Insomnia, sleep apnea, restless legs -- learn who’s at risk for sleep problems, signs you might have one, and where to get help.
What
Are Sleep Disorders?
Sleep disorders are conditions that
affect how much and how well you sleep. The causes range from poor habits that
keep you awake to medical problems that disrupt your sleep cycle. If you don't
feel rested in the mornings, see your doctor. Insufficient sleep is a serious
problem that poses a threat to your health and safety.
The
Dangers of Poor Sleep?
Lack of sleep can take a toll on
nearly every aspect of daily life. Research has linked sleep deprivation to car
accidents, relationship troubles, poor job performance, job-related injuries,
memory problems, and mood disorders. Recent studies also suggest sleep
disorders may contribute to heart disease, obesity, and diabetes.
Symptoms
of Sleep Disorders
Symptoms vary depending on the type
of sleep disorder but may include:
- Excessive sleepiness during the day
- Trouble falling asleep or staying asleep
- Snoring or brief pauses in breathing during sleep
- Urge to move your legs at rest or an uncomfortable feeling in the legs at night
The
Sleep Cycle
·
There are two forms of sleep: REM
sleep and non-REM sleep. REM stands for rapid eye movement and is associated
with dreaming. It accounts for 25% of normal sleep, coming in longer periods
toward morning. The rest of our sleep time is spent in NREM, which consists of four
stages from light sleep (stage 1) to deep sleep (stage 4). Sleep disorders
interfere with normal sleep cycles, preventing a good night's rest.
How Much Sleep Is Enough?
Sleep needs vary widely from person to person, but general guidelines are:- 16 hours for infants
- 9 hours for teenagers
- 7-8 hours for adults
Insomnia
Most people have trouble sleeping
once in awhile, but when the problem lingers night after night you may have
insomnia. People with insomnia may lie awake for hours before falling asleep.
They may wake up too early and be unable to drift off again. Or they may wake
up repeatedly throughout the night. Insomnia is the most common sleep disorder
in the U.S.
Insomnia
and Sleep Hygiene
In many cases, insomnia is related
to poor sleep hygiene. This refers to bad habits that interfere with sleep.
Examples include drinking coffee in the afternoon or evening, smoking or eating
heavy foods before bed, going to bed at a different time each night, or falling
asleep with the television or lights on.
Insomnia
and Mental Health
Mental health problems can lead to
insomnia. These include depression, anxiety, and posttraumatic stress disorder.
Unfortunately, some of the medications used to treat these conditions may also
cause sleep problems. If you suspect your medication is disrupting your sleep,
talk to your doctor about adjusting your treatment.
Insomnia
and Medical Conditions
Insomnia is often related to medical
problems, including:
- Arthritis
- Heartburn
- Chronic pain
- Asthma
- COPD
- Heart failure (due to breathing problems)
- Thyroid problems
- Neurological disorders, such as stroke, Alzheimer's or Parkinson's
Other Causes of Insomnia
·
Insomnia can occur during pregnancy, especially
in the first and third trimesters. The problem may return during menopause,
when hot flashes can interrupt a good night's sleep. Both men and women tend to
have more sleep problems over age 65. And shift workers and frequent fliers can
develop a circadian rhythm disorder. In this case, a sort of "internal
body clock" that controls sleep, hormone production, and other body
functions is disturbed.
Sleep
Apnea
People with this sleep disorder have
episodes when they stop breathing many times while they sleep. The breathing pauses
last several seconds and trigger a switch from deep sleep to light sleep. These
interruptions can lead to daytime sleepiness. Many people with sleep apnea
don't know they have it. Snoring is a common warning sign, and a spouse may
notice breathing pauses followed by a snort or gasp.
Risk
Factors for Sleep Apnea
Sleep apnea is most common in people
who are male, overweight, and over age 65. Hispanics, African-Americans, and
Pacific Islanders also have a higher risk of developing the condition. While it
is more common in adults, sleep apnea sometimes occurs in young children who
have enlarged tonsils.
Restless
Legs Syndrome
People with restless legs syndrome
experience discomfort and the urge to move the legs at rest. The problem is
usually at its worst during the evening and night. This can make it tough to
fall asleep. Others experience twitching motions during sleep that may cause
brief awakenings.
