Common Sleep Disorders

Quality sleep is essential for physical health, mental well-being, and overall quality of life. Yet millions of people struggle with sleep disorders that prevent them from getting the rest they need. Understanding these conditions is the first step toward finding solutions and improving your sleep health.

What Are Sleep Disorders?

Sleep disorders are conditions that impair your ability to get enough quality sleep on a regular basis. They can affect how long you sleep, when you sleep, and the quality of your sleep, leaving you feeling tired and impaired during the day. Sleep disorders can also contribute to or worsen other health problems.

Sleep disorders are extremely common, affecting an estimated 50-70 million Americans. They can occur at any age and affect both physical and mental health. Chronic sleep deprivation is linked to increased risk of heart disease, diabetes, obesity, depression, and accidents.

Major categories of sleep disorders include:

• Insomnia - Difficulty falling or staying asleep
• Sleep-related breathing disorders - Including sleep apnea
• Central disorders of hypersomnolence - Excessive daytime sleepiness, including narcolepsy
• Circadian rhythm sleep-wake disorders - Problems with sleep timing
• Parasomnias - Abnormal behaviors during sleep
• Sleep-related movement disorders - Including restless legs syndrome

Most Common Sleep Disorders

Insomnia

Insomnia is the most common sleep disorder, affecting approximately 30% of adults occasionally and 10% chronically. It involves difficulty falling asleep, staying asleep, or waking too early and not being able to return to sleep.

Types:

• Acute insomnia (short-term, often triggered by stress)
• Chronic insomnia (occurring at least 3 nights per week for 3 months or more)

Sleep Apnea

Sleep apnea is a serious disorder where breathing repeatedly stops and starts during sleep. Obstructive sleep apnea (OSA) is the most common type, occurring when throat muscles relax and block the airway.

Risk factors: Obesity, older age, male gender, large neck circumference, family history, alcohol use, smoking

Restless Legs Syndrome (RLS)

RLS causes uncomfortable sensations in the legs and an irresistible urge to move them, typically worse in the evening and at night. It can severely disrupt sleep onset.

Narcolepsy

Narcolepsy is a neurological disorder affecting the brain’s ability to control sleep-wake cycles. People with narcolepsy experience excessive daytime sleepiness and may have sudden sleep attacks.

Circadian Rhythm Disorders

These disorders occur when your internal clock is out of sync with your environment, leading to sleep problems. Common types include delayed sleep phase disorder, advanced sleep phase disorder, jet lag, and shift work disorder.

Causes and Risk Factors

Sleep disorders have various causes depending on the specific condition.

General risk factors:

• Age (different disorders affect different age groups)
• Gender (some disorders are more common in men or women)
• Family history and genetics
• Underlying medical conditions (heart disease, chronic pain, neurological conditions)
• Mental health conditions (anxiety, depression, PTSD)
• Medications and substances
• Lifestyle factors (irregular schedule, poor sleep habits, stress)
• Work schedule (shift work)

Specific causes by disorder:

• Insomnia often results from stress, anxiety, poor sleep habits, or medical conditions
• Sleep apnea is primarily caused by airway obstruction or brain signaling problems
• RLS may be related to dopamine imbalances, iron deficiency, or genetics
• Narcolepsy is often caused by loss of hypocretin-producing brain cells

Common Symptoms

Symptoms vary by disorder but often overlap. Watch for these signs:

General symptoms of sleep disorders:

• Difficulty falling asleep
• Waking frequently during the night
• Waking too early and unable to return to sleep
• Unrefreshing sleep
• Excessive daytime sleepiness
• Difficulty concentrating during the day
• Irritability and mood changes
• Decreased performance at work or school
• Memory problems

Sleep apnea specific symptoms:

• Loud snoring
• Gasping or choking during sleep
• Observed pauses in breathing
• Morning headaches
• Dry mouth upon waking

Restless legs syndrome symptoms:

• Uncomfortable sensations in legs (crawling, pulling, throbbing)
• Urge to move legs that worsens at rest
• Symptoms that worsen in the evening
• Temporary relief from movement

Narcolepsy symptoms:

• Sudden muscle weakness (cataplexy)
• Sleep paralysis
• Hallucinations when falling asleep or waking
• Automatic behaviors during microsleep episodes

Diagnosis

Proper diagnosis is essential because treatment varies significantly by disorder.

