Sleep Disorders

Sleep disorders can significantly impact various aspects of health, including cognitive function, mood, physical well-being and overall quality of life. The cumulative effects of sleep loss and sleep disorders have been associated with a wide range of negative health issues including risk of hypertension, diabetes, obesity, depression, heart attack and stroke.  About 70 million people experience sleep disorders each year.

Insomnia

Insomnia is when you don’t get enough quality sleep affecting how you feel and function during waking hours.  This may be characterized by difficulty falling or staying asleep. Causes of insomnia may include:

• Stress and anxiety
• Medical conditions such as depression, pain, or sleep apnea
• Lifestyle habits such as caffeine or alcohol consumptions and  irregular sleep schedules
• Medications that may act as a stimulant
• Genetics

Sleep Apnea  

Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly, wake up with headaches or feel tired even after a full night’s sleep, you may have sleep apnea.  There are three types of sleep apnea:

• Obstructive Sleep Apnea (OSA). In this condition, the muscles in your throat relax while you’re asleep, causing surrounding tissue to press on your windpipe. This blocks air movement.
• Central Sleep Apnea (CSA). With this condition, your brain doesn't send signals to keep breathing-related muscles working while you sleep.
• Mixed/Complex Sleep Apnea. This type is a combination of both obstructive and central sleep apnea types. 

Restless Legs Syndrome (Movement Disorder) 

Restless legs syndrome (RLS) is a movement condition that causes a strong urge to move your legs when you are resting. You may also feel sensations such as itching, pulling, crawling or throbbing. Causes are not well understood but research suggests the following may contribute to RLS:

• Genetics
• Iron deficiency
• Underlying medical conditions such as anemia, diabetes, kidney disease, peripheral neuropathy, pregnancy or substance abuse
• Medications such as antihistamines, antidepressants or antinausea medications

Circadian Rhythm Sleep-Wake Disorders 

Your body has a natural, automatic clock called the circadian rhythm. Circadian rhythm sleep-wake disorders (CRSDs) are a group of conditions characterized by disruptions in the body’s natural sleep-wake cycle. Types include:

• Delayed sleep-wake phase disorder (DSWPD): Individuals have difficulty falling asleep and waking up at desired times, typically later in the day or night.
• Advanced sleep-wake phase disorder (ASWPD): Individuals fall asleep and wake up earlier than desired, often in the early morning hours.
• Irregular sleep-wake rhythm disorder (ISWRD): Individuals have a highly variable and unpredictable sleep-wake schedule.
• Non-24-hour sleep-wake disorder (N24): Individuals have a sleep-wake cycle that is not aligned with the 24-hour day, resulting in a cycle that is longer or shorter than 24 hours. 

Narcolepsy 

Narcolepsy is a chronic neurologic disorder that affects the brain’s ability to control sleep-wake cycles. People with narcolepsy feel very sleepy during the day and experience uncontrollable episodes of falling asleep. Symptoms include:

• Extreme daytime sleepiness making it hard to focus and function
• Automatic behaviors where some people fall asleep and continue doing a task such as writing, typing or even driving.
• Sudden loss of muscle tone, called cataplexy. These symptoms can include slurred speech or more significant loss of strength, even falling.
• Sleep paralysis that may involve inability to speak or move. 
• Hallucinations.
• Changes in (REM) sleep patterns where timing of rapid eye movement sleep can occur right after falling asleep or during the day. 

Hypersomnia 

Hypersomnia is the inability to stay awake and alert during the day despite having an adequate amount of nighttime sleep. 

Parasomnias 

Parasomnias are a type of sleep disorder that causes abnormal experiences or behaviors during sleep. These can happen as you’re falling asleep, during sleep or right before you wake up. A person with parasomnias may seem to be alert, walking or talking or eating or other activities but without awareness because the brain is only partially awake. There are three types of parasomnias based on the stage of sleep in which they happen.

• Non-Rapid Eye Movement (non-REM) Sleep. Types of parasomnia include:
  • Sleep terrors - when you wake up suddenly scared
  • Sleepwalking - when you get out of bed and move about with your eyes wide open, but you are actually still asleep.
  • Confusional arousals - when you wake up, you feel confused and disoriented. You may sit up, have your eyes open or express emotions like crying. You may speak slowly or not understand what others are saying to you.
• Rapid Eye Movement (REM) Sleep
  • Nightmare disorder - when you have vivid dreams that cause feelings of fear, terror and/or anxiety. If you wake up, you’ll be able to describe your dream in detail and you may have difficulty falling back asleep.
  • Recurrent isolated sleep paralysis - when you wake up and can’t move your body. It usually happens when your muscles are already relaxed, like before you fall asleep or as you wake up.  Episodes may last seconds to a few minutes.
  • REM sleep behavior disorder (RSBD) - when you act out, vocalize (talk, swear, laugh, shout) or make aggressive movements (punching, kicking, grabbing) as a reaction to a violent dream. This sleep disorder is more common among adults and people with neurodegenerative diseases like Parkinson’s disease, Lewy body dementia or multiple system atrophy.
• Other Parasomnias
  • Sleep enuresis (bedwetting) - when you have accidental release of urine during sleep. This usually happens after the age of five and may occur at least two times a week for at least three months
  • Sleep-related groaning (catathrenia) - when you make repeated moanings or groaning noises during sleep.
  • Exploding head syndrome - when you hear a loud noise or crashing sound in your head as you are falling asleep or waking up.
  • Sleep-related hallucinations - when you experience false perceptions and may see, hear or feel things that don’t really exist.
  • Sleep-related eating disorder - when you eat and drink while sleeping. This may include eating foods you don’t normally eat or inedible or toxic foods.
  • Sesomnia - where you may carry out sexual behaviors during your sleep.