Sleep Disorders

       Is it hard for you to fall asleep or stay asleep though the night? Do you wake up feeling tired or feel very sleepy during the day, even if you have had enough sleep? You might have a sleep disorder. The most common kinds are:
Insomnia - a hard time falling or staying asleep
Sleep apnea - breathing interruptions during sleep
Restless legs syndrome - a tingling or prickly sensation in the legs
Narcolepsy - daytime "sleep attacks"
Nightmares, night terrors, sleepwalking, sleep talking, head banging, wetting the bed and grinding your teeth are kinds of sleep problems called parasomnias. There are treatments for most sleep disorders. Sometimes just having regular sleep habits can help. Sleep disorders and other sleeping problems cause more than just sleepiness. Poor quality sleep can have a negative impact on your energy, emotional balance, productivity, and health.Sleeping well is essential to your physical health and emotional well-being. Unfortunately, even minimal sleep loss can take a toll on your mood, energy, efficiency, and ability to handle stress. Ignoring sleep problems and disorders can lead to poor health, accidents, impaired job performance, and relationship stress. If you want to feel your best, stay healthy, and perform up to your potential, sleep is a necessity, not a luxury.

Insomnia: The most common type of sleep disorder

       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.Whatever the cause of your insomnia, being mindful of your sleep habits and learning to relax will help you sleep better and feel better. The good news is that most cases of insomnia can be cured with lifestyle changes you can make on your own—without relying on sleep specialists or turning to prescription or over-the-counter sleeping pills.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 unrefreshing, You need to take something (sleeping pills, nightcap, supplements) in order to get to sleep, Sleepiness and low energy during the day.Insomnia can be grouped into primary and secondary, or comorbid, insomnia.

Narcolepsy:

       Narcolepsy is a chronic sleep disorder, or dyssomnia, characterized by excessive sleepiness and sleep attacks at inappropriate times, such as while at work. People with narcolepsy often experience disturbed nocturnal sleep and an abnormal daytime sleep pattern, which often is confused with insomnia. Narcoleptics, when falling asleep, generally experience the REM stage of sleep within 10 minutes; whereas most people do not experience REM sleep until an hour or so later.Another one of the many problems that some narcoleptics experience is cataplexy, a sudden muscular weakness brought on by strong emotions (though many people experience cataplexy without having an emotional trigger).Narcolepsy is a neurological sleep disorder. It is not caused by mental illness or psychological problems. It is most likely affected by a number of genetic abnormalities that affect specific biologic factors in the brain, combined with an environmental trigger during the brain's development, such as a virus.The main characteristic of narcolepsy is Excessive Daytime Sleepiness (EDS), even after adequate night time sleep.The classic symptoms of the disorder, often referred to as the "tetrad of narcolepsy," are cataplexy, sleep paralysis, hypnagogic hallucinations, and excessive daytime sleepiness. Other symptoms include automatic behaviors.

Sleep apnea:

       Sleep apnea is a common sleep disorder in which your breathing temporarily stops during sleep due to 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 feel the effects in other ways, such as exhaustion during the day, irritability and depression, and decreased productivity. Sleep apnea is a serious, and potentially life-threatening, sleep disorder.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 unrefreshed 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.

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.

Periodic limb movement disorder (PLMD):

Periodic limb movement disorder (PLMD), previously known as nocturnal myoclonus, is a sleep disorder where the patient moves limbs involuntarily during sleep, and has symptoms or problems related to the movement. PLMD should not be confused with restless leg syndrome (RLS). RLS occurs while awake as well as when asleep, and when awake, there is a voluntary response to an uncomfortable feeling in the legs. PLMD on the other hand is involuntary, and the patient is often unaware of these movements altogether.It is mostly unknown what causes PLMD, but in many cases the patient also suffers from other medical problems such as Parkinson's disease or narcolepsy.PLMD is diagnosed with the aid of a polysomnogram or PSG.PLMD is often treated with anti-Parkinson's medication. These include anticonvulsants, benzodiazepines, and narcotics.It is also advised to not consume caffeine, alcohol or antidepressants as these substances could worsen the PLMD symptoms.

Circadian rhythm sleep disorder:

Circadian rhythm sleep disorders are a family of sleep disorders affecting, among other things, the timing of sleep. People with circadian rhythm sleep disorders are unable to sleep and wake at the times required for normal work, school, and social needs.Humans, like most animals and plants, have biological rhythms, known as circadian rhythms, which are controlled by a biological clock and work on a daily time scale. These affect body temperature, alertness, appetite, hormone secretion etc. as well as sleep timing.Jet lag sleeping problems,Shift work sleeping problems,Delayed sleep phase disorder are few of the subdivisions of Circadian rhythm sleep disorders

General principles of treatment:

Treatments for sleep disorders generally can be grouped into four categories:
• Behavioral and psychotherapeutic treatment
• Rehabilitation and management
• Medication
• Other somatic treatment

None of these general approaches is sufficient for all patients with sleep disorders. Rather, the choice of a specific treatment depends on the patient's diagnosis, medical and psychiatric history, and preferences, as well as the expertise of the treating clinician. Often, behavioral/psychotherapeutic and pharmacological approaches are not incompatible and can effectively be combined to maximize therapeutic benefits. Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.Effective treatment begins with careful diagnosis using sleep diaries and perhaps sleep studies. Modifications in sleep hygiene may resolve the problem, but medical treatment is often warranted.Special equipment may be required for treatment of several disorders such as obstructive apnea, the circadian rhythm disorders and bruxism. In these cases, when severe, an acceptance of living with the disorder, however well managed, is often necessary.

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