Definition & Overview

Sleep problems refer to changes in sleeping patterns or habits or abnormal sleep behaviors that make it difficult for an individual to fall and stay asleep. This results in severe daytime sleepiness and irregular breathing affecting not just school or work performance but also one’s quality of life.

Sleep is divided into rapid eye movement (REM) sleep and non-REM. REM sleep is one of the four stages of sleep that most people experience nightly. It is characterized by low muscle tone throughout the body, random movements of the eyes, and the tendency of the sleeper to dream vividly. Meanwhile, non-REM refers to three stages, each one lasting about 15 minutes. Stage one is when the eyes are closed, but the individual is not yet asleep while stage two is when the body temperature starts to drop in preparation for deep sleep. Stage three refers to the deep sleep stage. During normal sleep, a person experiences the first three non-REM stages before going through REM sleep. Sleep problems occur when the cycle is constantly interrupted.

There are various types of sleep problems with the most common listed below:

  • Insomnia – A very common sleep problem or disorder that affects millions of people worldwide, insomnia results in a general feeling of being unwell both physically and mentally. This occurs when the circadian rhythm has been disrupted or due to the presence of psychological issues, medical conditions, and hormonal imbalances. Recent studies confirmed that media technology also contributes to the development of this problem.

  • Sleep Apnoea – this is a common disorder characterized by pauses in breathing during sleep. The pauses, which can last from several seconds to minutes, typically lead to loud snoring that wakes up the individual. This can happen as often as 30 times per night, severely affecting the quality of sleep.

  • Pregnancy – Women experience sleep problems during and after pregnancy. Morning sickness, frequent trips to the bathroom, pain and discomfort contribute to the problem.

  • Narcolepsy – this is a chronic neurological disorder that affects the brain’s ability to regulate sleep-wake cycles. This is a lifelong condition that results in uncontrollable sleep attacks, making the patient overwhelming tired. It can be extremely dangerous as sleep attacks can occur at any time of the day even while the patient is in the middle of an activity such as eating or driving.

  • Delayed Sleep Phase Disorder – This refers to the delay in the biological clock or the 24-hour cycle of sleep and wakefulness. This disorder prevents patients from sleeping earlier than 2 am to 6 am regardless of the amount of effort they put in.

Cause of Condition

Various sleep problems are caused by a wide variety of physical, medical, psychiatric, and environmental factors that essentially disrupt the body’s natural cycle of slumber and daytime wakefulness. Short-term sleeping problems are typically due to environmental factors such as extreme temperatures or events such as losing a job or a death of a loved one. Meanwhile, serious sleeping problems that warrant medical attention include chronic stress, depression, and medical conditions such as narcolepsy and restless leg syndrome.

In children, the common causes of sleep problems are bedwetting, anxiety, teeth grinding, nightmares, allergies, upper respiratory infections, snoring, and colds.

Meanwhile, individuals who are at least 50 years old and have degenerative disorders such as Parkinson’s disease, are at a higher risk of having chronic sleep problems.

Key Symptoms

  • Difficulty falling or staying asleep during the night
  • Sleepiness during the day
  • Loud, chronic snoring
  • Feeling exhausted after waking up
  • Waking up with nasal congestion, chest pains, dry throat, and headaches
  • Difficulty staying awake
  • Difficulty in following a regular sleep schedule
  • Dizziness
  • Drooling
  • Tremor in the chin, foot, hand, and ankle
  • Relying on alcohol or sleeping pills to sleep
  • Difficulty concentrating during the day
  • Daytime fatigue and irritability

Who to See & Types of Treatments Available

The first medical professional to consult regarding sleep problems is your family doctor or a GP. During your first appointment, your medical history, symptoms, and the medications that you’re taking will be thoroughly discussed. The diagnosing physician will also want to interview your sleeping partner, if you have one.

If initial tests suggest a sleep problem, physical and neurological exams will be conducted to evaluate your REM sleep behavior and to rule out other problems including obstructive sleep apnoea and narcolepsy. A polysomnogram or nocturnal sleep study will also be performed wherein your sleep pattern will be evaluated either in a hospital or at your house. During the test, your breathing patterns, arm and leg movements, as well as your brain, heart, and lung activities will be monitored.

Depending on the result of the exams, you will either be provided with medications or referred to specialists. For instance, if your condition stems from psychological conditions such as schizophrenia, you will be referred to a psychiatrist.

Most sleep problems can be treated using tried and tested medication-free home remedies, which include the following:

  • Establishing and following a strict sleep schedule/routine
  • Making sure your bedroom is quiet, dark, and free from any distractions
  • Avoiding naps during the day
  • Limiting nicotine, alcohol, and caffeine intake
  • Yoga and meditation exercises
  • Progressive muscle relaxation exercises

Sleep problems can also be treated using medications such as Valerian, a mild sedative that can help you sleep better, and Melatonin, a naturally occurring hormone that is proven effective in treating short-term sleep problems such as those that caused by jetlag or extreme temperature.

If home remedies and supplements fail to treat your condition, your other options include cognitive behavioral therapy and prescription sleeping pills.

References:

  • American Academy of Family Physicians.
  • American Academy of Child and Adolescent Psychiatry.
  • Lucile Packard Children's Health Services.
  • Medline Plus: "Narcolepsy."
  • Agency for Healthcare Research and Quality.
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