A sleep disorder is a condition that abnormally affects the quality, duration, or behavior of a person's sleep.
Sleep disorders fall into three general categories: primary sleep disordersdisorders secondary to a mental disorderother sleep disorders, which are related to a medical condition or substance abuse
Primary sleep disorders are caused by some sort of internal disturbance in the sleep-wake cycle. They are categorized as dyssomnias or parasomnias. Dyssomnias involve abnormalities in the amount, quality, or timing of sleep. Common dyssomnias include: circadian rhythm sleep disorder, which involves a resetting of the body's sleep clockhypersomnia, which is sleeping too much and sleeping at the wrong timesnarcolepsy, which involves a sudden, overwhelming need to sleep at all times of the dayprimary insomnia, which is trouble falling or staying asleepsleep apnea, a condition in which breathing stops during sleep
Parasomnias involve unusual behaviors or body events associated with sleep. These include: nightmare disorders, which involve frightening dreamssleep terrors, which involve abrupt awakening and intense fearsleepwalking
Sleep disorders may also be part of a mental disorder, such as anxiety or depression. Other sleep disorders may be caused by medical conditions, such as hormonal imbalances. They may be caused by abuse of substances, such as cocaine or alcohol.
Each sleep disorder has its own characteristic symptoms.
Each sleep disorder has its own causes and risk factors. However, the following things worsen most sleep disorders: alcoholchanges in the sleep schedulechronic illness or paindepression and anxietydrugs, such as caffeine, nicotine, and cocaineexcessive daytime nappingmedicines, such as stimulants, cold medicines, and sleep medicinesa poor sleep environmentevening or night shift workstress
People who are obese have an increased risk of sleep apnea. Narcolepsy and some other sleep disorders are thought to have a genetic component.
Good sleep habits can prevent many cases from developing. Here are some recommendations from sleep experts. Avoid alcohol, caffeine, and other drugs, especially after dinner.Avoid excessive daytime naps. A person should take only one nap a day, if any, and the nap should be less than 1 hour.Do not go to bed unless you are tired.Have a comfortable, dark, quiet sleeping environment.Use the bed only for sex and sleep.Wake up at the same time every morning.
Treatment of any underlying psychiatric condition may prevent some sleep problems from occurring. Weight management may prevent some cases of sleep apnea. Some sleep disorders cannot be prevented.
Diagnosis of a sleep disorder begins with a medical history and physical exam. If an underlying medical condition is suspected, further tests such as blood tests may need to be done.
A sleep study, called a polysomnogram (PSG), may be recommended. This test measures the following body functions during sleep: airflow and respiratory effortblood oxygen levelsblood pressure and heart rateelectrical activity in the braineye movementmuscle movement
A multiple sleep latency test (MSLT) measures the speed of falling asleep. An arterial blood gas test may also be performed to check levels of carbon dioxide and oxygen.
Sleep deprivation can lower a person's quality of life and increase the risk for injuries. Up to 50% of the individuals with sleep apnea have high blood pressure. They are also at increased risk for the following disorders: arrhythmia, or irregular heart rhythm, which may be fatalcor pulmonale, or enlargement and weakening of the right side of the heartheart attackpulmonary hypertension, or high blood pressure in the lungsstroke
Sleep disorders are not contagious and pose no risk to others.
Treatments vary depending upon the specific sleep disorder. Sleep disorder clinics often help people return to normal sleep patterns. Sometimes, sleep disorders go away by themselves. Other times, medicines can be used. For example, sleeping pills, such as zolpidem (i.e., Ambien), zaleplon (i.e., Sonata), temazepam (i.e., Restoril), or eszopiclone (i.e., Lunesta) may be given for insomnia.
The treatment for sleep apnea involves weight loss for obese persons. The healthcare professional may also prescribe a CPAP machine, a special type of breathing machine used during sleep. The treatment of narcolepsy involves the use of powerful stimulant drugs, such as dextroamphetamine (i.e., Dexedrine), or non-amphetamine drugs, such as selegiline (i.e., Eldepryl, Zelapar), methylphenidate (i.e., Ritalin), pemoline (i.e., Cylert), or modafinil (i.e., Provigil) to keep people awake during the day. Other treatments are also used, depending on the disorder.
Some medicines used to treat sleep problems can be physically and psychologically addicting. They may cause daytime drowsiness.
A sleep disorder may return if the person does not continue good sleep habits. If the sleep apnea is improved by weight loss, it is important that the individual keep the excess weight off.
Some treatments, such as the use of a CPAP machine, are usually lifelong. The use of any sleeping medicines should usually only be for a few weeks or less. If the sleep disorder goes away, no further treatment is needed. Some sleep conditions, such as narcolepsy, may need ongoing treatment for prolonged periods of time.
A log can be kept to record how adjustments to lifestyle and medicines have affected a person's sleep. Any new or worsening symptoms should be reported to the healthcare professional.
