleep issues can lead to memory problems, weight gain, impaired work performance, accidents and relationship issues.
Try to relax and stay healthy, or you cannot manage sleep disorders on your own, then visit your physician or sleep specialist to help you combat the sleeping issues.
Signs and symptoms associated with sleep disorders
The following are the signs and symptoms of sleep disorder:
- Difficulty to stay awake
- Fall asleep while driving
- Difficulty in concentrating
- Tired feeling
- React slowly
- Extremely emotional
- Require caffeinated beverages to remain awake
- Need a nap frequently during the day
- Depression and anxiety
If you experience such symptoms commonly, then you are suffering from the sleep disorder.
Causes of sleep disorders
Following are the causes associated with sleep disorder:
- Nocturia or frequent urination
- Allergies or respiratory issues
- Chronic pain
- Stress or anxiety
Types of sleep disorders
Following are the most common type of sleep disorders experienced by the patients:
Obstructive sleep apnea
OSA is considered as an extreme form of snoring. Around one in 5 people suffer the mild form of sleep apnea.
Obstructive sleep apnea occurs due to the physical blockage of an individual’s airway.
People with sleep apnea might experience severe issues such as a pause in the middle of breathing for seconds to minutes.
In obstructive sleep apnea as soon as the individuals sleep, the throat muscles relax and jump back, leading to blockage of the airway.The primary risk factor for OSA includes obesity which leads to airway obstruction.
Other causes include inherited factors such as massive overbite, small jaw size or behavioural factors,i.e. drinking alcohol before going to bed.
OSA can result in heart disease, high blood pressure, memory and mood disorders. You need to consult your primary physician for the treatment of such sleeping disorders.
Central sleep apnea
During this sleep disorder, the breathing pattern is regularly disrupted while asleep because the brain functions in such a way. Snoring is the typical symptom linked with sleep apnea along with morning headaches.
Also termed as Daytime sleepiness or excessive sleepiness. It is a condition during which the person feels challenging to stay awake during the daytime.
On an average, 30-40 million Americans face insomnia. It is a sleep disorder which is characterised by difficulty in staying or falling asleep and waking up earlier in the morning. It does not work on its own.
Insomnia is a common symptom as well as a disorder itself. Insomnia is considered as the primary symptom of other sleep disorders which include snoring or sleep apnea.
Many people experience insomnia as the secondary cause, and they need to address the leading cause of sleep disorder.
An individual experiencing insomnia might bear it for days or months. Less sleep at night leads to compromised health, functional impairment and many others.
Different studies conclude that insomnia might result in depression, poor concentration and lead to accidents.
Types of insomnia
Insomnia is categorised into acute and chronic forms. The acute one is experienced by many individuals when they are suffering from environmental or stressful situations such as jet lag, job loss and others.
However, the chronic insomnia is less common but occurs due to poor sleeping habits, consumption of caffeine, alcohol or involved in stimulating activities.
Certain medications might also result in insomnia such as steroids, antidepressants or cold and allergy products.
Insomnia can also occur due to the underlying medical condition such as asthma, arthritis or psychiatric state, for example, depression or anxiety.
These are described as the disruptive sleep disorders which might occur during complete or partial arousal from REM or non-REM sleep.
Parasomnia sleep disorders include night terrors, nightmares, confusional arousals, sleepwalking and many others.
Parasomnia is most commonly experienced in children. The most common symptoms linked with parasomnia include the following:
- Night terrors
- Sleep-eating disorders
Circadian rhythm sleep disorders
During such sleep disorders, the person’s internal body clock or circadian rhythm is disrupted which regulates the person’s 24-hour cycle regarding the biological processes.
Rem sleep behavioural disorders
The REM sleep disorders result in paralysis while asleep which are either absent or incomplete allowing an individual to act his or her dreams. The patient experiences intense and sudden movements while sleeping.
Non-24 hour sleep-wake disorder
It is a specific type of sleep disorder which occurs commonly in blind people. The people suffering from such disorder experience late sleep timings at night and later waking up further late in the morning till the schedule is completely disturbed.
