The most common clinical difficulties encountered in medicine and psychiatry are sleep disorders. The asleep disease is characterized by sleep problems such as sleeping time, amount, and quality. It can create an atmosphere of distress and dysfunction during the daytime.
A patient’s quality of life can be significantly affected by insufficient or non-restorative sleep. In addition, the sleep disorder can occur due to depression, anxiety, and other analytical changes that should be contended as part of the treatment planning and management process.
Types of Sleep Disorders
The following disorders fall into this category:
- Insomnia
- Hypersomnia
- Narcolepsy
- Breathing related sleep disorders
- Obstructive sleep apnea-hypopnea
- Central sleep apnea
- Sleep-related hypo-ventilation
- Circadian rhythm sleep-wake disorder
- Parasomnias
- Non-rapid eye movement disorder
- Rapid eye movement disorder
- Nightmare disorder
- Restless Legs Syndrome
- Sleep Disorder due to Medication and Drugs
The most commonly observed sleeping disorder includes three of them such as; insomnia, hypersomnia, and Parasomnias, explained below in detail;
1. Insomnia: Causes, symptoms & Treatment
Sleep disorders such as insomnia make it difficult to fall asleep or stay asleep, or they wake you up too early and prevent you from going back to sleep. In some cases, the condition is acute (short term), while in others, it can be chronic (long time), and sometimes it may be intermittent. Acute insomnia is short-term insomnia that lasts for a few days. Chronic insomnia happens at a minimum of 3 nights a week for at least 3 months.
Types of Insomnia
Insomnia can be either primary or secondary;
- Primary Insomnia: In the case of primary insomnia, your medical health is not the reason for your sleep disorder.
- Secondary Insomnia: Secondary insomnia is due to medical conditions (like asthma, depression, arthritis, cancer, or heartburn), pain, medication, or drugs.
Causes of Insomnia
Primary causes of insomnia are:
- A stressful life event such as losing or changing a job, losing a close personality, getting divorced, or shifting a place.
- Environments such as noise, light, or temperature
- Having adjustment to a new sleep schedule
- Many sleep disorders are inherited, like insomnia
Secondary causes of insomnia
- Anxiety and depression
- Sleep problems such as bed sores
- Intake of caffeine, tobacco, alcohol
- Problems with the endocrine system, including hyperthyroidism
- Sleep problems like sleep apnea and restless legs syndrome
- During pregnancy
- Dementia, including Alzheimer’s disease
- ADHD
- Premenstrual syndrome and menopause
Symptoms of Insomnia
Insomnia can depict the following symptoms:
- Daytime sleepiness
- Exhaustion
- Stubbornness
- Memory or concentration problems
Treatment of Insomnia
Acute insomnia may not need treatment. However, a short-term prescription of sleeping pills may be prescribed by your doctor if you can’t do everyday activities due to fatigue. Don’t take sleeping pills for insomnia without a prescription. Fast-acting but brief-acting medications may prevent problems such as drowsiness the next day.
In the case of persistent insomnia, you may need a cure for the underlying causes that make you unable to sleep. However, these treatments might have a reaction and work ineffectually over time. Therefore, your physician may also recommend behavioral therapy. By doing this, you will be able to change your habits that cause insomnia and learn about what you can do to prevent it.
Preventions of Insomnia
Sleep hygiene, which is also known as good sleep habits, can help you recover from insomnia. Following are a few tips:
- Wake up at a fixed time every morning and sleep simultaneously every night. Avoid taking naps during the day.
- Avoid using electronic devices before bed. The light they emit can keep you awake.
- Limit the use of caffeine and nicotine because they are stimulants, making it difficult to fall asleep.
- Exercise regularly but avoid working out right before going to bed because it may make it difficult to sleep. Instead, experts recommend exercising 3 to 4 hours before bedtime.
- Eat light dinner before going to bed.
- Comfortable sleep requires a dark, quiet bedroom and an appropriately chilly or warm temperature.
2. Hypersomnia: Causes, Symptoms, and Treatment
Hypersomnia is a sleep disorder that causes extreme daytime sleepiness despite getting adequate (or more than sufficient) sleep at night. A person with hypersomnia falls asleep several times during the day. It interferes with your ability to function at work and socially degrades your quality of life, and increases your risk of accidents.
Types of Hypersomnia
There are two types of hypersomnia as insomnia primary and secondary;
- Primary Hypersomnia: In the case of primary hypersomnia, your health condition is not the reason for a sleep disorder.
- Secondary Hypersomnia: Secondary hypersomnia refers to excessive sleepiness caused by other factors like depression, bipolar disorder, obstructive sleep apnea, epilepsy, hypothyroidism, etc.
Causes of Hypersomnia
The cause of hypersomnia is not known in most cases. However, there has been considerable research on the potential roles of neurotransmitters in the brain and cerebrospinal fluid, such as gamma-aminobutyric acid (GABA), dopamine, histamine, serotonin, and hypocretin/orexin.
Up to 39% of persons with idiopathic hypersomnia have a family background of the disorder. Researchers are also investigating whether specific genes play a role in circadian rhythm that may differ among individuals with idiopathic hypersomnia.
Symptoms of Hypersomnia
Hypersomnia has the following signs and symptoms:
- Extreme sleepiness throughout the day is continuous and recurrent.
