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Sleep Disorders


Getting a good night's sleep is essential for feeling refreshed and alert during the day. Unfortunately, not everyone is able to get the restorative sleep they need.
According to the National Institute of Neurological Disorders and Stroke, chronic, long-term sleep disorders affect at least 40 million Americans each year. Left untreated, sleep disorders, and the resulting sleep deprivation, will likely interfere with your work, driving, and social activities and have negative effects on your physical and mental well-being.
What is a sleep disorder?
A sleep disorder is any difficulty with sleep, including:
  • difficulty falling or staying asleep,
  • difficulty staying awake during the daytime (excessive sleepiness),
  • sleeping too much,
  • difficulty sleeping during normal sleep hours at nighttime,
  • abnormal behaviors during sleep which disrupt sleep, or
  • unrefreshing sleep.
 
Although snoring may cause difficulty with sleep for your bed partner, snoring by itself is not a sleep disorder. However, snoring may be a symptom of a very serious sleep disorder, such as sleep apnea.
What are the symptoms of a sleep disorder?
Many people complain that they can’t fall asleep or stay asleep, or that they are sleepy during the day, but few consider these to be symptoms of a sleep disorder. Sleep deprivation is a symptom of a sleep disorder.
Particular behaviors during normal daytime activities are telltale signs of sleep deprivation. If you are experiencing one or more of the following symptoms during the day, you may not be getting enough restful sleep at night, and you may even have a sleep disorder.
Do you . . .
  • feel irritable or sleepy during the day?
  • have difficulty staying awake when sitting still, such as when watching television or reading?
  • fall asleep sometimes while driving?
  • have difficulty paying attention or concentrating at work, school, or home?
  • perform below your potential in work, school, or sports?
  • often get told by others that you look tired?
  • have difficulty with your memory?
  • react slowly?
  • have emotional outbursts?
  • feel like taking a nap almost every day?
  • require caffeinated beverages to keep yourself going?
 
If you suspect that you are not getting enough sleep or that you might have a sleep disorder, consult a physician or sleep specialist for a diagnosis..
Each type of sleep disorder has its own particular symptoms, but each results in some of the above signs of sleep deprivation.
What are the most common types of sleep disorders?
Over 100 types of sleep disorders exist. The tables below summarize details on symptoms and treatment of the most common types of sleep disorders:
  • Insomnia
  • Sleep apnea sleep disorder
  • Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD)
  • Narcolepsy
Insomnia
Insomnia is a significant lack of high-quality sleep. It can be short-term or chronic. Insomnia may be caused by stress, a change in time zones or sleep schedule, poor bedtime habits, or an underlying medical or psychiatric condition.
Insomnia
 
Symptoms and Forms of Insomnia
 
 Treatment Approaches for Insomnia
  • Difficulty falling asleep despite being tired
  • Requiring sleeping pills or alcohol to fall asleep
  • Awakening frequently during the night or lying awake in the middle of the night
  • Awakening too early in the morning despite not feeling refreshed
  • Daytime drowsiness, fatigue, and irritability
  • Relaxation
  • Stress reduction
  • Behavior modification
  • Cognitive-behavioral therapy
  • Alternative therapies
Sleep apnea sleep disorder
Sleep apnea is a breathing interruption during sleep. Sleep apnea is a very serious sleep disorder and can be life-threatening.
Sleep Apnea Sleep Disorder
Symptoms of Sleep Apnea
Treatment for Sleep Apnea
  • Frequent waking episodes at night
  • Gasping, gagging, or choking for air during sleep
  • Behavioral changes
  • Physical and mechanical devices
  • Surgery
Restless Legs Syndrome (RLS)
Restless Legs Syndrome is a neurological disorder characterized by uncomfortable, tingly, or creeping sensations in your legs, which create an uncontrollable urge to keep them moving. RLS is not necessarily confined to your sleep time.
Restless Legs Syndrome (RLS)
Symptoms of Restless Legs Syndrome
Treatment for Restless Legs Syndrome
  • Irritating sensations in your legs which give you an overwhelming urge to walk around and move your legs
  • Your symptoms most often occur when you relax or lie down
  • When you rest, small movements of the toes, feet, or legs may be visible
  • You have trouble going to sleep, and your sleep is very restless
  • Lifestyle changes
  • Medication
  • Alternative therapies and nutritional supplements
Periodic Limb Movement Disorder (PLMD)
Periodic Limb Movement Disorder is episodes of rhythmic jerking of your feet or legs during sleep, to the point of disrupting your sleep. PLMD is not associated with a cramp in the leg or a change in body position.
Periodic Limb Movement Disorder
Symptoms of Periodic Limb
Movement Disorder
Treatment for Periodic Limb
Movement Disorder
  • Repetitive twitches of your legs, particularly the calves, during sleep
  • Not feeling rested after sleep
  • Tiredness during the day
  • Medications
Narcolepsy
Narcolepsy is a chronic neurological disorder which impairs the ability of your central nervous system to regulate sleep. Because falling asleep during some activities like walking, driving, or cooking can have drastic effects, narcolepsy is a dangerous sleep disorder. In addition, the social consequences of narcolepsy are serious.
Narcolepsy
Symptoms of Narcolepsy
Treatment for Narcolepsy
  • Intermittent, uncontrollable episodes of falling asleep during the daytime
  • Excessive daytime sleepiness
  • Sudden, short-lived loss of muscle control during emotional situations (cataplexy)
 
