An Expert Guide to Sleep Disorders

A consistent good night’s sleep is necessary to maintain optimal health. A lack of restful sleep can negatively affect hormone balance, mood, stress levels, body weight, and even pain.

Sleep disorders are chronic problems with sleeping, including trouble falling or staying asleep, nodding off at the wrong times, getting too much sleep, or exhibiting abnormal behaviors while asleep. The American Academy of Sleep Medicine recognizes more than 80 different sleep disorders. These disorders chronically afflict 50 to 70 million Americans according to the Centers for Disease Control and Prevention.

Common Sleep Disorders

These are some of the most common and dangerous sleep disorders that we suffer from:

Insomnia

A difficulty falling or staying asleep and waking up not feeling well-rested. Incidences of insomnia often increase with age. Insomnia is typically more common among people in lower socioeconomic groups, chronic alcoholics, and mental health patients.

Who it affects: Insomnia impacts the quality of life of one-third of all Americans (people in all age groups), but it tends to plague women more often than men.

Symptoms: Most cases of insomnia are related to poor sleep habits, depression, anxiety, chronic diseases, lack of regular exercise, or as a side effect of taking certain medications.

When to seek help: Although insomnia is usually able to be self-diagnosed, seek out medical assistance if you experience sleeplessness regularly and it impacts your ability to function normally on a daily basis.

Treatment: Insomnia can be treated by improving sleep habits, identifying and addressing underlying causes, behavioral therapy, and through the administration of sleeping pills, which should be closely monitored for potential side effects.

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Sleep Apnea

A potentially serious disorder in which breathing repeatedly stops and starts while sleeping. There are three primary types of sleep apnea. Obstructive sleep apnea (OSA), the most common form, occurs when throat muscles relax. Central sleep apnea occurs when the brain fails to send proper signals to the muscles that control breathing. Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, occurs when an individual has a combination of obstructive sleep apnea and central sleep apnea.

Sleep apnea has been tied to obesity, which can lead to excess fat that places added weight and pressure on throat, neck, soft palate, and jaw muscles. Left unchecked, sleep apnea may result in health issues, including diabetes, high blood pressure, and weight gain. It can even cause serious complications like heart disease and stroke.

Who it affects: People of all ages, primarily men and individuals who are severely overweight. One in five adults have at least a mild form of apnea.

Symptoms: Snoring loudly and stopping breathing while sleeping followed by feeling tired even after a complete night’s sleep. You may have sleep apnea if you snore loudly and you feel tired even after a full night’s sleep.

When to seek help: As soon as you experience any of the symptoms on a regular basis. Sleep apnea is a dangerous condition and should not be ignored.

Treatment: Lifestyle changes, including weight loss. Many patients use a breathing assistance device while sleeping at night including continuous positive airway pressure (CPAP) machines. Practicing oropharyngeal (mouth and tongue) exercises can significantly reduce snoring frequency for patients with mild obstructive sleep apnea.

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Hypersomnias

Any of several disorders that manifest in the form of excessive daytime sleepiness or the tendency to fall asleep at any time and during any activity, even while driving or performing duties at work. In addition to causing sudden attacks of sleep, a loss of muscle tone and hallucinations might also occur with hypersomnias.

Narcolepsy

The most common form of hypersomnia, narcolepsy affects five percent of the population with about 200,000 new cases diagnosed annually. According to the Division of Sleep Medicine at Harvard Medical School, narcolepsy’s root cause is not well understood, but may be related to certain genetic factors and abnormal brain signaling.

Who it affects: Narcolepsy tends to afflict men and women equally and usually starts between ages 10 and 25, though it sometimes doesn’t begin until as late as age 40 or 50.

Symptoms: Falling asleep during the day, cataplexy (sudden weakening of muscles), sleep paralysis, and hallucinations while falling asleep or waking up.

When to seek help: As soon as you experience any of the symptoms on a regular basis. Not only can narcolepsy result in dangerous situations, but there is also an increased risk for REM sleep behavior disorder (RBD), which involves violently acting out dreams.

Treatment: There is no cure for narcolepsy, but there are ways to manage the condition. Drug options include stimulants, such as Modafinil, which help sufferers to stay awake in the daytime. Antidepressant Tricyclic can suppress REM sleep and treat cataplexy.

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Sleep Related Moving Disorders

A category of sleep disorders with conditions that cause involuntary movement prior to or during sleep that can make it difficult to fall asleep, stay asleep, or to get restful sleep. These disorders can affect people across all age groups of both genders.

