Sleep Disorders

I didn't realize there are over 100 different sleep disorders, but I learned quickly when I started researching sleep disorders. I found out there are four main categories of sleep disorders which are described below. Each of these categories have several subcategories which list different types of disorders. I chose a few of the disorders and have expanded a bit about them. I'll go into more detail in later posts.

Four Main Categories of Sleep Disorders

Dyssomnias are disorders of timing, amount, or quality of sleep and results in excessive sleepiness during the day and insomnia.

1. Intrinsic sleep disorders originate inside the body like psychophysiological insomnia, ideopathic insomnia, narcolepsy, obstructive sleep apnea, central sleep apnea, restless leg syndrome, and periodic limb movements disorder which are a few of the more common intrinsic sleep disorders.
2. Extrinsic sleep disorders originate outside the body like inadequate sleep hygiene, environmental sleep disorder, insufficient sleep syndrome, stimulant-dependent sleep disorder, alcohol-dependent sleep disorder, and hypnotic-dependent sleep disorder are a few of the extrinsic sleep disorders.
3. Circadian rhythm sleep disorders describe the disruption of the sleep cycle like jet lag, shift-work sleep disorder, irregular sleep-wake pattern, delayed sleep phase syndrome, and advanced sleep phase syndrome.

Parasomnias are disorders of partial arousal, disorders that interfere with sleep stage transitions or abnormal events that occur during sleep.

1. Arousal disorders like confusional arousals, sleepwalking, and sleep terrors are common examples of arousal disorders.
2. Sleep-wake disorders interfere with sleep stage transitions such as rhythmic movement disorder, sleep starts, sleeptalking, and nocturnal leg cramps are a few examples.
3. Other parasomnias include these common disorders; sleep bruxism (teeth grinding), sleep enuresis (bedwetting), primary snoring, infant sleep apnea, and sudden infant death syndrome (SIDS).
4. Parasomnias like nightmares, sleep paralysis, and REM sleep behavior disorder are disturbances of the rapid eye movement (REM) stage of sleep.

Medical/Psychiatric Disorders are attributed to medical or psychiatric disorders.

1. Alcoholism, chronic obstructive pulmonary disease, asthma, sleep-related gastroesophageal reflux, peptic ulcer, and fibrositis syndrome are examples of medical disorders associated with sleep disorders.
2. Degenerative brain disorders, dementia, sleep-related epilepsy, and sleep-related headaches are associated with neurological disorders.
3. Psychoses, anxiety, depression, and panic disorders can result in excessive sleepiness, insomnia, or other disruptions in the sleep cycle and associated with psychiatric disorders.

Proposed Sleep Disorders are sleep problems with not enough information available to positively establish them as distinct disorders. Examples are:

• short sleepers (someone who regularly sleeps less than 75% of the sleep time typically required for his or her age group but feels no negative effects from this shortened sleep)
• long sleepers (someone who regularly sleeps more than 10 hours a night)
• subwakefulness syndrome (lack of daytime alertness with no apparent sleep disruption)
• fragmentary myoclonus (brief, involuntary jerks or twitches), sleep hyperhydrosis (night sweats)
• menstrual-associated sleep disorder
• pregnancy-associated sleep disorder
• terrifying hypnagogic hallucinations
• sleep-related laryngospasm
• sleep choking syndrome

Insomnia is the inability to fall asleep or stay asleep, so you are unable to get enough sleep for you to feel rested. This is the most common sleep disorder in America. More women than men experience insomnia, and the older we are the more likely we'll experience insomnia. Insomnia is usually caused by some underlying condition like stress, anxiety, digestive problems, pain, medications, restless leg syndrome, sleep apnea, and others.

Narcolepsy is the inability to control the timing of sleep. People with narcolepsy are not perpetually sleepy; they can't control when they will sleep. They are also more prone to accidents and interpersonal problems. Symptoms include excessive daytime sleepiness, falling asleep at inappropriate times, loss of muscle tone caused by emotional stimuli but no loss of consciousness and the inablilty to speak (cataplexy), hypnogenic hallucinations in the period between the transition between waking and sleep, sleep paralysis between sleeping and waking, waking up repeatedly during the night, as well as leg jerks, nightmares, and restlessness.

Obstructive Sleep Apnea is the brief and repeated stopping of breathing during sleep due to the throat muscles being unable to keep the throat open when trying to breathe. Uncontrolled sleep apnea can be life threatening, causing heart failure, high blood pressure, and other health problems, but the most dangerous thing you can do is get behind the wheel of a motor vehicle. When the sleep apnea is uncontrolled, you are very likely to fall asleep behind the wheel. You may not be injured, but others involved in the accident can be killed. I liken it to drunk driving. With sleep apnea you are not only sleepy, but your mental facilities are impaired by not enough oxygen in your blood. There is a forum at this link for those with sleep apnea.

REM Sleep Behavior Disorder is a rare condition that interferes with normal REM sleep. The pons, an area of the brainstem, sends signals to the cerebral cortex which controls thinking and organizing information. The pons also sends signals to the muscles during REM sleep that causes temporary paralysis. In people with REM sleep disorder, these signals are turned into dreams that the person acts out their dreams, and can actually hurt themselves or someone else.

Sleepwalking (Somnambulism) is more common in children than in adolescents or adults. Not serious unless the sleepwalker injures themselves or others. The sleepwalker doesn't remember the episodes. Isn't related to REM sleep behavior disorder.

Restless legs syndrome and periodic limb movement disorder are very uncomfortable and keep waking the sleeper up, even if the sleeper isn't aware of the problem at night, like me. I have RLS and PLMD. RLS causes strange feelings in your legs and you feel like you just have to move them. Many times when these feelings come on I would rub the leg that was giving problems at that time. PLMD causes uncontrolled muscle movements, usually in the legs, but can also affect other parts of the body. I have been awakened by every muscle in my body jerking just as I'm drifting off to sleep.

Inadequate Sleep Hygiene is poor sleep habits that you can correct yourself. Some of the bad habits are: alcohol, caffeine loaded drinks, nicotine, spend too much time in bed, donÂ’t go to bed and wake up at the same times everyday, nap too often or too long, worry, excitement, mental stress, and physical exercise too close to bedtime. Inadequate sleep hygiene can cause mood changes, depression, short attention span, poor concentration, daytime sleepiness , frustration with sleeping, caffeine dependence, and alcohol abuse or dependence.

I will continue in the next post with more detailed descriptions of the different sleep disorders.

Dale L. Edwards