Less common:
  • Hallucinations while falling asleep or waking (hypnagogic hallucinations)
  • Paralysis while falling asleep or waking (sleep paralysis)
  • Automatic, seemingly awake behaviors during sleep, such as talking or putting things away
 A combination of:
  • Medication
  • Behavioral treatments
  • Counseling
How are sleep disorders diagnosed?
A doctor or a sleep specialist can diagnose a sleep disorder based on a number of factors including:
  • your description of symptoms,
  • your age and gender,
  • your psychological history,
  • your medical history, and
  • a family member’s or partner’s observation of your disruptive sleep patterns.
 
To determine if you have a sleep disorder, first pay attention to your sleep habits and daily routine. Keeping a sleep diary may be helpful in discussing your daily patterns with your doctor or sleep specialist.
Following are common tests that physicians and sleep specialists use to diagnose sleep disorders.
  • Epworth Sleepiness Scale-This sleep questionnaire asks you to rank whether certain situations make you sleepy and, if so, how sleepy. Your responses assist your doctor in providing a formal diagnosis.
  • Nocturnal polysomnogram -This test measures the electrical activity of your brain (electroencephalogram) and heart (electrocardiogram), and the movement of your muscles (electromyogram) and eyes (electro-oculogram), and usually requires an overnight stay at a sleep clinic for observation purposes.
  • Daytime Multiple Sleep Latency Test (MSLT) -This test measures how long it takes for you to fall asleep during the day, plus the kind of sleep you get during such a nap. Sleep specialists analyze your brain waves (EEG), heart rate (EKG), muscle activity, and eye movements.
  • Repeated test of sustained wakefulness (RTSW) -This test measures how long it takes for you to fall asleep in a situation that challenges you to stay awake. During the test, you are placed in a quiet room with dim lighting, told to close your eyes, and asked to stay awake.
  • Blood test - Depending upon your description of your symptoms and your personal and family medical histories, your sleep specialist may also conduct a blood test. The blood test may not be conclusive but can be helpful in establishing the possibility and probability of certain sleep disorders.
 
You can address most common sleep problems through lifestyle changes and improved sleep hygiene (see Tips for a Good Night's Sleep), but it is important to see your doctor or a sleep specialist for a diagnosis if your sleep does not improve.
Am I at risk for developing a sleep disorder?
You might want to take an interactive quiz about your risk factors for developing a sleep disorder.
The following habits and conditions are risk factors for a sleep disorder:
  • poor sleep environment (e.g., too noisy, too brightly lit, too hot, or too cold)
  • excessive caffeine or alcohol
  • use of certain medications and drugs
  • smoking or chewing tobacco
  • anxiety, depression, or another mood disorder
  • stress, such as the death of a loved one, or job pressure
  • an unhealthy sleep routine
  • daytime napping
  • early or late-night bedtimes
  • traveling between time zones
  • shift work with a rotating schedule
  • illness
  • obesity
 
There are many things you can do to reduce your risk of developing a sleep disorder. You may want to consider making changes to your lifestyle, or you can consult with your doctor to learn how you can improve your health. By making small changes, you can greatly improve the quality of your sleep and thereby the overall quality of your mental and physical well-being. See Tips for a Good Night’s Sleep for specific tips on reducing your risk of developing a sleep disorder.
How can I prevent a sleep disorder?
According to the founder of the American Academy of Sleep Medicine, the root cause of America’s sleep-deprivation problems has been the “complete absence of teaching about sleep at any level of the educational system.” Good starting points for preventing sleep disorders include:
  • educating yourself about the sleep cycle, sleep stages, and common sleep disorders,
    developing a healthy sleep routine, and
  • talking with your doctor or a sleep specialist about your sleep concerns.
 
For help with developing a healthy sleep routine, see Tips for a Good Night’s Sleep.
What are the categories or major types of sleep disorders
Experts divide sleep disorders into four categories or major types:
  • Dyssomnias
  • Parasomnias
  • Sleep disorders due to medical, neurological, or psychiatric conditions
  • Other proposed sleep disorders
 
The list below defines these four major types of sleep disorders and gives links to information about many individual sleep disorders.
Categories or Major Types of Sleep Disorders
 
1.      Major Type or Category
Dyssomnias – Disturbance in the amount, timing, or quality of sleep. Dyssomnias result in excessive daytime sleepiness or an inability to fall asleep or stay asleep. Dyssomnias can originate from causes inside or outside the body.
Parasomnias– Disorders of partial arousal from sleep, or disorders that interfere with sleep stage transitions. Behaviors not normally associated with sleeping may occur during sleep.
Proposed sleep disorders – Similar to other classified sleep disorders, but different enough to be considered distinct sleep disorders.