Periodic limb movement disorder
It is sleep disorder with characteristic features of rhythmic movements observed in limbs while asleep.
This condition affects 34% of the adults aged above 60 years. Periodic limb movement disorder leads to jerking and kicking movements in legs and arms.
Patients who experience restless leg syndrome,i.e. an urge to move their legs often suffer from periodic limb movement disorder.
It is treated with medications used for Parkinson’s disease, or sleeping pills might help in some conditions.
Shift work sleep disorder
It is defined as a condition experienced by individuals working at nights or rotating shifts such as in hospitals, factories and others.
You might experience this order if you face some trouble staying awake at night or working with an attentive mind while at work.
Narcolepsy affects one individual in 2000 people. It is a neurological sleep disorder which affects the control of wakefulness and sleep.
Narcolepsy is linked with those individuals who might fall asleep in the middle of their work timings.
The primary symptom associated with narcolepsy includes excessive sleepiness during the daytime.
The people suffering from excessive daytime sleepiness might have an urge to sleep at inappropriate times during working hours.
Narcoleptics lead to the episodes of slurred speech, sudden muscle weakness, and events of Cataplexy and then further collapse.
Cataplexy is a sudden condition of muscle weakness or where reversible paralysis is experienced in arms, legs or face.
Hypnagogic hallucinations might also be experienced in narcolepsy,i.e. intense dreams during the transition to deep sleep.
Sleep paralysis is another condition where you fell the inability to move or talk for short periods when falling asleep or waking up.
The narcolepsy sleep disorder occurs when it is unable to manage the regulation of sleep-wake cycles.
Some people follow all the steps to fall asleep,i.e. non-REM sleep, then REM sleep and finally dreaming phase. Narcolepsy involves the REM sleep phase leading to less restorative and less deep sleep.
Along with it you might experience other symptoms such as Hypnagogic hallucinations and sleep paralysis. The transition happens due to the rapid descent in and out of the REM state.
Diagnostic tests for sleeping disorders
If you experience sleeping issues, you need to discuss the symptoms with the primary care physician so that he or she can perform the physical examination.
If the physician then diagnoses the sleep disorder, then he will recommend you to the sleep specialist.
- A polysomnogram or Sleep study is a type of test which electronically transmits and records the physical activities of an individual while asleep. It evaluates the oxygen levels, brain waves and body movements which determines the cause of sleep disruption.
- An electroencephalogram is a test which assesses the electrical activity within the brain and detects the potential problems linked with activities.
- Blood tests are commonly used for the diagnosis of narcolepsy or finding out the underlying health conditions.
What are the treatment options available for sleep disorders?
Sleep disorders are highly resistant, and you need your doctor’s consultation in the first place to identify and detect all the causes linked with sleep disorders.
The doctor will help you get rid of the signs and symptoms connected with sleep disorders. Many individuals suffer from sleep disorders and lead to depression.
The treatment options for sleep disorders include the following:
Evaluate the patients suffering from sleep disorders such as sleep apnea, the effects of underlying psychiatric, medical or substance abuse disorders. Consider sleep hygiene and choose medications if necessary.
Consultation is an important part which allows you to identify the leading cause of sleep disorders.
The evaluation team must involve the neurologist, psychiatrist, pulmonologist, and dietitian and sleep medicine specialists.
Maintain sleep hygiene
Understand and follow the sleep hygiene rules as it serves as the keystone in the treatment phase.
If you are diagnosed with sleep disorders, then you need to develop and maintain a stable bedtime schedule following the perfect bedtime habits. Consider the following recommendations:
- Use bed for sex or sleep. Avoid watching television or reading books in bed.
- Practice techniques which make you feel relaxed at night.
- Stay motivated and stick to your sleep schedules even on weekends.
- Shift your sleeping schedule by advancing the internal clock or delaying the internal clock also termed as chronotherapy.
- Avoid consumption of caffeinated products which includes tea, coffee, non-cola pops, chocolates, colas, energy drinks or medications for example Excedrin.
- Avoid stimulants which might result in sleep disturbance such as sleeping pills, alcohol or nicotine.
- Maintain a perfect ambience in your bedroom, e., comfortable, quiet, calm and peaceful.
- Avoid stimulating activities before sleeping time such as watching television or playing computer games and being social while using cell phones.
- Maintain a proper schedule for sleeping and wakening, avoid taking naps in between.
- Find the right mattress that help you rest easier with certain medical conditions and help you sleep better during the night.
Exercise & Diet
Diet is not the specific key to treat insomnia, but avoid eating spicy foods and large meals at least 3 hours before going to bed.
Avoid disturbing sleep content such as consumption of alcohol, caffeine and nicotine. Alcoholic drinks offer you a perfect illusion of good sleep, but it has a negative impact on your sleep architecture.
Caffeine and nicotine should be strictly avoided during the second half of the day so that you can sleep well.
Start eating tryptophan-rich foods which induce perfect sleep such as warm milk. Incorporate fish and vegetables into your diet and drink enough water.
Exercise during the daytime for around an hour or so, which results in better sleep, however, if you perform strenuous exercise 3 hours before going to bed, it might result in initial insomnia.
Other interventions involved in the treatment of sleep disorders include:
- Lose weight.
- Use of continuous positive airway pressure or CPAP, other alternatives for treating sleep apnea include the use of oral or dental appliances.
- Surgical procedures.
- Sleepwalkers should be prevented from hurting themselves accidentally while walking around in home or nearby areas.
- Light-phase shift therapy- it is useful for treating disorders linked with abnormalities associated with circadian rhythm. The patients are exposed to the lightbox, bright light or natural sunlight which aids in normalising the sleep schedule. The light should be exposed for around 30 minutes in the morning so that it helps in normalising the internal clock or circadian rhythm.
- Cognitive behavioural therapy- these treatments are short-term and are efficacious for the treatment of insomnia. According to a study conducted on 160 adults by Morin et al., he concluded that the use of CBT along with Zolpidem helped in improving the sleep cycles along with sleep efficacy.
- Software programs are commercially available which help in identifying and recording the proper sleep cycles along with the patient’s behaviour.
- Biofeedback ease and meditation can also help in treating insomnia.
- Pharmacological therapy.
Medications used for treating insomnia
- Short term drug therapy or hypnotic drugs which are approved to use for two weeks. In chronic conditions, long-term drugs are used for complete success.
- Chloral hydrate and barbiturates are seldom used these days for treating the sleeping disorders due to the safety concerns.
- Over-the-counter drugs such as histamine type-1 receptor blockers are also used by some patients as they are inexpensive. However, be cautious while using these medications in older patients, patients suffering from cognitive disorders, prostatic hypertrophy or constipation.
- Zaleplon and Zolpidem are the newest and safest drugs for short-term hypnotic use. Eszopiclone is approved by FDA, for treating chronic insomnia.
- Tasimelteon is used for the treatment of non-24 hour sleep-wake disorder, as approved by FDA and concluded from the study conducted on 84 patients during a 26-week long study.
- FDA has approved Provigil and Modafinil for treating the shift-work disorder.
- Melatonin and Vitamin B12 are useful for normalising the circadian rhythm in patients suffering from DSPS or delayed sleep phase syndrome. It is also concluded from the study conducted in 2010 that Melatonin aids in curing the Delayed sleep phase syndrome or DSPS.
- Sleep medications or relaxation techniques can be used to treat parasomnia.
- Narcolepsy can be treated with stimulants or other medications such as antidepressants.
- Long-term monitoring
Rarely, few patients might need inpatient care for the treatment of insomnia. A severe form of medical, substance abuse disorder or psychiatric cause might require inpatient care for such individuals.
The diagnosis of sleep disorder is challenging for multiple reasons lead to such sleeping issues.
Control your sleep timings along with wakeup timings. Ask for help from the family members or consult a sleep specialist who can help you cure the sleeping disorders.
It takes much time to rest the circadian rhythm, so you need to stay motivated during the entire process.
Maintain healthy sleeping times, exercise regularly, consume a healthy diet and avoid using handheld devices for extended periods.