Diagnostic methods:

• Sleep history and diary - Detailed tracking of sleep patterns, symptoms, and habits
• Physical examination - Checking for underlying conditions
• Questionnaires - Standardized assessments like the Epworth Sleepiness Scale or Pittsburgh Sleep Quality Index
• Polysomnography (sleep study) - Overnight monitoring of brain waves, oxygen levels, heart rate, breathing, and movement
• Home sleep apnea testing - Simplified testing for suspected sleep apnea
• Multiple Sleep Latency Test (MSLT) - Measures how quickly you fall asleep during the day
• Actigraphy - Wearable device tracking movement patterns over days or weeks
• Blood tests - Checking for conditions like thyroid problems or iron deficiency

Treatment Options

Treatment depends on the specific disorder and its underlying causes.

Insomnia treatments:

• Cognitive Behavioral Therapy for Insomnia (CBT-I) - The gold standard treatment
• Sleep restriction therapy
• Stimulus control therapy
• Relaxation training
• Sleep medications (short-term use)

Sleep apnea treatments:

• CPAP (Continuous Positive Airway Pressure) - Most common treatment
• BiPAP (Bilevel Positive Airway Pressure)
• Oral appliances to keep airway open
• Positional therapy
• Weight loss
• Surgery in some cases

Restless legs syndrome treatments:

• Iron supplementation if deficient
• Dopamine agonists
• Alpha-2 delta ligands (gabapentin, pregabalin)
• Lifestyle modifications

Narcolepsy treatments:

• Stimulant medications for daytime sleepiness
• Sodium oxybate for nighttime sleep and cataplexy
• Antidepressants for cataplexy
• Scheduled naps

Circadian rhythm disorder treatments:

• Light therapy
• Melatonin supplements
• Chronotherapy (gradually shifting sleep times)
• Good sleep hygiene

What You Can Do

Regardless of your specific sleep disorder, these sleep hygiene practices can help improve your sleep quality.

1. Maintain a consistent sleep schedule - Go to bed and wake up at the same time every day, including weekends. This helps regulate your body’s internal clock.

2. Create an optimal sleep environment - Keep your bedroom dark, quiet, and cool (65-68 degrees F). Use blackout curtains, white noise machines, or earplugs if needed.

3. Limit screen time before bed - The blue light from phones, tablets, and computers suppresses melatonin. Stop using screens at least 1 hour before bedtime.

4. Watch what you consume - Avoid caffeine for at least 6 hours before bed. Limit alcohol, which disrupts sleep quality. Avoid heavy meals close to bedtime.

5. Exercise regularly - Physical activity promotes better sleep, but finish vigorous exercise at least 3-4 hours before bedtime.

6. Manage stress - Practice relaxation techniques like deep breathing, meditation, or progressive muscle relaxation before bed.

7. Use your bed only for sleep and intimacy - This strengthens the mental association between bed and sleep. Don’t work, watch TV, or scroll your phone in bed.

8. Get daylight exposure - Natural light during the day helps maintain healthy circadian rhythms. Aim for at least 30 minutes of sunlight, especially in the morning.

9. Limit naps - If you must nap, keep it to 20-30 minutes and avoid napping late in the afternoon.

10. Create a bedtime routine - Develop relaxing pre-sleep rituals like reading, gentle stretching, or taking a warm bath to signal your body it’s time to wind down.

When to See a Doctor

Consult a healthcare provider if:

• Sleep problems persist for more than a few weeks
• Daytime sleepiness interferes with work, driving, or daily activities
• Your partner observes that you snore loudly or stop breathing during sleep
• You experience unusual behaviors during sleep
• You fall asleep at inappropriate times during the day
• You have uncomfortable sensations in your legs that disrupt sleep
• Good sleep hygiene practices don’t improve your sleep

Seek immediate attention if:

• You have severe daytime sleepiness that puts you at risk while driving
• You experience sudden weakness with strong emotions (possible cataplexy)
• You’re told you stop breathing during sleep and feel excessively fatigued

Key Takeaways

• Sleep disorders are common conditions that can significantly impact physical health, mental well-being, and quality of life
• The most common disorders include insomnia, sleep apnea, restless legs syndrome, and circadian rhythm disorders
• Proper diagnosis is essential because treatments vary significantly depending on the specific disorder
• Good sleep hygiene practices benefit everyone and should be the foundation of any sleep improvement plan