Learning about Sleep Problems

Sleep disorders are medical conditions that make it hard for people to sleep normally, which affects the quality, length, and timing of their sleep. These conditions can have significant effects on both mental and physical health.

Some common sleep disorders are 

Insomnia: When you have trouble falling asleep or staying asleep.

• Restless Legs Syndrome (RLS): A strong need to move the legs that can’t be stopped, usually at night.
• Narcolepsy is a long-term neurological disorder that makes it hard for the brain to control sleep-wake cycles, which makes people very sleepy during the day.
• Sleep apnea is a serious condition in which breathing stops and starts repeatedly during sleep.

Sleep disorders can cause more than just tiredness. They can also make it hard to concentrate, change your mood, and hurt your long-term health. Fortunately, many ways exist to treat these problems and get better sleep.

What Are Sleep Problems?

Sleep disorders are medical conditions that make it hard to get enough sleep and stay awake at the correct times. Healthcare professionals have identified more than 80 unique sleep disorders that impact three essential components of sleep:

Sleep quality: how deep and restorative sleep is

Sleep timing: The ability to fall asleep and stay asleep all night

Sleep duration: The total amount of time spent sleeping and awake

It is normal to have trouble sleeping from time to time, but if someone has trouble sleeping all the time, feels tired during the day even though they get enough sleep, or has difficulty doing everyday tasks, they may have a sleep disorder.

ICSD-3R Categories for Sleep Disorders

The International Classification of Sleep Disorders, Third Edition, Revised (ICSD-3R) classifies sleep disorders according to symptoms, pathophysiology, and impacted bodily systems. The six main groups are:

1. Sleep Disorders

Characterized by ongoing challenges in initiating or sustaining sleep, leading to daytime dysfunction.

2. Breathing Problems That Happen While You Sleep

Conditions characterized by atypical respiratory patterns during sleep encompass sleep apnea syndromes.

3. Central Disorders of Hypersomnolence

Conditions that lead to excessive daytime sleepiness despite sufficient nocturnal rest.

4. Sleep-Wake Disorders Related to Circadian Rhythm

When the body’s internal biological clock doesn’t match the times you want to sleep and wake up.

5. Parasomnias

Behaviours, movements, or experiences that are not normal happen during sleep transitions or stages.

6. Movement Disorders Related to Sleep

Conditions characterized by repetitive movements or urges to move that interfere with the onset or maintenance of sleep.

Common Types of Sleep Problems

Main Sleep Disorders

Chronic Insomnia: The most common sleep disorder, it makes it hard to fall asleep for at least three months, three or more nights a week.

Obstructive Sleep Apnea (OSA): A breathing problem that causes repeated blockages in the airway while you sleep, which makes your sleep less restful and lowers your oxygen levels.

Restless Legs Syndrome (RLS): A neurological disorder causing uncomfortable sensations in the legs and an irresistible urge to move them, particularly during rest periods.

Narcolepsy is a long-term neurological disorder that makes it hard for the brain to control sleep-wake cycles. This causes people to feel very sleepy during the day and have sudden sleep attacks.

Problems with Circadian Rhythm

Shift Work Sleep Disorder: A condition that affects people whose work schedules don’t match their body’s natural circadian rhythms.

Delayed Sleep Phase Syndrome: a condition in which sleep onset occurs much later than regular bedtimes, making it hard to get up for morning obligations.

Disorder of Behaviour During REM Sleep

A parasomnia characterized by the physical enactment of dreams during REM sleep may lead to injury for the individual or their bed partner.

Sleep Needs and Suggestions

Sleep is necessary for good physical and mental health. The American Academy of Sleep Medicine and the Sleep Research Society say:

• Adults (18 to 64 years old): 7 to 9 hours of sleep a night
• Adults over 65: 7–8 hours of sleep per night
• Teenagers should sleep 8 to 10 hours a night.
• Depending on age, kids need 9 to 11 hours of sleep each night.

