A look into common sleep disorders, including their causes and symptoms
Written By: Shriya
Most of us experience trouble sleeping at one time or another. Usually it can be a result of stress, travel, illness, or any other interruptions to your normal routine. However, if sleep problems become a regular occurrence they can begin interfering with your daily life. You sleep poorly at night, which leaves you tired in the morning and drained as you go on through your day. Then, no matter how exhausted you feel, you still have trouble sleeping at night. This cycle then repeats, and day by day, it can take a deeper, more serious, toll on you. Ignoring sleep problems and disorders can damage your physical health and lead to weight gain, car accidents, impaired job performance, memory problems, and strained relationships as well as affecting your mood, energy, efficiency and ability to handle stress. (1)
In 1979, the American Sleep Disorders Association published the first classification system dedicated to sleep disorders. (2) Since then, sleep disorders have become increasingly prevalent, especially in the United States. According to the CDC, more than one-third of adults in the United States report getting fewer than 7 hours of sleep in a 24-hour period and more than 70 percent of high school students report getting fewer than 8 hours of sleep on weeknights. (3)
Most sleep disorders can be characterized based on the following signs:
consistently taking more than 30 minutes to fall asleep
perpetual fatigue and irritability during the day
waking up several times in the middle of the night and remaining awake
frequent and long naps during the day
difficulty concentrating
falling asleep at inappropriate times
waking up too early in the morning
loud snoring, breathing, or gasping noises while you sleep
an irresistible urge to move your legs, or a tingling or crawling feeling in the legs, particularly at bedtime
requiring a stimulant such as caffeine to keep you awake during the day
How are sleep disorders diagnosed?
If you suspect you may have a sleeping disorder, it is important to consult your doctor. There are various tests that can be performed to medically diagnose a sleep disorder.
Polysomnography (PSG): monitors your sleep stages and cycles to identify if or when your sleep patterns are disrupted and why. While you are sleeping, a specialist will evaluate your brain waves, eye movements, heart rate, breathing pattern, blood oxygen level, body movement, and noises such as snoring.
Electroencephalogram (EEG): detects abnormalities in your brain waves, or in the electrical activity of your brain. During the procedure, electrodes, consisting of small metal discs with thin wires are pasted onto your scalp, identify tiny electrical charges that result from the activity of your brain cells. (3)
Common Sleep Disorders:
More than 100 specific sleep disorders have been identified and today’s classifications use complex methodologies to categorize these disorders based on causes, symptoms, physiological and psychological effects, and other criteria. (2) However, there are certain sleep disorders that are more common amongst the general population.
1. Insomnia
About: Insomnia is characterized by a persistent difficulty falling or remaining asleep despite the opportunity and motivation to do so. Chronic insomnia occurs when sleepers experience symptoms at least three times per week for at least three months. Insomnia lasting less than three months is known as short-term insomnia. (2)
Causes: Stress, travel or work schedule, poor sleeping habits, eating too late, caffeine, nicotine and alcohol, mental health disorders (anxiety, depression), medications
Symptoms: Difficulty falling asleep at night, waking up during the night, waking up too early, not feeling well-rested after a night's sleep, daytime tiredness or sleepiness, irritability, depression or anxiety, difficulty paying attention, problems focusing on tasks or remembering (4)
2. Sleep Apnea
About: Sleep Apnea is characterized by a temporary stop in breathing during sleep. The main types of sleep apnea are obstructive sleep apnea (occurs when throat muscles relax), central sleep apnea (occurs when your brain doesn't send proper signals to the muscles that control breathing), and treatment-emergent central sleep apnea (occurs when someone has both obstructive sleep apnea and central sleep apnea). (5)
Causes: Obstructive sleep apnea - airway is blocked due to certain physiological factors, such as a narrow throat, large tongue, smaller lower jaw, or obesity.
Central sleep apnea - the brain stops sending signals to muscles that regulate breathing which can be due to factors such as heart disease, stroke, or opioids.
Symptoms: Loud snoring, gasping for air during sleep, awakening with a dry mouth, morning headache, difficulty staying asleep (insomnia), excessive daytime sleepiness, difficulty paying attention while awake, irritability
3. Narcolepsy
About: Narcolepsy is characterized by an irrepressible urge to sleep or involuntarily lapse into sleep on a daily basis, whether it be while talking, walking, or even driving. This condition falls into two primary categories. Narcolepsy Type 1 includes cataplexy, a sudden muscle weakness or paralysis, whereas Narcolepsy Type 2 may include some muscle weakness but not to the same extent.
