SLEEP PROBLEMS AND DISTURBANCES

Types, Symptoms, Treatment & Help for Common Sleep Disorders

Reported by: Jemica G. Ganacia BSA-2B

IS IT A SLEEP DISORDER?Do you. . . feel irritable or sleepy during the day? have difficulty staying awake when sitting still,

watching television or reading? fall asleep or feel very tired while driving? have difficulty concentrating? often get told by others that you look tired? react slowly? have trouble controlling your emotions? feel like you have to take a nap almost every day? require caffeinated beverages to keep yourself

going?If you answered “yes” to any of the previous questions, you may have a sleep disorder.

THE MOST COMMON TYPE OF SLEEP DISORDER: INSOMNIA Insomnia, the inability to get the

amount of sleep you need to wake up feeling rested and refreshed, is the most common sleep complaint. Insomnia is often a symptom of another problem, such as stress, anxiety, depression, or an underlying health condition. It can also be caused by lifestyle choices, including the medications you take, lack of exercise, jet lag, or even the amount of coffee you drink.

COMMON SIGNS AND SYMPTOMS OF INSOMNIA INCLUDE: Difficulty falling asleep at night or

getting back to sleep after waking during the night.

Waking up frequently during the night Your sleep feels light, fragmented, or

exhausting. You need to take something (sleeping

pills, nightcap, supplements) in order to get to sleep.

Sleepiness and low energy during the day.

PUTTING A STOP TO THE PROBLEM OF SLEEPLESS NIGHTS Insomnia takes a toll on your energy,

mood, and ability to function during the day. But you don’t have to put up with insomnia. Simple changes to your lifestyle and daily habits can end sleepless nights.

Solution: Never try to sleep, and don't spend extra

time in bed. When you are not sleeping, get up and do a quiet activity until you feel drowsy, and then return to bed. Relaxation exercises or guided-imagery CDs can be useful sleep aids.

OTHER COMMON TYPES OF SLEEP DISORDERS: In addition to insomnia, the most

common sleep disorders are sleep apnea, restless legs syndrome (RLS), and narcolepsy.

SLEEP DISORDER 1: SLEEP APNEA Sleep apnea is a common sleep

disorder in which your breathing temporarily stops during sleep due to the blockage of the upper airways. These pauses in breathing interrupt your sleep, leading to many awakenings each hour. While most people with sleep apnea don’t remember these awakenings, they might feel exhausted during the day, irritable and depressed, or see a decrease in productivity.

SLEEP DISORDER 1: SLEEP APNEA Sleep apnea is a serious, and potentially

life-threatening, sleep disorder. If you suspect that you or a loved one may have sleep apnea, see a doctor right away. Sleep apnea can be successfully treated with Continuous Positive Airway Pressure (CPAP), a mask-like device that delivers a stream of air while you sleep. Losing weight, elevating the head of the bed, and sleeping on your side can also help in cases of mild to moderate sleep apnea.

SYMPTOMS OF SLEEP APNEA INCLUDE: Loud, chronic snoring. Frequent pauses in breathing during

sleep. Gasping, snorting, or choking during

sleep. Feeling exhausted after waking and

sleepy during the day, no matter how much time you spent in bed.

Waking up with shortness of breath, chest pains, headaches, nasal congestion, or a dry throat.

SLEEP DISORDER 2: RESTLESS LEGS SYNDROME (RLS) Restless legs syndrome (RLS) is a

sleep disorder that causes an almost irresistible urge to move your legs (or arms). The urge to move occurs when you’re resting or lying down and is usually due to uncomfortable, tingly, aching, or creeping sensations.

COMMON SIGNS AND SYMPTOMS OF RESTLESS LEGS SYNDROME INCLUDE: Uncomfortable sensations deep within

the legs, accompanied by a strong urge to move them.

The leg sensations are triggered by rest and get worse at night.

The uncomfortable sensations temporarily get better when you move, stretch, or massage your legs.

Repetitive cramping or jerking of the legs during sleep.

SLEEP DISORDER 3: NARCOLEPSY Narcolepsy is a sleep disorder that

involves excessive, uncontrollable daytime sleepiness. It is caused by a dysfunction of the brain mechanism that controls sleeping and waking. If you have narcolepsy, you may have “sleep attacks” while in the middle of talking, working, or even driving.