How common are sleep disorders?

A large number of people have sleep disorders:

• More than 50 million Americans have been told they have sleep problems.
• More than 100 million Americans say they don’t get enough sleep.

Sleep disorders contribute significantly to healthcare costs and reduce productivity.

• Signs of a sleep disorder: When to see a doctor

Symptoms at Night

• Sleeping for more than 30 minutes every night
• Waking up often at night and having trouble going back to sleep
• Breathing problems while sleeping, like snoring, gasping, or choking
• Unpleasant feelings that need to be moved to feel better
• Sleep paralysis when you wake up

Symptoms that happen during the day

• Constant daytime sleepiness even after getting enough sleep
• Unintentional napping or microsleep occurrences
• Cognitive impairment, encompassing challenges in attention and concentration
• Mood swings, irritability, and problems with controlling emotions
• Lower performance in school or at work
• Higher chance of accidents and safety issues

When to See a Doctor

People who have trouble sleeping all the time or have daytime symptoms that make it hard for them to do their daily tasks should see a qualified healthcare professional for an evaluation. Getting diagnosed and treated for sleep disorders early can significantly improve your quality of life, lower your health risks, and make you feel better overall.

Sleep medicine specialists can do thorough evaluations, including sleep studies when needed, to diagnose different sleep disorders and create individualized treatment plans correctly.

Understanding the Real Reasons Behind Sleep Disorders

When your body’s natural circadian rhythm is disrupted, it can lead to sleep disturbances. This is the cycle that controls when you sleep and when you wake up. Many things can cause these conditions, and the root causes can be different for each type of diagnosed sleep disorder.

The main things that cause sleep disorders

Many things can cause sleep disorders, such as:

Medical Conditions: Long-term health problems like cardiovascular disease, asthma, chronic pain syndromes, and neurological disorders often make it hard to sleep.

Mental Health Disorders: Psychological conditions, especially depression and anxiety disorders, are closely linked to disruptions in sleep patterns.

Genetic Predisposition: Genetic mutations and hereditary factors can make people more likely to get certain sleep disorders.

Side Effects of Medications: Some prescription and over-the-counter drugs can make it hard to sleep, usually.

Occupational Factors: Working at night or on a schedule that isn’t regular can mess up the body’s natural sleep-wake cycle.

Using drugs: Taking stimulants like caffeine or depressants like alcohol, especially before bed, can make sleep worse.

Neurochemical Imbalances: A lack of essential brain chemicals and minerals that control sleep can lead to sleep problems.

Idiopathic Cases: Sleep disorders sometimes happen without an apparent reason.

Things that make you more likely to get a sleep disorder

Who Is Most Likely to Get It?

There are a few demographic and lifestyle factors that make it more likely that someone will develop sleep disorders:

• Pre-existing Health Conditions: People with long-term medical problems are at a higher risk.
• High Stress Levels: Long-term stress has a significant effect on how well and how long you sleep
• Shift Work: Working late at night or on rotating shifts messes up your body’s natural circadian rhythms.
• Family History: Genetic predisposition is a contributing factor, with family history as a notable risk element.
• Gender: Studies show that women are more likely than men to have sleep problems.
• Age: About half of adults over 65 have some sleep disorder.

Health Effects of Not Getting Enough Sleep

• Immediate Effects of Not Getting Enough Sleep
• Not getting enough sleep can cause more than just daytime tiredness. It can also lead to:
• Cognitive impairment: Trouble with learning, remembering things, and making decisions
• Changes in mood: more irritability and changes in personality
• Slower reflexes make it more likely to have an accident

Long-Term Health Problems

Chronic sleep deprivation leads to the emergence of severe health conditions, including:

• Clinical depression
• Obesity and metabolic conditions

Type 2 diabetes mellitus

• Heart disease
• Dementia and other neurodegenerative diseases

In rare instances, specific sleep disorders may evolve into life-threatening conditions necessitating prompt medical intervention.

