Understanding sleep disorders and sleeping problems

If you’re having trouble sleeping, you’re in good company. According to the National Commission on Sleep Disorders Research, at least 40 million Americans suffer from chronic, long-term sleep disorders and another 20 to 30 million experience occasional sleep problems.

Unfortunately, even minimal sleep loss can take a toll on your mood, energy, efficiency, and ability to handle stress. Ignoring sleep problems and disorders can lead to poor health, weight gain, accidents, impaired job performance, and relationship strain. If you want to feel your best, stay healthy, and perform up to your potential, sleep is a necessity, not a luxury.

It’s not normal to feel sleepy during the day, to have problems getting to sleep at night, or to wake up feeling exhausted. But even if you’ve struggled with sleep problems for so long that it seems normal, you can still learn to sleep better. You can start by tracking your symptoms and sleep patterns, and then making healthy changes to your daytime habits and bedtime routine. If self-help doesn’t do the trick, you can turn to sleep specialists who are trained in sleep medicine. Together, you can identify the underlying causes of your sleeping problem and find ways to improve your sleep and quality of life.

Signs and symptoms of sleep disorders and sleeping problems

Everyone experiences occasional sleeping problems, so how can you tell whether your sleeping problem is just a minor, passing annoyance or a sign of a more serious sleep disorder or underlying medical condition?

Start by scrutinizing your symptoms, looking especially for the telltale daytime signs of sleep deprivation. If you are experiencing any of the following symptoms on a regular basis, you may be dealing with a sleep disorder.

Insomnia: The most common type of sleep disorder

Insomnia, the inability to get to sleep or sleep well at night, is an all-too common sleeping problem—in fact, it’s the most common sleep complaint. Insomnia can be caused by a wide variety of things including stress, jet lag, a health condition, the medications you take, or even the amount of coffee you drink. Insomnia can also be caused by other sleep disorders or mental health conditions such as anxiety and depression.

Common signs and symptoms of insomnia include:

• Difficulty falling asleep at night or getting back to sleep after waking during the night
• Waking up frequently during the night
• Your sleep feels light, fragmented, or unrefreshing
• You need to take something (sleeping pills, nightcap, supplements) in order to get to sleep
• Sleepiness and low energy during the day

Whatever the cause of your insomnia, being mindful of your sleep habits and learning to relax will help you sleep better and feel better. The good news is that most cases of insomnia can be cured with lifestyle changes you can make on your own—without relying on sleep specialists or turning to prescription or over-the-counter sleeping pills.

Circadian rhythm sleep disorders

We all have an internal biological clock that regulates our 24-hour sleep-wake cycle, also known as our circadian rhythms. Light is the primary cue that influences circadian rhythms. When the sun comes up in the morning, the brain tells the body that it’s time to wake up. At night, when there is less light, your brain triggers the release of melatonin, a hormone that makes you sleepy.

When your circadian rhythms are disrupted or thrown off, you may feel groggy, disoriented, and sleepy at inconvenient times. Circadian rhythms have been linked to a variety or sleeping problems and sleep disorders, including insomnia, jet lag, and shift work sleep difficulties. Abnormal circadian rhythms have also been implicated in depression, bipolar disorder, and seasonal affective disorder (the winter blues).

Shift work sleeping problems

Shift work sleep disorder occurs when your work schedule and your biological clock are out of sync. In our 24-hour society, many workers have to work night shifts, early morning shifts, or rotating shifts. These schedules force you to work when your body is telling you to go to sleep, and sleep when your body is signaling you to wake.

While some people adjust better than others to the demands of shift work, most shift workers get less quality sleep than their daytime counterparts. As a result of sleep deprivation, many shift workers struggle with sleepiness and mental lethargy on the job. This cuts into their productivity and puts them at risk of injury.

There are a numbers of things you can do to reduce the impact of shift work on sleep:

• Take regular breaks and minimize the frequency of shift changes.
• When changing shifts, request a shift that’s later, rather than earlier as it’s easier to adjust forward in time, rather than backward.
• Naturally regulate your sleep-wake cycle by increasing light exposure at work (use bright lights) and limiting light exposure when it’s time to sleep. Avoid TV and computer screens, use blackout shades or heavy curtains to block out daylight in your bedroom.
• Consider taking melatonin when it’s time for you to sleep.

