Insomnia

  • a consistent difficulty in falling or staying asleep
  • one of the most common sleep disorders in the world
  • many factors can contribute to insomnia\
    • this includes age, drug use, exercise, mental status, or bedtime routines.

Symptoms

  • People with insomnia may experience:
    • long delays between going to bed and falling asleep.
    • waking up several times during the night only to find that they have difficulty of getting back to sleep
    • increased levels of anxiety
    • feelings of tiredness
    • symptoms of depression

Treatment

  • Some treatment approaches may include:
    • limiting use of stimulant drugs (eg. caffeine)
    • increasing amount of physical exercise during the day
    • using OTC or prescribed medications
      • should be used sparingly as dependence can alter the nature of the sleep cycle
      • in turn, it may eventually increase insomnia over time.
    • consult a professional for psychotherapy
      • cognitive-behavioral therapy often helps on cognitive processes and problematic behaviors
      • this may include stress management and changes in behaviors that contribute to insomnia

Tips in Maintaining a Healthy Sleep

  • Stick to a sleep schedule even during weekends.
    • This keeps our biological clock in sync which makes our body a habit of sleeping every night.
  • Avoid anything stimulating (eg. exercise or bright light) for an hour before bed.
  • Exercise daily.
  • Avoid naps
  • Avoid alcohol, cigarettes, caffeine, and heavy meals before bed.
    • Alcohol disrupts REM sleep, leading to awakenings.
    • Heavy meals may make you feel sleepy, but it can lead to gastric distress, which can lead to awakenings
  • If you cannot fall asleep, leave the bed and do something until you feel tired again.
    • This is to train your body to associate the bed with sleeping instead of other activities.

Parasomnia

  • sleep disorders in which unwanted or disruptive motor activities or experiences occur during sleep.
  • can occur during REM or NREM phases of sleep.

Sleepwalking

  • also called somnambulism.
  • sleeper engages in complex behaviors, ranging from wandering to driving a car
  • during sleepwalking, sleepers have their eyes open
    • however, they cannot respond nor communicate to you.
  • occurs during slow-wave sleep
    • may occur at any period in some affected individuals.
Treatment
  • Sleepwalking had been treated with a varieties of pharmacotherapies
    • These can range from benzodiazepines to antidepressants.
  • Recent research find that the success rates of such treatments is questionable.
  • However, treating sleep-related breathing problems on somnambulistic patients have proved to decrease sleepwalking experiences.

REM Sleep Behavior Disorder (RBD)

  • occurs when muscle paralysis that happen during REM sleep does not occur.

  • they also experience high levels of physical activities during REM sleep, especially during disturbing dreams.

  • these behaviors vary widely, but they can include:

    • yelling
    • kicking
    • punching
    • scratching
    • behaving like an animal that has been frightened or attacked.
  • people suffering in RBD can injure themselves or their sleeping partners when engaging in these behaviors.

  • they can disrupt sleep but leave no memories of these behaviors ever occurring to affected individuals.

  • RBD is associated with some neurodegenerative diseases (eg. Parkinson’s disease).

    • This strong relationship between RBD and neurodegenerative diseases serves as potential aid in diagnosis and treatment of neurodegenerative diseases in the presence of RBD.
Treatment
  • Anti-anxiety medication with sedative properties Clonazepam can be used to treat RBD.
    • Melatonin may also be used in conjunction to it.
  • The sleeping environment may also be modified to reduce possibility of injuries for people suffering from RBD

Restless Leg Syndrome

  • persons with this disorder has uncomfortable sensations in the legs when trying to sleep.
  • discomfort is relieved by deliberately moving the legs, which contributes to difficulty in falling or staying asleep
  • associated with other diseases, such as chronic kidney disease and diabetes.
  • it can be treated with benzodiazepines, opiates, and anticonvulsants.

Night Terrors

  • persons with this condition result in a sense of panic
  • it is often accompanied by screams and attempts to escape from the immediate escape from the environment.
  • during terror attacks, individuals appears to be awake but attempts to console them proves to be ineffective.
    • they will also have no memories of that ever happening
    • they will also fall back asleep again after a short amount of time
  • attacks often happen during the NREM sleep phase.
  • treatment for night terrors is unnecessary unless underlying medical or psychological conditions is contributing to night terrors.

Sleep Apnea

  • a condition where an individual experiences irregular disruptions in breathing during sleep

    • episodes of breathing stops can last between 10-20 seconds or longer.
    • often associated with brief periods of arousal.
  • persons with this condition are often unaware of repeated disruptions in breathing during sleep.

    • they may, however, experience increased levels of fatigue during the day.
  • Sleep apnea is much more common in overweight people.

    • It is also associated with loud snoring noises.
    • It may also worsen effects of cardiovascular disease.
  • People with undiagnosed sleep apnea may experience consequences of insufficient sleep, and may affect their performance in their careers.

Types

  • Obstructive Sleep Apnea
    • occurs when individual’s airway becomes blocked during sleep.
  • Central Sleep Apnea
    • disruption in brain signals that regulate breathing cause periods of interrupted breathing.

Treatment

  • Common treatment involves use of continuous positive airway pressure (CPAP) device
    • This is a mask that fits over the individual’s nose.
    • It is connected to a pump that pumps air into the person’s airway to make them remain open.
  • Some alternative treatment options are also explored.
    • This is because continued compliance to CPAP devices pose a problem.
    • EPAP (expiratory positive air pressure) devices is one such example, which have shown promising results in recent double-blind trials.

Sudden Infant Death Syndrome (SIDS)

  • occurs when an infant stops breathing during sleep and dies.

Risk Factors

  • Some risk factors include:
    • infants younger than 12 months,
    • infants assigned male at birth.
    • infants born prematurely
    • smoking within the home
    • hyperthermia
    • differences in brain structure and function

Prevention

  • Substantial research had lead to aa number of recommendations for protection.
    • Infants should be placed on their backs when they are put down.
    • Cribs should not contain items that pose suffocation threats
      • This includes pillows, blankets or padded crib cushions.
    • Infants should not have caps on their head when put to sleep.
    • People in the home should abstain from smoking in the home.

Narcolepsy

  • a person with this condition cannot resist falling asleep at the most unfortunate/inconvenient times.
  • often last from a minute to half an hour.

Symptoms

  • often associated with cataplexy, also known as muscle weakness.
    • some cases may involve complete paralysis of voluntary muscles.
    • similar to the kind of paralysis experienced during REM sleep.
  • may take on other features of REM sleep
    • example: dream-like hallucinations during narcoleptic attacks
  • feelings of being refreshed after a narcoleptic attack

Note

Symptoms of narcolepsy and effectiveness of treatment may vary between different patients.

Treatment

  • it can be generally treated with psychomotor stimulant drugs like amphetamines.
    • they can promote increased levels of neural activity.
  • newer medications for treating narcolepsy may target the hypocretin system
    • this is because narcolepsy is shown to have associated with reduced levels of hypocretin in some areas of the brain.