COMMON SIGNS AND SYMPTOMS OF NARCOLEPSY INCLUDE: Seeing or hearing things when you’re

drowsy or starting to dream before you’re fully asleep.

Suddenly feeling weak or losing control of your muscles when you’re laughing, angry, or experiencing other strong emotions.

Dreaming right away after going to sleep or having intense dreams.

Feeling paralyzed and unable to move when you’re waking up or dozing off.

SLEEP PROBLEMS Pregnancy Reflux Nightmares Sleep Walking Sleep Problems in Children Physical Effects on Oversleeping Bedwetting Teeth Grinding Sleep Paralysis

PREGNANCY Women often experience sleepless

nights and daytime fatigue in the first and third trimesters of their pregnancy. During the first trimester, frequent trips to the bathroom and morning sickness may disrupt sleep. Later in pregnancy, vivid dreams and physical discomfort may prevent deep sleep. After delivery, the new baby's care or the mother's postpartum depression may interrupt sleep.

REFLUX If someone has gastroesophageal

reflux disease (GERD), stomach acid moves backward up into the esophagus, producing the uncomfortable, burning sensation known as heartburn. GERD symptoms can be worse when someone is lying down. Even if someone doesn't notice the feelings of heartburn during sleep, the discomfort it causes can still interfere with the sleep cycle.

NIGHTMARES Most teens have nightmares on

occasion. But frequent nightmares can disrupt sleep patterns by waking someone during the night. Some things can trigger more frequent nightmares, including certain medications, drugs, or alcohol. Ironically, sleep deprivation can also be a cause.

The most common triggers for more frequent nightmares are emotional, such as stress or anxiety. If nightmares are interfering with your sleep, it's a good idea to talk to a parent, doctor, or counselor.

SLEEPWALKING Sleepwalking may run in families. It

tends to happen most often when a person is sick, has a fever, is not getting enough sleep, or is feeling stress.

Because most sleepwalkers don't sleepwalk often, it's not usually a serious problem. Sleepwalkers tend to go back to bed on their own and don't usually remember sleepwalking. (Sleepwalking often happens during the deeper sleep that takes place during stages 3 and 4 of the sleep cycle.)

TIPS TO PREVENT SLEEPWALKINGThere is no known way to absolutely prevent sleepwalking; however, certain steps can be taken to minimize one's risk. These include: Get adequate sleep. Limit stress. Meditate or do relaxation

exercises. Avoid any kind of stimulation (auditory

or visual) prior to bedtime.

TIPS TO PROTECT YOURSELF WHEN SLEEPWALKING These are steps you can take to prevent

harm if and when you do sleepwalk: Keep a safe sleeping environment, free

of harmful or sharp objects. Sleep in a bedroom on the ground floor,

if possible. Lock the doors and windows. Cover glass windows with heavy drapes. Place an alarm or bell on the bedroom

door.

MEDICAL TREATMENT FOR SLEEPWALKING If sleepwalking is caused by underlying

medical conditions, such as gastroesophageal reflux, obstructive sleep apnea, seizures, periodic leg movements, or restless legs syndrome, sleepwalking episodes should stop once the underlying medical condition is treated.

Medications may be necessary if the sleepwalker is at risk of injury, if sleepwalking causes significant family disruption or excessive daytime sleepiness, and when other treatment options have not worked.

OTHER SLEEPWALKING TREATMENT OPTIONS Relaxation techniques, mental imagery, and

anticipatory awakenings are the preferred treatment options for long-term treatment of people with a sleepwalking disorder. Anticipatory awakenings consist of waking the child or person approximately 15-20 minutes before the usual time of a sleepwalking episode, and then keeping him or her awake through the time during which the episodes usually occur.

Relaxation and mental imagery techniques are most effective when done with the help of an experienced behavioral therapist or hypnotist.

Follow-up with your sleep disorders specialist if symptoms persist, or if injury to self or to others occurs.

PHYSICAL SIDE EFFECT OF OVERSLEEPING For people who suffer from hypersomnia,

oversleeping is actually a medical disorder. The condition causes people to suffer from extreme sleepiness throughout the day, which is not usually relieved by napping. It also causes them to sleep for unusually long periods of time at night. Many people with hypersomnia experience symptoms of anxiety, low energy, and memory problems as a result of their almost constant need for sleep.

