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Sleep Disorders Explained All you need to know

December 31, 2021

Everyone knows what it's like to have a bad night's sleep due to outside influences. Stress, traveling, and hectic schedules can all affect sleep and lead to issues with how much sleep we get, but when this occurs regularly, it may be caused by a sleep disorder.

As with most health conditions, it is important to diagnose and treat these kinds of disorders as soon as possible.

Early treatment can mean the issues are dealt with sooner, and the negative health consequences are diminished.

Sleep Disorders Diagnoses Warnings Prevention & More

Warning Signs of a Sleep Disorder

Chronic sleep problems will affect sufferers in different ways, it is vital to seek treatment and advice if someone has the symptoms listed below:

• Perpetually taking more than 30 minutes to fall asleep

• Tiredness and irritability during the day following a full night's sleep

• Constantly waking up during the night and lying awake for hours

• Needing naps during the day to function

• Lack of concentration

• Dropping off regularly while doing regular tasks

• Regular changes to your sleep/wake schedule

• Unpleasant twitching when falling asleep

• The need for stimulants like caffeine to keep awake during the day

Diagnosing Sleep Disorders

Before you seek medical help, it is important to know as much about your condition as you can. Keep a sleep journal for a week and fill in the entries honestly, with as much detail as possible.

Check out the therapy section of this book for a detailed sleep journal you can use to record how different factors affect your sleep.

Once you have kept a sleep journal for a few weeks, you will already know the factors you can change yourself and how to implement them.

If your sleep is still not satisfactory, it is time to get a medical diagnosis and identify what particular sleep disorder you are suffering from.

Sometimes sleep disorders are a symptom of underlying medical conditions, and it is important to examine the reasons behind your lack of sleep.

The following medical conditions can lead to sleep disorders:

• Sinusitis, symptoms include blocked nose, tenderness around the nose and cheeks, discharge, toothache, and bad breath.

• Asthma

• Mellitus, a form of diabetes that can be dangerous if left untreated

• Hypertension

• Depression and anxiety

• Parkinson's

There are also several non-medical reasons for sleep disorders, which include:

• Bad sleep habits

• Unhealthy lifestyle choices

• Poor diet choices

• Stressful influence from work or personal life

Identifying the Disorder

There is no stigma attached to sleep disorders. Many people suffer from them, and the treatment is effective and available. Don't hesitate to consult your doctor if you believe you have one.

Insomnia

This is the most commonly diagnosed sleep disorder that can affect all ages. It is common in pregnant women, especially during the second and third semesters, and it can also affect children.

The symptoms of insomnia include waking up too early, poor quality sleep, and issues with remaining asleep for long periods.

Women are more likely to suffer from insomnia as compared to men, and menopause can be a factor in some cases, but both men and women from all walks of life could be affected by the following risk factors that can result in insomnia:

• Elevated stress levels

• Emotional upheavals following a trauma

• Lower standard of living due to low income

• Regular travel to different time zones

• Working irregular hours

• Sedentary lifestyle

Restless Leg Syndrome

As the name suggests, this syndrome involves aches and pain in the lower limbs that interfere with sleeping patterns.

While it primarily affects sleep, RLS is classed as a neurological disorder, and treatment will differ from other sleep disorders.

There is no real explanation that what causes RLS, but it is believed that caffeine and alcohol can trigger the syndrome and make symptoms worse.

There is no test for RLS, and it is mostly diagnosed following the description of symptoms from the patient.

All the following symptoms need to be present to reach a definitive diagnosis of RLS.

• Unusual physical feelings accompanied by an uncontrollable desire to twitch

• The urge to move for no reason

• Symptoms are heightened when relaxing or sleeping

• The symptoms alleviate with movement

Sleep Apnea

Disrupted sleep caused by breathing difficulties defines this disorder. The sufferer will often momentarily cease breathing or wake themselves up with a loud gasping sensation or noisy snoring.

This is because the condition is brought on by a lack of oxygen that causes sleep apnea symptoms.

PTSD or post-traumatic stress disorder can lead to serious sleep apnea cases, and veterans and other sufferers of PTSD may experience this disorder.

Obesity and age also play a part in identifying people who are more likely to experience sleep apnea and other sleeping disorders.

There are three types of sleep apnea which are:

1) Obstructive: Physical causes are responsible for this type of sleep apnea. The narrowing of the central airway leads to a lack of oxygen, which leads to disturbed sleep.

2) Central: Unlike obstructive sleep apnea, this is a psychological disorder. There is no physical reason for blocking oxygen, but the brain is failing to send the correct signals to the respiratory muscles to breathe.

3) Mixed: This is a combination of both physical and psychological sleep apneas.

How is Sleep Apnea Diagnosed?

There needs to be a complete physical examination of the patient to establish the factors that can signal this type of sleep disorder.

The head and neck may provide clues to aid the diagnosis, while a complete medical history questionnaire will need to be completed.

Once the medical diagnosis has been established, a doctor will often suggest a series of further tests to give a more detailed idea of the severity of the disorder and the treatments needed to cure it.  

These extensive tests will often require a stay in a hospital or designated sleep clinic so the experts can witness what happens during a full night's sleep. The procedure is called a polysomnogram and includes the following procedures:

EEG or Electroencephalogram

This test monitors brain waves and tells the doctors what kinds of sleep the patient is experiencing. Electrodes will record periods of REM sleep and non-REM sleep.

They will record periods of dreaming, irregular movements, and forms of paralysis during the night and how long the periods lasted.

EMG or Electromyography

This diagnostic procedure reveals any muscle dysfunction or problems with muscle to nerve signals.

