What Are Sleep Disorders?
Strange nocturnal behaviors may indicate one of these conditions.
There are more than 80 different sleep disorders, or health conditions that disturb your normal sleep patterns.
Most adults need at least seven hours of sleep each night. Though having trouble sleeping may seem like an ordinary, harmless issue, it can significantly impact your life. Aside from feeling tired, sleep disorders can affect your physical and mental health, thinking, and daily functioning.
Sleep disorders vary, meaning their symptoms, causes, and treatments also vary. Read on to learn about some of the most common sleep disorders, what to do about them, and when to consult a healthcare provider.
Types of Sleep Disorders
Sleep disorders include several conditions that impact your ability to fall or stay asleep or disrupt your regular sleep patterns. According to the International Classification of Sleep Disorders (ICSD), there are several subtypes of sleep disorders.
Insomnia
Insomnia causes trouble falling asleep or staying asleep. With insomnia, you might have symptoms like:
Laying awake for a long time before you fall asleep
Waking up a lot during the night
Waking up feeling unrested
Waking up too early in the morning and not being able to get back to sleep
Stress or changes in your schedule or environment may trigger short-term insomnia for a few days or weeks. In contrast, chronic insomnia occurs three or more nights a week and lasts over three months.
Obstructive Sleep Apnea
People with obstructive sleep apnea have narrow or blocked airways that suddenly cause their breathing to stop and restart while sleeping.
The hallmark of obstructive sleep apnea is loud snoring that can be interrupted by a long silent period while your breathing stops. You may let out a loud snort and gasp to regain your breath. That cycle repeats several times while you are sleeping.
Other obstructive sleep apnea symptoms include:
Falling asleep while working, reading, or watching TV
Feeling sleepy while driving
Forgetfulness
Grumpiness
Headaches that do not go away easily
Waking up feeling unrefreshed and sleepy
When you sleep, your airways relax. Under normal circumstances, your throat stays open enough to let air pass through. Some people have a narrow throat that causes the tissues to close in and block the airway, causing obstructive sleep apnea.
Other causes of obstructive sleep apnea include having a short lower jaw compared to your upper jaw. A large neck, tongue, tonsils, and adenoid can narrow or block your airways. Your tonsils are the lumps of tissue at the back of your throat. Your adenoid is a tissue patch high up in your throat, just behind your nose.
Problems Staying Awake
Hypersomnia causes repeated episodes of sleepiness during the day. People with hypersomnia may want to nap at inappropriate times, like during work or meals. Hypersomnia is different from typical fatigue. Usually, tiredness does not go away after naps.
People with hypersomnia may have symptoms like:
Anxiety
Decreased energy
Feeling disoriented
Hallucinations
Irritability
Slow speech
Trouble waking up from a long sleep
Other sleep disorders like narcolepsy or sleep apnea may cause hypersomnia. Other causes include nervous system dysfunction, substance and alcohol abuse disorder, and certain medications.
Related: Can't Fall Asleep? 12 Tips for What To Do
People with narcolepsy feel extremely tired and have a strong urge to sleep during the day. Some of the most common symptoms of narcolepsy include:
Cataplexy, or sudden muscle weakness
Difficulty falling or staying asleep at night
Disruptions in sleep via insomnia, vivid dreaming, sleep apnea, acting out while dreaming, and periodic leg movements
Excessive daytime sleepiness
Hallucinations
Sleep paralysis
Nearly all people with sudden muscle weakness caused by narcolepsy have extremely low hypocretin levels. Hypocretin is a naturally-occurring chemical that promotes wakefulness and regulates REM sleep. Generally, narcolepsy may have other causes, including certain autoimmune diseases, genes, and a history of brain injuries.
Typically, narcolepsy is a lifetime problem but does not worsen with age. Narcolepsy may improve, though it will never resolve completely.
Restless Legs Syndrome
Restless legs syndrome is a neurological disease that causes painful feelings in the legs, most commonly at night.
People with restless legs syndrome constantly need to move. They may feel uncomfortable sensations in their lower limbs, like aching, throbbing, pulling, itching, crawling, or creeping. Those feeling usually affects both sides and can alternate between sides.
Sleep-Disruptive Behaviors
Sleep-disruptive behavior might include nightmares or abnormal actions. Also known as parasomnia, those actions may include talking and walking while sleeping.
Sleep-disruptive behavior includes sleep disorders, such as:
Night terrors: Also called sleep terrors, these episodes occur when a person quickly wakes up in a terrified state. Common symptoms of night terrors include heavy breathing, screaming, sweating, and thrashing movements. Unlike nightmares, people with night terrors remain asleep and rarely remember their dreams the next day. Night terrors are most prevalent in young children and rarely affect adults.
