Sleep Disorders

What are Sleep Disorders?

Sleep disorders comprise a group of conditions that disturb the normal sleep pattern of a person. It is one of the most commonly encountered clinical problems which can affect the quality of life immensely. Insomnia is significantly associated with this.

Sleep disorders can be classified into primary and secondary sleep disorders. Primary sleep disorders arise from endogenous causes. They can be further divided into Parasomnias (unusual behaviours during sleep like sleep walking, nightmares etc.) and Dyssomnias (abnormality in the amount, quality or timing of sleep such as hypersomnia, narcolepsy etc.)

The prevalence varies with the type of sleep disorder. It is common in both adults and children.

Causes

The cause is unknown sometimes. However, many medical conditions can cause different types of sleep disorders-

• Cardiac: heart failure
• Neurologic: stroke, central sleep apnea, hypnic jerk, restless leg syndrome, headache, cerebral degenerative disorder.
• Endocrine: hyperthyroidism, pregnancy, menopause, diabetes mellitus, vitamin D deficiency.
• Pulmonary: obstructive sleep apnea, asthma, chronic obstructive pulmonary disease.
• Gastrointestinal: GERD
• Musculoskeletal: pain from arthritis, fibromyalgia, or any chronic pain
• Depression, anxiety, phobias and panic attacks
• Certain environmental problems like aging, disturbed sleep cycle and childhood trauma

Sign and symptoms

Sleep disorders can manifest in various forms-

• Insomnia: It presents as difficulty falling asleep and/or staying asleep. Patients report taking thirty minutes or more to fall asleep (for those with sleep initiation difficulties) or spending thirty minutes or more awake during the night (for those with sleep maintenance difficulties).
• Hypersomnia: The patients with hypersomnia complain of disabling excessive daytime sleepiness.
• Narcolepsy: It is a chronic neurological disorder caused due to the brain's inability to control sleep and wakefulness.
• Obstructive sleep apnea (OSA): It is a disorder characterized by obstructive apneas/hypopneas caused due to the laxity of pharyngeal musculature leading to the repetitive collapse of the upper airway during sleep.
• Night terrors: They occur most common in children aged 2 to 12 years of age, which usually resolve spontaneously as child ages. It occurs in non-REM sleep.

On physical examination, poor concentration, drowsiness, slowed reaction time and poor growth is observed.

Diagnosis

A sleep diary must be maintained by the affected patient consisting of a record of sleep and wakefulness over a period of weeks to a month.

Sleep studies like Electroencephalography (EEG) and Polysomnography (PSG) are also recommended. Some of the lab investigations include haemoglobin and hematocrit, ABG, Thyroid function tests and iron studies.

General management

Non pharmacological interventions include Cognitive behavioural therapy, sleep restriction therapy, relaxation training and hypnosis may help in the improvement of sleep disorders.

Warning: Above information provided is an overview of the disease, we strongly recommend a doctor's consultation to prevent further advancement of disease and/or development of complications.

Disclaimer: The information provided herein on request, is not to be taken as a replacement for medical advice or diagnosis or treatment of any medical condition. DO NOT SELF MEDICATE. PLEASE CONSULT YOUR PHYSICIAN FOR PROPER DIAGNOSIS AND PRESCRIPTION.