The effects of not getting enough sleep can have a detrimental impact on overall health.

Neuraxpharm provides medication alternatives for sleep disorders and once your doctor has determined your specific needs, they can prescribe the product that best adapts to your needs and condition.

Read on to find out more about sleep disorders.

What is a sleep disorder?

The term ‘sleep disorders’ refers to a group of conditions that affect the quality, timing, or length of sleep. Problems can range from having difficulty falling or staying asleep to getting too much sleep, or even experiencing abnormal behaviours during sleep.

Sleep disorders have an impact on your ability to function properly while awake, and can be linked to other health conditions(1).

What are the main types of sleep disorder?

There are thought to be around 100 different types of sleep disorder. These are the most common:

  • Insomnia: Struggling with falling and staying asleep. This is a very common sleep disorder which affects around 6% of the general population(2).
  • Excessive daytime sleepiness: Difficulty staying awake. In a 2002 study, 15% of individuals in five European countries were found to suffer with this(3). Some sufferers may be diagnosed with narcolepsy – a rare long-term neurological condition that causes sufferers to suddenly fall asleep at inappropriate times.
  • Sleep-related breathing disorders: Difficulty breathing during sleep. This is quite common; in developed countries it is reported to affect 3–7% of adult men and 2–5% of women(4). One such disorder is sleep apnoea, in which breathing is interrupted during sleep. If left untreated, it can seriously impact quality of life and health.
  • Parasomnia: Abnormal behaviour while sleeping, such as walking or talking. This is relatively common in the general population (7.6%) and more frequent in students and psychiatric patients(5).
  • Restless leg syndrome: Sufferers experience an overwhelming desire to move their legs and can also feel an uncomfortable sensation in the limbs. This is a condition that affects the nervous system and is more common in middle age.
  • Sleepwalking: This is most common in children but can affect any age group. Someone who is sleepwalking may go for a walk or carry out a complex activity while not fully awake.

How many people have a sleep disorder?

It’s quite common to suffer from problems sleeping at some point in your life. Most of the time, the problems are short-lived and resolve themselves. However, once you have been experiencing a niggling sleep issue for around three months, it becomes what is known as a sleep disturbance.

If the sleep disturbance continues for a further three months, it is classified as a sleep disorder.

Sleep disorders are particularly prevalent in children, women, and those aged over 65, but can affect anyone at any stage of life.

Symptoms

What are the symptoms of a sleep disorder?

There are many different types of sleep disorder, and the symptoms vary. Some of the more common ones are:

Insomnia

Sufferers of this condition find it hard to go to sleep and then to stay asleep, with frequent waking throughout the night. They can wake up early and find it difficult to go back to sleep, which can lead to irritability and low mood.

Narcolepsy

There are five main symptoms of narcolepsy. These are: a sudden, brief loss of voluntary muscle tone, hallucinations, excessive daytime sleepiness, sleep paralysis, and sleep disruption.

Restless leg syndrome

The main symptom of this condition is an overwhelming urge to move your legs. People with restless leg syndrome can also experience an unpleasant crawling or creeping sensation in the feet, calves, and thighs, which is often worse in the evening or at night and makes it difficult to sleep.

Sleep apnoea

Symptoms occur during sleep and include ‘stop/start’ breathing, making gasping, snorting or choking noises, and loud snoring.

What are the early signs of a sleep disorder?

Many people suffer from some sort of problem sleeping; it is only when the problems have been experienced for around six months that they become classified as a sleep disorder.

It makes sense to be aware of changes to your sleeping pattern and take early action to try to address them, such as by practising effective sleep hygiene.

Sleep hygiene encompasses all the routines and environmental aspects you need to have a relaxing bedtime and a restful night’s sleep. There is more information about sleep hygiene in the Prevention section.

Causes, risk factors and life expectancy

What causes a sleep disorder?

There are numerous reasons why people develop sleep disorders, and they can occur in isolation or as a combination. Stress and anxiety can lead to sleep problems because it’s hard for your brain to switch off and relax to go to sleep when worries are playing on your mind. Sometimes sleep problems can be a symptom of an underlying physical or mental health condition and can be resolved once the condition is treated. Other causes can include:
  • Ageing: As the body ages, the sleep required changes and becomes less deep. It may also be necessary to get out of bed to urinate more frequently, which can affect sleep patterns.
  • Surroundings: If a bedroom is too hot or too cold, this can have an impact on quality of sleep which, if it continues, can have a more lasting impact.
  • Disrupted sleep routine: Shift workers may find it harder to get to sleep and stay asleep.
Neurological psychiatric conditions: Sleep disturbance is very common in neuropsychiatric conditions and is considered a cross-cutting symptom. It occurs so frequently in major depressive disorder, bipolar disorder, generalised anxiety disorder, and post-traumatic stress disorder that it is included in diagnostic criteria(6).

