Sleep disorders (or sleep-wake disorders) involve problems with the quality, timing, and amount of sleep, which result in daytime distress and impairment in functioning. Sleep-wake disorders often occur alongwith medical conditions or other mental health conditions, such as depression, anxiety or cognitive disorders.

What are the types of Sleep Disorders?

There are approximately 80 different types of sleep disorders. The top ones are:
A. Insomnia
B. Sleep Apnea
C. Restless Leg Syndrome
D. Nacrolepsy

A. Insomnia

It is characterized as a complaint of inadequate or unrestorative sleep. Insomnia is defined by the ICSD3 (International Classification of Sleep Disorder-3) as “a recurrent problem with sleep initiation, duration, consolidation, or quality that persists in the face of sufficient opportunity and conditions for sleep and causes some sort of daytime impairment.”

Insomnia is a sleep disorder in which you have trouble falling and or staying asleep.

– The condition can be short term (Acute) or can last a long time (Chronic). It may also come and go.

– Acute insomnia lasts from 1 night to a few weeks, insomnia is chronic when it happens at least 3 nights a week for 3 months.

Types of Insomnia :

1. Psychophysiological Insomnia
2. Idiopathic Insomnia
3. Paradoxical Insomnia

1. Psycho-physiological Insomnia

It is very prevalent. The insomnia must last at least one month to classify as psycho-physiological insomnia, and is not caused by an outside stressor. Rather Psycho-physiological insomnia is caused by a learned response that teaches the subject to not fall asleep when planned.  The subject typically has no difficulty falling asleep when sleep is not planned naps, sleep on set is difficult to achieve.

2. Idiopathic Insomnia

Insomnia, which is sometimes known as “lifelong” insomnia, is first seen in infancy or early childhood and lasts the patient’s entire life. There doesn’t seem to be any outside explanation for insomnia, and there are no other sleep disorders that might be a contributing issue.

3. Paradoxical Insomnia

Previously known as sleep state perception. Paradoxical insomnia consists of the subject’s complaint of insomnia without any actual evidence of insomnia. When a patient returns to the lab after a study, they frequently complain of staying up all night, despite the fact that the technician could see from the EEGS that sleep had been obtained. Sometimes a patient would claim they did not sleep at all even though they may have had a typical amount of sleep.

A sleep diary is a helpful tool for both the therapist and the patient while treating paradoxical insomnia. A sleep diary or sleep log is a sleep report of sleep habit over a period of time ,sleep diaries usually last 5 days and sometimes as long as a month.

A sleep diary may help the patient see abnormalities in their own, sleep habits such as irregular or inconsistent bedtimes, or day time naps that may affect the sleep schedule at night, clinicians can use a patient’s sleep diary to point out some of these in consistencies or poor sleep habits, they can also use patients sleep diary during recorded sleep from sleep study to identify the patients misperception of sleep.

B. Sleep ApneaSleep Apnea

When a person’s breathing is disturbed while they are asleep, they may have a potentially dangerous sleep disorder called sleep apnea. People with untreated sleep apnea stop breathing repeatedly during their sleep.

There are two types of sleep apnea: obstructive and central.

Obstructive sleep apnea (OSA) is the more common of the two. It is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep. Symptoms of OSA may include snoring, daytime sleepiness, fatigue, restlessness during sleep, gasping for air while sleeping and trouble concentrating.

In central sleep apnea (CSA), the airway is not blocked, but the brain fails to tell the body to breathe. This type is called central apnea because it is related to the function of the central nervous system. People with CSA may gasp for air but mostly report recurrent awakenings during night.

C. Restless Leg Syndrome

Restless legs syndrome (RLS) is a sleep disorder that causes an intense, often irresistible urge to move the legs. This sensation is brought on by resting such as lying down in bed, sitting for prolonged periods such as while driving or at a theatre.

RLS frequently manifests in the evening, making it challenging to get to sleep and stay asleep. Problems with daytime tiredness, irritability, and concentration may be related to it. Often, people with RLS want to walk around and shake their legs to help relieve the uncomfortable sensation.

