Sleep disorders -- causes, types, symptoms, diagnosis, treatment and prevention
The fact that we spend around one third of our lifespan sleeping itself demonstrates the importance of sleep in our lives. That said, sleep is a complex neurological process essential for the body to restore its energy levels and keep you fully active, focused and functioning in the daytime.
Sleep cycle and stages
It is constantly being said that 7-8 hours of sleep is necessary for full restoration of energy levels. However, sleep requirements vary from person to person. Sleep is a process that involves several brain areas that regulate the phases of sleep cycle. The two main phases of sleep are Rapid Eye Movement (REM) stage and the Non-Rapid Eye Movement (NREM) phase, which keep altering about 4-5 times during a night of normal sleep.
Rapid Eye Movement (REM): This is a short phase (10 minutes) during which your heart rate and breathing rate increases and your eyes begin to move rapidly.
Non-Rapid Eye Movement (NREM): This is a longer phase that may even last for about 90 minutes. It consists of 4 different stages.
Stage 1 is the where you have just entered the sleep cycle. In this phase you are prone to wake up easily.
Stage 2 is called the light sleep phase where your heart rate slowly starts lowering along with your body temperature. This is the phase of preparation of entering deep sleep.
Stages 3 and 4 are the phases of deep sleep where you may become disoriented for a while if awaken.
Types and causes of sleep disorders
'Sleep disorder is a condition that thwarts a person from getting peaceful sleep. Any kind of alteration in the quality, quantity and pattern of sleep can result in sleep disorder. It can result in daytime sleepiness and dysfunction,' says Dr Prachi, Clinical Psychologist, Delhi based Sri Balaji Action Medical Institute.
Dr Prachi explains the most common types of sleep disorders: Insomnia, Hypersomnia, Sleep apnea, Restless legs syndrome and Narcolepsy.
- Insomnia: It is a disorder wherein a person faces difficulty in falling asleep. The person may tend to wake up in the middle of the night or get up earlier than usual. People suffering from insomnia often complain of un-refreshing sleep. Here's a detailed account on insomnia: Insomnia causes, symptoms, diagnosis and treatment.
- Obstructive Sleep Apnea (OSA): This sleep disorder has a person's breathing interrupted during sleep causing brief cessations due to physical obstruction along with loud snoring, excessive daytime sleepiness, morning headaches and awakening with shortness of breath. Read more about the causes, diagnosis and treatment of Obstructive Sleep Apnea Syndrome (OSAS)
- Narcolepsy: It is a disorder which causes excessive sleepiness. The patient feels an uncontrollable urge to fall asleep and thus, suffers from sudden muscle loss, sleep paralysis and hypnagogic hallucinations. Here's everything you would like to know about narcolepsy or excessive sleep disorder causes, symptoms, diagnosis, treatment and complications
- Restless Legs Syndrome: In this sleeping disorder, the patient feels an intense and often an uncontrollable urge to move the legs. They may experience a tingling or aching sensation in their leg that occur just before falling asleep that creates this urge.
Other less common sleep disorders include:
- Sleepwalking: This is a condition in which a person gets up and walks around while sleeping
- Parasomnia: In parasomnia, a person has disrupted sleep. It occurs during arousals from REM sleep or partial arousals from non-REM sleep.
- Sleep paralysis: This condition makes a person unable to move while sleeping
- Periodic limb movement disorder (PLMD): This condition is characterized by intermittent limb movement while the person is asleep.
Sleep problems can be caused by various reasons:
- Stress: Chronic stress that leads to depression can affect the sleep pattern and cycle resulting in insomnia.
- Medical condition: Pain due to an underlying medical condition can affect sleep quality
- Age: As we grow old our sleeping cycle is altered such that we tend to spend most of the night in light stage of sleep cycle rather than deep sleep.
- Medication: There are several drugs known to interfere with sleep cycle. These include hypertension medicines, antidepressants and some over-the-counter pills
- Lifestyle: People who have bad eating habits, stay awake at late nights, work in night shifts are more prone to sleep disorders.
- Genetics: Narcolepsy and sleep walking are among some sleep disorders that are found to be inherited with some genetic basis.
Symptoms of sleep disorders:
Symptoms are specific to the type of sleep disorder you're suffering from. But in general, you should visit a specialist if any of these symptoms are bothering you.
- Constant irritability during the daytime
- Feel fatigued and sleep even after sleeping for 8 or more hours
- Your family members complain about your snoring
- Difficulty in staying awake when sitting still
- Difficulty in falling asleep (more than a month)
- Difficulty in concentrating or focusing
- Lowered reaction or reflex action
- Difficulty in controlling emotions
- Feeling of depression
- Jerky limbs while sleeping
- Night time sweating
Diagnosis of sleep disorders:
Diagnosis of sleep disorders is based on the type of disorder you're suffering from. Here are some diagnostic tests used to diagnosed specific sleep disorders
- Polysomnography: It is a sleep study, where electrodes are wrapped around different parts of your body with the help of bands and different tests to monitor brain waves (electro-encephalography EEG), muscle tone (electromyography EMG), heart rate (electrocardiography (ECG) and breathing are carried out to asses you while sleeping.
- Sleep latency test: This test is performed analyses how long does it take for you to fall asleep.
- CPAP titration study: In this test, the continuous positive airway pressure (CPAP) is determined in overnight study for the treatment of OSA.
Treatment and prevention of sleep disorders
'There are numerous sleeping disorders with their own potential causes. And, if you're diagnosed with a sleeping disorder, there is nothing to worry about because there are a variety of treatment options available to choose from,' says Dr Prachi.
Sleep disturbances, poor quality of sleep and insomnia are mainly treated with sleeping pills.
- Benzodiazepines are frequently used to treat insomnia
- Excessive day time sleepiness is treated with amphetamines to induce day time alertness
- Restless leg syndrome may be treated with dopamine agonists
- Continuous positive airway pressure (CPAP) is the gold standard for the treatment of sleep apnea. It applies positive pressure through a nasal mask to hold the upper airway open throughout the breathing cycle
'In major cases, behavioral therapies like cognitive behavioral therapy (CBT), cognitive therapy, relaxation techniques, sleep hygiene and stimulus control as well as surgical options like tonsillectomy, adenoidectomy, jaw surgery or uvulopharyngoplasty (UPPP) take charge of correcting the sleeping disorders,' says Dr Prachi.
Here are some for prevention of sleep disorders offered by Dr Prachi:
- Sleep at the same time each night and get up at the same time each morning without taking any naps in the middle of the day.
- Avoid any caffeine, nicotine, and alcohol intake late in the day.
- Avoid exercising close to sleep time.
- Avoid heavy meal late in the night.
- Follow a routine that would help in relaxation and wind up before sleep.
To further prevent sleeping disorders, one must make certain modifications in their lifestyle through regular exercising, practicing good sleeping habits and a healthy diet.
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