Everything you need to know about sleep disorders

Sleep disorder or Somnipathy is a medical condition affecting a person’s sleep quality. Sleep disorders, whether they are driven by a medical condition or an external stimulus, affects the sleep’s pattern. In short, sleep disorders are a group of conditions causing the interruption in sleeping pattern, resulting in less quality sleep, unrefreshing sleep and influencing the quality of life, concentration, work and overall health. By that, we mean that even when a person is really tired and exhausted, he/she is unable to sleep.

Every once in a while people tend to experience minor or passing sleep disturbances due to stress, nutrition, or other inside or outside factors, but if these problems keep occurring regularly, then that would indicate a “sleep disorder”.

Sleep disorders are divided into categories based on their specifications and causes, and they need to be diagnosed by a specialized doctor and the root cause has to be found. Sometimes sleep disorders happen due to a medical condition, which may also be serious.  In such cases when the treatment starts, the problem with sleeping may go away.

We must emphasize that, it’s not normal for a person to regularly have sleeping problems, so if a person is having sleeping issues more often and he/she thinks they might have a type of sleep disorder, they must visit the doctor in order for it to be diagnosed and addressed and a proper treatment needs to be chosen for that specific sleeping disorder or sleeping problem.

Types of sleep disorders

Insomnia

It is a type of sleep disorder, in which the person has difficulty falling or remaining sleep during the night. This can have various reasons such as digestive problems, stress, anxiety, and hormonal issues. Insomnia may result in obesity, depression, mood swings, loss of concentration, unresponsive to dangerous situations, loss of reasoning, irritability, low-quality performance in school or at work.

Insomnia is also divided into subcategories.

• Chronic: When insomnia happens on a regular basis for at least 30 days in a rowand becomes a permanent sleeping problem, it’s called chronic.
• Intermittent: When insomnia happens at specific intervals.
• Transient: When insomnia happens for a few nights in a row.

Some cases of insomnia can be cured naturally without a need to visit the doctor and using prescription drugs, and only by changing or modifying daily habits, relaxing before sleep, not drinking caffeinated drinks such as tea/coffee before sleep, or improving sleeping hygiene.

Sleep Apnea

While sleeping, a person might experience abnormal breathing pattern. Sleep apnea results in body’s less oxygen intake and causes the person to wake up several times during the night. During the day the person might not remember waking up during the night, but they would feel exhausted, irritable, vulnerable, depressed and unproductive. Sleep apnea is serious and life-threatening and needs doctor’s visit and evaluation as soon as possible. Today, sleep apnea is curable through a number of surgical procedures. (Read more about sleep apnea surgery)

Parasomnias

Sleep disorders including sleepwalking, sleep talking, bedwetting, nightmares, teeth grinding and/or jaw clenching, groaning is called Parasomnias.

Restless leg syndrome (RLS)

RLS is the need to move legs, sometimes with tingling sensations in them. Although this can also occur during the day, it’s more prevalent during the night. Restless leg syndrome is also called Willis-Ekbom disease, which disturbingly disables a person to comfortably fall asleep.

There are some self-help home remedies to help relieve this problem.

Narcolepsy

Episodes of extreme tiredness, fatigue and sleeping attacks during the day, is called Narcolepsy. These episodes usually come without warning, in the middle of talking, working and even driving. This disorder might also paralyze the person during the sleep, preventing them from being able to move their limbs or body right after waking up. This disorder might happen independently or it can be a symptom of multiple sclerosis (MS).

Symptoms of sleep disorders

• Irritability
• Anxiety
• Fatigue during the day
• Difficulty staying awake when sitting still, watching television, reading
• Falling asleep or feeling very tired while driving
• Difficulty concentrating
• Tired-looking face
• Slow reaction
• Inability to control emotions
• Feeling like taking a nap during the day every day
• Needing caffeinated drinks for energy boost
• Depression

Experiencing the above symptoms regularly means the person has some type of sleep disorder.

Circadian rhythm sleep disorders

 What is Circadian rhythm

 Our bodies’ biological clock is called Circadian rhythm.

How Circadian rhythm works?

This internal clock regulates our daily sleep/wake cycles and it is “light-driven”. What this means is that, during the day with the presence of light, our body knows that it’s not the right time to sleep, as the light decreases and the night sets in, the brain triggers the release of melatonin, which is a sleeping hormone, and makes us sleepy. When the sun comes up and there’s light, our body tells us that it’s time to wake up.

