Sleep Disorders: Symptoms, Causes and Treatment

Sleep is a vital biological process that allows our bodies and minds to rest, repair, and rejuvenate. It is crucial in maintaining physical health, cognitive function, and emotional well-being. Colten HR’s 2006 report of the Institute of Medicine Committee on Sleep Medicine and Research shows that between 50 and 70 million Americans experience chronic sleep and wakefulness disorders that negatively impact their health and daily functioning. 

Sleep disorders involve many conditions that affect sleep quality, timing, and duration. These disorders present themselves in various ways, including difficulty falling asleep, staying asleep, or experiencing unusual behaviors during sleep. The types of sleep disorders are insomnia, sleep apnea, narcolepsy, and restless legs syndrome. Each type of sleep disorder is unique in its symptoms and treatment.

Sleep disorders stem from physical health issues, such as chronic pain or respiratory problems, or are rooted in mental health conditions like anxiety and depression. External factors, like stress and lifestyle choices, also contribute to the development of sleep disorders. 

The treatment methods for sleep disorders include cognitive-behavioral therapy for insomnia, continuous positive airway pressure (CPAP) machines for sleep apnea, and medications for narcolepsy or restless leg syndrome. Treatments, lifestyle modifications, and sleep hygiene improvements are often combined.

What are sleep disorders?

Sleep disorders are conditions that affect the quality, amount, and timing of sleep, resulting in daytime distress and impairment in functioning, as suggested by the American Psychiatric Association article “Sleep Disorders.” These disorders manifest as difficulties falling asleep, staying asleep, or experiencing restful sleep and are often associated with various mental health and medical problems.

Sleep disorders take many forms, including insomnia, sleep apnea, restless legs syndrome, narcolepsy, and circadian rhythm disorders. They affect sleep quality and duration, leading to daytime sleepiness, fatigue, difficulty concentrating, and mood changes. 

These disorders are distinct from occasional sleep disturbances and persist over time, causing significant impairment in various aspects of a person’s life. According to San, L., & Arranz, B. of Actas EspañOlas de Psiquiatría journal, sleep disorders affect anyone regardless of age, gender, or other factors. Also, certain groups of people are more susceptible to developing sleep disorders, such as individuals with mental health conditions, chronic medical illnesses, or those who work irregular schedules.

What are the types of sleep disorders?

The five main types of sleep disorders are insomnia, sleep apnea, restless legs syndrome (RLS), narcolepsy, parasomnias, hypersomnia, and sleep-related movement disorders, according to Holder S, Narula NS’s  2022 study “Common Sleep Disorders in Adults: Diagnosis and Management” on Am Fam Physician Journal.

Insomnia

Insomnia is characterized by difficulty falling asleep, staying asleep, or both despite having adequate sleep opportunities. It can be classified as chronic, intermittent, or transient.

Causes of insomnia include stress, anxiety, jet lag, digestive problems, and hormonal changes. Symptoms include difficulty falling asleep, waking up during the night, waking up too early, and feeling unrefreshed upon waking. 

Treatment involves cognitive behavioral therapy, relaxation techniques, and, in some cases, short-term use of sleep medications.

Sleep apnea

Sleep apnea is a disorder characterized by abnormal breathing during sleep. There are two main types of sleep apnea: obstructive and central. Obstructive sleep apnea occurs when the airway space becomes blocked or collapses during sleep. Central sleep apnea occurs when the brain fails to signal correctly to the muscles that control breathing.

Symptoms include loud snoring, gasping for air during sleep, and excessive daytime sleepiness.

Treatment often involves using a continuous positive airway pressure (CPAP) machine, lifestyle changes, or, in some cases, surgery.

Restless legs syndrome (RLS)

Restless legs syndrome (RLS) is a condition that causes an irresistible urge to move the legs, often accompanied by uncomfortable sensations. RLS is also associated with attention deficit hyperactivity disorder (ADHD).

Symptoms worsen in the evening or at night. Treatment includes lifestyle changes, iron supplementation if deficient, and medications that increase dopamine in the brain.

Narcolepsy

Narcolepsy is a neurological disorder characterized by excessive daytime sleepiness and sudden, uncontrollable episodes of falling asleep during the day. People with narcolepsy also experience cataplexy, a sudden loss of muscle tone. Treatment involves medications to promote wakefulness and manage other symptoms.

Parasomnias

Parasomnias are a group of sleep disorders characterized by unwanted events or experiences that occur while falling asleep, sleeping, or waking up. Common types include sleepwalking, sleep talking, and teeth grinding (bruxism).

Treatment depends on the specific parasomnia and consists of ensuring a safe sleep environment, stress reduction techniques, and, in some cases, medication.

