Types Sleep Disorders & Symptoms

Sleep disorders are sleep problems that, if untreated, can affect a person's physical health, daily activities, and mental health. More than the once-in-a-while tossing and turning or waking up early, sleep disorders are medical conditions that can potentially be serious. But, there is treatment for all of these disorders. Talk with your health care provider if you think you may have a sleep disorder.

It a fact, sleep deteriorates with age: you sleep fewer hours, you sleep less deeply, you have more trouble falling asleep, you wake more easily, you're more tired during the day, you have less REM (rapid eye movement) sleep, and so on. What is surprising, though, according to a study in the Journal of the American Medical Association, is that some of these changes occur much earlier than we previously thought, and that they are also linked to some other surprising metabolic alterations.

How much sleep does a person need?
There is no hard and fast answer to this question. The amount of sleep a person needs depends on many things, including age. Most adults need at least 7 to 8 hours of sleep per night, although some people may need as many as 10 hours. Children and adolescents need about 9 hours of sleep, while young infants may need around 16 hours per day. Women in the first 3 months of pregnancy often need a few more hours of sleep than normal, and sleep quality is decreased. When people sleep too little over a period of a few days, they build up a "sleep debt," like being overdrawn at a bank. This debt needs to be repaid sooner or later. A person's body is not able to get used to less sleep than they need. Aging does not seem to change the amount of sleep a person needs, although older people tend to sleep more lightly and for shorter periods of time. About half of the people over 65 have frequent sleeping problems, such as insomnia, and deep sleep stages that are shortened or completely stopped. These changes in sleep may be a normal part of aging, or can be caused by medications or treatments for other health problems.

How can I tell if I have a sleep problem or a sleep disorder?
Because so many people "burn the candle at both ends" and have large sleep debts, sleep problems are common. Side effects from medications or treatments and stress and worry can also cause sleep problems. For women, hormone changes during pregnancy, menopause, and the menstrual cycle can cause sleep problems.

Sleep experts say that if you feel sleepy during the day, even when doing something boring, you haven't had enough sleep. If you usually fall asleep within 5 minutes of lying down, you probably have a severe sleep debt, maybe even a sleep disorder. Very short periods of sleep throughout the day (sometimes you may not even know that you are sleeping) are also another sign of a sleep disorder. To learn about the signs for the most common sleep disorders, read the sleep disorder-related FAQs (sleep apnea, narcolepsy, restless legs syndrome, and insomnia) on this site. Talk with your health care provider if you are having a problem with sleep or think that you may have a sleep disorder.

What can I do to get a good night's sleep?
Good sleep habits can help you get a good night's sleep. Here are some tips:

Try to go to bed at the same time every night and get up at the same time every morning. Try not to take naps during the day because naps may make you less sleepy at night.

Try to avoid caffeine, nicotine, and alcohol late in the day. Caffeine and nicotine are stimulants and can keep you from falling asleep. Alcohol can make you wake up later in the night.

Get regular exercise. Try not to exercise close to bedtime because it may stimulate you and make it hard to fall asleep. Experts suggest not exercising for 3 hours before the time you go to sleep.

Don't eat a big meal late in the day, although a light snack before bedtime may help you sleep.

Make your sleeping place comfortable. Be sure that it is dark, quiet, and not too warm or too cold. If light is a problem, try a sleeping mask. If noise is a problem, try earplugs, a fan, or a "white noise" machine to cover up the sounds.

Create a routine to help you relax and wind down before sleep, such as reading a book or taking a bath. Watching the news just before bed may keep some people awake, especially if the news is upsetting.

Try not to use your bed for anything other than sleeping and sex.

If you can't fall asleep and don't feel sleepy, get up and do something else until you feel sleepy. Just make sure that you don't do anything stimulating.

If you have trouble lying awake worrying about things, try making a to-do list before you go to bed. This may help you to "let go" of those worries overnight.

See your health care provider if you think you have a sleep problem or a sleep disorder.

Sleep disorders are usually classified into three major categories, including lack of sleep, insomnia; disturbed sleep (obstructive sleep apnea, REM sleep behavior disorder, and restless legs syndrome and periodic limb movement), and too much sleep (narcolepsy).

Sleeplessness or Lack of Sleep
Insomnia Insomnia is the inability to fall asleep. It is a common sleep problem that most people at least occasionally experience at various points in their lives. When it occurs, people feel tired much of the time and tend to worry a lot about the fact that they are not getting enough sleep. Consequently, insomnia often disrupts a person's daily life. It can result from emotional difficulties, stress, diet (caffeine and alcohol, for example, both significantly affect sleep), an underlying disease, and a host of other factors. For short-term insomnia, sleeping pills can be effective. For long-term insomnia, however, sleeping pills can actually make the insomnia worse.

