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What Are Sleeping Disorders?
Sleep disorders are abnormal or unhealthy patterns of sleeping and waking that result in insufficient or poor quality sleep.
The most common varieties of sleeping disorders are:
- Insomnia: difficulty falling or staying asleep; waking frequently or too early; not feeling refreshed by sleep. Insomnia causes excessive daytime drowsiness and tiredness, is often produced by anxiety or stress, and can be experienced on a short-term situational basis, or be a chronic condition.
- Narcolepsy: a neurological condition that causes sleep to be unregulated. Sufferers experience excessive daytime sleepiness and are prone to suddenly and uncontrollably falling asleep no matter the current situation. Individuals with narcolepsy can fall asleep in the middle of a sentence that they will finish when they wake up, without necessarily realizing that they have been asleep.
- Sleep Apnea: interrupted breathing during sleep, which is usually caused by obstruction of the airway by the soft tissue at the back of the throat during sleep. Central sleep apnea is caused by dysfunction in the area of the brain that transmits the signal to breathe.
- Restless Leg Syndrome: a neurological disorder characterized the irresistible urge to move one’s legs while at rest, thereby preventing the individual from falling asleep.
- Bruxism: clenching the jaw and grinding the teeth while asleep. This can cause headaches, dental problems, and poor sleep quality.
Less Common Sleep Disorders:
- Sleepwalking: the act of performing any complex movement or behavior, not just walking, while the individual is asleep. As long as the condition is not induced by medication, sleepwalking is usually harmless. It is most often seen in children who outgrow it.
- Night Terrors: when a sleeping person experiences a nightmare but can’t be woken up; they may scream or flail their limbs in terror, or may even act out their dreams in some cases. Night terrors are most common in children but are experienced by a small number of adults as well.
- Non-24-hour Sleep-Wake Syndrome: a disruption of the circadian rhythm which causes an individual’s pattern of sleeping and waking to be longer than 24 hours, so that they cannot function on a regular day and night schedule.
- Sleep Paralysis: when an individual remains conscious as their body transitions into sleep, they can experience paralysis and an overwhelming sense of dread, and may even hallucinate menacing figures in the room. This condition can be caused by stress and sleep deprivation, which means that having one episode can make an individual more vulnerable to experiencing more episodes. However, simply becoming aware that this is an experience shared by many other people can often help reduce the frequency.
What Are the Signs and Symptoms of Sleeping Disorders?
The wide variety of sleeping disorders that exist means that there are a wide variety of symptoms that may occur, depending upon the individual disorder. There are, however, some general symptoms that can be expected with any sleep disorder, usually as a result of sleep deprivation, including:
- Daytime sleepiness
- Under or over-sleeping
- Fatigue and lethargy
- Concentration difficulties
- Mood swings
- Memory problems
- Impaired performance
- Physical complaints such as unexplained pain
- Impaired immune system
- Brain fog
- Difficulty adapting and learning
How Are Sleeping Disorders Diagnosed?
Sometimes an individual is aware that they have a sleep problem, but are unsure what kind of problem it is. A doctor can prescribe these individuals to undergo a sleep study that can be used as a diagnostic tool.
A sleep study is an overnight exam conducted in a dark, comfortable room with a bed, where doctors can monitor your sleep stages and cycles, eye movements, oxygen levels, breathing and heart rates, body movements, and snoring. This is a non-invasive test with relatively comfortable sensors and electrodes put on the body, and no needles required.
Even if an individual is unable to get a full night’s sleep in this unfamiliar setting, the exam can provide a wealth of informative data that can be used to diagnose the unique sleep disorder in question. Most follow-up appointments will take place around two weeks after a sleep study is completed.
How Do Sleeping Disorders Interact with Addiction?
Sleep disorders are often co-occurring with substance use disorders. Sometimes the sleep disorder is a result of substance use. Any drug that slows down or speeds up the central nervous system can have an opposite rebound effect as the drug wears off, and regular substance use can even disrupt the normal functioning of the central nervous system in ways that create a new, chronic sleeping disorder. Some sleeping pills, such as Ambien, are notorious for causing parasomnias (unusual activities during sleep). Some of these parasomnias can be frightening or dangerous, such as having sex, cooking, or driving a car while asleep.
In recovery, insomnia is a common side effect experienced during detox and in the early phases of treatment for most substances. Many people lose their healthy 24-hour sleep/wake cycle as a result of drug use, and it can take a long time for the body and brain to repair these changes in sobriety. Cognitive behavioral therapy is very useful in these cases, to make sure that the person in recovery uses healthy ways of coping with insomnia, and does not return to dangerous self-medicating behaviors.
Some individuals with sleep disorders develop addictions as a result of their sleeping disorder. If a patient develops a tolerance to a medication prescribed for a sleeping disorder (such as a benzodiazepine prescribed for insomnia, or a stimulant prescribed for narcolepsy), or misuses that prescription in any way, addiction can develop. Some individuals may acquire prescription medications or illicit drugs without seeing a doctor and self-medicate their problems. This is even more likely to result in addiction, as drug use is not being guided by a doctor in any way, and there is no way to be certain what exactly is in any medication that is obtained illegally. Drug dealers can sell drugs that have been pressed on a machine that makes the pills look just like particular prescription medication, while the contents are something completely different.
How Are Sleeping Disorders and Addiction Treated?
Some sleeping disorders have relatively simple and effective treatments, such as getting a custom mouthguard made to protect the teeth from grinding during sleep (bruxism). Other sleeping disorders, such as narcolepsy, require the prescription of controlled substances that must be carefully taken according to a doctor’s instructions.
Both obstructive and central sleep apnea requires sleeping with a mask hooked up to a small machine that delivers continuous or differing patterns of air pressure to ensure deep and healthy sleep with sufficient oxygen intake.
Some sleeping disorders have a psychological component and may require a more involved, multi-step approach. Insomnia can be treated with medication, but most of these drugs are highly addictive and can only be used on a short-term basis. An effective, long-term treatment will require psychotherapy, as well as an overhaul of sleep hygiene habits.
Good sleep hygiene includes:
- Avoiding exposure to screens for one or more hours before bed, as the blue light emitted by cell phones, computers, and televisions prevents the brain and body from going through the hormonal changes necessary for sleep. Some people may use orange-tinted glasses or set their phones or tablets on a warm, night setting to avoid this effect.
- Turning the lights down and making your home quiet as bedtime approaches.
- Waking up at the same time every morning, and going to bed as soon as you feel sleepy.
- Avoiding caffeine and nicotine late in the day.
- People with acid reflux (a condition which does not always have obvious symptoms) should stop eating at least two hours before bedtime and avoid trigger foods.
- Opening blinds or going outside to get exposed to sunlight first thing in the morning to help restore a healthy sleep-wake cycle.
Melatonin is a hormonal sleep aid that is available over the counter in doses up to 10 mg or more, but a 1 mg dose of a children’s strength melatonin is enough for most individuals. Lower doses will prevent morning grogginess, difficulty waking up, and oversleeping. Melatonin should not be taken for more than two weeks in a row to avoid dependence, and to avoid disrupting the body’s hormonal system. Melatonin and Vitamin D levels are also linked in the body in interdependent ways. Vitamin D should only be taken in the morning to avoid sleep disruption, and a vitamin D deficiency can result in insomnia or excessive sleepiness.
Regular aerobic exercise (walking, running, swimming, biking) and a healthy diet with plenty of nutritionally dense plant foods can help regulate energy and improve sleep as well.