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Sleep Problems. Do you have one? PDF Print E-mail
Written by Aleksandr Kavokin, MD, PhD   

In General:
Reasons for changing the sleep patterns include changes in the body clock, emotional problems, sleeping environment and many other things.

A third of population has some sleep problems from time to time. You probably would agree with this notion.


 Do you remember when a noise or overeating made it difficult for you to fall asleep? It is a common cause.

Let’s look at some of the sleep disorders.

1. Insomnia is characterized by difficulties falling or staying asleep. Medically speaking insomnia is considered when
a) You can not fall asleep for more than 45 minutes.
b) You are frequently awakening
c) After the awakening you can not go to sleep again.
d) You experience early morning loss of sleep.

Obviously, all of that can happen to a healthy person, However in insomniacs those problems lead to fatigue after a night of sleep. The problem rises when you feel the same tiredness during the rest of the day.

Any person can get this type of problems. They are often linked to noisy surroundings, bad weather, heat or cold, changes of time zones, shifts in your daily schedule or your work, stress and anxiety in your life, worries about a stressful situation. Some people believe that earth magnetic field plays role too.

This type of insomnia lasts up to several weeks and usually resolves when the situation is adjusted. 


Insomnia that lasts months or years might be a sign of aging or psychiatric problem. Such psychiatric disorders as depression, bipolar disorder or anxiety disorders (i.e. panic attacks, posttraumatic stress disorder) may be under way.
 Another common cause of the insomnia is a side effect of a medical drug use.

People with chronic pain, neuralgia, herpes infection, back pain may also experience difficulties with sleep.

Chronic heart and lung diseases often lead to multiple symptoms, including insomnia. Heart failure, angina arrhythmias, asthma, chronic obstructive pulmonary disease (COPD) may lead to problems with our blood oxygenation, cause panic and insomnia. Often people with circulatory problems or the lungs problems need to sleep in a sitting position to avoid gasping for air (this need to sit to avoid your lung drowning in the body fluids is named orthopnea).
Withdrawal from a drug often causes the insomnia too. It could be a prescribed drug.  Illegal drugs and alcohol cause problem with sleep as well.

2. Obstructive Sleep Apnea causes a person to stop breathing for a while during the sleep. The period of the stopped breathing lasts for at least 10 second. The name is “episode of apnea”.

 

 

Obstructive Sleep Apnea often develops in morbidly obese people.
Enlarged tonsils and adenoids (people name them glands occasionally) can obstruct the airways too. When person asleep, some muscles of your mouth and throat relax, the enlarged structures move lower and plug the airways. The enlargement of the structures can happen form many reasons. It is common in obese people e, but also in some relatively healthy people too. Snoring during the sleep could be the sign of the obstructive sleep apnea.
Since people are deprived of oxygen, they periodically wake up during the night. This combination of low oxygenation and frequent awakening leads to tiredness and unhealthy sleepiness during the day. The poor guys become also very easily irritable. Advanced stage of obstructive sleep apnea may require the person to sleep with special device creating the air pressure; that helps to keep airways open. In worse case scenario a surgery to remove extra tissue might be required.

 You should get evaluation by your doctor if your snore loudly and feel very tired during the day.


3. Gastroesophageal reflux disease (GERD) causes stomach acid to move into your esophagus.
Reflux means “coming back”. There are many reasons of that. Some of them may be incorrect work of the sphincter between esophagus and stomach and uncoordinated work of the esophageal muscles. It is also common to find a hiatal hernia together with GERD.
GERD brings heartburn. The symptoms worsen in lying position. The reflux interferes with the sleep cycle. For this type of problem, you definitely need to talk with your doctor.


4.  One more disorder of sleep is caused by  Periodic Limb Movement Disorder (PLMD), including Restless Legs Syndrome. Suddenly, leg or arm movements awake a sleeping person.
People become tired in the day time from the lack of sleep.

