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What is a Sleep Disorder?
A sleep disorder is defined as any condition that results in disrupted or abnormal sleeping patterns. There are numerous categories and sub-types of sleep disorders.
These disorders are classed according to how they manifest and the underlying cause. Lifestyle factors, diseases, and genetics can play a role in the development of sleep disorders.
Anyone can develop a sleep disorder. Health consequences can range from mild to severe, depending on the specific type. (1)
Symptoms
You will spend about one third of your life sleeping. The average adult should be getting approximately eight hours of sleep a night.
Although the exact mechanisms of sleep are not fully understood, it is established that sleep is vital for our survival.
Sleep is an active process during which restoration, strengthening, and processing occur throughout your body.
While you are asleep, you will progress through four stages. These involve non-rapid eye movement (NREM) sleep and rapid-eye movement (REM) sleep.
Your brain waves grow slower with increased amplitude (wave vibrations) as you progress through the stages. The first and second stages consist of NREM sleep, which is lighter.
Stages three and four are REM sleep, also known as “deep” sleep. It is difficult to wake a person up from REM sleep, particularly in stage four (2)
A sleep disorder will usually cause a disruption to the the sleep cycle, and can impact the progression through these stages.
The symptoms of a sleep disorder can include one or more of the following: (3)
Difficulty Sleeping
Anyone can have trouble falling asleep on occasion. However, if you are consistently having difficulty getting to sleep, you may have a sleep disorder.
This symptom can also manifest as an inability to stay asleep. You may wake up frequently during the night, and be unable to fall back asleep.
Excessive Daytime Sleepiness
Feeling constantly sleepy during the day is not normal. You may have a disorder that can disrupt your sleep without waking you up, such as sleep apnea.
Unusual Sleeping Hours
If you find yourself sleeping at odd hours, this could indicate a sleep disorder. You might find it hard to sleep at conventional hours (e.g. at night), or sleep in several episodes over 24 hours.
Abnormal Events While Sleeping
Sleep related movement disorders (SRMDs) can result in abnormal behaviors while you are asleep. This includes walking, eating, or night terrors.
If you wake up outside of your bed, or awaken with injuries (e.g. bruises) you may have an SRMD. Your family members or roommates may also alert you of unusual sleep behavior.
Stages
A sleep disorder does not generally progress through stages. However, according to the International Classification of Sleep Disorders, there are 90 different types which fall into specific categories.
How these conditions develop depends on multiple factors. The underlying cause of the disorder (e.g. illness, jet lag, etc) and the affected person’s health play a role. (4)
Each disorder can be broadly classified according to how it impacts sleep. They can be acute or chronic, and symptoms can range from mild to severe.
The categories of sleep disorders are as follows:
Insomnia
Insomnia usually manifests as difficulty staying or falling asleep. It can be provoked by physical or psychological causes, such as disease or anxiety.
It may take you a long time to fall asleep. You may also wake up frequently throughout the night, and be unable to get back to sleep. (5)
Hypersomnias
Hypersomnias are conditions that result in excessive sleepiness. The sleepiness can impair your daily activities, and is not relieved by getting more sleep.
These disorders can be primary or secondary. Primary hypersomnias are syndromes such as narcolepsy, which causes you to fall asleep suddenly without warning.
Secondary hypersomnias are caused by underlying conditions, such as a physical or psychological ailment. (6)
Parasomnias
Parasomnias are conditions which cause abnormal physical behaviors during sleep. These can include sleepwalking, sleep paralysis and sleep eating.
Sleep terrors (or night terrors) are also a type of parasomnia. These disorders can result in injury to the sleeper, as they are unaware of their activities. (7)
Sleep Related Movement Disorders (SRMDs)
These are disorders that cause involuntary movements during sleep. These movements are typically repetitive and rhythmic.
Your arms or legs may twitch during sleep, or you might experience cramps. These involuntary motions can wake you up, or make it difficult to fall back asleep. (8)
Sleep Related Breathing Disorders (SRBDs)
Sleep related breathing disorders (SRBDs) impact your breathing while you sleep. Your breathing can be reduced or stop entirely as you sleep.
SRBDs are one of the main causes of excessive daytime sleepiness. There are three disorders in this category.
These include sleep apnea (obstructive or central), and sleep related hypoventilation syndrome (SRHS). (9)
Circadian Rhythm Sleep Disorders
Your circadian rhythm is the internal clock that dictates when you sleep and wake up. This disorder affects your natural sleep cycles.
For example, you may sleep over three or four periods across 24 hours rather than one. Alternately, you may wake up at odd hours.
