Sleep Disorders

This article is by Dr Sara McNellis Clinical Lead Consultant for the Sleep service at the Royal National ENT and ED Hospital at UCLH NHS Foundation Trust. Chief Medical Officer; Principal Consultant (Founder) Sleep and Health Clinic Ltd, which covers common sleep disorders that cause degradation of wellbeing.

Sleep disorders encompass a range of conditions that affect the quality, timing, and amount of sleep, leading to daytime distress and impairment in functioning. Here’s an overview of some common sleep disorders:

1. Insomnia

Description: Difficulty falling asleep, staying asleep, or waking up too early and not being able to get back to sleep.Symptoms: Trouble falling asleep, frequent awakenings during the night, waking up too early, daytime fatigue, irritability, and concentration problems.

2. Sleep Apnea

Description: A serious disorder where breathing repeatedly stops and starts during sleep. Types:

  • Obstructive Sleep Apnea (OSA): Caused by the relaxation of throat muscles.
  • Central Sleep Apnea: Occurs when the brain doesn’t send proper signals to the muscles that control breathing.Symptoms: Loud snoring, episodes of stopped breathing, gasping for air during sleep, dry mouth, morning headache, insomnia, excessive daytime sleepiness.

3. Restless Legs Syndrome (RLS)

Description: A condition characterized by an uncontrollable urge to move the legs, usually because of an uncomfortable sensation. Symptoms: Leg discomfort often described as creeping, crawling, pulling, throbbing, or itching, which improves with movement, especially in the evening or night.

4. Narcolepsy

Description: A chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep.Symptoms: Excessive daytime sleepiness, sudden loss of muscle tone (cataplexy), sleep paralysis, hallucinations.

5. Circadian Rhythm Disorders

Description: Disorders where there is a mismatch between the body’s internal clock and the external environment.Types:

  • Delayed Sleep Phase Disorder: Falling asleep and waking up much later than usual.
  • Advanced Sleep Phase Disorder: Falling asleep and waking up much earlier than usual.
  • Shift Work Disorder: Insomnia or excessive sleepiness due to working nontraditional hours.
  • Jet Lag: Temporary disruption of sleep patterns due to crossing multiple time zones.

6. Parasomnias

Description: Involves abnormal behaviors during sleep. Types:

  • Sleepwalking (Somnambulism): Performing activities while asleep, such as walking.
  • Sleep Talking (Somniloquy): Talking during sleep.
  • Night Terrors: Episodes of screaming, intense fear, and flailing while still asleep.
  • REM Sleep Behavior Disorder: Acting out dreams during REM sleep.

7. Sleep-Related Movement Disorders

Description: Involuntary movements during sleep. Types:

  • Periodic Limb Movement Disorder (PLMD): Repetitive cramping or jerking of the legs during sleep.
  • Bruxism: Grinding or clenching of the teeth during sleep.

Diagnosis and Treatment

Diagnosis typically involves a combination of:

  • Medical history and sleep diaries
  • Physical examinations
  • Polysomnography (sleep study)
  • Home sleep tests

Treatment options vary based on the disorder but can include:

  • Lifestyle changes and sleep hygiene: Establishing a regular sleep schedule, creating a restful sleeping environment, avoiding caffeine and electronics before bed.
  • Cognitive-behavioral therapy (CBT): Especially for insomnia.
  • Medications: Such as sleeping pills, stimulants, or medication for underlying conditions.
  • Medical devices: Continuous Positive Airway Pressure (CPAP) for sleep apnea.
  • Surgery: In severe cases of sleep apnea.

Understanding the specific type of sleep disorder is crucial for effective treatment and management, as each type may require a different approach.



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