Sleep Disorders 101
Sleep disorders affect more than 70 million Americans. It’s estimated that 1 in 3 people will suffer from insomnia at some point in their lives, and up to 60 percent of the people who have sleep problems may have a chronic disorder affecting the quality of their sleep.
If you’re struggling to get a good night’s rest or are tired throughout the day, you may have a sleep disorder. Various common disorders can result in poor quality of sleep and affect your waking life, making it difficult to complete menial tasks. Below you’ll find a few of the most common sleep disorders to watch out for, as well as their symptoms and treatments.
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Obstructive Sleep Apnea
This potentially serious disorder is caused by the excessive relaxation of throat muscles during sleep. When these muscles relax, the structures they support drop into the airway, restricting the flow of oxygen. People with obstructive sleep apnea may stop breathing intermittently throughout the night for periods of 10 to 20 seconds.
When this happens, your brain recognizes the trouble and sends signals to wake you up to correct the problem. People with sleep apnea may have their sleep disrupted multiple times per hour for an entire night. This makes it difficult to reach restful sleep and can lead to waking up without feeling rested.
One of the most prevalent and obvious signs of sleep apnea is snoring, especially when it’s accompanied by intermittent gasping or choking noises. Your sleeping partner may notice that you stop breathing at points throughout the night.
Other signs include:
- Waking with a sore throat or dry mouth
- Headaches in the morning
- Poor concentration
- High blood pressure
- Mood changes
- Daytime drowsiness
Not everyone who snores has sleep apnea. However, if your snoring is severe or accompanied by other symptoms, it may be a sign of disrupted nighttime breathing.
Once obstructive sleep apnea has been diagnosed, the most common treatment is to sleep with a device known as a CPAP, which provides supplemental oxygen at night to keep your airway open. Other options, such as specially shaped mouthpieces or even surgical intervention, are also available.
Upper Airway Resistance Syndrome
Upper airway resistance syndrome (UARS) is similar in many ways to obstructive sleep apnea. In fact, researchers currently believe that sleep apnea is a progressive disorder that occurs on a spectrum. In other words, UARS is a mild or early form of sleep disruption that may develop into sleep apnea under certain circumstances.
Upper airway resistance is a broad description that can refer to any sort of resistance that occurs in the airway during sleep. The most common physical manifestation of this symptom is snoring.
Snoring occurs when air flows past relaxed tissue in the throat, causing those tissues to vibrate. UARS occurs when snoring becomes severe enough to potentially disrupt sleep but does not yet cause breathing disruption at night.
Some signs you may have UARS include:
- Frequent waking throughout the night
- Difficulty maintaining sleep
- Chronic insomnia
- Sleepiness during the day
People with UARS will not stop breathing during the night. However, untreated UARS can develop into full sleep apnea. UARS treatments are very similar to those offered for sleep apnea patients.
Periodic Limb Movement Disorder
Periodic limb movements in sleep (PLMS) describe clusters of repetitive movements that occur during sleep. They are most commonly observed as muscle twitching or jerking. Episodes of movement may last just a few minutes to several hours, and the involuntary movements may wake the sleeper and cause disrupted sleep. PLMS may occur alongside restless leg syndrome, but they are not the same disorder.
Most people who experience periodic limb movements are unaware that they are doing it. They may experience disrupted sleep without knowing what woke them. Limb movements may be discovered during a sleep study or noticed by a bed partner.
Periodic limb movements may occur on their own or secondary to other medical issues. Some of the things that can cause PLMS include:
- Spinal injury or tumor
- Anemia and iron deficiency
- Drug withdrawal or interaction
Despite some clear indicators, PLMS sometimes occurs on its own for no obvious reason. The underlying cause is currently unknown.
Current treatments for periodic limb movements include medical interventions to relieve symptoms by relaxing the muscles or providing the patient with enough sedation to sleep through muscle movements. Some common drug options include benzodiazepines, dopaminergic agents, and anticonvulsant drugs.
