Sleep Problems and Disorders - Helpguide

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SYMPTOMS, TYPES, TESTS, AND TREATMENT CENTERS

Sleep problems cause more than just sleepiness – a lack of quality sleep can cause accidents, affect your relationships, health, and mental prowess; and make you feel generally “disconnected” from the world. If your sleeplessness is caused by a tough deadline or a common cold, you might not have trouble getting your sleep back on track after the deadline or cold go away, but if you have trouble sleeping on a regular basis, this guide to managing common sleep problems and disorders can help you be well on your way to experiencing healthy, restorative sleep.

Symptoms of sleep problems and disorders

Everyone experiences occasional sleep problems, but getting a good night’s sleep is essential for feeling refreshed and alert during the day. Lack of sleep might make you feel foggy and unable to concentrate, or just a lesser version of your normal self. Sleep problems will eventually disrupt your work, family and personal relationships.

How do you tell if your sleepless night is an isolated occurrence or if it is related to a chronic sleep problem or disorder? Start by identifying your symptoms. Particular behaviors during the day are telltale signs of sleep deprivation. If you are experiencing any of the following symptoms on a regular basis, your sleeplessness might be part of an ongoing problem or 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 emotional outbursts?
* feel like taking a nap almost every day?
* require caffeinated beverages to keep yourself going?

Common types of sleep problems and sleep disorders

Insomnia

Almost everyone will be affected by insomnia at some point during life. Insomnia – a short term or chronic inability to get high quality sleep – is a common sleep problem and can be caused by a variety of things including stress, a change in time zones, an altered sleep schedule or poor bedtime habits. Whether your problem is an occasional sleepless night or a series of them, plenty of solutions exist to help you get better sleep.

Pay Attention to Insomnia

Insomnia often acts as a flashing yellow light in terms of sleep problems. Your insomnia might be a symptom of a more significant sleep problem or disorder, or a starting point for dealing with a physical, mental or emotional challenge. Your inability to go to sleep or stay asleep might be related to your partner’s snoring, your own sleep apnea or restless legs syndrome, or it might be related to an urgent situation at work, or a difficult family issue. 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 great news is that insomnia doesn’t have to be a permanent problem. In many cases, self help techniques, including improved sleep hygiene, relaxation and cognitive behavioral therapy (CBT), can alleviate insomnia and promote better health as well as better sleep. Helpguide has two articles devoted to a wide range of insomnia cures and self help tips for improving your sleep.

Medications should be a last resort for insomnia – they do not provide lasting treatment and have numerous possible side effects.

Sleep apnea sleep disorders

Sleep apnea is a common sleep disorder that can be potentially very serious, and even life-threatening. In sleep apnea, your breathing stops or gets very shallow while you are sleeping. Each pause in breathing typically lasts 10 to 20 seconds or more, and the pauses can occur 20 to 30 times or more an hour. During the episodes of apnea, the sleeper wakes up to breathe again, disrupting sleep, and also suffers from a brief lack of oxygen.

Symptoms of sleep apnea include:
* Frequent gaps in breathing during sleep (apnea)
* Gasping or choking for air to restart breathing, often causing sleeper or partner to wake
* Loud snoring
* Feeling unrefreshed after a night’s sleep and excessive daytime tiredness

The most common type of sleep apnea is obstructive sleep apnea. Causes of sleep apnea are generally physical in nature, including excess weight or tissue (sometimes from being overweight or obese), large tonsils or adenoids, nasal congestion or blockage or a unique shaped head, neck or chin.

CPAP, a mechanical device worn while sleeping which provides continuous air pressure to keep the airway open, is the most recommended treatment for moderate to severe sleep apnea. CPAP can take some getting used to, but provides effective relief when used correctly.

Self help treatments, like losing weight, elevating the head of the bed or sleeping on your side, can also be effective remedies for mild to moderate sleep apnea. Dental appliances and surgery are also treatment options.

Snoring

Snoring, which is sometimes confused with sleep apnea, can be a significant obstacle to quality sleep both for yourself and your partner.

Snoring is caused by a narrowing of your airway, either from poor sleep posture, excess weight or physical abnormalities of your throat. A narrow airway gets in the way of smooth breathing and creates the sound of snoring. The snoring noise doesn’t necessarily that the airway is obstructed, as it is in sleep apnea. Snoring may accompany sleep apnea, but not always.

There are many self help remedies and cures for snoring. If you are a mild snorer, sleeping on your side, elevating the head of your bed, or losing weight may stop the snoring. Don’t give up trying to find a solution for your snoring – it will make you and your partner sleep better.

Restless Legs Syndrome (RLS) and Periodic Limb Movements in Sleep (PLMS)

Restless legs syndrome (RLS) is a disorder causing an almost irresistible urge to move the legs (or arms). The urge to move occurs when resting or lying down and is usually due to uncomfortable, tingly, or creeping sensations in the legs or affected limbs. Movement eases the feelings, but only for a while.