Hypersomnia

Hypersomnia is characterized by excessive sleepiness during the day, even after adequate or prolonged nighttime sleep. People with hypersomnia may sleep for unusually long periods at night and still struggle to stay awake during the day.

Treatment often involves stimulant medications and addressing any underlying conditions.

Sleep-related movement disorders

Sleep-related movement disorders involve repetitive physical movements that disrupt sleep. These include periodic limb movement disorder, in which a person moves their limbs involuntarily during sleep. Treatment may include medications to reduce movements and improve sleep quality.

Sleep disorders often overlap or coexist with other medical or mental health conditions. Proper diagnosis and treatment by a healthcare professional specializing in sleep medicine is crucial for managing these disorders effectively.

What are the causes of sleep disorders?

The causes of sleep disorders include medical conditions, mental health conditions, genetic factors, medications, and the use of substances such as caffeine and alcohol, according to Karna B, Sankari A, and Tatikonda G.’s 2004 study  “Sleep Disorder in StatPearls Publishing.”

These factors can significantly impact sleep quality and duration, leading to various sleep-related issues.

The causes of sleep disorders are listed below.

Medical Conditions

Certain medical conditions, such as chronic pain, respiratory disorders, neurological disorders, and hormonal disorders, disrupt sleep patterns and lead to sleep disorders. Chronic pain conditions, including arthritis, fibromyalgia, and migraines, can cause significant discomfort that makes it challenging to both fall asleep and stay asleep. 

Similarly, respiratory disorders such as sleep apnea and chronic obstructive pulmonary disease (COPD) interrupt sleep due to breathing difficulties. Neurological disorders, like Parkinson’s disease and multiple sclerosis, also impact sleep regulation, further complicating the ability to achieve restful sleep. Certain medications prescribed for these medical conditions can also interfere with sleep. For instance, some antidepressants and blood pressure medications have side effects that disrupt standard sleep patterns.

Mental Health Conditions

Mental health conditions are significant contributors to sleep disorders. Stress, anxiety, and depression lead to difficulties in achieving restful sleep. Individuals with anxiety disorders often experience racing thoughts and heightened arousal, making it challenging to relax and fall asleep.

High stress levels lead to hypervigilance, preventing the body from entering the restful state needed for sleep. These mental health disorders create a vicious cycle where poor sleep exacerbates mental health issues, leading to further sleep disturbances.

Genetic Factors

Genetic factors play a role in developing sleep disorders. Some individuals have hereditary predispositions to certain sleep conditions. Research has identified specific genetic mutations associated with sleep disorders, influencing how individuals regulate sleep-wake cycles.

For example, Bidaki, R., Zarei, M., and Toosi, A. K.’s 2011 study in the Iranian Journal of Psychiatry and Behavioral Sciences found that a small number of sleep disorders, including four rare diseases, are caused by a single gene mutation. 

These are fatal familial insomnia, familial advanced sleep-phase syndrome, persistent primary insomnia, and narcolepsy with cataplexy. These conditions have a known genetic foundation. It suggests that even within the same family, the majority of sleep disorders are complicated due to their hereditary predisposition and the varying expressivity of the symptom.

Medications

Certain medications like antidepressants and antipsychotics also contribute to sleep disorders. While some antidepressants help improve sleep, others can lead to insomnia or disrupted sleep patterns as a side effect. Antipsychotics cause sedation and also lead to irregular sleep patterns or excessive daytime sleepiness.

Individuals need to discuss potential side effects with their healthcare providers, especially if they experience sleep disturbances after starting a new medication. Caffeine and Alcohol: Substance use, particularly caffeine and alcohol, can significantly impact sleep quality.

Caffeine causes difficulty falling asleep and reduced sleep duration if consumed too close to bedtime. While alcohol induces sleepiness, it also disrupts sleep cycles and leads to fragmented sleep, particularly during the second half of the night. Similar to caffeine, nicotine is a stimulant that interferes with the ability to fall asleep and stay asleep.

Reducing or eliminating these substances, especially before bedtime, helps improve sleep quality.

What are the symptoms of sleep disorders?

The main symptoms of sleep disorders include difficulty falling asleep, daytime fatigue, urge to take naps, unusual breathing patterns, unusual movement, and changes in sleep/wake schedule, according to Karna B, Sankari A & Tatikonda’s 2023  review on “Sleep Disorder”  on PMID Journal.

The symptoms of sleep disorders are listed below.

• Difficulty falling asleep: This is the struggle to initiate sleep at night, often leading to frustration and prolonged wakefulness.
• Daytime fatigue: Persistent tiredness or lack of energy during the day can interfere with daily activities and overall productivity.
• Urge to take naps: An overwhelming desire to sleep during the day indicates inadequate nighttime rest or poor sleep quality.
• Unusual breathing patterns: These involve irregularities such as snoring, gasping, or pauses in breathing during sleep, which are often associated with conditions like sleep apnea.
• Unusual movement: Involuntary movements during sleep, such as kicking or thrashing, can disrupt sleep and may be linked to disorders like restless legs syndrome.
• Changes in sleep/wake schedule: This symptom involves significant alterations in the timing of sleep and wakefulness, leading to insomnia or excessive sleepiness at inappropriate times.

