Where do sleep disorders come from and how to deal with them

Lack or poor quality of sleep seriously affects physical and mental health. Constant fatigue during the day, Sleep Disorder Complications / BayCare problems with heart and blood vessels, overweight, diabetes, depression What Are Sleep Disorders? / American Psychiatric Association, persistent cognitive impairment are just some of the complications of not being able to rest at night.

Country studies show Andrew Stickley, Mall Leinsalu, Jordan E. DeVylder, Yosuke Inoue & Ai Koyanagi. Sleep problems and depression among 237,023 community-dwelling adults in 46 low- and middle-income countries / Nature, that up to 56% of all adults face sleep problems.

But you can fight this - if you make the right diagnosis in time and start treatment. Here are six common sleep disorders and scientific ways to manage them.

1. Insomnia

Insomnia, aka insomnia, is a condition in which you find it difficult to fall asleep or you wake up every now and then during the night. This is the most common Sleep and Sleep Disorder Statistics / American Sleep Association sleep disorder.

There are two What Are the Different Types of Insomnia? / Sleep Foundation type of insomnia:

Short-term, or acute. The trigger for this type is often a stressful event, such as a problem at work or in a personal relationship. The disorder lasts less than three months and goes away on its own when the person copes with the stress they have experienced.
Chronic. Insomnia is considered insomnia if it manifests itself at least three times a week for three months or longer.

What is the reason

There are dozens of them Insomnia / NHS. Stress, constant fatigue, poor sleep hygiene and its unfavorable conditions (uncomfortable bed, stale air, external noise, excessive light), side effect of drugs, disturbance of circadian rhythms due to shift work or jet lag, anxiety or depression, alcohol abuse, taking drugs, somatic and neurological diseases - these are the main ones.

How to recognize

In addition to difficulties with falling asleep and night awakenings, insomnia also manifests itself in this way Insomnia - Symptoms and causes / Mayo Clinic:

you regularly wake up earlier than planned and cannot sleep anymore;
don't feel rested after the night;
during the day you are haunted by fatigue and drowsiness;
you notice that you have become irritable, anxious, depressed;
you have problems with attention and concentration, memory has deteriorated;
you began to catch yourself making stupid mistakes, including when crossing the road or driving;
constantly worrying whether you will manage to fall asleep today or whether you will have to toss and turn again at midnight.

How to treat it

The first Insomnia / NHS that your therapist will advise you to do if you go to him is to make a little lifestyle change. And it can actually improve your night's sleep. Try this:

give up daytime sleep;
try to go to bed and get up at the same time every day;
at least an hour before bedtime, slow down the rhythm of life and try to relax - put down your phone, turn off your laptop, do not eat, take a warm bath, read a book with a measured plot, turning on a cozy warm light;
be physically active during the day, you need to get tired;
make sure your mattress, pillow, blanket is comfortable.

If this does not help, you will have to make an appointment with a doctor again. Your goal is to find out the cause of your insomnia. To do this, it is necessary to undergo a comprehensive examination: from a medical examination and blood tests to polysomnography (registration of indicators of a sleeping person with computer programs), which is carried out in specialized sleep clinics.

Then you will be treated by a specialized doctor - a somnologist, a psychotherapist, a psychiatrist. In some cases, persistent insomnia cannot be managed without medication.

2. Sleep apnea

Sleep apnea is a temporary stop in breathing when a person is asleep. Sometimes air does not flow for a minute or more, and the number of such pauses can reach 30 per hour. The body does not immediately understand that it lacks oxygen. And when this does happen, the reflex turns on: the person takes a sharp breath, which is accompanied by a loud snoring sound.

You cannot die directly from sleep apnea, but it puts a serious strain on the heart and dramatically increases the risk of myocardial infarction and strokes.

What is the reason

Apnea is most often caused by Sleep apnea - Symptoms and causes / Mayo Clinic by the fact that the throat muscles relax during sleep and the soft palate begins to block the pharynx. This is the so-called obstructive sleep apnea. Risk factors for this type of disorder include:

excess weight;
anatomically narrow pharynx and larynx;
the presence of close relatives suffering from the same sleep disorder;
age over 65;
enlargement of the palatine tonsils (adenoids);
smoking, alcohol abuse;
the habit of sleeping on your back;
persistent nasal congestion;
some diagnoses, such as heart failure, type 2 diabetes, hypertension, hormonal disorders.