Is sleep disorder hereditary?

There is no definitive answer to the question of whether sleep disorders can run in families, but genes may play a significant role in how much sleep we need.

Scientists have identified several genes involved with sleep and sleep disorders. Genome-wide association studies – which scan the complete DNA of many different individuals to identify genetic markers linked to a disease or condition – have discovered various genetic sites that increase our susceptibility to sleep disorders. Essentially, this means it’s possible that our genetic make-up determines our predisposition to suffer from a sleep disorder.

Some genes have been linked to specific sleep disorders such as familial advanced sleep-phase disorder (which sees sufferers persistently fall asleep early in the evening and wake up early in the morning), narcolepsy, and restless leg syndrome.

Who gets sleep disorders?

Anyone of any age or gender can be affected by a sleep disorder, although the conditions are more common in women, children, and older people.

How long can you live with a sleep disorder?

Although a sleep disorder is not a terminal condition, it can have a far-reaching detrimental impact on your quality of life and overall health.

Those who are chronically sleep deprived are more likely to be overweight, have a stroke, or develop cardiovascular disease.

Diagnosis

How is a sleep disorder diagnosed?

It’s common to have brief instances of poor sleep. Worry can lead to difficulty drifting off, while changes in life circumstances, such as having a baby, can lead to poor sleep. These causes tend to be temporary and usually resolve themselves. If you have had trouble sleeping for several months and it is affecting your daily life in a way that makes it hard to cope, you could benefit from further support.

A visit to the doctor to discuss your sleeping patterns and the impact they are having on your life is the first step to diagnosis. The doctor will ask questions about your history and any other symptoms; they may test your blood pressure and take blood samples for tests to rule out any underlying conditions.

Tests to diagnose a sleep disorder

Depending on the type of sleep disorder suspected, the doctor may suggest a sleep study to find out what is happening to your body and brain while asleep. This could involve wearing a device at home to measure your breathing and heartbeat while you sleep.

Alternatively, you may be asked to stay overnight at a sleep clinic, where a more detailed analysis of your sleeping pattern will be carried out. This could involve the use of electrodes, sensors and bands on your body while you sleep to record outputs like heart rate, oxygen levels, and brainwaves.

Treatment and medication

How are sleep disorders treated?

Treatment options are dependent on the disorder diagnosed and are tailored to individual circumstances. For example, narcolepsy has no cure, but medication can be used to manage symptoms, while sleep hygiene improvements can help combat sleepwalking.

How is Autism trated?

Because autism is a complex condition that affects people differently, the approaches will depend on the individual’s needs and may well change over the course of their life.

Many autistic people also have co-existing conditions, such as a learning disability, mental health problems, epilepsy, sleep problems and digestive issues. Certain treatments or support methods may be helpful for these and should always be monitored carefully.

Medication

A clinician may prescribe medication. Some drugs that can be used to treat particular sleep disorders are listed below.

Insomnia
A range of products is available to help with insomnia, both on prescription and over the counter. These include benzodiazepines, benzodiazepine receptor agonists, anti-depressants, and anti-histamines(7).
Narcolepsy
Stimulants which enhance the release and inhibit the reabsorption of hormones from the adrenal glands are the main medication treatment for narcolepsy. Wake-promoting medication could also be prescribed. Any course of medication should be under medical supervision and should only be continued for as long as the doctor believes it to be beneficial.

Melatonin or other natural herbal supplements can be used to help promote relaxation and sleep. Melatonin, which is a naturally occurring hormone, is said to contribute to reducing the time it takes to fall asleep. Of course, any medication may have side effects, and some could also cause dependency, so most medication should only be used under medical supervision.

It’s more likely that a treatment plan would involve therapy and changes to your sleep environment and routine, such as getting into a regular pattern at bedtime; however, as with medications, this is dependent on the type of sleep disorder you have.

Therapy

Cognitive behavioural therapy (CBT) can be used to treat sleep disorders such as insomnia. In fact, it’s recommended as the first treatment option in insomnia in guidelines developed by a task force of the European Sleep Research Society(7). CBT for sleep disorders is likely to include education around sleep hygiene to highlight factors that may promote or disrupt sleep. It could also include relaxation therapy to provide techniques to encourage relaxation. Another element of CBT treatment is sleep restriction therapy, which sees the time spent in bed changed according to the amount of sleep being experienced.

