Sleep Disorders


Adults typically need six to eight hours of sleep per night in order to be refreshed the next morning and ready to take on a new day.  When an individual consistently does not get enough sleep, a sleep disorder may be the problem.

Overview

While some people believe sleep disorders are not very common, the opposite is true:  about half of all adults suffer from insomnia, the most common sleep disorder, which consists of difficulty falling asleep or staying asleep. 

Many medical professionals believe that a lack of a good night's sleep is "epidemic" in today's society.  Drowsiness is the first sign the body needs more sleep.  When this stage happens during the day it is a good sign that more sleep is needed.  One study used a group of people who felt they were tired too much and had them sleep 10 hours per night for 6 straight nights.  When this group was tested afterward, they showed major improvements in alertness and intellectual performance.

Causes

Sleep disorders can be caused by many factors.  Some of the most common include:

  • Age - The risk for night terrors is increased by a sleep-wake cycle which has not fully matured, as is the case in young children.  In middle age, insomnia becomes more common as the "architecture" of sleep changes.  As they age, people spend less time in deep sleep, which increases the odds for waking up too soon.

  • Environmental Factors - A bout of insomnia which lasts for several days to several weeks can be brought on by flying to a different time zone.  The area of the hypothalamus in the brain that contains the "biological clock" is reset and sleep is disrupted.  Working at night and attempting to sleep during the day can also interfere with this biological clock.  Smoking can also cause insomnia due to the stimulants found in cigarette smoke.  Other factors include an uncomfortable mattress and too much noise or light in the bedroom.

  • Psychosocial Factors - Stress is a great disruptor of sleep.  Anticipating an upcoming event, grief and worry can cause a temporary loss of sleep.  Any kind of psychological distress can increase the risk for children having night terrors.  Family history and fatigue can also increase this risk.

  • Nutrition - Several nutrients, drinks and foods are known to interfere with a good night's sleep.  Caffeine, the stimulant found in tea, coffee, colas and chocolate, can keep some people awake when it is consumed in late afternoon or evening.  Although alcohol is a depressant, it can cause an individual to wake up (often in the middle of the night) when the depressant effect wears off.

  • Health Conditions - Several illnesses can be the culprit behind chronic insomnia.  Narcolepsy, a neurological disorder where sleep-wake cycles are abnormal, causes the person to be sleepy during the day and awake at night.  Insomnia can also be caused by depression, an overactive thyroid, cancer, asthma, kidney disease, gastrosophogeal reflux, Alzheimer's disease, and sleep apnea.  When sex hormones are in a state of flux (such as just before and during menstruation, during menopause and during pregnancy), the incidence of insomnia increases.

  • Medication - Stimulants can often be found in medications, causing an individual to have difficulty in falling asleep.  These medications can include serotonin reuptake inhibitors found in drugs for depression, thyroid conditions, decongestants and oral contraceptives.  Tapering off of sleeping pills can also cause a return of insomnia.

  • Behavioral Factors - Some habits can add to problems with insomnia, including working in the bedroom, upsetting conversations prior to bedtime, and exercising (within three hours of going to bed).

Common Sleep Disorders

Insomnia is the most common sleep disorder.  Other sleep disorders include parasomnias, or abnormal behaviors which occur during sleep, such as night terrors (which affects young children).

Diagnosis

Most health care professionals are able to diagnose a sleep disorder by performing a physical exam and asking questions regarding sleep patterns.  A thorough examination may help detect any underlying health conditions adding to the condition.

Possible Treatments

Unfortunately, there is no treatment for night terrors.  Insomnia treatments depend on the cause.  Frequently, treating the underlying cause (such as narcolepsy or sleep apnea) can alleviate the insomnia. 

Aside from minimizing stress, a few other steps to try for a better night's sleep include:

  • Go to bed and wake up at the same time every day.

  • Never work in the bedroom.

  • Do not drink beverages with caffeine in the afternoon or evening.

  • Do not smoke.

  • Avoid alcohol two hours before going to bed and do not drink more than two alcoholic drinks in one day.

  • Exercise every day.

  • Keep the bedroom quiet and dark.

  • Wear loose-fitting pajamas, replace the mattress when it is lumpy or sagging, and maintain a moderate temperature in the bedroom (not too hot or cold).

Some other treatments that can be very effective include:

  • Nutrition - Turkey, milk and some other types of meats, cheeses and pumpkin seeds contain a compound known as L-tryptophan, an amino acid that helps to induce sleep by producing melatonin.

  • Valerian - Teas, tinctures and pills made from the roots of valerian, a perennial herb native to North America, Asia and Europe has sedative properties.  When taken nightly for four weeks or more, valerian is effective in reducing the time it takes to fall asleep.

  • Melatonin - This hormone aids in regulating the biological clock.  Produced by the pineal gland in the brain, melatonin is produced in response to darkness and helps to stimulate sleep.  Melatonin levels decrease with age.

  • Medication - Mild tranquilizers, sedatives and anti-anxiety medications can be used to treat insomnia for short periods of time (up to a few weeks).

Beginning in the 1950s, researchers have used polysomnography (the simultaneous recording of electrophysiological and other data) during sleep to try to interpret the activities taking place in the sleeping body and brain. 

References

  1. Lack, L. et al.(2003). Insomnia : how to sleep easy. Double Bay, N.S.W. : Media 21 Publishing.
  2. Servan-Schreiber, D. (2006). The Duke encyclopedia of new medicine : conventional and alternative medicine for all ages. London : Rodale.
  3. Vukovic, L. (2005). Overcoming sleep disorders naturally. Laguna Beach, CA : Basic Health.
  4. Wilfred, P. (2010). Sleepmanual : how to achieve the perfect night's sleep. London : New Holland.

Posted in Sleep Disorders

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Sleep Disorders

Insomnia

The world seems to never stop spinning. The brain can't stop thinking or worrying about the day just spent or the day ahead. So how can one possibly fall asleep and get a good night's sleep? Insomnia is the broad term that encompasses one or all of the difficulties with sleep, including the ability to fall sleep and to stay asleep.

Central Sleep Apnoea

CSA is marked by a limitation or cessation of breathing while sleeping. The main difference between CSA and obstructive sleep apnoea (OSA) is that no obstruction exists in the airway. In CSA, the airway remains open but breathing is interrupted. In this condition, the "central" refers to the fact that the heart and the brain (which regulate breathing during sleep) are the culprits for the pause in breathing.

Obstructive Sleep Apnoea

In OSA, the breathing is briefly and repeatedly completely stopped or reduced during one's sleep. The term "apnoea" is used to describe a cessation of breathing that lasts for at least ten seconds during sleep. This type of apnoea occurs when the airway collapses and completely closes off the passageway. When this happens, the tongue falls back into the throat just a little and further blocks the airway.

Restless Leg Syndrome

RLS is a neurological disorder occuring in 10 to 15 percent of the adult population and just 2 percent of children. The primary feature of RLS is a compelling urge to move the legs while waking. An uncomfortable sensation is usually present in the legs, becoming more pronounced during periods of inactivity and in the evening.

Snoring

Snoring occurs when the air flowing from the mouth and nose on its way to the lungs is restricted. The noise produced from snoring is the result of tissue vibrating in the back of the throat as air moves across it. The sounds seems as if it may be coming from the nose, mouth or both. While snoring can occur in any stage of sleep, this condition tends to be worse in slow-wave sleep and REM sleep.

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