- Sleeping for longer than average (at least 10 hours) but still feeling extremely sleepy during the day and having difficulty staying awake.
- The inability to wake up in the morning (“sleep drunkenness”) or appearing confused or combative after daytime naps.
- A daytime nap doesn’t improve alertness. They are not refreshing or restorative.
- Irritability and anxiety
- Feeling fatigued
- Inability to think, speaking slowly, and having trouble focusing.
- Dizziness
- Anorexia
- Delusions
Treatment of Hypersomnia
The treatment for hypersomnia depends on what’s causing it. It may involve medication or a lifestyle change.
Medications
Hypersomnia can also be treated with various drugs prescribed by your doctor.
Some of these include:
- Medications stimulate the central nervous system, such as methylphenidate, modafinil, and Ritalin.
- There are various antidepressants, including citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).
- Several medicines are used to treat the excessive sleeping behavior of narcolepsy, including pitolisant (Wakix), sodium oxybate (Xyrem, Xywav), and solriamfetol (Sunosi).
- IH with sodium, magnesium, potassium, and calcium oxybates (Xywav) can also be used.
Lifestyle Changes:
You should maintain a healthy sleeping pattern. These things are establishing a regular sleep schedule, creating an environment conducive to sleep (cool, dark room; comfortable pillows and bed), and limiting caffeine and exercise before bedtime.
3. Parasomnias: Causes, Symptoms, and Treatment
A parasomnia is an unusual or undesirable incident, event, or experience that disturbs your sleep. Parasomnias occur during sleep, before sleeping, or when waking from asleep. You might move abnormally, talk abnormally, or act unusually if you have parasomnia. For example, your bed partner may believe you are awake but sleeping.
Types of Parasomnia
There are usually four types of parasomnia;
- Non-rapid eye movement sleep
- Rapid Eye movement sleep
- Nightmares
- Restless legs syndrome
- Non-Rapid Eye Movement Sleep: Non-rapid eye movement sleep arousal is distinguished by recurring periods of incomplete waking involving behaviors such as sleepwalking and sleep terrors during sleep.
- Rapid Eye Movement Sleep: The Rapid Eye Movement (REM) sleep disorder is defined by physical actions during sleep. The dreams are vivid, often unpleasant, and contain vocal sounds. Moreover, it usually involves violent movements of the arms and legs during REM sleep.
- Nightmares: A vivid dream that causes a perception of fear, terror, or anxiety. You might feel threatened or in danger. It is usually difficult to fall asleep again after experiencing suffering. Sleep disorders mainly occur when you’re stressed or have a traumatic event, ill/fever, tired, or after taking drugs.
- Restless Legs Syndrome: RLS (restless legs syndrome) is marked by an uncontrollable desire to move the legs triggered by discomfort. It usually happens when you’re sitting or lying in the evening or night. Moving relieves the discomfort.
Causes of Parasomnia
Parasomnias can be classified as disturbances of sleep or as general health issues that are caused by the following factors;
Disrupt Sleep Pattern
- Sleep transition is incomplete when a person is awake.
- Sleep deprivation, irregular sleeping patterns (jet lag, shift work).
- Medications to treat sleep disorders, depression, psychotic disorders, hypertension, seizures, asthma, allergies, and infections.
- A disorder disrupts sleep, such as restless leg syndrome, obstructive sleep apnea, pain, narcolepsy, sleep distress, circadian rhythm disorder, etc.
- The sleep-wake cycle is not mature in kids with parasomnias.
Health Issues
- Fever
- Stress
- Alcohol/ drugs
- Pregnancy
- Head injury
- Hereditary
Symptoms of Parasomnia
There are various types of parasomnia, and each style has its features. Some of the symptoms are:
- Don’t be able to sleep at night.
- Feeling unfresh when you wake up.
- Tired throughout the day.
- Not being able to recall the cause of cuts or bruises found on your body.
- Your bed partner describes movements, expressions, vocalizations, or activities you do not remember.
Treatment of Parasomnia
The treatment for parasomnia begins with;
- Analysis and curing of any other sleep problems or other health conditions.
- Reviewing medications that might trigger parasomnias.
Non-REM and REM sleep disorders can be managed in the following ways:
- Practice good sleep habits and get 7-9 hours of sleep every night.
- Avoid strenuous exercise close to bedtime.
- Maintain a regular sleeping and waking schedule. Make sure you wake up and go to bed simultaneously every day.
- Restrict the use of alcohol.
- Take your medication as per your doctor’s advice.
References:
- https://www.webmd.com/sleep-disorders/insomnia-symptoms-and-causes#:~:text=Insomnia%20is%20a%20sleep%20disorder,for%203%20months%20or%20more retrieved on March 18, 2022.
- https://my.clevelandclinic.org/health/diseases/21591-hypersomnia#:~:text=Hypersomnia%20is%20a%20condition%20in,several%20times%20during%20the%20day retrieved on March 18, 2022.
- https://www.webmd.com/sleep-disorders/hypersomnia-treatments#:~:text=Your%20doctor%20can%20also%20prescribe,Paxil)%2C%20sertraline%20(Zoloft) retrieved on March 18, 2022.
- https://my.clevelandclinic.org/health/diseases/12133-parasomnias–disruptive-sleepdisorders#:~:text=A%20parasomnia%20is%20a%20sleep,emotions%20or%20do%20unusual%20things retrieved on March 18, 2022.