Sleep Deprivation
Sleep deprivation is not really a disorder. It simply indicates that a person has not been sleeping enough. Not getting enough sleep can affect a person's judgement, reaction-time, hand-eye coordination, memory, and general well-being. Studies have shown that sleep deprivation can have damaging effects on a person's immune system. If a person feels drowsy during the day, falls asleep for very short periods of time (5 minutes or so), or regularly falls asleep immediately after lying down, they are probably sleep-deprived.

Disturbed Sleep
Sleep Apnea Sleep apnea is interrupted breathing during sleep. It can result from malfunctioning neurons, though usually it is a mechanical problem in the windpipe. As people age, their muscle tone relaxes and their windpipe can collapse as a result. Known as obstructive sleep apnea, this causes loud snoring and blocked air flow through the windpipe. A person is unable to breathe for anywhere from 10 to 60 seconds. It may appear that the person is gasping or snorting. Luckily, the brain quickly reacts to the sudden lack of oxygen, the muscles tighten, and the windpipe opens.

Two things happen in a person who suffers from sleep apnea. First, they lose sleep, because every time the windpipe closes, the person has to wake up enough to contract those muscles and resume breathing. As a result, their sleep cycle can be interrupted up to a 100 times a night. Second, every time the windpipe closes, the brain is deprived of oxygen; eventually, this lack of oxygen can cause problems such as morning headaches or a decreased mental functioning. People who have sleep apnea are at a greater risk for heart disease and strokes. A narrowing of the nasal passages or back of the mouth, enlarged tonsils, and obesity are all factors that may contribute to obstructive sleep apnea. Sleep apnea may also be related to the use of alcohol, tobacco, or sedatives.

REM Sleep Behavior Disorder During REM, the dream phase of sleep, signals are sent from a part of the brainstem called the pons to the cerebral cortex, the area of the cerebrum responsible for thinking and organizing information. In a person with REM sleep behavior disorder, the signals that the pons sends out somehow translate into the bizarre images that make up dreams. The pons also sends out signals to all the muscles in the body that cause a temporary paralysis. If these signals are interfered with, people will physically act out their dreams though asleep. So if dreaming about running, for example, the patient with REM sleep disorder might actually get up and run, with the potential of causing serious damage to themselves, other people or their surroundings. Though potentially quite dangerous, REM sleep behavior disorder is rare.

Restless legs syndrome. A person with this disorder can have unpleasant feelings or sensations in the legs, mostly in the calves or lower legs. In some cases, the arms may also be affected. These feelings are often described as creeping, crawling, tingling, pulling, or painful. This disorder can be hard to diagnose and is sometimes mistaken for nervousness, insomnia, stress, or arthritis. It seems to affect women more often than men.

Abnormally Increased Sleep
Narcolepsy People with narcolepsy are sleepy during the day and fall asleep uncontrollably throughout the day for periods that last for less than a minute to more than half an hour. These random sleep attacks can occur at anytime, even while the person is engaged in an activity. When they are asleep, narcoleptics have an abnormal sleep pattern: They enter REM sleep prematurely without going through the normal sequence of sleep stages. Other classic symptoms include cataplexy, sleep paralysis, and hypnagogic hallucinations. The symptoms of narcolepsy usually begin sometime between the ages of 15 and 30.

Narcolepsy is usually a genetic disorder, although sometimes it is associated with brain damage or neurological disease. Some people with narcolepsy have noticed that the sleep attacks increase in frequency during certain times, such as pregnancy, illness, fever, or periods of increased stress.

Sleep Paralysis Sleep paralysis is the inability to move the arms or legs or the complete paralysis of the whole body that occurs when a person is falling asleep or waking up. It usually lasts for only a very brief period of time. People who are experiencing sleep paralysis may become very anxious and often regain movement only if they hear a loud noise or if some other stimulus jolts them out of it.

Hypnagogic Hallucinations Hypnagogic hallucinations or pre-sleep dreams, are dream-like hallucinations that occur in the transition between being awake and being asleep, that is, while falling asleep. Sometimes they occur while the person is still awake. They are very vivid, frightening dreams.

For more information...
You can find out more about sleep disorders by contacting the National Women's Health Information Center at (800) 994-9662 or the following organizations:

National Center on Sleep Disorders Research Phone Number(s): (301) 435-0199 Internet Address: http://www.nhlbi.nih.gov/sleep National Heart, Lung, and Blood Institute Phone Number(s): (301) 592-8573 Internet Address: http://www.nhlbi.nih.gov National Institute of Neurological Disorders and Stroke Phone Number(s): (800) 352-9424 Internet Address: http://www.ninds.nih.gov American Academy of Sleep Medicine Phone Number(s): 708-492-0930 Internet Address: http://www.aasmnet.org National Sleep Foundation Phone Number(s): (202) 347-3471 Internet Address: http://www.sleepfoundation.org

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