Periodic Limb Movement Disorder (PLMD) is a related condition involving involuntary, rhythmic limb movements, either while asleep or when awake. While most people who have Restless Legs Syndrome also have PLMD, only some people with PLMD also have RLS.

RLS can occur on its own or be related to other medical conditions, such as anemia, kidney disease, pregnancy, thyroid problems, Parkinson’s or alcoholism. RLS may run in families.

Alternative therapies, lifestyle changes, and even nutritional supplements have proven helpful for RLS and PLMD sufferers.

Narcolepsy

Narcolepsy is a neurological disorder that causes extreme sleepiness and may even make a person fall asleep suddenly and without warning. Specific causes of narcolepsy are not known but people with narcolepsy are lacking hypocretin, a brain chemical which regulates sleep and wakefulness.

The “sleep attacks” experienced by people with narcolepsy occur even after getting enough sleep at night, and make it difficult for people to live normal lives. Falling asleep during activities like walking, driving or working can have dangerous results.

Symptoms of narcolepsy include:
* Intermittent, uncontrollable episodes of falling asleep during the daytime
* Excessive daytime sleepiness
* Sudden, short-lived loss of muscle control during emotional situations (cataplexy)

Narcolepsy may be genetic, but it also appears to be influenced by environmental triggers. Treatment requires a combination of medication, behavioral treatments, and counseling.

Learning more about your sleep problem or disorder

Self-diagnosis

To determine if you have a sleep disorder, first pay attention to your sleep habits and daily routine. Keeping a record of your sleep patterns will help you and your doctor find the cause of your sleep problems.

A sleep diary, compiled by you and your sleep partner, can highlight lifestyle factors related to sleep disorders, and help your doctor or sleep specialist, if you choose to see one. A sleep diary should record all sleep-related information, including:
* time you went to bed and woke up (total sleep hours)
* quality of your sleep - times that you were awake and activity (e.g., stayed in bed with eyes closed, 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
* feelings and moods before bed ­– happiness, sadness, stress, anxiety
* drugs or medications taken, amounts taken, and times of consumption

The details can be important, and a sleep diary might reveal that your pre-bedtime behavior is ruining your chance for a good night’s sleep. For example, after keeping the diary for a week your might notice that more than two alcoholic drinks in the evening disrupts your sleep or that regular exercise helps you sleep better.

Seeing a doctor

You can address many common sleep problems through lifestyle changes and improved sleep hygiene, but see your doctor or a sleep specialist if your sleep does not improve.

What can you expect when you go to see a doctor about your sleep problem? Doctors will consider many things before making a diagnosis including:
* description of symptoms
* age and gender
* psychological and medical history
* sleep diary and sleep questionnaire
* possible medical conditions
* medical tests
* sleep center data

Your doctor will probably suggest behavioral and environmental changes as first steps of your treatment. Regardless of your sleep problem, a consistent sleep routine and improved sleep habits will translate into better sleep over the long term.

Sleep Centers

How sleep centers diagnose sleep disorders

If your physician refers you to a sleep center, the latest technology will be used to monitor you while you sleep. A sleep 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 fall asleep very easily.

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.
Accredited sleep centers

The American Academy of Sleep Medicine provides a sleep center locator with information on finding a sleep center near you.

Helpguide Related Links for Sleep Disorders
* Insomnia Causes and Cures – Comprehensive guide to conquering insomnia
* Sleep Apnea – Symptoms, diagnosis ands treatment
* Restless Legs Syndrome (RLS): Finding Relief for Symptoms and Choosing a Treatment
* Snoring - Guide to causes, cures and treatments
* Narcolepsy - Symptoms, diagnosis and treatment
* Sleep & Aging - Healthy habits to reduce sleep problems & prevent insomnia

Sleep Disorders General Information

Common Adult Sleep Problems/Disorders – Information on a number of sleep disorders (in children and adults) and treatment options. Includes relaxation techniques, sleep hygiene tips, and what to expect during an overnight sleep test at a sleep clinic or hospital. (University of Maryland Medical Center)

Sleep Disorders Information – Downloadable fact sheets on the most common sleep disorders, including insomnia, sleep apnea, Restless Legs Syndrome, and narcolepsy. Also information on how to sleep better. (National Heart, Lung, and Blood Institute, Department of Health and Human Services, National Institutes of Health)

Sleep disorders – Includes information on types, symptoms, causes, complications, and treatments of sleep disorders, along with the latest news and research. (MedlinePlus, U.S. National Library of Medicine / National Institutes of Health)

Sleep problems in children – Discusses common sleep issues with young children including babies, young children and teenagers. (University of Michigan Health System)

Sleep Centers

View a Sleep Study – A photo-guided tour of a typical sleep study at a sleep clinic. Helps you to know what to expect at your sleep study. (TalkAboutSleep and Stanford University Sleep Disorders Clinic)

Suzanne Barston, Gina Kemp, M.A., and Robert Segal, M.A., Contributed to this article. Last modified: October 08.