Narcolepsy
Narcolepsy causes extreme sleepiness
during the day. People may find it hard to function without naps, despite
spending enough time in bed at night. Other warning signs include:
- Being unable to move when you first wake
- Losing muscle control with strong emotions
- Dreaming during naps
- Dream-like hallucinations as you fall asleep or wake up
People with narcolepsy enter REM
sleep almost immediately, without the NREM sleep stages that normally lead up
to dream sleep.
Sleepwalking
People with this sleep problem can
literally get up and walk while they are sleeping. The episodes occur during
the deeper stages of NREM sleep, and the person may do a variety of activities
without waking up. Sleepwalkers typically don't respond to questions and won't
remember what they did once they wake up. Sleepwalking is most common in
children but can last into adulthood.
When
to Call the Doctor
There are steps you can take to
fight sleep disorders on your own, but some situations require medical
attention. Call your doctor if you snore loudly or gasp during sleep, if you
think a medical condition or medication is keeping you up at night, if you're
tired all the time or if you fall asleep during daytime activities.
Sleep
Diary
Charting your habits for 1-2 weeks
can provide valuable information. Include:
- When you go to bed, fall asleep, and wake
- How long and well you slept
- Time awake during the night
- Caffeine or alcohol consumed and when
- What/when you ate and drank
- Emotion or stress
- Drugs or medications
Diagnosing Sleep Disorders
·
To diagnose a sleep disorder, your doctor will
ask about your sleep habits and medical conditions. Next, you may be referred
to a sleep clinic for testing. A polysomnogram, also called a sleep study,
records brain activity, eye movements, and breathing while you sleep. These
patterns can indicate a disorder like sleep apnea or a less common type.
Research has identified more than 85 sleep problems, including sleep terrors,
REM sleep behavior disorder, and sleep starts.
Treating
Sleep Disorders
For sleep apnea, a CPAP device
increases air pressure to keep airways open so you can rest more soundly
without the breathing pauses that interrupt sleep. Narcolepsy and restless legs
syndrome can be treated with lifestyle changes and prescription medication.
There are also effective medications for insomnia. However, many people can
beat insomnia without medication by changing poor sleep habits and taking care
of related conditions.
Cognitive-Behavioral
Therapy
Several methods can ease sleep
anxiety, which makes insomnia worse. Relaxation training and biofeedback help
to calm your breathing, heart rate, muscles, and mood. Talk therapy can
help replace bedtime worries with positive thinking, so your mind can settle
down at night. Cognitive behavioral therapy (CBT) works as well as prescription
drugs for many people with chronic insomnia.
Sleep
Hygiene: Exercise
Adopting habits that promote sleep
is known as good sleep hygiene. Regular exercise should be part of the plan,
but the timing is important. Exercise in the late afternoon can make it easier
to fall and stay asleep – just don't let it get too late. Exercise within a
couple hours of bedtime can make it harder to fall asleep.
Problem
Foods
Certain foods and drinks should be
avoided in the 4-6 hours before bed:
- Caffeine, including coffee, tea, and soda
- Heavy or spicy foods
- Alcohol (While alcohol helps some people fall asleep, it leads to nighttime awakenings.)
Helpful Foods
·
A light evening snack of complex carbs and
protein can lead to better sleep. Cereal with milk or crackers and cheese fit
the bill, but they should be eaten at least an hour before bed. Warm milk and
chamomile tea raise body temperature and make many people feel sleepy.
Television
·
Late-night television may be part of your
routine, but chances are it is not helping you sleep. Television engages the
mind and can increase alertness, keeping you awake. Playing video games before
bed or surfing the Internet may have the same effect. The National Sleep
Foundation recommends removing televisions and computers from your bedroom
altogether.
Bedtime Rituals
·
You can signal your mind and body that it's time
for sleep by creating a bedtime ritual. This may include a warm bath, reading a
chapter of a book, or practicing relaxation techniques, such as deep breathing.
It's also important to stick to a firm bedtime and wake-up time, even on the
weekends. If you still have trouble sleeping despite improving your sleep
hygiene, check with your doctor.
Source: Web MD
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