But sometimes the disorder leads to Sleep apnea - Symptoms and causes / Mayo Clinic lack of "respiratory" impulses from the brain to the muscles. In this case, we talk about central sleep apnea. The risk of impairment increases if you are over 40 years old, a man, have had a stroke, are taking narcotic pain relievers, or are diagnosed with congestive heart failure.

How to recognize

Harsh sniffling sounds during sleep, frequent and seemingly unreasonable awakenings at night, daytime weakness and drowsiness, headaches in the morning, problems with concentration and memory - these are the main symptoms of Sleep apnea - Symptoms and causes / Mayo Clinic sleep apnea.

How to treat it

As with insomnia, they start with lifestyle adjustments. First of all, the therapist will recommend Sleep apnea / Mayo Clinic to get rid of excess weight and give up the habit of sleeping on your back.

If this does not work, you will be examined in more detail. This is to rule out diagnoses that could trigger sleep apnea. If the disease is found, it will be necessary to get rid of the underlying disorder, and then the problem of apnea will go away by itself.

In the event that all of the above does not work, you will need the help of a sleep doctor. Thus, one of the most effective methods of treating obstructive sleep apnea is CPAP therapy (CPAP - Constant Positive Airway Pressure). The medic will select a special mask for you to wear at night. This mask is connected to a compressor that blows air into the respiratory tract.

If for some reason CPAP therapy is not suitable for you, your doctor will suggest other options to cope with apnea - for example, surgery in the nasopharynx.

3. Restless legs syndrome

Restless legs syndrome / Mayo Clinic restless legs (RLS, Willis-Ekbom disease) is a neurological disorder in which itching, throbbing, burning, tingling, or other obsessive sensations develop in the muscles of the lower extremities. Discomfort is reduced by moving the legs. Therefore, a person who suffers from RLS is forced to wiggle their fingers, flex their muscles.

RLS attacks usually occur during moments of relaxation. Most often it happens in the evening and at night, so restless legs syndrome makes it difficult to get a good night's sleep.

What is the reason

It is not really known yet. Restless Legs Syndrome Fact Sheet / National Institute of Neurological Disorders and Stroke suggests that this could be a complex cocktail of genetics and brain disorders such as those associated with dopamine imbalances. This neurotransmitter plays a key role in the mechanism of muscle movement control. …

In addition, iron deficiency, a variety of neuropathies, including those caused by diabetes, bad habits (excessive consumption of alcohol, nicotine, caffeine) and taking certain medications can provoke restless legs syndrome.

How to recognize

The key symptom is unpleasant itching or tingling sensations that make you want to move your toes and stretch your legs. Restless Legs Syndrome Fact Sheet / National Institute of Neurological Disorders and Stroke may experience discomfort only from time to time, for example, once every few months. This happens in the early stages of the disease. However, the signs of RLS gradually build up, and in severe cases, the seizures bother several times a week.

How to treat it

Complaints about RLS should be addressed to a therapist. The doctor will examine you, ask about your symptoms, and ask you to get tested. This is necessary to exclude iron deficiency and other diseases - the same diabetes. If it is possible to detect a violation, the doctor will prescribe treatment.

However, it is not always possible to find the causes of restless legs syndrome. Therefore, RLS is most often treated symptomatically. The doctor will recommend Restless legs syndrome / Mayo Clinic moderate physical activity, warm foot baths. Perhaps prescribes iron supplements, anticonvulsants, muscle relaxants.

4. Narcolepsy

Narcolepsy Narcolepsy - Symptoms and causes / Mayo Clinic is a chronic sleep disorder in which a person suffers from severe daytime sleepiness and regularly falls asleep at the most unexpected moments. Doctors associate Overview - Narcolepsy / NHS disorder with the fact that the brain cannot normally regulate sleep and wakefulness.

What is the reason

Not exactly established. But Overview - Narcolepsy / NHS suggests that a lack of orexin (hypocretin), a neurotransmitter responsible for maintaining a state of wakefulness, leads to narcolepsy. Sometimes this is caused by the body's immune system malfunctioning and attacking the parts of its own brain that produce an important substance.

Also, heredity, hormonal changes, severe psychological stress, diseases - for example, swine flu - can play a role in the development of the disease.

