Sleep is an important aspect of health. Inadequate or non-restorative sleep can interfere with normal physical, mental, social, and emotional functioning.
Sleep disorders are common in both adults and children. There are many different types of sleep disorders. Read on to know more about sleep disorders, its causes, its signs, its types and sleep specialists.
Understanding Sleep Disorders
Proper sleep is not a luxury, it is a necessity. Lack of sleep affects nearly all bodily systems such as the nervous system, cardiovascular system, respiratory system and the digestive system.
Sleep is important for:
- Brain functions
- Energy levels
- Heart health
- Respiratory and immune systems
- Hormones
- Metabolism
- General well-being
Sleep disorders are a group of conditions that disturb normal sleep patterns. It is a clinically significant disturbance in either the quantity, the quality or rhythm of sleep, wakefulness, or the wake-sleep cycle.
Patients with sleep disorders can be categorized into three groups: people with problems falling asleep, people with behavior and movement disturbances during sleep, and people with excessive daytime sleepiness.
Common Signs You Might Have a Sleep Disorder
Sleep disorders can present with a myriad of signs depending on the type of sleep disorder. The common signs of sleep disorders are:
- Too many naps in a day
- Disturbed sleep patterns
- Trouble falling asleep
- Trouble with focussing on tasks or at work
- Difficulty waking up from sleep
- Excessive drowsiness
- Irritability
- Slow response time
- Snoring or gasping
- Teeth grinding (bruxism) during sleep
- Dry mouth in the morning
The signs associated with sleep disorders are commonly exacerbated by sleep deprivation, physical or emotional stress, traumatic events and abuse of alcohol/ medications.
Common Sleep Disorders and Their Treatments
1. Sleep apnoea:
Sleep apnoea is a condition in which breathing stops and starts several times during sleep, due to a blocked airway. It is regarded as apnoea if the airway remains blocked for more than 10 seconds.
2. Insomnia
Difficulty sleeping or insomnia symptoms are among the most common medical complaints affecting adults. Patients with insomnia report taking 30 minutes or more to fall asleep (for those with sleep initiation difficulties) or spending 30 minutes or more awake during the night (for those with sleep maintenance difficulties).
Insomnia can often be a persistent (continuous) or recurrent (intermittent) condition.
3. Restless legs syndrome (RLS)
Restless leg syndrome is a condition that affects the nervous system. This neurological disorder causes an irresistible urge to move the legs shortly after you get into bed, in the middle of the night or during the day. It can also cause an uncomfortable sensation in the limbs.
It is more prevalent in the elderly and in women.
4. Narcolepsy
Narcolepsy is a rare neurological condition that causes a person to suddenly fall asleep at inappropriate times. Narcolepsy is characterized by excessive daytime sleepiness, cataplexy, sleep paralysis, and sleep hallucinations.
5. Other
Other sleep disorders include:
- idiopathic hypersomnia (falling asleep during the day)
- circadian rhythm disorders (inability to fall asleep at normal time)
- parasomnias (such as sleepwalking, confusional arousals, sleep terrors, sleep talking, and nightmares)
- insufficient sleep syndrome (insufficient sleep without a specific sleep dysfunction)
Causes of Sleep Disorders
There are various potential causes or risk factors that predispose a person to developing sleep disorders.
- Obesity
- Age over 40 years
- Smoking
- Alcohol consumption
- Certain medications (muscle relaxants, antihistamine drugs, asthma drugs, sedatives)
- Diabetes
- Long-term stress
- Enlarged or inflamed tonsils
- Nasal allergies
- Structural problem in the nose or jaw
- Mental health conditions (depression/ anxiety)
- Medical conditions (Alzheimer’s disease, Parkinson’s disease, migraines)
When to See a Sleep Specialist
If you have been having trouble sleeping for some time, it is time to see a Sleep Specialist.
The following are the signs that require you to consult with a Sleep Specialist:
- You feel tired during the day in spite of a full night’s sleep
- You tend to fall asleep mid-day, mid-work, while driving etc
- You wake up with a headache
- You have unwanted behaviours during sleep such as restless legs, sleepwalking, sleep paralysis
- You have trouble breathing while sleeping
- You snore loudly or choke during sleep
- You have trouble falling asleep or tend to lie awake all night
- You have tingling feeling in your legs
- You have hallucinatory behaviours during, before or after sleep period
How Sleep Specialists Diagnose Sleep Disorders
Sleep specialists have the knowledge and expertise to accurately diagnose sleep disorders through history taking, physical examination and by conducting special sleep tests.
