Sleep Disorders: Do you have one?
Almost everyone experiences sleep problems from time to time. Stress and other factors cause occasional sleep disruptions. If sleeplessness becomes routine and interferes with your life however, you may have a sleep disorder.
Sleep disorders often lead to poor health – both mentally and physically. A sleep disorder can easily result in weight gain and cause serious health problems. It also takes a toll on performance, mood, energy and the ability to handle stress. The sleep deprivation that results can have serious and dangerous effects.
• Do you regularly have trouble falling or staying asleep?
• Do you fall asleep at inappropriate times?
• Do you sleep too much?
• Do you have abnormal behaviors while sleeping?
If any of these apply, learn more about sleep disorders, along with their causes, symptoms and treatments. Find out if it is time to consult a sleep disorder specialist.
The sleep disorders…by classification ›
Over 80 different sleep disorders have been identified. Classification of these disorders exists in order to help facilitate a better understanding of their symptoms, their causes and their treatments.
› The Insomnias
Insomnia is by far the most common of all sleep disorders. Insomnia affects over 70 million Americans – mostly older adults. Sufferers regularly have trouble falling asleep, staying asleep, waking up too early or getting enough restorative sleep.
Insomnia also has daytime symptoms and can affect nearly all aspects of life. Those who suffer from this sleep disorder usually report a lower overall quality of life.
There are several different types of insomnias and they are usually categorized into two groups: primary and secondary.
A primary insomnia – also called a comorbid insomnia – is not caused by other disorders.
· Adjustment – due to a particular stress
· Psychophysiological – due to an over-concern with sleep difficulties
· Paradoxical – due to sleep-state misperception
· Idiopathic – due to no known factors
· Sleep hygiene – due to daily behaviors inconsistent with sleep (see Sleep Hygiene)
· Behavioral – due to refusal to sleep (childhood)
A secondary insomnia is a result of other problems, such as a medical or psychiatric illness, substance abuse, or another sleep disorder. They include the following:
· Insomnia due to a drug or substance – such as excessive alcohol or caffeine intake
· Insomnia due to a medical condition – or a neurological disorder
· Insomnia due to an underlying mental condition
· Physiologic insomnia – due to a medical condition or a substance not mentioned above
› The Sleep-Related Breathing Disorders
With sleep-related breathing disorders, restrictions or difficulties with respiration result in disrupted sleep.
Sleep apnea is a disorder in which breathing is paused, infrequent or shallow. The pauses (apneas) last from several seconds to several minutes, and occur at least five times in an hour. Carbon dioxide levels build in the bloodstream during these pauses which signals the person to awaken and breathe. Restorative deep sleep is rarely achieved with these interruptions, causing exhaustion the next day.
There are three types of apnea, with obstructive sleep apnea, or OSA, being the most common by far. With OSA, the breathing airway is physically restricted. This usually results in loud snoring, gasping, snorting or choking noises.
Sleep apneas are typically diagnosed with an overnight test in a sleep study called a polysomnogram.
Catathrenia (Sleep-Related Groaning)
Catathrenaia is a relatively undocumented and unusual disorder characterized by chronic, often nightly, groaning while asleep. Although commonly listed as a parasomnia, it can also be classified as a sleep-related breathing disorder because the treatments are similar to that of sleep apneas.
› The Hypersomnias (Hypersomnolence)
Excessive daytime sleepiness (EDS) is the primary symptom of a hypersomnia disorder. Even with normal, adequate and uninterrupted sleep, the sufferers of these sleep disorders do not feel rested.
Narcolepsy is one of the most common sleep disorders among the hypersomnias. Subjects with narcolepsy usually have feelings of extreme exhaustion and suffer sleep attacks at any time, even when driving. This lifelong and potentially dangerous disorder may run in the family.
Idiopathic hypersomnia is a debilitating disorder characterized by constant bouts of extreme sleepiness without a clear cause. People with this condition can sleep for ten or more hours at night, take a couple of naps during the day, and still feel sleepy. It differs from narcolepsy in that those with idiopathic hypersomnia do not suffer sleep attacks.
Although this disorder is also known as the “Sleeping Beauty Syndrome”, about 70% of people who suffer Kleine-Levin Syndrome are male. This rare disorder causes the need for an excessive amount of sleep. Along with up to 20 hours of sleep per day, those afflicted tend to eat compulsively, exhibit an overactive sex drive, and experience wide mood swings. See more on Kleine-Levin Syndrome…
› The Circadian Rhythm Sleep Disorders
A circadian rhythm sleep disorder is a disruption to a person’s internal clock (circadian rhythm). With these sleep disorders, the body’s sleep-wake patterns are not in tune with the surroundings.
Jet lag is a temporary and common sleep disorder caused by traveling to different time zones. The body’s circadian rhythms are out of sync with the new – or destination – time zone. With this disorder come fatigue, disturbed sleep and problems with concentration.
Delayed Sleep Phase Syndrome
Delayed sleep phase syndrome, also known as delayed sleep-wake phase disorder, DSPS or DSP, is a condition in which the typical sleep pattern is pushed back by two or more hours. This delay in bedtime and wake-up times is usually outside of societal norms, resulting in problems with work and social functioning.
