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A sleep disorder is a disorder in the sleep patterns of a person or animal. Some sleep disorders can interfere with mental and emotional function, due to their interference with REM sleep.
A majority of sleep disorders which originate within the body (for example, insomnia, Delayed Sleep Phase Syndrome, or Advanced Sleep Phase Syndrome) result from errors in synchronization of sleep with the body clock. Only a fraction of sleep problems are organic and cannot be resolved with chronotherapy. One of the simplest solutions towards getting good sleep is free-running sleep. Free-running sleep entails ignoring alarm clocks and schedules in order to sleep when, and only when tired. Free-running sleep can resolve the majority of synchronization-dependent sleep disorders, but usually cannot be employed due to the resulting loss of synchronization of sleep with the outside world (including day-night cycle).
Sleep disorders are often observed in patients with a number of psychiatric problems (e.g. bipolar disorder, depression, schizophrenia, etc.).
One form of sleep disorder, narcolepsy, probably has a genetic basis. Subjects not only fall asleep several times during the day, they also experience abnormal sleep patterns at night
Insomnia is a sleep disorder
characterized by an inability to sleep and/or to remain asleep for a reasonable period during the night. Sufferers typically complain of being unable to close their eyes for more than a few minutes at a time, or of 'tossing and turning' through the night.
If insomnia continues for more than a few nights running, it can become chronic and cause a sleep deficit that is extremely detrimental to the sufferer's well-being. Insomnia interrupts the natural sleep cycle, which can be hard to restore. Some insomniacs unwittingly perpetuate their complaint by napping in the late afternoon or early evening, leading to wakefulness at bedtime and more insomnia. Others push their bodies to the limits, until their sleep deficit causes severe physical and mental effects.
Many people who feel they are suffering from insomnia may actually have a lower physical need for sleep than they believe they do. A normal part of the ageing process is to sleep more lightly and for shorter periods of time, and some elderly people toss and turn in bed late at night or early in the morning when their body has no physical need for more rest, because they believe that they must 'need' a certain amount of sleep to be rested.
Insomnia is a common side-effect of some medications, and it can also be caused by stress, emotional upheaval, physical or mental illness, dietary allergy and poor sleep hygiene. Insomnia is a major symptom of mania in people with bipolar disorder, and it can also be a sign of hyper-thyroidism, depression, or other physical complaints with stimulating effects.
Delayed sleep phase syndrome (DSPS) is a sleep disorder in which the patient's internal body clock is not in sync with the morning-rise evening-sleep pattern of the majority of adults. A growing body of evidence suggests that the problem is genetic, and may be inherited.
Sufferers – traditionally termed "night owls" – have an identifiable sleep pattern, with the majority falling asleep in the pre-dawn hours and waking in the afternoon. If the sufferer is allowed to follow their in-built sleep pattern, there are generally no problems with either falling asleep or waking naturally.
However, left unacknowledged, DSPS can cause the same problems that would be expected if an adult with a normal sleep pattern forced themselves to wake up in the middle of the night and go to sleep in the early evening.
For most sufferers, the problem is evident from birth. Parents may find themselves chastised for not giving their children acceptable sleep patterns, and schools are generally unco-operative in helping children. This can have severe physical and mental ramifications, as children are treated for insomnia when there is no real problem falling asleep – except it's at an unsocial hour.
Often, sufferers manage on a few hours' sleep a night during the working week, then "catch up" by sleeping excessively at the weekend, with the corresponding effects on social activities.
Advanced sleep phase syndrome (ASPS) is a sleep disorder in which patients feel very sleepy early in the evening (e.g. 18:00-19:00) and wake up very early in the night (e.g. midnight, 1:00, etc.).
It is the opposite of delayed sleep phase syndrome.
ASPS is frequently encountered in the elderly and in post-menopausal women. It can be treated pharmacologically, with evening bright lights, or behaviorally with chronotherapy or free-running sleep.
Most people with sleep apnea
have obstructive apnea, in which the person stops breathing during sleep due to airway blockage. Sufferers usually resume breathing within a few seconds, but periods of as long as sixty seconds are not uncommon in serious cases. It is more common amongst people who snore, who are obese, who consume alcohol, or who have anatomical abnormalities of the jaw or soft palate. However, atypical cases do occur, and the condition should not be ruled out unilaterally merely because the patient does not fit the profile.
"OSA" is caused by the relaxation of the muscles in the airway during sleep. Whilst the vast majority of people successfully maintain a patent (open) upper airway and breathe normally during sleep, a significant number of individuals are prone to severe narrowing or occlusion of the pharynx, such that breathing is impeded or even completely obstructed (Mortimore & Douglas, 1997). As the brain senses a build-up of carbon dioxide, airway muscles are activated which open the airway, allowing breathing to resume but interrupting deep sleep.
Sleep hygiene is the practice of following simple guidelines to ensure restful, effective sleep promoting daytime alertness and helping avoid the onset of sleep disorders. Trouble sleeping and daytime sleepiness are indicators of poor sleep hygiene.
Measures include:
Going to bed and rising at the same time seven days a week
Reserving the bedroom for only sleep and lovemaking
Keeping the bedroom at a comfortable temperature
Keeping the bedroom as dark as possible
Establishing a regular bedtime routine
Avoiding drugs of any kind within one hour of retiring (e.g., caffeine, alcohol)
Avoiding large meals within one hour of sleep
Use relaxation techniques (e.g., meditation) shortly before sleep
Regular, vigorous, daily exercise, preferably in the morning
Getting adequate exposure to natural daylight every day
Avoid exercise within one hour of sleeping
If possible, avoid napping during the day
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