Last reviewed:
Dec 22nd 2022
OTR/L
Sleep disorders are a collection of medical conditions that impact the quality, quantity, and length of sleep. They can cause or exacerbate several physical and mental health conditions, cause impairments in cognitive functioning, and create dangers for the person affected [1].
Some of the most common or most disruptive sleep disorders are as follows:
Insomnia is the most common sleep disorder, with around a third of all adults experiencing short- or long-lasting insomnia at some point in their lives [2]. Long-term or chronic insomnia is diagnosed when symptoms have persisted for at least three months, occurring three or more times per week.
Symptoms of insomnia include [3]:
There are two types of sleep apnea; obstructive sleep apnea, caused by a blocked airway, and central sleep apnea, caused by a reduction in brain signals that are required to breathe.
Symptoms of sleep apnea include [4]:
Symptoms of narcolepsy include [5]:
Symptoms of restless leg syndrome include [6]
The circadian rhythm, or sleep-wake cycle, is actually slightly over 24 hours, but with environmental, social, and natural cues, we typically are able to maintain a 24-hour cycle. However, some people are unable to utilize these cues to regulate their circadian rhythm (most often due to total blindness, although it can occur in the sighted), causing a non-24-hour sleep wake disorder, also known as circadian rhythm disorder.
Symptoms of non-24-hour sleep wake disorder include [8]:
Shift work disorder occurs in those who work shifts during the night or early morning, between 7pm and 6am, disrupting the circadian rhythm.
Symptoms of shift work disorder include [9]:
Parasomnia is the collective name of several unusual behaviors that occur during the various stages of sleep and impact sleep quality [10]. Many of these experiences can be very frightening or concerning.
Parasomnias that can occur during non-rapid eye movement (NREM) sleep, when sleep is shallow, include:
Parasomnias that can occur during rapid eye movement (REM) sleep, or deep sleep, include:
Parasomnias that can occur in the time between being asleep and being fully awake include:
Research suggests that most sleep disorders are genetic, with increased risks in those with a family member who has been diagnosed with a sleep disorder [3][4][6][10].
Several studies suggest that the way in which the brain works can impact sleep, including changes in signals being sent to the body [4], changes or deficiencies in neurotransmitters, particularly dopamine [6], and an impaired ability for the brain to regulate the circadian rhythm [8].
Stress and anxiety related to work, family, relationships, illnesses, or life changes, can greatly impact sleep quality and quantity [2][7][10].
Disturbed sleep has been found to be common during pregnancy, particularly the third trimester, and within the first four weeks following childbirth.
This could be due to extreme hormone changes, particularly progesterone, which impacts melatonin and sleep; changes in lifestyle while caring for a newborn baby; postpartum depression or mood changes; or changes in weight [11].
Hormone levels fluctuate during the menstrual cycle and many women experience premenstrual symptoms (PMS) prior to their period caused by these hormone changes, which can impact sleep as melatonin levels can be altered. Similarly, mood changes within this time can also impact sleep, such as feelings of anxiety or depression [12].
As people age, their risk of experiencing sleep disorders increases [1]. This applies to most sleep disorders, although certain disturbances, especially various parasomnias, occur more often in children and can reduce with age [10].
Working shifts, regularly traveling, and experiencing regular noise disturbances during the night can all increase the risk of experiencing a sleep disorder.
The risk of sleep disorders is increased in those who don’t engage in any exercise, are obese, smoke cigarettes, take illicit substances, or drink a lot of caffeine or alcohol [3][4][6].
Initially, your doctor will conduct physical health checks such as blood tests, gather a medical history of any mental or physical health conditions experienced by you or your family members, and ask for information on any medications you are currently taking [1].
There may be an underlying physical or mental health condition that is impacting your sleep, such as an iron deficiency, diabetes, anxiety, or depression. If so, your doctor will aim to treat this condition first, which could reduce your issues with sleep.
They will ask questions about your sleep, such as what disturbances you are experiencing, how often they occur, and how they are affecting your life and functioning. They will ask about your caffeine and alcohol intake, lifestyle, and schedule.
They may ask you to complete a sleep diary, to get a clearer picture of your sleep patterns, disturbances, and symptoms [3][4].
After gathering this information, your doctor may be able to make a diagnosis, based on which they will recommend a treatment plan.
However, they may require further information, so might suggest that you take part in a sleep study. This could take place at your home or in a specialized place and will involve monitoring your sleep for a length of time, while potentially monitoring brain changes and physical symptoms, to better understand your condition [1][2].
Engaging in therapy, particularly cognitive behavioral therapy (CBT), may help to reduce your feelings of anxiety or stress, help you form better sleep hygiene, or manage and change your negative beliefs around sleep. Developing more positive feelings or behaviors around sleep could reduce your symptoms [3][10].
Light therapy involves the use of a specifically designed light box. This can help reset your circadian rhythm by affecting the release of brain chemicals, particularly melatonin and serotonin, which regulate sleep [3].
Sunlight reduces the release of melatonin, causing us to feel more awake, while darkness prompts the release of melatonin, causing us to feel sleepy, so with the use of the light box, you can help to create these effects and improve your sleep-wake cycle [8].
Your doctor may prescribe medication to help reduce the symptoms of your sleep disorder.
To help you go to sleep, they may prescribe melatonin supplements, antihistamines with a sedative effect, or a short-term course of benzodiazepines [3].
To help you stay awake, you may be prescribed an amphetamine medication, such as methylphenidate [5].
To prevent unwanted movements during sleep, you may be prescribed an anti-seizure medication, such as gabapentin [6][7].
It is important that you take your medication exactly as prescribed by your doctor, as taking too much, missing doses, or suddenly stopping a medication can cause serious adverse effects.
For sleep apnea or other breathing-related sleep disturbances, your doctor may recommend a breathing device, such as a continuous positive airway pressure (CPAP) machine [4].
You can do several things to improve your sleep quality and reduce symptoms of sleep disorders, including:
Ensuring you get enough sleep is vital to your physical and mental well-being, as it has several functions in the development, protection, and restoration of the body and mind [13].
Inadequate amounts or quality of sleep can cause increased risks of:
Resources: