Sleep disorder

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 23, 2016
StartDiseasesSleep disorder

The term sleep disorder refers to a broad group of conditions impacting an individual’s ability to sleep on a consistent basis. It is estimated that as many as 40 million Americans experience long-term sleep disorders, and another 30 million suffer occasional sleep difficulties.

If left untreated, sleep disorders can impair a person’s ability to perform daily tasks, interfere with personal and professional relationships, and lead to additional health problems, including obesity and high blood pressure.

Contents

Definition & Facts

There are two basic types of sleep. The first is non-REM sleep and the other is REM sleep. Non-REM sleep consists of four stages with stage 1 being the lightest and stage 4 being the heaviest. Typically, an individual will cycle through these stages multiple times through a normal night’s sleep.

When a person suffers from a sleep disorder, they do not cycle through the different stages of sleep appropriately, or the cycles are interrupted repeatedly. This can leave the person feeling fatigued, irritable, and mentally unfocused. The most common types of sleep disorders include circadian rhythm sleep disorders, insomnia, sleep apnea, narcolepsy, and restless legs syndrome.

Symptoms & Complaints

Individuals suffering from a sleep disorder can experience a wide variety of symptoms depending on the severity and specific type of disorder. General symptoms include:

Anyone experiencing these symptoms should consult his or her doctor if the symptoms persist, start to impact daily life, and do not respond to self-help measures. It is also important to seek immediate medical attention if the individual snores loudly, gasps during their sleep, stops breathing during sleep, or falls asleep at inappropriate times or places. These can all be symptoms of a serious underlying health condition.

Causes

A number of factors and health conditions can cause a sleep disorder. Circadian rhythm disorders occur when the internal clock that regulates the sleep-wake cycle is disrupted, and the body is forced to stay awake when it should sleep and sleep when it should be awake. This is frequently seen among shift workers who work overnight, early morning, or rotating shifts. It can also occur when traveling between time zones as the body struggles to adjust to the changes in schedule.

Insomnia is characterized by difficulty falling asleep, waking up frequently during the night, and waking up too early. Insomnia can be caused by stress, anxiety, depression, and environmental factors, such as noise or excess light. Health conditions, including chronic pain and frequent nighttime urination, can affect the duration and quality of sleep.

Sleep apnea is a disorder in which the person stops breathing repeatedly for short periods while sleeping due to an obstruction of the upper airway. Sleep apnea is potentially life-threatening but is easily treated.

Narcolepsy is characterized by excessive daytime fatigue and periodic sleep attacks in which the person falls asleep in the middle of tasks like eating, driving, or talking. Narcolepsy is caused by a dysfunction of the portion of the brain that controls the sleep-wake messages.

Restless leg syndrome is a neurological disorder characterized by an overwhelming urge to move the legs accompanied by tingling or burning sensations in the legs. The exact cause of the condition is not known, but individuals with Parkinson’s disease and ADHD are more prone to develop restless leg syndrome.

Diagnosis & Tests

To diagnose a sleep disorder, a doctor typically begins with a physical examination and blood tests to rule out possible medical conditions that could affect sleep. A thorough patient history that includes questions regarding daily activities and sleep patterns may also be helpful in identifying environmental or lifestyle factors that are contributing to insomnia.

Polysomnography, also known as a sleep study, is another common tool used to diagnose sleep disorders. The test, usually performed in a sleep lab, uses monitoring devices attached to the body to measure heart rate, breathing patterns, oxygen levels, and body movements to identify sleep disruptions.

An electroencephalogram may also be used to detect abnormal brain patterns that may interfere with sleep. Once the underlying cause of the sleep disorder is identified, the doctor can determine the proper course of treatment.

Treatment & Therapy

The medical treatment of sleep disorders varies based on the cause and type of disorder. The most common treatments include over-the-counter or prescription sleep aids or melatonin supplements. Sleep aids should only be used on the advice of a doctor and only for a short time. Sleeping pills do not cure insomnia and can even make the problem worse if used for a prolonged time. Some sleep aids also carry the risk of dependence and tolerance if used on a regular basis.

When using sleeping pills, it is important to follow all dosing instructions, and only take the medication when there is enough time to get seven to eight hours of sleep. Sleeping pills should never be mixed with alcohol and should not be taken when driving or operating machinery.

Breathing devices may also be a viable treatment. If an individual is suffering from sleep apnea, the doctor will likely recommend CPAP therapy. A CPAP is a device that uses positive air pressure to keep the airway open.

Treatment of sleep disorders will also necessarily involve treatment of any underlying medical conditions. If the insomnia is due to issues such as chronic pain, frequent nighttime urination, narcolepsy, or restless leg syndrome, the doctor will typically prescribe medications to treat the condition.

Prevention & Prophylaxis

The best way to prevent sleep problems is to practice good sleep hygiene. It is important to follow a set sleep schedule, even on the weekends, that allows for seven to eight hours of sleep. Most people find it easier to sleep in a room that is slightly cool.

It also helps to limit exposure to TVs, smartphones, and other electronics for several hours before bedtime. These devices emit a type of blue light than can interfere with the brain’s production of melatonin. It is also a good idea to limit caffeine intake starting in the early afternoon and avoid alcohol and heavy meals before bedtime.