Causes: The exact cause of narcolepsy is unknown. People with type 1 narcolepsy have low levels of the chemical hypocretin, which is an important neurochemical in your brain that helps regulate wakefulness and REM sleep. (6)
Symptoms: Excessive daytime sleepiness, sudden loss of muscle tone, sleep paralysis, changes in REM sleep, hallucinations
4. Restless Leg Syndrome (Willis-Ekbom Disease)
About: Restless Leg Syndrome is characterized by unpleasant or painful sensations in their legs. These sensations are usually more pronounced at night when the individual sits or lies down for prolonged periods, creating strong urges to move the legs in order to alleviate the discomfort.
Causes: There's no known cause for Restless Leg Syndrome. Researchers suspect the condition may be caused by an imbalance of the brain chemical dopamine, which sends messages to control muscle movement. (6) Additionally, RLS sometimes accompanies peripheral neuropathy, iron deficiency, kidney failure, and spinal cord conditions.
Symptoms: Sensations within the limb described as crawling, creeping, pulling, throbbing, aching, and itching, relief with movement such as stretching, jiggling your legs, pacing or walking, or nighttime leg twitching
Parasomnias are a group of sleep disorders that involve unwanted events or experiences that occur while falling asleep, sleeping or waking up. Parasomnias may include abnormal movements, behaviors, emotions, perceptions or dreams.
1. Confusional Arousals:
About: Confusional Arousals occur when a sleeping person appears to wake up but their behavior is unusual or strange. Confusional arousals typically occur in the first 2 hours of falling asleep during a transition from "deep" sleep to a lighter stage of sleep. (7)
Causes: Sleep disruptions caused by health problems (such as fever), travel, abrupt sleep loss, migraine, and irregular sleep-wake schedules may trigger an episode.
Symptoms: Disorientation, unresponsiveness, slow speech, or confused thinking
2. Sleepwalking (Somnambulism)
About: Sleepwalking occurs when people get out of bed and move about while still asleep. Sleepwalkers may remain in their bedrooms, but some travel to other areas in or outside of their residence. Attempting to wake up a sleepwalker can result in aggressive behavior. (8)
Causes: Sleep deprivation, stress, fever, sleep schedule disruptions, medications, substance use, restless leg syndrome
Symptoms: Get out of bed and walk around, sit up in bed and open eyes, have a glazed, glassy-eyed expression, not respond or communicate with others, be disoriented or confused for a short time after being awakened
3. Sleeptalking (Somniloquy)
About: Sleep talking is characterized by talking during sleep without being aware of it. Sleep talking can involve complicated dialogues or monologues, complete gibberish or mumbling. (9)
Causes: Medications, emotional stress, fever, mental health disorder, substance abuse, genetics
Symptoms: Audible expression, mumbling, silent speech
4. Night terrors
About: Sleep terrors are characterized by episodes of screaming, intense fear and flailing while still asleep.
Causes: Sleep deprivation and extreme tiredness, stress, sleep schedule disruptions, fever, restless legs syndrome, mood disorders (depression and anxiety)
Symptoms: Appearear frightened, stare wide-eyed, sweat, breathe heavily, and have a racing pulse, flushed face and dilated pupils, kick and thrash, possibly, getting out of bed and run around the house or have aggressive behavior if blocked or restrained (10)
5. Rapid Eye Movement (REM) Sleep Behavior
About: REM sleep behavior disorder occurs when you physically act out vivid, often unpleasant dreams with vocal sounds and sudden, violent arm and leg movements during REM sleep.
Causes: Nerve pathways in the brain that prevent muscles from moving are active during normal REM or dreaming sleep, resulting in temporary paralysis of your body. In REM sleep behavior disorder, these pathways no longer work and you may physically act out your dreams. (11)
Symptoms: Movement, such as kicking, punching, arm flailing or jumping from bed, in response to action-filled or violent dreams, such as being chased or defending yourself from an attack, noises, such as talking, laughing, shouting, or emotional outcries
6. Exploding Head Syndrome
About: Exploding Head Syndrome is characterized by hearing a loud noise that you suddenly imagine just before you fall asleep. It can seem like a violent explosion has gone off in your head. (12)
Causes: Minor seizures in temporal lobe, sudden shifts in part of the middle ear, stress, anxiety, medication, mental health disorder, or substance abuse
Symptoms: ‘Hearing’ a loud noise (often described as a loud bang, clash of cymbals, or bomb exploding), distress and fear, or muscle twitch
Sleeping disorders can have a large impact on not only our nights but also our lifestyles. For this reason, it is important to gain a thorough understanding of them and to seek help from a professional when necessary. If you want to feel your best, stay healthy, and perform up to your potential, quality sleep is a necessity, not a luxury. (1)
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