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5 Common Sleep Disorders

The five most common sleep disorders are:

Sleep Apnea Essentials:

What is it?

The most common type of sleep apnea is called obstructive sleep apnea. It happens because the muscles in your throat relax, blocking the flow of air to your lungs. Your airway might be completely blocked or only partly blocked. When you stop breathing, the amount of oxygen in your blood drops. Your brain recognizes this and makes your body start breathing again.

If you have sleep apnea, there are times during the night when you stop breathing for 10 seconds or longer. Sleep apnea can make you feel tired during the day. You may wake up with a snorting, choking, or gasping sound. You start breathing again and go back to sleep. This can happen several times an hour, all night, so you can't stay in a deep sleep.  

You may not even be aware that you woke up briefly. But if your sleep is upset throughout the night, you'll feel sleepy during the day.

Doctors call this type of disturbed sleep and daytime sleepiness obstructive sleep apnea/hypopnea syndrome (OSAHS).

There are also two other kinds of sleep apnea: central sleep apnea and complex sleep apnea.

To find out if you have sleep apnea, and how bad it is, your doctor will need to find out more about how well you breathe while you're asleep. He or she will also ask about how sleepy you are during the day.

Breathing during sleep

Your doctor needs to know how often there is a pause in your breathing. This helps to determine how severe your problem is. You might be asked to stay overnight in a sleep laboratory. Or your doctor might ask you to have your breathing measured at home.

Here's one guide that doctors use:

Daytime sleepiness

You may be asked to fill in a questionnaire called the Epworth Sleepiness Scale.

You are more likely to develop sleep apnea if you are:

What are the symptoms?

If you have sleep apnea, there are times during the night when you stop breathing. However, you may not be aware that you have sleep apnea. It may be your partner or another family member that notices the signs first.

Having sleep apnea can make you feel very drowsy during the day. You may find it hard to concentrate or remember things, feel tired when you wake up, and feel moody.

If you have severe sleep apnea, you get an overwhelming urge to fall asleep in situations where you need to be fully awake.

Here are some signs that you may have sleep apnea:

There are lots of other things that can upset your sleep. You should see your doctor to find out what may be causing your problems.

How common is it?

Sleep apnea is very common, but often goes undiagnosed.

One study found that:

A quarter of men and 1 in 10 women had episodes where they stopped breathing more than five times an hour. About 4 in 100 men and 2 in 100 women stopped breathing more than five times an hour and were extremely sleepy during the day.

What will happen?

If you have severe sleep apnea, it usually won't get better on its own. So it's important to get treatment.

Sleep apnea can affect how much you enjoy life. If you are sleepy during the day, you may have problems doing your job. It can also affect your driving.

People with severe sleep apnea may be at an increased risk of high blood pressure, heart disease and stroke and dying early.

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Insomnia Essentials:

What is it?

Insomnia is poor-quality sleep. You may find it difficult to get to sleep or to stay asleep at night. You may wake early in the morning or not feel refreshed when you get up.

Some people only have problems sleeping for a short time, whereas others have longer-lasting insomnia.

Insomnia for a short time

Temporary insomnia can happen for a couple of days to people who usually sleep well. Your sleep may be disturbed by noise, shift work, jet lag, or short-term anxiety or depression.

Short-term insomnia may last for a few weeks. And it may happen again. You may find it difficult to sleep because you're worried about something (such as an illness or anxieties about money) or because of an emotional problem (such as coping with the death of someone close to you).

Longer-lasting insomnia

If you've had problems sleeping on at least three nights a week for one month or more, you probably have longer-lasting (or chronic) insomnia.

Some people don't sleep well because of a medical or psychiatric condition, such as sleep apnea, depression, or dementia. If you have one of these conditions, you may sleep better if it's treated. (To learn more about these conditions, see our information on sleep apnea, depression, and dementia.)

Women also have significantly more sleep problems when they are pregnant.

Here we're looking only at chronic insomnia that hasn't been caused by any other illness. This is known as primary insomnia.

We don't know for sure why some people have problems sleeping and others don't. But we do know that:

Some medications can disturb your sleep. These include:  

Some people may just need less sleep. How long people sleep and what they think is normal varies a lot. Most people sleep for between six hours and eight hours a night. But you may find you sleep less as you get older.