CRSDs can be caused by external circumstances, such as traveling to a different time zone (jet lag). They can also be intrinsic, meaning there is a problem with your internal clock itself. (10)
Treatment
Sleep disorders can be diagnosed through a description of your symptoms. However, your doctor may also recommend you undergo a sleep study.
A sleep study will allow your doctor to monitor what happens when you sleep. It is typically performed for suspected breathing and movement related sleep disorders.
You will be required to spend the night in a sleep clinic. A comfortable, dark room will be prepared for you to sleep in.
Before you sleep, electrodes and sensors will be placed on your body and head. These devices will measure your blood oxygen, eye movements, breathing and heart rate.
Your brain waves will also be monitored through an electroencephalogram (EEG). The results can help to determine potential causes and treatment of your sleep disorder. (11)
The treatment for a sleep disorder can include one or more of the following options: (12)
Addressing Underlying Conditions
Your sleep disorder can be a symptom of an underlying condition. Your doctor will assess if you have a psychiatric or physical ailment.
Treatment for the specific condition – e.g. antidepressants for depression – can in turn alleviate the sleep disorder.
If you have a sleep-related breathing disorder (SRBD), you may be prescribed a breathing device.
Alternatively, surgery to correct a respiratory abnormality may be performed.
Good Sleep Hygiene
Sleep hygiene are habits you can implement to improve your sleep. This involves
avoiding stimuli and practices that can worsen a sleep disorder.
Try to restrict stimulants (e.g. caffeine) towards late afternoon. Set a regular schedule for sleeping and waking up.
Learn to associate your bedroom with sleep instead of activities like eating or watching television. Your doctor may also recommend practicing meditation or other techniques to relieve stress.
Cognitive Behavioral Therapy (CBT)
In some cases, sleep disorders can be caused by anxiety or behavioral issues. For example, a strong fear of waking up late can result in disrupted sleep.
Some individuals exacerbate the disorder by developing negative or unhealthy associations with sleep.
Cognitive behavioral therapy (CBT) aims to gradually change behavior and thoughts over time.
A therapist will work with you to develop strategies to reduce poor sleep behaviors.
Medications
Some sleep disorders require medications to reduce symptoms. Anticonvulsants may
be recommended to a person with a severe sleep related movement disorder (SRMD).
For individuals with hypersomnia, stimulants may be prescribed to help them stay awake. Sedatives can help with chronic insomnia, but carry a risk of rebound insomnia
once treatment stops.
The risks and benefits of any potential pharmacological intervention will be detailed by your doctor.
FAQ
What is a sleep disorder? A sleep disorder is any condition that impacts normal sleep patterns or results in abnormal sleeping behaviors.
What are the signs of a sleep disorder? Signs of a sleep disorder can include difficulty sleeping, excessive daytime sleepiness, and unusual sleeping hours. You may also experience or be alerted to abnormal behaviors while asleep.
How do you develop a sleep disorder? A sleep disorder can be caused by physical, lifestyle, or psychological factors. Certain diseases can also cause a sleep disorder.
How are you diagnosed for a sleep disorder? Some sleep disorders can be diagnosed based on a description of your symptoms. Others may require that you spend a night in a sleep clinic for observation.
What is the best treatment for sleep disorder? Treatment for a sleep disorder can include addressing underlying conditions, practicing sleep hygiene, and cognitive behavioral therapy (CBT). Medications may also be prescribed.
What are the long term complications of a sleep disorder? A chronic lack of sleep can increase your risk of heart disease, obesity and diabetes. (13)
Is a sleep disorder considered a disability? Certain sleep disorders qualifiy as disabilities. If your doctor can prove that you have chronic insomnia which impairs your ability to function, you may be eligible. A severe sleep related breathing disorder can also be classed as a disability. (14, 15)
Is there any cure for a sleep disorder? Certain disorders, such as jet lag, can resolve themselves. Other disorders such as narcolepsy are incurable. (16, 17)
Is a sleep disorder life threatening? Long term sleep deprivation significantly heightens your mortality risk. You are also at an increased risk of potentially fatal injury or accident due to sleep deprivation. (18, 19)
Summary
Sleep deprivation can have severe impacts on your health. Even short term sleep loss can impair your ability to function during the day.
Lifestyle factors, such as night shift work, lengthy work hours and poor sleep hygiene can heighten your risk of developing a sleeping disorder.
If you suspect you have a sleep disorder, consult your doctor. It is important to seek treatment as early as possible to reduce the risks of long term sleep deprivation. (20)