Electrodes are attached to the muscles as the patient sleeps and can reveal which areas are affected by pain, cramping, or tingling.

EKG or Electrocardiogram

This 12-lead test is designed to detect the presence of heart disease. Doctors measure the heart’s rate and rhythm and check how healthy the heart is during episodes of sleep apnea.

Pulse Oximetry

When the patient sleeps, a small device measures the amount of oxygen in their blood and how the levels differ during disturbed sleep.

ABG or Arterial Blood Gas

This test can be performed in your doctor's facility or at a sleep clinic. It involves a blood sample being tested to measure certain factors, including levels of bicarbonate and oxygen, the pressure levels created by both oxygen and carbon, and the way these levels affect the quality of sleep.

These tests may seem obtrusive and time-consuming, but they give the experts a bigger picture and help them derive a successful treatment plan.

Less Common Sleep Disorders

Narcolepsy

A very chronic condition with no known cure. There are medications and techniques to help relieve symptoms, but the biggest aid sufferers can have support.

Narcolepsy can strike at any time, and if you have a strong support group, there will always be someone around to help you.

People with narcolepsy will struggle to stay awake no matter what the situation. Narcolepsy can also be accompanied by a condition known as cataplexy that means the sufferer will experience a loss of muscle tone.

This is known as narcolepsy type 1, while other symptoms without the cataplexy are known as narcolepsy type 2.

Other Symptoms of Narcolepsy

• Severe daytime fatigue: Narcolepsy means that sufferers can fall asleep anywhere, anytime, and without warning.

People with the disorder can nod off during a lively conversation, at work, or even while walking. They can sleep for a few minutes or up to 30 minutes at a time.

• Loss of concentration and failure to focus

Cataplexy: This loss of muscle tone can occur during periods of intense emotions like happiness or surprise.

It can cause the person to suffer blurred speech or weakened leg muscles for a period of a few minutes.

Some will experience bouts of cataplexy every day, while others will only experience the symptom a couple of times a year.

Sleep Paralysis: Loss of control and paralysis when falling asleep or waking up is a terrifying symptom of narcolepsy.

People with the disorder report that they are aware of paralysis episodes but are unable to control them.

This type of immobility mimics the natural paralysis that occurs during REM that prevents us from performing dream activities.

Hypnagogic Hallucinations: Narcoleptic sleep can often include these specific types of soporific sightings.

The period between waking and sleeping can be disturbed by visions or sounds that aren't physically there.

People with narcolepsy often see vivid scenarios described as living their dreams, or they may experience the feeling of someone in their bedroom.

Circadian Rhythm Sleep Disorder

Your body is affected by the natural internal clock that makes you feel sleepy at night and alert during daytime hours.

This condition is known as the circadian rhythm and is a critical part of how we sleep. When this rhythm is disturbed, it can lead to different disorders that affect how people sleep.

Based on the characteristics of their sleep, people can be classed into several circadian sleep disorders.

ASP or Advanced Sleep Phase

This disorder is defined by an early bedtime, followed by a wake-up time in the early morning.

For instance, if someone goes to bed between 5 p.m. and 9 p.m. and wakes between 1-2 am. and 5 am, then they can be diagnosed with ASP.

Most people with ASP are older adults, and the condition is exceedingly rare in younger people.

DSPS or Delayed Sleep Phase

It is believed that around 20% of teenagers and adolescents suffer from this sleep disorder.

DSPS is defined by late bedtimes and difficulties waking up on  time.

Non-24 Sleep Disorder

This condition is rare in healthy people and usually affects people with intellectual disabilities or blindness.

People with Non-24 don't have the mental ability to recognize natural sleep cues such as sunlight and darkness.

They will have less conventional sleeping patterns that they find themselves completely at odds with their circadian rhythms.

ISWD or Irregular Sleep-Wake Disorder

This disorder is defined by broken sleep taken during undefined times throughout the day.

People will often sleep three or four separate times during a 24-hour period, and often report being constantly tired.

Kleine-Levin Syndrome

Patients with KLS are often described as childlike, dreamy, and spacey. They will be constantly disorientated and lack normal levels of apathy.

The condition is largely undefined, and a proper diagnosis can take four years. The cause of KLS is unknown, and there is no cure.

Most patients will experience hypersensitivity to light and noise, while others will become aggressive or irritable. Hypersexuality and binge eating are also symptoms of KLS.

Idiopathic Hypersomnia

This is an uncommon sleep disorder that can be difficult to spot. Patients will be excessively sleepy despite having a good night's sleep and can be affected by the need to sleep at any time.

This can cause dangerous scenarios for sufferers, especially when driving or working. The condition is also known as EDS or excessive daytime sleeping and can be extremely debilitating.

Sleep disorders can be misunderstood by people who have no concept of their seriousness.

Patients can often be dismissed as lazy, lethargic, and generally worthless. Relationships can be hard to form as intense emotions trigger some disorders, and some people will withdraw from feelings to try to control their disorders.

Some people with sleep disorders can harm themselves and others when their symptoms appear.

Sleep attacks aren't common, but they are widely misunderstood. If you believe you are suffering from  a sleep disorder, then you must seek a diagnosis and treatment soon.

There is a positive outlook for most people, and sometimes just the most basic of changes will improve your symptoms to help you sleep well.

Abdur Rashid
Medically Reviewed By Abdur Rashid
MSC Public Health, MCSP, MHCPC
BSC (Hon) Physiotherapy
Consultant Neuro-spinal & Musculoskeletal Physiotherapist

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