What are the symptoms?

If you have insomnia (poor-quality sleep), you may find it hard to fall asleep, to stay asleep, or both.

The three main types of sleep disturbance are:

You could also have problems during the day because you haven't had enough sleep. You may:

 How common is it?

Insomnia is very common, especially in older people.

About 4 in 10 adults report having insomnia, with a higher prevalence in women than in men.

What will happen?

If you have problems sleeping, you may find it affects you during the day. For example, you may find it difficult to concentrate on your work. Older people with sleep problems may be more prone to falls.

Insomnia (poor-quality sleep) sometimes lasts a long time. But it can also come and go.

Insomnia may lead to:

 So it's a good idea to ask your doctor for help if you have long-lasting sleep problems.

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Restless Leg Syndrome (RLS)

What is it?

Restless Legs Syndrome (RLS) is a disorder related to sensation and movement. People with RLS have an unpleasant feeling or sensation in their legs when they lie down to sleep. Most people also have a very strong urge to move their legs, and moving the legs sometimes makes them feel better. But all this movement makes it hard or impossible to get enough sleep.

When you don't get enough sleep, you may start to have problems getting things done during the day because you're so tired. You may also be sleepy or have trouble concentrating. So it’s important to see your doctor and get help to manage your symptoms.

What causes Restless Legs Syndrome?

Usually there isn't a clear reason for restless legs. The problem may run in families. Sometimes there is a medical cause, like not getting enough iron. If that’s the case, treating the cause may solve the problem.

Women sometimes get restless legs while they are pregnant. The problem usually goes away after the baby is born.

Other problems that are sometimes linked to RLS include kidney failure, rheumatoid arthritis, diabetes, nerve damage, anemia, and Parkinson's disease. But most people who seek treatment do not have any of these other problems.

What are the symptoms?

RLS makes you feel like you must move your legs. These feelings are often described as tingling, "pins and needles," prickling, pulling, or crawling.

Moving your legs will usually make your legs feel better, at least for a short time. This problem usually happens at night when you are trying to relax or go to sleep.

After you fall asleep, your legs may begin to jerk or move. These movements are called periodic limb movements. They can wake you from sleep, which adds to your being overtired. Although periodic limb movement is considered a separate condition, it often happens to people who have RLS.

How is Restless Legs Syndrome diagnosed?

One of the hardest parts of having RLS is getting to the diagnosis. Often doctors don't ask about sleep or don't ask about the symptoms of restless legs. If you're not sleeping well, or if you think you may have RLS, tell your doctor.

Your doctor will talk with you about your symptoms to make sure that the feelings in your legs you describe are typical of RLS and not caused by some other problem.

You may have blood tests to rule out other problems that could be causing your symptoms. In some cases, the doctor may order tests of your nerves to be sure there is no nerve damage. Your doctor may also order a sleep study called a polysomnography. This test records how often your legs jerk or move while you sleep.

How common is it?

About 10 out of 100 of people are affected by symptoms of RLS. And about 2 or 3 out of 100 people have symptoms that are bad enough to need treatment. The condition may also occur in children, although the symptoms may not be recognized. Most people diagnosed with RLS are middle-aged and older.

Episodes usually occur sporadically in early adulthood, gradually increasing in frequency. After age 50, many people with this condition have daily occurrences.

Some estimates suggest that RLS affects twice as many women as men. Up to 20 out of 100 women develop it during pregnancy, although it usually goes away without treatment soon after the baby is born.

What will happen?

Like all sleep disorders, RLS can take its toll on you, causing problems both physically and mentally. Equally, people do leave this disorder unnoticed and untreated which can cause further problems. RLS is generally a lifelong condition and may disappear for weeks to months on end, but it does normally re-appear (except in pregnant women cases). However, even though it is a lifelong condition, this does not mean that it is completely hopeless to do anything about it and let it affect your life. There are solutions available and with support, you should be able to have a good night’s sleep once again.

Due to its disruptive nature on your sleep, RLS could seriously affect your waking life. Anyone who suffers from a sleep disorder is at a higher risk of road traffic accidents and of accidents when operating heavy machinery at work.