Diagnosis and testing for sleep disorders

A full diagnostic approach

Healthcare providers use a multifaceted approach to determine what sleep disorders someone has. They start with:

• Physical Examination: A complete evaluation of symptoms and medical history
• Laboratory Testing: Blood tests and imaging tests to find out if there are any underlying health problems
• Sleep Diary Documentation: Patients keep detailed records of how they sleep.

What You Need for a Sleep Diary

A complete sleep diary should include:

• You should record the time you go to bed and fall asleep.
• Times to wake up and sleep for
• Naps during the day

Mood and energy levels before and after sleep

Professional Tip: Keep writing tools by your bed to ensure you write things down correctly. Wearable devices or actigraphy monitors can provide objective information about your sleep-wake cycles.

Testing for Advanced Diagnostics

For complicated cases, primary care doctors may send patients to sleep medicine specialists for:

Polysomnography (Sleep Study): This thorough overnight test records brain activity, heart rate, breathing patterns, and other bodily functions while you sleep. Sleep specialists look at this information to determine what kind of sleep disorder someone has.

Sleep disorders should be diagnosed and treated as soon as possible to avoid long-term health problems and improve quality of life.

Questions Your Healthcare Provider Might Ask

Your provider may ask you several questions during your appointment to find out how well you sleep, such as:

• How many hours of sleep do you usually get each night?
• Do you have trouble sleeping, like tossing and turning?
• How often and for how long do you sleep?
• How long does it usually take you to fall asleep?
• Do you wake up in the middle of the night?
• Do you work at night or have a schedule that isn’t always the same?
• How sleepy do you feel during the day?

Do you snore, or has someone told you that you do?

A sleep specialist will see you.

If your doctor thinks you have a sleep disorder, they might send you to a sleep specialist. A sleep specialist is a doctor who has received a lot of training in diagnosing and treating problems related to how sleep affects the body.

How to Handle and Treat Sleep Disorders

There are many ways to treat sleep disorders; the best one for each person depends on their specific condition and needs.

What do doctors do to treat sleep disorders?

Some common ways to treat the problem are  :

• Changes to your behaviour and lifestyle: Changing how you sleep to help you stick to a regular schedule and improve your sleep hygiene.
• Cognitive Behavioural Therapy for Insomnia (CBT-I) is a structured program that helps you find and change the thoughts and actions that make it hard to sleep.
• Pharmacotherapy is the use of drugs (like sleeping pills or wakefulness-promoting agents) or supplements (like melatonin) to help with symptoms.
• Medication Adjustment: Changing the dose or time of day you take medications might make you too sleepy. Please don’t stop taking any medicine your doctor has told you to take without first talking to them.
• A CPAP (Continuous Positive Airway Pressure) machine or an implantable neurostimulator can treat conditions like sleep apnea.
• Light therapy is when you expose your body to specific wavelengths of light to help it keep track of time.

Your provider will suggest a treatment plan and discuss possible side effects based on your diagnosis.

What drugs help with sleep problems?

Your doctor may suggest medications or supplements based on your diagnosis, such as:

• Melatonin, zolpidem, zaleplon, eszopiclone, ramelteon, suvorexant, lemborexant, or doxepin can help with insomnia.
• Gabapentin, gabapentin unacerbic, or pregabalin are some of the drugs that can help with Restless Legs Syndrome (RLS).
• Stimulants or wake-promoting drugs like modafinil, armodafinil, petulant, mixed amphetamine salts, sodium oxybate, or solarimeter are used to treat narcolepsy.
• Better sleep hygiene means better sleep quality.