Addressing these symptoms with a healthcare provider is crucial for effectively diagnosing and treating sleep disorders. Proper management can enhance overall health and well-being.

What are the treatments for sleep disorders?

The most common treatment methods for sleep disorders are lifestyle changes, medications, and cognitive behavioral therapy (CBT), depending on the specific type of disorder and its underlying causes, according to a study titled ” Sleep Disorder Treatments” (March 2022).

Lifestyle Changes

Lifestyle changes are foundational in treating sleep disorders. Incorporating more vegetables and fish while reducing sugar intake significantly improves sleep quality. Regular physical activity can help regulate sleep patterns and reduce anxiety. Deep breathing, meditation, and gentle stretching help calm the mind before bedtime.

Medications

Medication for insomnia is effective in the short term. However, it is generally not recommended for long-term use due to potential side effects and dependency issues. A healthcare provider may prescribe medications like eszopiclone (Lunesta) to help with sleep onset and maintenance. Ramelteon (Rozerem) also mimics the natural sleep hormone melatonin.

Cognitive Behavioral Therapy (CBT)

CBT is particularly effective for insomnia. It involves stimulus control therapy and relaxation techniques. Stimulus control therapy consists of training individuals to associate the bed with sleep, which only helps reduce anxiety related to sleep.

CBT is as effective, if not more so, than medications for treating insomnia, making it a preferred first-line treatment option, according to a study titled “Cognitive-Behavioral Therapy for Insomnia” by Jeffrey Rossman (Nov 2019).

In addition to the primary treatments mentioned, there are other, less emphasized methods for managing sleep disorders. Breathing devices like CPAP machines help manage sleep apnea, while melatonin supplements benefit circadian rhythm disorders. Additionally, breathing techniques alleviate symptoms of conditions such as sleep apnea, and dental guards can address teeth grinding, which often disrupts sleep.

Addressing sleep disorders often requires a multifaceted approach that includes medical intervention and lifestyle adjustments. By implementing these strategies, individuals can significantly enhance their sleep quality and overall health.

How much sleep do I need per day?

You need different amounts of sleep per day, depending on your age. For example, newborns (0-3 months): 14 to 17 hours, infants (4-11 months): 12 to 15 hours, toddlers (1-2 years): 11 to 14 hours, preschoolers (3-5 years): 10 to 13 hours, school-age children (6-13 years): 9 to 11 hours, teenagers (14-17 years): 8 to 10 hours, adults (18-64 years): 7 to 9 hours and older adults (65+ years): 7 to 8 hours, according to the Sleep Foundation article “How Much Sleep Do You Need?” by Eric Suni (May 2024).

This study recommends these ranges for optimal health and well-being. Individual needs vary, so listening to and adjusting to your body is essential.

What is the most common sleep disorder?

The most common sleep disorder is insomnia, which is characterized by an ongoing difficulty in falling or remaining asleep despite having the opportunity to sleep, according to Roth, T. (2007). Insomnia: Definition, Prevalence, Etiology, and Consequences in the Journal of Clinical Sleep Medicine. This condition leads to significant daytime sleepiness and impairments in functioning.

How do I know if I have a sleep disorder?

To determine if you have a sleep disorder, pay attention to common symptoms such as persistent difficulty falling or staying asleep, excessive daytime sleepiness, loud snoring, irregular breathing during sleep, or experiencing sudden episodes of sleep, as suggested by Holder S, Narula NS’s  2022 study “Common Sleep Disorders in Adults: Diagnosis and Management” on Am Fam Physician Journal.

If you frequently wake up feeling unrefreshed or have difficulty concentrating during the day, these are indicators of a sleep disorder. If these symptoms persist and impact your daily life, it’s advisable to consult a healthcare professional.

How do I get better sleep?

To improve your sleep, establish good sleep hygiene by maintaining a consistent sleep routine of 7-9 hours, as recommended by Baranwal N, Yu PK, and Siegel NS.Sleep physiology, pathophysiology, and sleep hygiene on Prog Cardiovasc Dis. 2023. Go to bed and wake up at the same time every day. Create an optimal sleeping environment by ensuring your bedroom is dark, quiet, and relaxed, and invest in a comfortable mattress and pillows.

Incorporate relaxation exercises such as deep breathing or gentle stretching before bedtime, and consider practicing meditation to calm your mind and reduce stress. Combining these strategies will enhance your sleep quality and allow you to wake up refreshed.