Nightmare disorder: Many people have had a bad dream at least once. In contrast, nightmare disorder frequently causes bad dreams. Nightmare disorder often causes symptoms like feeling angry or sad upon waking, leg movements during REM sleep, and sweating.
Parasomnia: This sleep disorder involves unusual behavior while sleeping, including talking and walking. Sleep talking can range from senseless mumblings to angry, vulgar rants. Sleepwalking episodes can last for up to 30 minutes. Upon waking, sleepwalkers may feel groggy or disoriented and have little to no recollection of their actions.
REM sleep behavior disorder (RBD): This sleep disorder occurs when you act out vivid dreams as your body enters REM sleep. Actions may include hand motions, reaching, punching, and kicking. Episodes tend to worsen over time. Usually, waking someone with RBD is easy. Unlike those who sleepwalk or have night terrors, they can easily recall clear details of their dreams.
Sleep paralysis: With sleep paralysis, you are not able to move your body or speak as you fall asleep or wake up. Sleep paralysis may occur when falling asleep or waking up, lasting from a few seconds to two minutes. Often, sleep paralysis causes hallucinations.
Sleep starts: Also known as hypnic jerks, sleep starts cause your muscles to contract with sharp, sudden jerks as you shift into the first levels of sleep. You may have visual and auditory symptoms, like seeing a bright light or hearing a loud noise that is not there.
Sleep Rhythm Problems
These sleep disorders are patterns that occur before or after the times that most people sleep.
With advanced sleep phase syndrome (ASPD), people wake early in the morning and have trouble staying awake in the evenings. With delayed sleep phase syndrome (DSPD), people are up well into the early morning and have difficulty waking until the late morning or afternoon.
Sleep Disorder Symptoms
Sleep disorders cause different symptoms. In general, symptoms that might signal a sleep disorder include:
Consistently taking more than 30 minutes to fall asleep
Feeling tired during the day
Having uncomfortable tingling sensations in your limbs that only go away when you move them
Having vivid dreams while falling asleep
Jerking your limbs frequently while sleeping
Not being able to move after waking up
Snoring loudly, gasping for breath and making choking noises, or stopping breathing while sleeping
Suddenly having weak muscles when feeling angry or scared or while laughing
Taking naps often or falling asleep at inappropriate times during the day
Waking up several times during the night and having trouble falling back asleep or waking up too early in the morning
What Causes Sleep Disorders?
A sleep disorder is a condition that interrupts your normal sleep patterns. A sleep disorder may impact your emotional, mental, and physical health and complicate your social functioning.
There are several causes for sleep disorders, such as:
A family history of sleep disorders
Anxiety
Certain medications
Depression
Underlying health conditions like chronic pain, heart and lung disease, and nerve problems
Other times, sleep disorders do not have a known cause.
Risk Factors
Anyone can develop a sleep disorder. Though, certain factors can increase your risk, such as:
Age (i.e., children are more likely to have sleep-disruptive behaviors than adults)
An irregular daily schedule
Caffeine and alcohol consumption
How Are Sleep Disorders Diagnosed?
A healthcare provider will likely ask about your sleeping patterns and perform a physical exam to diagnose sleep disorders. For example, a healthcare provider can administer a questionnaire or ask you to keep a sleep diary.
In a sleep diary, you record factors like:
How long it takes you to fall asleep
How many times you wake up during the night
When you go to bed
Whether you take any naps
Related: How Is Sleep Apnea Diagnosed?
A healthcare provider may advise a polysomnogram, or a sleep study. A sleep study monitors your sleeping patterns and takes note of factors like:
Blood pressure
Brain wave changes
Breathing
Eye movements
Heart and muscle electrical activities
Heart rate
In some cases, a healthcare provider may order lab studies that measure factors like thyroid hormones, iron levels, and cerebrospinal fluid (CSF).
Other tests include actigraphy and multiple sleep latency testing (MSLT). Actigraphy uses a device like a wristwatch to measure your sleep-wake cycles. MSLT estimates how sleepy you are at different parts of the day.
Treatments for Sleep Disorders
Generally, sleep disorder treatments may include:
Cognitive behavioral therapy (CBT)
Good sleep habits (e.g., avoiding TV, computer, or phone screens before bedtime; going to bed and waking up at the same times daily; and making sure your environment is dark and quiet)
Medicines (i.e. sleeping pills)
Natural therapies (i.e. melatonin)
Relaxation techniques to reduce anxiety
A healthcare provider can advise specific treatments depending on your sleep disorder.
Insomnia
Generally, a healthcare provider may suggest that you try practicing good sleep hygiene or cognitive behavioral therapy (CBT), a type of counseling. Several medicines can help manage insomnia, such as benzodiazepines and melatonin receptor agonists.
Obstructive Sleep Apnea
Lifestyle changes, like avoiding alcohol or medicines that make you sleepy at bedtime and losing excess weight, can help. A continuous positive airway pressure (CPAP) device can help keep your airways open while you sleep. Dental appliances may help, too.