Delayed sleep phase disorder

Delayed sleep phase disorder is a condition where your 24-hour cycle of sleep and wakefulness—your biological clock—is significantly delayed. As a result, you go to sleep and wake up much later than other people. For example, you may not get sleepy until 4 a.m., at which time you go to bed and sleep soundly until noon, or at least you would if your daytime responsibilities didn’t interfere. Delayed sleep phase disorder makes it difficult for you to keep normal hours—to make it to morning classes, get the kids to school on time, or keep a 9-to-5 job.

It’s important to note that this sleeping problem is more than just a preference for staying up late or being a night owl.

• People with delayed sleep phase disorder are unable to get to sleep earlier than 2 to 6 a.m. no matter how hard they try. They struggle to go to sleep and get up at socially acceptable times.
• When allowed to keep their own hours (such as during a school break or holiday), they fall into a regular sleep schedule.
• Delayed sleep phase disorder is most common in teenagers, and many teens will eventually grow out of it.
• For those who continue to struggle with a biological clock that is out of sync, treatments such as light therapy and chronotherapy can help. To learn more, schedule an appointment with a sleep doctor or local sleep clinic.

Jet lag sleeping problems

Jet lag is a temporary disruption in circadian rhythms that occurs when you travel across time zones. Symptoms include daytime sleepiness, fatigue, headache, stomach problems, and insomnia. The symptoms typically appear within a day or two after flying across two or more time zones. The longer the flight, the more pronounced the symptoms. The direction of flight also makes a difference. Flying east tends to cause worse jet lag than flying west.

In general, it usually takes one day per time zone crossed to adjust to the local time. So if you flew from Los Angeles to New York, crossing three time zones, your jet lag should be gone within three days. However, jet lag can be worse if you:

• lost sleep during travel
• are under a lot of stress
• drink too much alcohol or caffeine
• didn’t move around enough during your flight

Other common types of sleep disorders

Sleep apnea

Sleep apnea is a common (and treatable) sleep disorder in which your breathing temporarily stops during sleep due to the blockage of the upper airways. These pauses in breathing interrupt your sleep, leading to many awakenings each hour. While most people with sleep apnea don’t remember these awakenings, they might feel exhausted during the day, irritable and depressed, or see a decrease in productivity. Sleep apnea is a serious and potentially life-threatening sleep disorder, so it’s wise to see a doctor right away if suspect that you or a loved one may be suffering from it.

Symptoms of sleep apnea include:

• Loud, chronic snoring
• Frequent pauses in breathing during sleep
• Gasping, snorting, or choking during sleep
• Feeling exhausted after waking and sleepy during the day, no matter how much time you spent in bed
• Waking up with shortness of breath, chest pains, headaches, nasal congestion, or a dry throat

For more on sleep apnea and what you can do to help yourself, see Sleep Apnea: Symptoms, Treatment, Causes, and Cures.

Restless legs syndrome (RLS)

Restless legs syndrome (RLS) is a sleep disorder that causes an almost irresistible urge to move your legs (or arms). The urge to move occurs when you’re resting or lying down and is usually due to uncomfortable, tingly, aching, or creeping sensations.

Common signs and symptoms of restless legs syndrome include:

• Uncomfortable sensations deep within the legs, accompanied by a strong urge to move them
• The leg sensations are triggered by rest and get worse at night
• The uncomfortable sensations temporarily get better when you move, stretch, or massage your legs
• Repetitive cramping or jerking of the legs during sleep

For more on RLS and what you can do to help yourself, see Restless Legs Syndrome (RLS): Symptoms, Treatment, and Self-Help.

Narcolepsy

Narcolepsy is a sleep disorder that involves excessive, uncontrollable daytime sleepiness. It is caused by a dysfunction of the brain mechanism that controls sleeping and waking. If you have narcolepsy, you may have “sleep attacks” while in the middle of talking, working, or even driving.

Common signs and symptoms of narcolepsy include:

• Seeing or hearing things when you’re drowsy or starting to dream before you’re fully asleep
• Suddenly feeling weak or losing control of your muscles when you’re laughing, angry, or experiencing other strong emotions
• Dreaming right away after going to sleep or having intense dreams
• Feeling paralyzed and unable to move when you’re waking up or dozing off

For more on narcolepsy and what you can do to help yourself, see Narcolepsy: Symptoms and Treatment of Narcolepsy.