Restless Leg Syndrome
Restless leg syndrome frequently coincides with PLMS, although not everyone with PLMS will have restless leg syndrome.
Restless leg syndrome causes an uncomfortable sensation in the lower extremities that might be described as an itch or “pins and needles”. The sensation leads to an irresistible urge to move the affected limb. The sensation is most common when at rest, and the urge to move your legs can cause difficulty in falling asleep or contribute to frequent sleep disruptions.
It’s estimated that restless leg syndrome affects about 10 percent of the population, with it being more common in women than in men. It’s suspected that the cause of the syndrome is genetic, but the underlying cause is often unknown.
Treatment options depend upon the severity of symptoms. In some cases, lifestyle changes can make a big difference. Doctors may recommend regular exercise, improved sleep hygiene and reduction of substances like caffeine and tobacco.
There are no medications known to help with restless leg syndrome, but treatments like leg massages and hot baths before bed can help to manage symptoms.
Narcolepsy is one of the less common sleep disorders, affecting just 1 in every 2,000 people. It is commonly misrepresented in media. Although people with narcolepsy can and do fall asleep involuntarily during the day, the condition is more complex than that.
For a narcoleptic, the boundary between wakefulness and sleeping is blurred. This can result in muscle paralysis and dream-like hallucinations during the day. People with narcolepsy may also experience sleep paralysis and vivid hallucinations while falling asleep.
In general, narcolepsy is a neurological condition caused by the insufficient production of the brain chemical hypocretin. This is a substance produced in the hypothalamus that serves to regulate sleep/wake cycles.
There is no known cure for narcolepsy, but medical interventions including medication and behavioral changes can help to mitigate symptoms and provide better sleep quality and reducing the risks of sleeping during the day.
REM Sleep Behavior Disorder
During normal sleep, your body is temporarily paralyzed during REM sleep. This is to prevent you from moving around physically while your mind peaks its electrical activity. In other words, this temporarily paralysis keeps you from acting out your dreams. In people with REM sleep behavior disorder (RBD), this paralysis is absent or incomplete.
People with RBD may exhibit a variety of signs including:
- Sleep walking
- Talking or yelling in their sleep
- Limb flailing
- Violent actions during sleep
- Sitting up in bed
Although many people may experience symptoms like this from time to time, especially while under the influence of alcohol or other circumstances, RBD is chronic and can dramatically affect the quality of sleep a person attains.
The exact cause of RBD is unknown, but it’s commonly seen in people with degenerative neurological conditions including:
- Lewy body dementia
- Parkinson’s disease
- Shy-Drager syndrome
It’s also commonly associated with drug interactions including antidepressants. Because of this, it seems likely that RBD has neurological roots. Symptoms of RBD can be managed through medication, including benzodiazepines.
Insomnia is a catch-all term for a variety of conditions that can cause poor sleep. Whereas the other conditions listed in this article have definitive symptoms, insomnia is more open-ended and can be caused by or expressed through various things.
In general, insomnia refers to an inability to maintain a healthy sleep/wake cycle due to difficulties falling asleep. Some people with insomnia may fall asleep naturally at first but wake up in the middle of the night and struggle to go back to sleep. Others may lie awake at night for a long time without being able to fall asleep.
Physical and psychological issues can lead to or exacerbate insomnia. These include:
- Neurological conditions
- Chronic pain
- Gastrointestinal problems
- Thyroid disease
People who experience any of the other sleep disorders described in this article may develop insomnia as a secondary symptom because of their disrupted sleep patterns.
Insomnia treatments will depend on the underlying cause of the poor sleep. In general, treatments may first target the underlying issues that are leading to poor sleep. Some medications, including sleep aids and sedatives, may be prescribed as well.
If you suspect that you may have a sleep disorder, you should discuss your concerns with your physician. Your doctor may recommend a sleep study test to identify the underlying cause of your problem and provide solutions for helping you get the rest you need.