Sleep Disorders

Sleep and Sleep Disorders:

According to research conducted at the Stanford Center for Sleep Sciences and Medicine the vast majority of people do not get the sleep they require.  In our hectic world many individuals are accruing a sleep deficit.  The average hours of healthy sleep per night are between 7 and 9 hours.  Most people feel their best when they get 8 hours of sleep.  Despite the fact that many people claim to feel well on 6 or less hours of sleep, the reality is that only about 1 per 1000 people actually get the sleep they need on 6 or less hours of sleep.

Over time sleep deprivation causes cognitive and physiological deficits, including memory impairments, a reduced ability to make decisions and serious attention issues.  Being sleep deprived increases the risk of car accidents, impacts work performance and affects ones mood and relationships.  Physically, the immune system is taxed, and risks for high blood pressure, heart disease, strokes, diabetes, obesity and depression are increased.

Good sleep hygiene can promote sound sleep.  The following are tips to improve sleep quality.

1. Create a sleep schedule by going to bed and rising at the same time each day (including the weekend).

2. Take care to have a bedroom that is quiet, dark, relaxing, and at a comfortable temperature.

3. It is important that your bed and is very comfortable and that it is only used for sleep and intimacy.  Other activities such as watching TV, being on electronics, eating etc. are best done in the common living space.

4. Agree on a time during the day to discuss and resolve issues.

5. Avoid eating heavy meals too late in the day.

6. Nap cautiously. Napping in the afternoon for more than 60 minutes can disrupt nighttime sleep.

7. Exercise as often as possible, but not too close to bedtime.

8. Avoid drinking alcohol, as it interferes with getting good quality sleep.

9. If you consume caffeinated beverages (tea, coffee, energy drinks etc.) keep in mind that caffeine can remain in your body up to 14 h.

10. Use the last hour of your waking time relaxing in a dimly lit space.

11. Don’t use alcoholic beverages as a “sleep aid”.

If despite practicing good sleep hygiene there are difficulties falling, or staying asleep, there could be an underlying sleep disorder.  Another sign of a sleep disorder is tiredness during the day despite adequate sleep time. Many people have a few sleepless nights here and there due to circumstantial life challenges, such as stress, excitement, or trauma.  This is a very different experience from people who suffer from a sleep disorder.

The following is a list of sleep disorders:

  • Insomnia:  Difficulty falling or staying asleep
  • Sleep Apnea:  Disrupted breathing during sleep
  • Restless Legs Syndrome:   Prickly tingly sensation in legs
  • Periodic Limb Movement Disorder:  Muscle twitches/kicking of the legs
  • Narcolepsy:  Sudden onset of sleep during the day

According to the National Institutes of Health (NIH Publication No. 11-5271), the most common sleep disorder is insomnia.  “Chronic insomnia is defined as having symptoms at least 3 nights per week for more than 1 month. Most cases of chronic insomnia are secondary, which means they are due to another disorder or medications. Primary chronic insomnia is a distinct sleep disorder; its cause is not yet well understood.

Chronic insomnia is often caused by one or more of the following: A disease or mood disorder. The most common causes of insomnia are depression and/or anxiety disorders. Neurological disorders, such as Alzheimer’s or Parkinson’s disease, also can have insomnia as a symptom. Chronic insomnia can result from thyroid dysfunction, arthritis, asthma, or other medical conditions in which symptoms become more troublesome at night, making it difficult to fall asleep or stay asleep. Furthermore, various prescribed and over-the-counter medications can disrupt sleep, such as decongestants, certain pain relievers, and steroids.  Some people, however, have primary chronic insomnia. This condition is linked to a tendency to be more “revved up” than normal (hyperarousal). People who have primary chronic insomnia may have heightened levels of certain hormones, higher body temperatures, faster heart rates, and a different pattern of brain waves while they sleep.”

Psychiatrists (medical doctor with a mental health specialization) and psychologists (trained in psychotherapy techniques) can diagnose and treat sleep disorders.  Often an interdisciplinary approach is used where neurologists, pulmonologists, ENTs, dentists and other specialists will work together to diagnose and treat a sleep disorder.

A psychiatric evaluation can establish if insomnia is caused by depression and/or anxiety disorder.  In such cases available treatment options are medication and psychotherapy/counseling.