How to recognize

Narcolepsy can present with one or more symptoms at the same time. Here they are Narcolepsy - Symptoms and causes / Mayo Clinic:

Daytime bouts of overwhelming drowsiness and sudden falling asleep.
Cataplexy is a peculiar state of a person in which he loses muscle tone due to strong emotional upheavals of a positive or negative nature. Usually, cataplexy develops rapidly, which leads to the fall of the relaxed body.
Hallucinations on falling asleep and waking. They are similar to waking dreams, when a person is still awake, but at the same time he already has visual and sound visions.
Sleep paralysis in the first seconds, and sometimes even minutes after waking up. At the same time, a person is in a clear consciousness, but is able to move only with his eyes and eyelids.

How to treat it

Doctors do not yet know how to get rid of this disease. Therefore, they resort only to symptomatic therapy. Specifically, the Narcolepsy / Mayo Clinic are prescribed psychostimulants and antidepressants to reduce drowsiness and ease the symptoms of cataplexy or sleep paralysis.

5. REM sleep behavior disorder

REM sleep behavior disorder - Symptoms and causes / Mayo Clinic (REM) is a disorder in which a person has very vivid, often unpleasant, frightening dreams with a lot of movements and sounds, and, following them, the person begins to actively pull his arms and legs.

The rapid eye movement (REM) phase is a normal part of healthy sleep, and it is during this phase that dreams appear. But normally at this moment people do not move: the brain paralyzes the muscles, with the exception of those responsible for the heartbeat and breathing. With behavioral disorder of the REM phase, the body gains an abnormal "freedom".

This is a fairly rare ailment that occurs Rapid eye movement sleep behavior disorder / UpToDate in about 0.5-1.25% of the world's population. In 90% of cases, the disease affects men.

What is the reason

It is not known exactly. However, REM sleep behavior disorder - Symptoms and causes / Mayo Clinic has been associated with various degenerative neurological diseases such as Parkinson's disease, multisystem atrophy, dementia, or Shay-Drager syndrome. In some cases, the disorder is caused by drinking alcohol or taking antidepressants.

How to recognize

The main signs of the disorder include REM sleep behavior disorder - Symptoms and causes / Mayo Clinic talking, screaming, laughing while sleeping, active limb movements, jumping out of bed. Sometimes "attacks" turn into injuries: a person either gets injured himself, striking violently against furniture or walls, or people sleeping next to him may suffer from his movements.

In the initial stages of the disease, symptoms appear only from time to time. But gradually the situation worsens: movements in a dream become more and more frequent and active.

How to treat it

REM sleep behavior disorder / Mayo Clinic is treated with medication. For example, antiepileptic drugs based on clonazepam or with the help of dietary supplements with the hormone melatonin - a regulator of circadian rhythms.

6. Parasomnia

Parasomnia Sleep Disorders / U. S. The National Library of Medicine is the generic name for disorders associated with unusual behavior while falling asleep, sleeping, or waking up.

The most famous example of Parasomnias & Disruptive Sleep Disorders / Cleveland Clinic is sleepwalking (sleepwalking). With such a violation, a person, without waking up, gets out of bed and begins to perform some usual actions. But parasomnia can manifest itself in other ways. For example, nightmares or sleep paralysis.

What is the reason

Parasomnias & Disruptive Sleep Disorders / Cleveland Clinic can lead to parasomnia due to lack of or poor quality of sleep, high temperature, taking certain medications, alcoholism and drug addiction, stress, anxiety, various neurological diseases. Genetics plays a role: if your blood relatives have people with any type of this sleep disorder, your risk of facing the same sleep disorder increases.

How to recognize

Symptoms vary depending on the type of parasomnia. But there are some common signs of Parasomnias & Disruptive Sleep Disorders / Cleveland Clinic:

Problems with sleeping at night. For example, you often wake up or experience unpleasant dream-related emotions.
Constant fatigue during the day.
Bruises, cuts on the body, the reasons for which you do not remember.
The stories of the person you sleep with about your restless or strange behavior at night.

How to treat it

Often, people with parasomnia do not need drug therapy. They are advised by Parasomnias & Disruptive Sleep Disorders / Cleveland Clinic to be less nervous and practice good sleep hygiene.

If this does not help, the doctor - a somnologist or psychiatrist - may prescribe antidepressants or tranquilizers. Hypnosis, cognitive behavioral therapy and other types of psychotherapy also help in the treatment of parasomnias.

This material was first published in March 2015. In August 2021, we updated the text.