Sleep is essential for our physical and emotional wellbeing, yet many of us struggle to get the restful sleep we need. There are several different types of sleep and wake disorders, of which insomnia is the most common. Other sleep and wake disorders include obstructive sleep apnea, parasomnias, narcolepsy, and restless legs syndrome. Insomnia is characterized by the inability to initiate or maintain sleep.
It can also take the form of waking up early in the morning, in which the person wakes up several hours earlier and cannot go back to sleep. Difficulty starting or maintaining sleep is often manifested as excessive daytime sleepiness, which is characterized by causing functional impairment throughout the day. Before arriving at a diagnosis of primary insomnia, the healthcare provider will rule out other possible causes, such as other sleep disorders, medication side effects, substance abuse, depression, or another previously undetected illness. Chronic psychophysiological insomnia (or “learned” or “conditioned” insomnia) can be the result of a stressor combined with a fear of not being able to sleep.
People with this condition can sleep better when they are not in their own beds. Healthcare providers can treat chronic insomnia with a combination of sedative-hypnotics or sedative antidepressants, along with behavioral techniques to promote regular sleep. Excessive daytime sleepiness (including episodes of irresistible sleepiness) combined with sudden muscle weakness are the hallmarks of narcolepsy. The sudden muscle weakness seen in narcolepsy can be triggered by a strong emotion or surprise. Episodes of narcolepsy have been described as “sleep attacks” and can occur under unusual circumstances, such as walking and other forms of physical activity.
The healthcare provider can treat narcolepsy with stimulant medications combined with behavioral interventions, such as regularly scheduled naps, to minimize potential disruptions of narcolepsy in the person's life. Snoring can be more than just an annoying habit: it can be a sign of sleep apnea. People with sleep apnea are characterized by periodic gasps or “snorts”, during which their sleep is interrupted momentarily. People with sleep apnea may also experience excessive daytime sleepiness, as their sleep is frequently interrupted and they may not feel restful. The treatment of sleep apnea depends on its cause.
If there are other medical problems, such as congestive heart failure or nasal obstruction, sleep apnea may resolve with treatment of these conditions. Gentle air pressure delivered during sleep (usually in the form of a continuous positive airway pressure nasal device) can also be effective in treating sleep apnea. As the interruption of regular breathing or the obstruction of the airway during sleep can pose serious health complications, the symptoms of sleep apnea must be taken seriously. Treatment should be discussed with a healthcare provider. However, the International Classification of Sleep Disorders, third edition (ICSD), is the main clinical text for the diagnosis and categorization of sleep disorders.
The ICSD-3 groups sleep disorders into six main categories instead of four. Insomnia can mean that a person has trouble falling asleep, wakes up frequently, or wakes up too soon and can't go back to sleep. It's also important to note that to receive a diagnosis of insomnia, a person must also have adequate time to sleep and have symptoms during the day. In some cases, there is a genetic component. One such example is fatal familial insomnia, which is a rare genetic brain disorder transmitted from parent to child.
The condition causes insomnia so severe that it is life threatening. The most effective treatment for comorbid insomnia depends on the cause and whether or not it's a chronic problem. With obstructive sleep apnea (OSA), a person experiences irregular breathing during sleep, which can cause them to stop breathing for 10 seconds or longer. Parasomnias are most common during childhood, but some may persist into adulthood. Some common ways of classifying parasomnias are those related to random eye movement (REM) and those not related to REM. REM-related parasomnias include REM behavior disorder and nightmare disorder.
If a person has narcolepsy, they have excessive daytime sleepiness and may fall asleep at inappropriate times, such as while working or driving. Narcolepsy that occurs with cataplexy is called type 1 narcolepsy. If a person doesn't have cataplexy, they have type 2 narcolepsy. Type 1 narcolepsy is related to low levels of a brain chemical called hypocretin. This chemical helps people stay awake and maintain muscle tone.
Type 2 narcolepsy causes many of the same symptoms as type 1 narcolepsy. However, type 2 narcolepsy is not associated with cataplexy or low levels of hypocretin. Restless legs syndrome (RLS) is a neurological condition that commonly affects women and gradually worsens with age. It causes uncontrollable urges to move the legs because they feel uncomfortable. The amount of sleep you need may be more or less than that of other people, but experts recommend that adults get seven to nine hours of sleep each night. Sleep disorders can also be grouped according to behaviors, problems with natural sleep-wake cycles, breathing problems, difficulty sleeping, or the degree of sleep you feel during the day. A sleep specialist is a highly trained healthcare provider who specializes in how sleep affects your body. Some of the signs and symptoms of sleep disorders include excessive daytime sleepiness, irregular breathing, or increased movement during sleep.
Sleep is essential to health, so anyone who has difficulty sleeping should talk to a doctor to determine the next steps. The most common types of sleep studies monitor and record data about the body during a full night's sleep. More recently, the International Classification of Sleep Disorders (ICSD) classified sleep disorders based on symptoms, how they affect the person (pathophysiology), and the body system they affect. Common sleep disorders prevent you from getting the deep, restful sleep you need to function at your best. Your primary care doctor may recommend that you visit a sleep specialist who will perform a sleep study (polysomnography). Your healthcare provider can refer you to a sleep specialist if they suspect you have a sleep disorder.
The amount of sleep you need depends on several factors, such as your age, lifestyle, health status,....