The same guidelines also indicate that light therapy and exercise may be useful additional therapies for insomnia, although the evidence for these is not as strong as for CBT.

CBT has also been shown to successfully manage symptoms of narcolepsy, usually alongside medication. In addition to CBT, other behavioural approaches that can be used to treat narcolepsy include strategic napping and sleep hygiene(8). Strategic napping is when short naps are scheduled in up to three times a day, while sleep hygiene involves measures taken in the lead-up to bedtime and changes to the environment in which sleep occurs.

Intervention

Making changes to your bedtime routine can help create the right conditions for a restful night’s sleep.

Avoid using electronics such as laptops or mobile phones before going to sleep, and make sure your sleeping area is not too hot or too cold and is dark and quiet.

Diet

Avoiding caffeine and alcohol is advisable when trying to combat a sleep disorder, and your eating habits can also have an impact on sleep quality and length. Eating too close to bedtime can lead to sleep disruption, while excessive calories and fat can make it harder to go to sleep. Eating a healthy balanced diet which includes key nutrients such as calcium and vitamins A, C, D, and E is best for overall health and wellbeing.

Exercise

It is not advisable to exercise close to bedtime; instead, meditation and relaxation techniques can help you prepare for sleep. That said, it has been shown that physical activity can improve sleep, with regular exercise found to have moderate and strong positive effects on overall sleep quality(9). Exercise can also act as a preventative measure to reduce the risk of sleep problems such as insomnia, sleep apnoea, or restless leg syndrome.

Prevention

Having a regular sleep routine and practising effective sleep hygiene can help prevent sleep disorders from developing.

Recommended sleep habits include:

  • Not consuming caffeine within six hours of bedtime
  • Avoiding the use of electronic devices in the hour before going to bed, and in the bedroom
  • Ensuring the bedroom is cool, dark, and quiet before getting into bed
  • Having a relaxing and consistent pre-bedtime routine, which could involve a warm bath, reading, or meditation.

Scientific studies

There have been numerous studies into sleep and in particular the impact that getting too little sleep can have on health and public safety.

Decades of studies have confirmed that sleep is necessary for our healthy functioning – and even survival.

The Journal of Clinical Sleep Medicine launched in 2005, by which time a large number of sleep disorders had been identified and clearly defined. Since then, the pace of research and discovery has accelerated, and the number of peer-reviewed sleep journals has more than tripled.

Current research tends to focus on how disrupted sleep affects the body and the impact it has on metabolism and hormone regulation. In addition, newer studies reinforce what is known and suspected about the relationships between inadequate sleep and a wide range of conditions including obesity, high blood pressure, heart disease, and mood disorders.

Referenced sources

  1.  Chattu VK, Manzar MD, Kumary S, Burman D, Spence DW, Pandi-Perumal SR. The global problem of insufficient sleep and its serious public health implications. Healthcare. 2019;7(1):1. doi: 10.3390/healthcare7010001
  2. Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2002;6(2):97-111. doi: 10.1053/smrv.2002.0186
  3. Ohayon MM, Priest RG, Zulley J, Smirne S, Paiva T. Prevalence of narcolepsy symptomatology and diagnosis in the European general population. Neurology. 2002;58(12):1826-1833. doi: 10.1212/wnl.58.12.1826
  4. Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc. 2008;5(2):136-143. doi: 10.1513/pats.200709-155MG
  5. Sharpless BA, Barber JP. Lifetime prevalence rates of sleep paralysis: a systematic review. Sleep Med Rev. 2011;15(5):311-315. doi: 10.1016/j.smrv.2011.01.007
  6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM). 5th Ed Washington D.C. 2013.
  7. Riemann D, Baglioni C, Bassetti C et al. European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Res. 2017;26(6):675-700. doi: 10.1111/jsr.12594
  8. Bhattarai J, Sumerall S. Current and future treatment options for narcolepsy: a review. Sleep Sci. 2017;10(1):19-27. doi: 10.5935/1984-0063.20170004
  9. Dolezal BA, Neufeld EV, Boland DM, Martin JL, Cooper CB. Interrelationship between sleep and exercise: a systematic review. Adv Prev Med. 2017;2017:1364387. doi: 10.1155/2017/1364387 corrigendum: 2017;2017:5979510
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