Lack of sleep can cause anxiety and stress, and provides symptoms linked to those of depression, which could lead to a wrong diagnosis. This will be more likely if you are not as aware of the jerking movements that may occur during your sleep. In minor cases of the disorder, people may not report a horrendously disturbed night’s sleep. However, if you do experience the symptoms, it would be advised to assess the condition sooner rather than later when the condition could worsen. Mild sufferers may only notice the sensations should they be awake and when they are still for a longer period of time than usual e.g. on a plane.

Anxiety and irritability that can be caused through the lack of sleep may have consequences on your work life, as you may not concentrate as well and relationships with your colleagues may break down due to your shorter patience span. Equally, relationships at home may be affected, either with your irritability making it difficult to communicate with you, or your partner may also suffer from disturbed night’s sleep due to your spontaneous movements.

Secondary causes of RLS may be more easily cured with a change in medication or lifestyle.  Dietary supplements have been known to be helpful in these cases.

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Narcolepsy

What is it?

Narcolepsy is a neurological disorder that affects the control of sleep and wakefulness. People with narcolepsy experience excessive daytime sleepiness and intermittent, uncontrollable episodes of falling asleep during the daytime. These sudden sleep attacks may occur during any type of activity at any time of the day.

In a typical sleep cycle, we initially enter the early stages of sleep followed by deeper sleep stages and ultimately (after about 90 minutes) rapid eye movement (REM) sleep. For people suffering from narcolepsy, REM sleep occurs almost immediately in the sleep cycle as well as periodically during the waking hours. It is in REM sleep that we can experience dreams and muscle paralysis which explains some of the symptoms of narcolepsy.

Narcolepsy usually begins between the ages of 15 and 25, but it can become apparent at any age. In many cases, narcolepsy is undiagnosed and, therefore, untreated.

What Causes Narcolepsy?

The cause of narcolepsy is not known; however, scientists have made progress toward identifying genes strongly associated with the disorder. These genes control the production of chemicals in the brain that may signal sleep and awake cycles. Some experts think narcolepsy may be due to a deficiency in the production of a chemical called hypocretin by the brain. In addition, researchers have discovered abnormalities in various parts of the brain involved in regulating REM sleep. These abnormalities apparently contribute to symptom development. According to experts, it is likely narcolepsy involves multiple factors that interact to cause neurological dysfunction and REM sleep disturbances.

What are the symptoms?

Symptoms of narcolepsy include:

How common is it?

The prevalence of narcolepsy is similar to that of Parkinson's disease and multiple sclerosis. In the United States, the National Institute of Neurological Disorders and Stroke estimates narcolepsy affects one in every 2,000 people. However, in some countries (for example, Israel), the prevalence of narcolepsy is much lower (one per 500,000) while in other countries (for example, Japan), it is much higher (one per 600). The American Sleep Association estimates that approximately 125,000 to 200,000 Americans suffer from narcolepsy, but only fewer than 50,000 are properly diagnosed.

Narcolepsy often remains undiagnosed or misdiagnosed for several years. This may occur because physicians do not consider the diagnosis of narcolepsy frequently enough. They may think of narcolepsy only in people who have the main symptom of excessive daytime sleepiness. Narcolepsy may not be considered in the evaluation of patients who come to doctors complaining of fatigue, tiredness, or problems with concentration, attention, memory, and performance, and other illnesses (seizures, mental illness, etc.).

What will happen?

Narcolepsy, like all sleep disorders, can be seriously threatening to your lifestyle. Its unpredictable nature can hamper activities and make you feel disabled by affecting relationships be they at home or at work. Prior to diagnosis narcoleptics may experience relationship problems with family members, employers and so on by the mistake that their sleepiness and fatigue is a sign of laziness, disinterest and antagonism. Even once diagnosed, there are many psychological issues particularly since the disorder is generally lifelong. The symptoms may be reduced with time but generally the excessive daytime sleepiness remains the same.

Proneness to Accidents

Due to its variable, abrupt nature, narcolepsy suffers are at great risk of accidents, even if they are aware of their disorder. Nearly 75% of narcolepsy suffers have been reported to have fallen asleep driving their car at some point and this is evidently a serious issue. It is vitally important that if you experience any signs of excessive sleepiness or cataplexy, that you do not drive or operate heavy machinery as you could cause serious injury to yourself or someone else. Immediate medical intervention is required.