The movements are involuntary. Jerks and twitches are common, together with aching inside muscles. Toes, ankles, knees, and hips may be involved. The patient does not control the movements consciously and may be even unaware of condition. Additional paresthesias like itching, tingling, or burning might be present. To rid of the discomfort the person, needs to move the limb. The unusual thing about this condition is that relaxing activates the symptoms.
The exact cause of periodic limb movement disorder is not known. However, some doctors offer solutions for the problem. The list of proposed treatment is long and may include drugs for Parkinson’s disease, benzodiazepines, opioids, and anticonvulsants. Treatment of a known disease such as peripheral neuropathy in diabetes, sometime relives the symptoms.


5. Nightmares are often triggered by some medications, alcohol, anxiety and stress. If nightmares interrupt your sleep, see a health professional.

Let’s go to some rare Sleep Disorders:


6. Sleepwalking is more common in children than adults. It might have genetic cause and happens in the same families. Again, the affected person is often ill or was under stress.

Those peoples tend to go back to bed on their own and do not remember what happen during that strange walk. Sometimes they need help to get to the bed. Woken up sleepwalker might be startled, since he or she does not realize the condition.

7. Narcolepsy is characterized by sudden sleep attack. The attack may happen in the middle of day. Sometimes it may happen during performing a job duty. It may be strange to see that during a dinner or in the middle of conversation, but it might be really dangerous if sleep attack happens during car driving, or working with heavy equipment.
It might happen few times daily. Some similar reaction is cataplexy. People, suffering cataplexy and being awake, suddenly find their muscles paralyzed when laugh or cry. It may be part of the body or the whole body. The sufferers might expect a sleep attack when they see hallucinations. The hallucinations sometime precede the sleep attack for a few minutes.

8. Sleep paralysis means an inability to move when you are falling asleep or just waking up. It may last few minutes. Unpleasant feeling.


Sleepwalking, restless leg syndrome, and night terrors are the types of parasomnia. Other types of parasomnia include teeth grinding, rhythmic movement disorder, REM behavior disorder, sleep drunkenness and sleep talking (somniloquy). Parasomnias are often triggered by stress or depression, and might have genetic components.
They are undesirable because normal sleep becomes difficult for people with parasomnias. Parasomnia may bring awkward and even dangerous nighttime activities. The sleeping parasomniac may walk, talk, move stuff around the house, eat, and try to play sports or prepare weapons. Yet they all are asleep at that moment. The conditions are classified under the “Other dysfunctions of sleep stages or arousal from sleep” in the diseases classification.


Parasomnias might happen during the stages 3 and 4 of the sleep cycle.
Stages 1 and 2 are periods of light sleep. Stages 3 and 4 are periods of deep sleep. It's more difficult to wake up a person from stage 3 and 4, and wakened up he will be groggy and disoriented. Stages 3 and 4 bring the most of the rest during our sleep. If the stages are disrupted, the episodes of missed sleeps accumulate into a sleep deficit. Sleep deficit makes you unable to concentrate and brings depression.

It was noted that dolphins do not sleep at all – at any given time at least half of their brain is fully awake, while the other may rest. In humans it is different – we need to go fully asleep.

However, at this moment your brain is still working. Five stages of sleep include 1, 2, 3, 4, and REM (rapid eye movement). Going through all the stages make up a sleep cycle. The sleep cycle lasts around one and half hour.


REM sleep makes you breathe rapidly, your heart beats faster. However, your muscles look paralyzed for a while. The REM is what brings us the colorful dreams. REM happens 4-5 times a night.

In General:
Reasons for changing the sleep patterns include changes in the body clock, emotional problems, sleeping environment and many other things.


Again, the disruption of the night sleep causes excessive daytime sleepiness. The serious problems arise when the person gets into a motor vehicle accident or work-related accidents. The work or school performance suffers too.

So, if you do not feel rested after night sleep and feel tired over the day, it's a good idea to visit a health professional. Excessive tiredness actually may be a sign of other health problem, not just sleep disorder. It is worthwhile to make lifestyle changes and adopt good sleeping habits. Avoid caffeine. Avoid watching TV right before sleep. Those things might interfere with your sleep.

 

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