MEDICAL PROBLEMS LINKED TO OVERSLEEPING CONTINUED... Back pain Depression Heart disease Death

BEDWETTING While bedwetting can be a symptom of

an underlying disease, a large majority of children who wet the bed have no underlying disease that explains their bedwetting

TEETH GRINDING (BRUXISM) Occasional teeth grinding, medically

called bruxism, does not usually cause harm, but when teeth grinding occurs on a regular basis, the teeth can be damaged and other complications can arise, such as jaw muscle discomfort or TMJ pain

SLEEP PARALYSIS Have you ever felt like you were awake

but unable to move? You might have even felt afraid but could not call for help? This condition is called sleep paralysis.

CIRCADIAN RHYTHM SLEEP DISORDERS When your circadian rhythms are

disrupted or thrown off, you may feel groggy, disoriented, and sleepy at inconvenient times. Circadian rhythms have been linked to a variety or sleeping problems and sleep disorders, including insomnia, jet lag, and shift work sleep difficulties. Abnormal circadian rhythms have also been implicated in depression, bipolar disorder, and seasonal affective disorder (the winter blues).

JET LAG SLEEPING PROBLEMS Jet lag is a temporary disruption in

circadian rhythms that occurs when you travel across time zones. Symptoms include daytime sleepiness, fatigue, headache, stomach problems, and insomnia. The symptoms typically appear within a day or two after flying across two or more time zones. The longer the flight, the more pronounced the symptoms. The direction of flight also makes a difference. Flying east tends to cause worse jet lag than flying west.

RESETTING YOUR INTERNAL CLOCK: HOW TO REDUCE JETLAG Switch as rapidly as possible upon arrival. On a long

trip, don’t turn in until it’s bedtime in the new time zone. For the first day or two, spend as much time outdoors as possible to let daylight reset your internal clock.

Use the sun. If you need to wake up earlier in the new setting (flying west to east), get out in the early morning sun. If you need to wake up later (flying east to west), expose yourself to late afternoon sunlight.

Drink plenty of fluids, but not caffeine or alcohol. Caffeine and alcohol promote dehydration, which worsens the physical symptoms of jet lag. They can also disturb sleep.

Don’t time-shift. On a brief trip just one or two time zones away, it may be possible to wake up, eat, and sleep on home time. If so, schedule appointments for times when you would be alert at home.

SHIFT WORK SLEEPING PROBLEMS Shift work sleep disorder occurs when your

work schedule and your biological clock are out of sync. In our 24-hour society, many workers have to work night shifts, early morning shifts, or rotating shifts. These schedules force you to work when your body is telling you to go to sleep, and sleep when your body is signaling you to wake.

While some people adjust better than others to the demands of shift work, most shift workers get less quality sleep than their daytime counterparts. As a result of sleep deprivation, many shift workers struggle with sleepiness and mental lethargy on the job. This cuts into their productivity and puts them at risk of injury.

REDUCE THE IMPACT OF SHIFT WORK ON SLEEP: Take regular breaks and minimize the

frequency of shift changes. When changing shifts, request a shift that’s

later, rather than earlier as it’s easier to adjust forward in time, rather than backward.

Naturally regulate your sleep-wake cycle by increasing light exposure at work (use bright lights) and limiting light exposure when it’s time to sleep. Avoid TV and computer screens, use blackout shades or heavy curtains to block out daylight in your bedroom.

Consider taking melatonin when it’s time for you to sleep.

DELAYED SLEEP PHASE DISORDER Delayed sleep phase disorder is a condition

where your 24-hour cycle of sleep and wakefulness—your biological clock—is significantly delayed. As a result, you go to sleep and wake up much later than other people. For example, you may not get sleepy until 4 a.m., at which time you go to bed and sleep soundly until noon, or at least you would if your daytime responsibilities didn’t interfere. Delayed sleep phase disorder makes it difficult for you to keep normal hours—to make it to morning classes, get the kids to school on time, or keep a 9-to-5 job.

People with delayed sleep phase disorder are unable to get to sleep earlier than 2 to 6 a.m. no matter how hard they try. They struggle to go to sleep and get up at socially acceptable times.