Poor Attention Span

The lack of sleep and disturbed nights that may be experienced for narcolepsy sufferers can begin to take its toll on them mentally during the day, regardless of whether they have attacks or not. They may begin to feel as though they have a short attention-span, struggling to concentrate on anything for long periods of time which adds another potential hazard with regard to driving and it may be advised to refrain from driving if you do experience excessive sleepiness as this too can be very dangerous. Equally, lack of attention may affect work and social life especially if the memory is affected. If given time to learn memory skills it has been noted that responses can become more positive.

Headaches and Obesity

Many Narcoleptics also experience headaches, often turning into migraines which is probably mostly due to the lack of sleep and the strain the brain is put under with the hallucinations and fatigue. Additionally, narcolepsy can be linked with obesity due to the lack of the protein hypo-cretin which also controls eating and could increase appetite levels.

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Night Terrors

What is it?

The sleep disorder of night terrors typically occurs in children aged 3-12 years, with a peak onset in children aged 3½ years.

Sleep is divided into 2 categories: rapid eye movement (REM) and non-rapid eye movement (non-REM). Non-REM sleep is further divided into 4 stages, progressing from stages 1-4. Night terrors occur during the transition from stage 3 non-REM sleep to stage 4 non-REM sleep, beginning approximately 90 minutes after the child falls asleep.

Night terrors are distinctly different from the much more common nightmares, which occur during REM sleep. Night terrors are characterized by frequent recurrent episodes of intense crying and fear during sleep, with difficulty arousing the child. Night terrors are frightening episodes that disrupt family life.  

Night Terrors Causes

Night terrors may be caused by the following: 

What are the symptoms?

In addition to frequent recurrent episodes of intense crying and fear during sleep, with difficulty arousing the child, children with night terrors may also experience the following: 

Unlike nightmares, most children do not recall a dream after a night terror episode, and they usually do not remember the episode the next morning. 

The typical night terror episode usually begins approximately 90 minutes after falling asleep. The child sits up in bed and screams, appearing awake but is confused, disoriented, and unresponsive to stimuli. Although the child seems to be awake, the child does not seem to be aware of the parents’ presence and usually does not talk. The child may thrash around in bed and does not respond to comforting by the parents. 

Most episodes last 1-2 minutes, but they may last up to 30 minutes before the child relaxes and returns to normal sleep. 

If the child does awake during a night terror, only small pieces of the episode may be recalled. Usually, the child does not remember the episode upon waking in the morning.

How common is it?

An estimated 1-6% of children experience night terrors. Boys and girls are equally affected. Children of all races also seem to be affected equally. The disorder usually resolves during adolescence.

What will happen?

Waking up in the middle of the night to see your loved one experiencing a night terror is a frightening experience. Knowing that she/he is asleep, even though their eyes may be open, and that they are not capable of receiving comfort from you is very difficult. Night terrors last just a few minutes and are more common in children than adults. The night terrors may disrupt everyone in the household.

Effects on the Body

A person experiencing night terrors may have:

  • rapid breathing.
  • racing heartbeat/pulse.
  • sweating.
  • difficulty being woken up during an acute episode. 
Combative Effects

The person experiencing the night terror can become a danger to themselves or others, although this combative effect is more typical in adults than children. The person may:

  • leap out of bed.
  • may flail their arms.
  • kick with their legs.
  • try to fight anyone who tries to calm them.

No matter how much you try to calm and reassure the child, they will not hear you until the night terror has passed and they awakens from it.

Effects after Awakening

Adults often remember a small portion of the night terror, but children rarely remember what they were dreaming about or anything about the episode.

Audible Effects

The child may scream and cry as if they are in severe pain. They may also shout and moan or say things that make no sense at all.

Visual Effects

The person suffering with the night terror may stare wide-eyed at nothing in particular; he also may look directly at you but not really see you.

Long-Term Effects

Children usually grow out of night terrors and they are rare in adults; but if fear of the night terrors causes the person to dread going to sleep at night, medical intervention may be necessary, according to the Mayo Clinic. Medical help may also be necessary if the night terrors increase over a period of time, result in injury or violent behavior toward others, or continually disrupt the person's sleep.

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