Your doctor may suggest that you work on your sleep hygiene, which is the things you do that help you sleep well. Some crucial suggestions are:

• Make your bedroom the best place to sleep by keeping it calm, quiet, and dark. Consider using “white noise” machines, earplugs, blackout curtains, or a sleep mask to keep things from bothering you.
• Before you go to bed, try to lower your stress levels. One way to do this is to make a to-do list earlier in the evening. It can also help to be mindful and have a positive attitude.
• Don’t watch TV, use your phone, eat, or work in bed. Instead, make your bed a place for sleep and intimacy.
• Set a regular bedtime routine: do things that help you relax before bed, like taking a warm bath, listening to calming music, reading a book, or doing relaxation exercises. Try to get up simultaneously every day, even on weekends.
• Don’t Look at the Clock: To stop worrying about being unable to sleep, turn your clock away. If you can’t fall asleep after 20 minutes, get out of bed and do something quiet and screen-free until you feel sleepy.
• Get some exercise every day: Regular exercise can help you sleep better. If you have trouble sleeping, though, don’t do any strenuous exercise for four hours before you go to bed.
• Make your bedroom the best place to sleep by keeping it calm, quiet, and dark. Consider using “white noise” machines, earplugs, blackout curtains, or a sleep mask to keep things from bothering you.
• Before you go to bed, try to lower your stress levels. One way to do this is to make a to-do list earlier in the evening. It can also help to be mindful and have a positive attitude.
• Don’t watch TV, use your phone, eat, or work in bed. Instead, make your bed a place for sleep and intimacy.
• Set a regular bedtime routine: do things that help you relax before bed, like taking a warm bath, listening to calming music, reading a book, or doing relaxation exercises. Try to get up simultaneously every day, even on weekends.
• Don’t Look at the Clock: To stop worrying about being unable to sleep, turn your clock away. If you can’t fall asleep after 20 minutes, get out of bed and do something quiet and screen-free until you feel sleepy.
• Get some exercise every day: Regular exercise can help you sleep better. If you have trouble sleeping, though, don’t do any strenuous exercise for four hours before you go to bed.

What to Expect and What to Expect with Sleep Disorders

What will happen if I have a sleep problem?

Not getting treatment for sleep disorders can have a significant effect on your health and quality of life. They can make you tired, hard to do things every day, and hard to be fully present in your personal and professional life. Also, conditions that make you sleepy during the day can make you more likely to have accidents, especially when driving or using heavy machinery.

If you have trouble getting good sleep, talk to a doctor. Some treatments work for most sleep disorders and can help you feel better.

How long do sleep problems last?

The length of a sleep disorder changes. Some people may feel better in a few weeks or months after starting treatment, while others may need to manage their condition for a long time. Your doctor can give you a more specific prognosis based on your health.

How to Avoid Sleep Problems

You can’t stop all sleep disorders from happening, but you can lower your risk of getting some by practicing good sleep hygiene.

What things should I stay away from to sleep better?

For at least three to four hours before bed, you should stay away from the following things and activities to get better sleep:

• Drinks with caffeine in them, like soda, tea, and coffee
• Products made with tobacco
• Drink
• Taking a nap after 3 p.m.
• Chocolate
• Big or heavy meals

When to Go to the Doctor

If you have trouble sleeping, such as falling asleep, staying awake during the day, or not feeling rested when you wake up, talk to a doctor.

What kinds of questions should I ask my doctor?

To help the conversation go smoothly, you could ask:

• What is the exact name of my sleep disorder?
• How bad is my condition?
• What kinds of treatment do you think are best?
• What are the possible side effects of the suggested treatment?
• How can I improve my sleep hygiene?
• Do I need a referral to see a sleep specialist?
• Do you have any medicines that would help my condition?
• What medicines should I think about stopping, if any?

What is the suggested schedule for follow-up?

Conclusion

Sleep problems can make your life much worse by messing with your cognitive function, your work or school performance, and your mental and physical health. People with these common conditions often can’t get the deep, restorative sleep they need to function at their best. It is essential to see a doctor if you are having trouble sleeping. Getting enough sleep is very important for your health and well-being. Following your healthcare provider’s advice and practising good sleep hygiene can help your condition improve immediately.