Self-help for sleeping problems and sleep disorders

While some sleep disorders may require a visit to the doctor, you can improve many sleeping problems on your own. The first step to overcoming a sleep problem is identifying and carefully tracking your symptoms and sleep patterns.

Keep a sleep diary

A sleep diary is a very useful tool for identifying sleep disorders and sleeping problems and pinpointing both day and nighttime habits that may be contributing to your difficulties. Keeping a record of your sleep patterns and problems will also prove helpful if you eventually find it necessary to see a sleep doctor.

Your sleep diary should include:

• what time you went to bed and woke up
• total sleep hours and perceived quality of your sleep
• a record of time you spent awake and what you did (“stayed in bed with eyes closed,” for example, or “got up, had a glass of milk, and meditated”)
• types and amount of food, liquids, caffeine, or alcohol you consumed before bed, and times of consumption
• your feelings and moods before bed ­(e.g. happiness, sadness, stress, anxiety)
• any drugs or medications taken, including dose and time of consumption

The details can be important, revealing how certain behaviors can be ruining your chance for a good night’s sleep. After keeping the diary for a week, for example, you might notice that when you have more than one glass of wine in the evening, you wake up during the night.

Download and print Helpguide’s sleep diary (PDF).

Improve your sleep hygiene and daytime habits

Regardless of your sleep problems, a consistent sleep routine and improved sleep habits will translate into better sleep over the long term. You can address many common sleep problems through lifestyle changes and improved sleep hygiene. For example, you may find that when you start exercising regularly and managing your stress more effectively, your sleep is much more refreshing. The key is to experiment. Use your sleep diary as a jumping off point.

Try the following simple changes to your daytime and pre-bedtime routine:

• Keep a regular sleep schedule, going to sleep and getting up at the same time each day, including the weekends.
• Set aside enough time for sleep. Most people need at least seven to eight hours each night in order to feel good and be productive.
• Make sure your bedroom is dark, cool, and quiet. Cover electrical displays, use heavy curtains or shades to block light from windows, or try a sleep mask to shield your eyes.
• Turn off your TV, smartphone, iPad, and computer a few hours before your bedtime. The type of light these screens emit can stimulate your brain, suppress the production of melatonin, and interfere with your body’s internal clock.

Do sleeping pills help sleep disorders and sleeping problems?

When taken for a brief period of time and under the supervision of your doctor, sleeping pills may help your sleeping problems. However, they are just a temporary solution. Insomnia can’t be cured with sleeping pills. In fact, sleeping pills can often make insomnia worse in the long run.

In general, sleeping pills and sleep medications are most effective when used sparingly for short-term situations, such as traveling across many time zones or recovering from a medical procedure. If medications are used over the long term, they are best used “as needed” instead of on a daily basis to avoid dependence and tolerance.

Safety guidelines for sleeping pills

• Only take a sleeping pill when you will have enough time to get a full 7 to 8 hours of sleep. Otherwise, you may be drowsy the next day.
• Read the package insert that comes with your medication. Pay careful attention to the potential side effects, dosage instructions, and list of food and substances to avoid.
• Never mix alcohol and sleeping pills. Alcohol disrupts sleep and can interact dangerously with sleep medications.
• Never drive a car or operate machinery after taking a sleeping pill, especially when you first start taking a new sleep aid, as you may not know how it will affect you.

When to call a doctor about sleep disorders

If you’ve tried a variety of self-help sleep remedies without success, schedule an appointment with a sleep specialist or ask your family doctor for a referral to a sleep clinic, especially if:

• Your main sleep problem is daytime sleepiness and self-help hasn’t improved your symptoms.
• You or your bed partner gasps, chokes, or stops breathing during sleep.
• You sometimes fall asleep at inappropriate times, such as while talking, walking, or eating.

At your appointment, be prepared with information about your sleep patterns and provide the doctor with as much supporting information as possible, including information from your sleep diary.

What to expect at a sleep clinic or center

If your physician refers you to a sleep center, a specialist will observe your sleep patterns, brain waves, heart rate, rapid eye movements and more using monitoring devices attached to your body. While sleeping with a bunch of wires attached to you might seem difficult, most patients find they get used to it quickly.

The sleep specialist will analyze the results from your sleep study and design a treatment program if necessary. A sleep center can also provide you with equipment to monitor your activities (awake and asleep) at home.

Source: http://www.helpguide.org/articles/sleep/sleep-disorders-and-sleeping-problems.htm