When allowed to keep their own hours (such as during a school break or holiday), they fall into a regular sleep schedule.

Delayed sleep phase disorder is most common in teenagers, and many teens will eventually grow out of it.

For those who continue to struggle with a biological clock that is out of sync, treatments such as light therapy and chronotherapy can help. To learn more, schedule an appointment with a sleep doctor or local sleep clinic.

SLEEP PROBLEMS/ DISORDER SOLUTIONSKEEP A SLEEP DIARY A sleep diary is a very useful tool for

identifying sleep disorders and sleeping problems and pinpointing both day and nighttime habits that may be contributing to your difficulties. Keeping a record of your sleep patterns and problems will also prove helpful if you eventually find it necessary to see a sleep doctor.

YOUR SLEEP DIARY SHOULD INCLUDE: what time you went to bed and woke up total sleep hours and perceived quality of

your sleep a record of time you spent awake and what

you did (“stayed in bed with eyes closed,” for example, or “got up, had a glass of milk, and meditated”)

types and amount of food, liquids, caffeine, or alcohol you consumed before bed, and times of consumption

your feelings and moods before bed (e.g. happiness, sadness, stress, anxiety)

any drugs or medications taken, including dose and time of consumption

IMPROVE YOUR SLEEP HYGIENE AND DAYTIME HABITS Keep a regular sleep schedule. Set aside enough time for sleep. Make sure your bedroom is dark, cool, and

quiet.  Turn off your TV, smartphone, iPad, and

computer.

If the word "hygiene" sounds like clean sleep, it is. And it is a term commonly used among sleep specialists to indicate setting the conditions for undisturbed slumber.

SLEEP SOLUTION The first injunction: The more you worry

about it, the worse it gets. Even thinking about sleep can cause you to become anxious. Picture the exhausted would-be sleeper, lying in bed with a tensed, rigid body, trying to force sweet sleep to overtake him. It's a contradiction in terms. Sleep cannot be willed. Often sleep needs to be set apart from everything else in life.

SLEEP SOLUTION Try to keep your sleep schedule

consistent. Plan regular hours of sleep time every day.

Eliminate caffeine and alcohol, particularly at night.

Don't exercise or start involving yourself in highly engaging mental tasks near bedtime.

Don't go to bed hungry or after eating a large meal. Eat a light snack before bedtime or drink a glass of warm milk, which contains tryptophan, an amino acid that is a known sleep inducer.

SLEEP SOLUTION Tell your spouse, bedmate, or yourself a

relaxing bedtime story. My favorite ones are about my turtle. My wife often asks me to tell her a turtle story, which usually puts her to sleep long before I nod off.

Take a hot bath. Make the bedroom a bedroom, a place to

sleep. Don't read or watch TV in bed. Remove all other stimulants from the bedroom, including work and bills.

Don't nap during the day. Confine your sleep to certain nighttime hours.

DO SLEEPING PILLS HELP SLEEP DISORDERS AND SLEEPING PROBLEMS?Safety guidelines for sleeping pills Only take a sleeping pill when you will have enough

time to get a full seven to eight hours of sleep. Otherwise, you may be drowsy the next day.

Read the package insert that comes with your medication. Pay careful attention to the potential side effects, dosage instructions, and list of food and substances to avoid.

Never mix alcohol and sleeping pills. Alcohol disrupts sleep and can interact dangerously with sleep medications.

Never drive a car or operate machinery after taking a sleeping pill, especially when you first start taking a new sleep aid, as you may not know how it will affect you.

WHEN TO CALL A DOCTOR ABOUT SLEEP DISORDERS Your main sleep problem is daytime

sleepiness and self-help hasn’t improved your symptoms.

You or your bed partner gasps, chokes, or stops breathing during sleep.

You sometimes fall asleep at inappropriate times, such as while talking, walking, or eating.

WHAT TO EXPECT AT A SLEEP CLINIC OR CENTER If your physician refers you to a sleep

center, a specialist will observe your sleep patterns, brain waves, heart rate, rapid eye movements and more using monitoring devices attached to your body. While sleeping with a bunch of wires attached to you might seem difficult, most patients find they get used to it quickly.

The sleep specialist will analyze the results from your sleep study and design a treatment program if necessary. A sleep center can also provide you with equipment to monitor your activities (awake and asleep) at home.