› The Parasomnias
A parasomnia disorder causes unwanted events while falling asleep, during sleep, or upon awakening. These sleep disorders include unusual emotions, dreams, behaviors or movements. There are usually no memories of these events upon awakening. People with a parasomnia often have difficulty sleeping throughout the night.
Sleepwalking, or somnambulism, is a parasomnia that causes complex behaviors, the most obvious of which is walking. These behaviors occur while the person is in deep sleep and are usually not remembered upon awakening.
Sleep paralysis is a recurrent parasomnia in which the subject is conscious, yet unable to move or speak. The episode is often accompanied by a disturbing hallucination and typically occurs just as the subject is falling asleep (hypnagogic paralysis) or upon awakening (hypnopompic paralysis). An episode can last between a few seconds and a few minutes.
Sometimes known as sexsomnia, sleep sex is another behavior (like walking, talking or eating) that is acted out while asleep. This disorder can lead to sexual behavior that ranges from mild to more serious – and unwanted – rough intercourse.
A nightmare is a very disturbing dream in which the subject awakens from sleep. Nightmares tends to occur later in the REM stage of the sleep cycle. Upon awakening from a nightmare, it is usually difficult to return to sleep. Therapy involving lucid dreaming is often successful in reducing the frequency of nightmares.
Exploding Head Syndrome
Despite how it may sound, the exploding head syndrome is not dangerous. It is, however, both startling and disruptive to sleep. People with this sleep disorder imagine hearing a loud noise, like a gunshot or bomb explosion, just before falling asleep or upon awakening.
REM Sleep Behavior Disorder
REM sleep behavior disorder, or RBD, occurs when a subject acts out realistic, action-packed dreams when sleeping. The subject can violently flail or thrash about, causing injury. Once awakened, the subject is usually able to recall details of the dream. These behaviors tend to get worse over time and are often ignored until someone gets hurt.
Sleep hallucinations are imagined events that seem genuine. These dream-like visualizations may also involve other senses as well – such as touch, taste, sound and smell. Like sleep paralysis, these events usually occur when falling asleep (hypnagogic hallucinations) or upon awakening (hypnopompic hallucinations).
Night terrors, also known as sleep terrors, are episodes of imagined terror that often cause screaming and thrashing while asleep. Violent actions are also possible and may lead to serious and even deadly injury. Although it often occurs during slow-wave sleep, it can occur throughout the sleep cycle.
Sleep-eating disorder, also known as sleep-related eating disorder or SRED, consists of recurrent episodes of uncontrollable binge eating and drinking at night. During these events, the subject is only partially awake. Episodes may occur nearly every night and the subject may or may not remember it afterwards.
Confusional arousal, also known as sleep drunkenness or excessive sleep inertia, is a disorder that causes people to awaken in a confused state. The subjects oftentimes do not realize where they are. This condition can sometimes be dangerous to both the subject and their bed partner. Most cannot remember the episode afterwards.
› The Sleep-Related Movement Disorders
A sleep-related movement disorder causes bodily movements, either while trying to transition into sleep or during sleep itself. Falling asleep, staying asleep or getting restful sleep is difficult with these sleep disorders.
Restless Leg Syndrome
Restless leg syndrome (RLS), also known as Willis-Ekbom Disease, is a neurological disorder characterized by the overwhelming urges to constantly move one’s legs while resting. The resulting motions reduce the time spent sleeping as well as the quality of sleep itself. RLS affects about one in ten adults and is twice as likely to affect women as men.
Periodic Limb Movement Disorder
Periodic limb movement disorder (PLMD) is characterized by uncontrollable, repetitive muscle jerks or twitches, usually in the lower legs. These movements usually occur around every 20-40 seconds and in episodes that can last from a few minutes to a few hours. Most occur while asleep (PLMS), however some occur while awake (PLMW). Those with PLMS may also suffer restless leg syndrome.
Leg Cramps at Night
Leg cramps at night, also known as sleep-related leg cramps, are sudden and uncontrollable muscle contractions that tend to jolt the subject awake. These spasms usually affect the calves or feet, and result in intense pain. Episodes can last from a few seconds to several minutes. Stretching the affected muscle usually brings relief.
Sleep bruxism (SB) is a disorder characterized by clenching and grinding of the teeth while asleep. If this activity is frequent or the clenching is strong enough, it can lead to jaw disorders and damage to the teeth.
› The Other Sleep Disorders
Other sleep disorders fall just outside the range of normal sleep, yet may not be considered dysfunctional to sleep.
Snoring is considered the diagnosis if the respiratory noises are disruptive to the subject’s sleep or to others nearby. Snoring can happen during all stages of sleep. About half the population snores at one time or another. If the respiratory sounds are linked to obstructive sleep apnea, then the diagnosis is not considered snoring.
Sleep talking, or somniloquy, is a fairly rare and short-lived sleep disorder in which a person talks, utters, mumbles or makes sounds during sleep. The sleep talker usually has no recollection of the event. Usually harmless, this disorder may be more disturbing to sleep partners.
Hypnic jerk, also known as hypnagogic jerk or sleep start, is a sudden and involuntary muscle contraction occurring right before falling asleep. The contraction is usually strong and affects much of the body. A hypnic jerks is often associated with a sensation of falling.