The circadian rhythm might be disrupted or thrown off. Putting aside the causes, this disruption, may make a person sleepy at inconvenient times.

A frequent disruption in circadian rhythm may result in a number of disorders such as sleep disorder or sleeping problems, bipolar disorder, depression, seasonal affective disorder (winter blues).

Below are a number of disorders caused by circadian rhythm disruption:

Shift work sleep disorder:

This happens when body’s working and sleeping (resting) schedules are not in sync with each other. People who do night shifts, early morning shifts, and rotating shifts are among those who need to stay awake when their bodies are telling them to sleep, and sleep when it’s time to be awake. Shift work results in less quality sleep, and less quality sleep results in sleep deprivation. Aside from mental lethargy, sleep deprivation increases the risk of injury.

Delayed sleep phase

In this sleep disorder, the body’s biological clock is significantly delayed. Which means that, sleeping and waking time of a person is much later than the average population. We shouldn’t mistake this sleep disorder as a voluntarily late sleeping and being a night owl, it’s specifically a sleep disorder which makes it hard for a person to keep normal sleeping and waking hours. This may result in missing morning classes, keeping a job and being able to make it on time in scheduled daily routines. People with this sleep disorder are unable to fall asleep earlier than 2 a. m to 6 a. m. The majority of the people with this disorder are teenagers and it may go away as they grow up and older.

Jet lag

Jet lag is a temporary off balance and disruption of circadian rhythm and it happens when someone travels from one time zone to other. The longer the flight, the more severe the jet lag is. Symptoms of jet lag may include:

• Stomach problems
• Insomnia
• Headache
• Fatigue
• Daytime sleepiness

It usually takes one time zone to adjust the local time.

Advanced sleep phase

In older adults, it’s quite common for the elderly to go to sleep early and wake up very early.

Sleep disorder causes

• Stress and anxiety
• Chronic pain can make it hard for a person to fall asleep and stay asleep. They tend to wake the person up in the middle of their sleep. Some of the chronic pain causes and conditions are listed below:
  • Fibromyalgia
  • Chronic fatigue syndrome
  • Arthritis
  • Inflammatory bowel disease
  • Persistent lower back pain
  • Persistent headaches
• Nocturia: Nocturia is frequent urge to urinate which disrupts the sleeping pattern. Hormonal imbalances, urinary tract problems or infections may be linked to this problem. This disorder is important and needs to be addressed.
• Allergies and respiratory problems: Colds, allergies and any upper respiratory related problems that makes breathing difficult can make sleeping and remaining sleep challenges, and results in sleep disorder.

How are sleep disorders diagnosed

In the first appointment, the doctor will do a physical exam, look and ask for any symptoms the patient might be having. There are a number of tests that will be ordered, such as:

• Polysomnography: In this test, body’s oxygen levels, body movements andbrain waves will be evaluated in order to see if they play any role in the patient’s sleep disorder.
• Electroencephalogram: Brain’s electrical activity will be checked in this study to see whether the sleep disorder is associated with this activity.
• Genetic blood testing: The blood test is ordered to diagnose Narcolepsy (if present) and to look for any medical problems that might be causing the sleeping disorder.

Sleep disorder treatments

Treatments for sleep disorder vary depending on the category they belong to and the root cause of it. Some can be cured with non medical treatment and some with natural remedies and lifestyle changes.

Medical treatments:

• Melatonin supplements
• Sleeping pills (in moderate doses)
• Pills for allergy and cold
• Taking medication (In cases that the root cause is linked to a medical condition)
• A device for breathing
• A dental guard for teeth grinding and jaw clenching
• Surgery (for sleep apnea)

Lifestyle changes

• Drinking less water before bedtime
• Consuming more vegetables and fewer carbohydrates
• Reducing stress
• Reducing caffeine consumption
• Setting a strict sleeping schedule and sticking to it
• Less tobacco use
• Less electronic devices use (television, computer, mobile phone, etc. ), at least an hour before bedtime
• Not sleeping on an empty stomach
• Avoiding a heavy meal near sleeping time and light snacking if needed
• Avoiding spicy foods
• Less sleeping pill consumption

Sleep disorder in Iran

It has been estimated that about 7 to 10 million of Iran’s population are suffering from sleep disorders. If we also take those with medical conditions into account, the number is even higher. Due to high levels of stress, pollution, wrong and unhealthy lifestyle habits this population is growing rapidly. This population needsto be acknowledged, evaluated and put on an appropriate plan and treatment.