Problems Staying Awake
A healthcare provider may prescribe medications that treat hypersomnia symptoms. They may advise behavioral changes, like avoiding night work, socializing late at night, and limiting alcohol and caffeine.
For narcolepsy, stimulants like modafinil help you stay awake during the day. Antidepressants suppress REM sleep and treat weak muscles.
Restless Legs Syndrome
There is no cure for restless legs syndrome. Still, there is a variety of treatment options. Lifestyle changes, like cutting back on the use of alcohol or tobacco and regularly exercising, may help. Iron supplements and anti-seizure medication may provide relief.
Standard Disclaimer
Dietary supplements are minimally regulated by the FDA and may or may not be suitable for you. The effects of supplements vary from person to person and depend on many variables, including type, dosage, frequency of use, and interactions with current medications. Please speak with a healthcare provider or pharmacist before starting any supplements.
Sleep-Disruptive Behaviors
Mainly, treatments for sleep-disruptive behaviors include CBT and relaxation techniques to reduce anxiety about sleeping. Practicing good sleep habits may help. In severe cases, a healthcare provider may prescribe medications.
Depending on what is disrupting your sleep, treatments may include:
Night terrors: One of the best treatments is proper sleep hygiene and stress management. A healthcare provider may prescribe medications or advise CBT.
Nightmare disorder: Because nightmares may link to psychological trauma, psychotherapy and psychoanalysis are common treatments. Certain medications may reduce the occurrence of nightmares.
Parasomnia: There is no cure, but generally, sleep talking goes away on its own. Short-acting tranquilizers may decrease sleepwalking. Some evidence suggests that self-hypnosis and relaxation techniques are effective treatments.
REM sleep behavior disorder: A healthcare provider may prescribe medications like Klonopin. They may advise taking safety precautions like keeping your bed near the floor to prevent falling or hiding any weapons locked away.
Sleep paralysis: Often, treatment is not necessary. Getting enough sleep each night can help reduce sleep paralysis episodes. A healthcare provider may prescribe medication to prevent REM sleep. Medicines that treat anxiety or other mental health conditions and talk therapy can also help.
Sleep starts: Limiting caffeine intake, moderately exercising during the daytime, or improving your sleep hygiene can help decrease sleep starts. A healthcare provider may prescribe medication if sleep starts regularly impacting your rest.
Sleep Rhythm Problems
A sleep specialist can determine factors that intensify ASPD or DSPD, such as not getting enough natural light during the day. Treatment ranges from melatonin to CBT. Chronotherapy, or shifting your bedtime a few hours later each day until you reach a regular sleep schedule, is a common treatment for DSPD.
Complications
Sleep disorders may lead to sleep deprivation and impact your emotional, mental, and physical health. If untreated, sleep disorders can cause complications, such as:
Accidents and injuries: Some sleep disorders may increase the risk of serious injuries. For example, sleepwalking may cause injuries if you trip and fall. In general, disrupted sleep raises the risk of industrial or motor vehicle accidents.
Anxiety and mood disorders: Sleep disorders can affect your emotional and mental health. Chronic sleep deprivation increases cortisol, a stress hormone. High cortisol levels can increase the risk of anxiety.
Decreased cognitive functioning: Sleep deprivation can impair your ability to focus and pay attention.
Heart disease and stroke: High cortisol levels can increase blood pressure and blood sugar, which impact your heart disease risk. Some evidence suggests that restless legs syndrome raises stroke risk.
Living With Sleep Disorders
The prognosis of sleep disorders depends on what condition you have. Some sleep disorders may go away or lessen with treatments, while others do not have a cure. For example, night terrors usually resolve with treatment. In contrast, chronic insomnia can be long-lasting and affect your quality of life.
Living with sleep disorders can be challenging due to their effects on your emotional, mental, and physical health. Still, you can practice good sleep hygiene to improve your sleep patterns and prevent sleep disorders.
Try some of the following to improve your sleep hygiene:
Avoid exercising too close to your bedtime.
Do not use your bed for activities other than sleep and sex.
Go to bed and wake up at the same time every day.
If you cannot fall asleep, try relaxing activities (e.g., enjoy a warm beverage or read a book).
Keep your environment calm, dark, and quiet while sleeping.
Limit your caffeine intake, especially in the evening.
Related: The Ultimate Guide to Sleep Sounds: Pink Noise, Brown Noise, and White Noise, Explained
A Quick Review
Sleep disorders are common conditions that negatively affect your regular sleep patterns. Sleep disorders can affect your emotional, mental, and physical health.
Consult a healthcare provider if you regularly have trouble falling or staying asleep or notice abnormal sleeping behaviors. Chronic sleep deprivation increases your risk of complications like accidents and injuries, anxiety, and heart disease.
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