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Sleep disturbances can refer to abnormal sleep duration or undesirable behavior during sleep. It is a very serious clinical problem that affects the daily functioning of the patient, sometimes making it impossible for him to carry out normal activities. See what types of sleep disorders are, learn about their causes and treatments.

Sleep disordersaffect an increasing percentage of the population - it is estimated that about 30% of people suffer from various types ofsleep problems . The most common disease of this type is insomnia - its symptoms may affect up to half of adults, and approx. 10% are diagnosed with its chronic (chronic) form.

Since sleep is a basic human physiological need, which regulates many important functions of the body (e.g. it has an impact on the hormonal balance, on brain functions such as remembering, associating, concentration), sleep disorders have a significant impact on our well-being and intellectual fitness during the day.

Those with the most turbulent course, such as narcolepsy, may significantly impede normal functioning or even pose a risk of loss of he alth (this also applies to, for example, the extreme form of somnambulism). But even episodic sleep disorders, if not treated in time by changing harmful habits, can turn into a long-term form that is much more difficult to treat.

Sleep disorders - classification

There are several classifications of sleep disorders. In Poland, the classification according to ICD-10 (the International Statistical Classification of Diseases and He alth Problems developed by the WHO) is generally applicable. It divides sleep disorders into two types:

  • organic sleep disorder (G47)- is one of the symptoms of another mental or somatic disorder, e.g. sleep start and duration disorders, sleep apnea, narcolepsy and catalepsy;
  • non-organic sleep disorders (F51)- are seen as a separate disorder caused by emotional factors, e.g. non-organic insomnia, somnambulism, night terrors, nightmares.

Currently, psychiatrists to classify sleep-related diseases more often use the American International Classification of Sleep Disorders (ICSD), the creation of which was alsothe beginning of a new field of science called somnology. The disease entities included in this classification are divided intoprimaryandsecondary .

Secondary disordersaccompany other mental and somatic diseases or are a consequence of previously taken chemicals (drugs, stimulants).Primary disordersare divided into dyssomnia and parasomnias.

Dyssomnieis a disorder involving an abnormal amount or quality of sleep. Sleep may be too short (insomnia), too long (hypersomnia) or may be abnormal (narcolepsy, disturbed sleep-wake rhythm).

Zparasomniaoccurs when the duration of sleep is normal, but undesirable behavior occurs during it, e.g. the patient sleepwalks, has nightmares, suffers from sleep paralysis or suddenly he starts screaming, crying, waving his arms in his sleep.

Ways to get a good night's sleep

Sleep disorders - types and characteristics

The following are distinguished among dyssomnias:

  • insomnia- is diagnosed when the patient has problems falling asleep or staying asleep for more than 3 nights during the week. When such a situation lasts longer than a month, we deal with chronic insomnia. The most common causes of insomnia are mental disorders and diseases (50-60%), especially depression and anxiety. It can also be a consequence of Restless Legs Syndrome (RLS).
  • hypersomnia- this is too much sleep (over 9 hours) or excessive sleepiness that occurs during the day despite a night's sleep. Hypersomnia is a common symptom of depression and taking too much psychotropic drugs or alcohol.
  • narcolepsy- this is a disease with several symptoms:
    • sleep attacks (the patient only needs 5 minutes to fall asleep in any situation, even one that requires concentration, e.g. during a conversation);
    • cataplexy - a sudden drop in muscle tension, as a result of which the patient falls to the ground;
    • hallucinations - the occurrence of very realistic images during sleep;
    • sleep paralysis - a feeling of total body paralysis while maintaining awareness that occurs when falling asleep or waking up.
  • sleep-wake rhythm disturbances- a type of dyssomnia that occurs as a result of disturbances in the functioning of the internal biological clock. It consists in the lack of synchronization between one's own sleep rhythm and the requirements of the environment. Often caused by changing time zones or shifts.

The more common parasomnias are:

  • sleepwalking- sitting on the bed, getting up and walking while sleeping without awareness
  • sleepy intoxication- feeling of disorientation immediately after waking up, accompanied by gibbering, chaotic movements, temporary lack of contact with the environment
  • night terrors- feeling of strong fear interrupting sleep, manifested by screaming, crying, sometimes aggression
  • nightmares- very realistic, fear-inducing dreams that the dreamer remembers long after waking up. They may be caused by childhood traumatic experiences or post-traumatic stress disorder.

Sleep disorders - causes

Sleep disorders can be a symptom of other mental and somatic disorders, for example depression, drug and drug addiction, pain syndromes, metabolic and endocrine disorders (including hyperthyroidism). Therefore, every person with sleep problems should undergo a package of general medical examinations, on the basis of which it will be possible to determine whether the disorders appearing in them are secondary (resulting from another disease) or primary.

For primary sleep disorders, the most common causes are:

  • genetic conditions- the patient has been showing symptoms of sleep disorders since childhood, his sleep is shallow, interrupted and short. With age, due to unhygienic lifestyle and natural aging mechanisms, these symptoms become more severe and become chronic;
  • psychophysiological causes- related to a difficult life situation, e.g. divorce, death of a loved one, financial problems and other situations that cause long-term stress. If the mental state of the patient does not improve for a long time, the sleep disorders become more permanent and become a chronic form;
  • failure to follow the rules of sleep hygiene- irregular lifestyle and harmful habits can lead to the development of chronic sleep problems. People who wake up and fall asleep at different times, spend a lot of time in bed (e.g. reading, watching TV), eat dinner late, spend a lot of time under artificial lighting or do not engage in regular physical activity are particularly vulnerable to their occurrence.

Sleep disorders - diagnosis and treatment

Diagnosis of sleep disorders should start with going to the family doctor, who will assess the general he alth of the patient and order basic laboratory tests. If a specialist has ruled out a somatic disease, the next step should be a visitat the regional Mental He alth Clinic.

There will be research conducted to exclude mental disorders. Only after making sure that sleep problems do not result from a somatic or mental illness, the patient may go to a specialist sleep medicine center (the list of centers is available on the website of the Polish Sleep Research Society). In such facilities, very thorough sleep tests are performed - polysomnographic tests, during which, inter alia, Brain bioelectrical activity (EEG), muscle tone, night and day activity level of the patient.

When secondary insomnia is found, sleep disorders are treated by treating the symptoms of the underlying disease. For example, in the case of depression, it will be therapy with antidepressants, in the case of hyperthyroidism, therapy with thyreostatic drugs.

If a patient is diagnosed with primary sleep disorders, the most common treatment method is the use of hypnotics combined with cognitive-behavioral psychotherapy.

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Category:

Psychiatry