D. Narcolepsy

A neurological sleep regulation condition called narcolepsy disrupts the ability to control both sleep and alertness. People with narcolepsy experience excessive daytime sleepiness and intermittent, uncontrollable episodes of falling asleep during the daytime. These unexpected sleep bouts can happen at any time of day and during any type of activity. Some narcolepsy sufferers describe a sudden onset of muscle weakness accompanied by laughter or other emotions.

Narcolepsy usually begins between the ages of 15 and 25, but it can become apparent at any age. In many cases, narcolepsy is undiagnosed and, therefore, untreated.

Causes of Sleep Disorder

Sleep problems can be caused by various factors. Although causes might differ, the end result of all sleep disorders is that the body’s natural cycle of slumber and daytime wakefulness is disrupted or exaggerated. Eight of these facors include :

• Physical (such as ulcers)
  
  
• Medical (Such as asthma)
  
  
• Psychiatrc (such as depression and anxiety disorders)
  
  
• Environmental (such as alcohol )
  
  
• Working the night shift ( this work schedule messes up “biological clocks”)
  
  
• Genetics
  
  
• Medications (some medications interfere with sleep)
  
  
• Aging (abut half of all adults over the age of 65 have some sort of sleep disorder. It is not clear if it is a normal part of aging or a result of medicines that older people commonly use).

Symptoms of Sleep Disorders

You might have a sleep disorder if you experience one or more of the following symptoms:

• Fall asleep while driving.
  
  
• Struggle to stay awake when inactive, such as when watching television or reading.
  
  
• Have difficulty paying attention or concentrating at work, school, or home.
  
  
• Have performance problems at work or school.
  
  
• Often get told by others that you look sleepy.
  
  
• Have difficulty with your memory.
  
  
• Have slowed responses.
  
  
• Have difficulty managing your emotions.
  
  
• Need to take naps almost every day.
  
  

Why therapies for sleep disorders and not medications?

It can be tempting to turn to a sleeping pill or an over-the-counter sleep aid when you’re in need of sleep. However, sleep medications won’t solve the issue or deal with the underlying symptoms; in fact, they frequently make sleep issues worse over time. That is not to imply that there is never a good time or place to take sleep aids. However, sleeping tablets work best when used sparingly for brief periods of time, such as while transitioning between time zones or recuperating from medical procedures, to avoid dependence and tolerance. Even if your sleep disorder requires the use of prescription medication, experts recommend combining a drug regimen with therapy and healthy lifestyle changes.

Cognitive Behavioral Therapy

CBT can improve your sleep by changing your behaviour before bedtime as well as changing the ways of thinking that keep you from falling asleep. It also focuses on improving relaxation skills and changing lifestyle habits that impact your sleeping patterns. Since sleep disorders can be both caused by and trigger emotional health problems such as anxiety, stress and depression, therapy is an effective way of treating the underlying problem rather than just the symptoms, helping you develop healthy sleeping patterns for life.

A study at Havard Medical School found that CBT was more effective at treating chronic insomnia than prescription sleep medication. CBT produced the greatest changes.

COGNITIVE BEHAVIORAL THERAPY (CBT) for insomnia and other sleep disorders.

It is the most widely-used therapy for sleep disorders. It may be conducted individually, in a group of people with sleeping problems, or even online. Since the causes and symptoms of sleep disorders vary considerably. CBT should always be tailored to your specific problems. CBT for insomnia, for example, is a specific type of therapy designed for people who are unable to get the amount of sleep they need to wake up feeling rested and refreshed.

The length of therapy also depends on the type and severity of your sleep disorder. While CBT is rarely an immediate or easy cure, it is relatively short-term. Many CBT treatment programs for insomnia, for example, report significant improvement in sleep patterns following a course of 5 to 8 weekly sessions.

Behavioral therapy 

Behavioral therapy teaches you how to avoid behaviors that keep you awake at night and replace them with better sleep habits.

Using a sleep diary in CBT : To identify patterns in your sleeping problems and decide on the best treatment approach, your therapist may start by asking you to keep a sleep diary. The details can be important, revealing how certain behaviors are ruining your chance for a good night’s sleep. 

Sleep restriction therapy (SRT) reduces the time you spend lying in bed awake by eliminating naps and forcing you to stay up beyond your normal bedtime. This method of sleep deprivation can be especially effective for insomnia. It not only makes you more tired the next night but builds a stronger association between bed and sleep rather than bed and lying awake.