Medical history and physical examination can help to identify risk factors for sleep disorders, such as being overweight or having a family history of the condition. A sleep study is used to confirm the diagnosis and assess the severity.
- Sleep study (polysomnogram): Overnight sleep study is done using sensors on the face and scalp to monitor brain, heart and eye activity during sleep. It measures brain signals, oxygen levels in the blood, sleep position and limb movements, heart rate, breathing and snoring.
- Drug-induced sleep endoscopy (DISE): This is done by inserting an endoscope (thin tube with a light and camera) down the throat to find the exact location of blockages in the upper airway. It is performed under sedation.
- Laboratory investigations: These include arterial blood gases (ABG), thyroid function tests, drug and alcohol toxicity screening, and iron studies and ferritin level
- Actigraphy: In this test, a device is worn on the wrist. The signals are detected when there is movement of the body and limbs. It assesses sleep-wake cycles or circadian rhythm.
- Other tests include home sleep study, Nasolaryngoscopy, advanced upper airway imaging and nap studies.
Lifestyle Changes for Better Sleep
- Maintain the same wake and sleep time each day: Sticking to a scheduled bed time routine can help regularise your sleep-wake cycle. Aim for at least 7-8 hours of sleep daily.
- Restrict activities on the bed: Strictly spend time in bed only for sleeping. Avoiding watching movies or performing work tasks while in bed.
- Avoid exercise before bedtime: exercise should be performed at least 2 hours before bed
- Avoid coffee before bedtime: Caffeine works as a stimulant for the nervous system, thus keeping you awake and preventing sleep. Some people may even be sensitive to caffeine and therefore experience sleep related issues even with small amounts of it. If you need to consume coffee, consume it at least 6 hours before sleep.
- Avoid alcohol before bedtime: Alcohol, on the other hand, prevents deep sleep by causing frequent wakings, leading to poor quality of sleep. It is important to understand that although alcohol may make you feel sleepy at first, it will affect your overall sleep.
- Spend time outdoors during daytime: Exposure to natural light during daytime gives you a good dose of melatonin. This hormone helps to trigger your body’s “natural clock” and promotes good quality sleep.
- Make your sleep environment comfortable: Making your bedroom conducive for sleep will help you get a good night’s sleep. This includes keeping the bedroom as dark as possible, well-ventilated, minimal to no noise, and cool ambient temperature.
The Importance of Early Diagnosis
There are several harmful health consequences of leaving sleep disorders untreated:
- Sleep apnoea, if left untreated, can contribute to several health conditions such as hypertension (high blood pressure), type 2 diabetes, heart disease and even stroke.
- Insomnia can be short-term or long-term, leading to chronic sleep deprivation if it persists.
- Falling asleep during tasks like driving or operating heavy machinery can lead to injuries and accidents
- Lack of sleep affects the cognitive functions of the brain including judgement, attention and impulse control.
- Lack of sleep also prevents the growth and recovery (rest) of the brain.
- Sleep disturbances might also contribute to development of some psychiatric conditions, such as anxiety or depression
Early identification of the underlying sleep disorder is essential to prevent complications and health consequences.
Why Choose a Sleep Specialist Over Self-Treatment
The clinical presentations of sleep disorders depend on the specific disease. In general, sleep disturbances can present with a wide range of clinical pictures. Diagnosis of sleep disorders is a complex task which requires expertise in the field of sleep medicine.
Sleep specialists are qualified medical professionals that can accurately diagnose and manage the condition depending on the type of sleep disorder. While some sleep disorders may only require lifestyle changes, several sleep disorders necessitate treatment by the use of certain medications, surgeries or respiratory machines.
Self- treatment of sleep disorders is not only ineffective, but can also lead to potentially life-threatening consequences.
Frequently Asked Questions
If you show certain signs such as difficulty getting enough sleep, excessive sleepiness, excessive tiredness or mood changes in spite of getting sleep, you may have a sleep disorder.
The most common types of sleep disorders are insomnia, narcolepsy and sleep apnea.
If your sleep difficulties are accompanied with excessive sleepiness, unwanted movements during sleep, difficulty with focussing on tasks and trouble breathing during sleep, then you need to see a sleep specialist.
No, sleep medications are not safe for long-term use. These medications can become habit-forming and addictive. Sleep medications are only for occasional use and only when necessary.
Yes, stress can cause sleep disorders. Stress and sleep are directly related. Stress affects the duration and quality of sleep.Yes, stress can cause sleep disorders. Stress and sleep are directly related. Stress affects the duration and quality of sleep.