Bruxism (Teeth Grinding)

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Bruxism, or grinding your teeth while sleeping, can cause moderate to severe tooth damage, headaches, and facial pain.

Who it affects: Bruxism is most common among young children, but can affect any age.

Symptoms: Waking up with tooth, jaw, and mouth pain or sore gums. Complaints from your sleeping partner.

When to seek help: If you experience moderate to severe tooth damage, headaches, or facial pain, see your dentist to address the issue.

Treatment: Plastic dental appliances (guards) are typically used to prevent grinding-related damage. Cutting back on stress, cigarette smoking, and caffeinated drinks before sleep can reduce teeth grinding, as can avoiding chewing on any items when not eating (even chewing gum), since it trains the jaw to clench.

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Sleep Starts (Hypnic Jerks)

Sleep starts are muscle contractions that cause sudden jerks, jumps, and ticks, sometimes accompanied by vocal cry out or the sensation of falling.

Who it affects: Though generally harmless, 70 percent of people experience sleep starts to some degree.

Symptoms: As the body shifts into the first levels of sleep, muscles can contract. This causes sudden movement and may include the sensation of falling or vocally crying out.

When to seek help: Sleep starts occur in up to 70 percent of people. Though usually harmless, if the events or your fear of them keep you or your partner from getting adequate sleep, see a doctor.

Treatment: Sleep experts will make an evaluation to determine if any underlying issue could be affecting your ability to stay asleep (sleep apnea, periodic limb movement disorder, or an undiagnosed mental health condition).

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Periodic Limb Movement Disorder (PLMD)

PLMD is repetitive, rhythmic movement of the legs (and sometimes arms) that occurs during sleep and causes sleep disruption.

Who it affects: PLMD affects five percent of people ages 30 to 50, 25 percent between 50 and 65, and 44 percent of those over 65. It also affects at least 80 percent of people with restless legs syndrome.

Symptoms: A sleep partner or someone present will notice movements such as brief muscle twitches, leg jerking, and upward flexing of the feet.

When to seek help: If you regularly experience poor sleep at night or other conditions (like diabetes) have made your PLMD worse, seek out medical attention.

Treatment: Several classes of drugs are used to treat PLMD, including dopamine agonists, anticonvulsant medications, benzodiazepines, and narcotics.

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Restless Legs Syndrome (RLS)

RLS is a creepy-crawly feeling in the legs interrupting sleep and causing discomfort (and sometimes even mental distress). This can lead to insomnia.

Who it affects: RLS chronically affects 10 percent of the population (30 to 40 percent periodically), primarily women, who make up two-thirds of sufferers.

Symptoms: Sensations of movement in the legs that interrupt sleep and the type of numbness usually associated with poor circulation (body parts falling asleep after sitting in the wrong position).

When to seek help: When the itchy, pins-and-needles, throbbing or other sensations in the legs creates an overwhelming urge to move them to alleviate the symptoms, interfering with sleep, contact a doctor.

Treatment: Getting up and moving around can provide temporary relief, as can self massage. Dopamine agonist drugs, including ropinirole (Requip), rotigotine (Neupro), and pramipexole (Mirapex) can be very effective, but may have side effects include daytime sleepiness, nausea, and lightheadedness.

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Parasomnias

A classification of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, during sleep, between stages of sleep, or when awakening from sleep. The various disorders can affect individuals in all age groups, male and female, to varying degrees.

Sleepwalking

Sleepwalking involves getting up from bed and walking or performing routine or strange physical actions. Sleepwalkers are difficult to awaken and often have little or no recollection of their episodes.

Who it affects: People of all age and both genders, but it is very common in young children.

Symptoms: Getting up from bed and walking or performing routine or strange physical actions. Sleepwalkers will not wake up from this state easily and may not remember episodes.

When to seek help: If episodes become dangerous, disturbing, or very uncomfortable, seek out help from a sleep expert. Sleepwalking in children is relatively common and does not necessarily require medical treatment.

Treatment: Obtaining regular and sufficient amounts of sleep, avoiding fluids (especially alcohol) before bedtime, and dealing with stress using relaxation techniques. Benzodiazepines, such as Klonopin (generic: Clonazepam), may also help.

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Confusional Arousal

Believed to be the result of incomplete arousal from sleep, confusional arousal causes sufferers to feel confused when waking up.

Who it affects: The disorder can afflict people of any age or gender, but is most common in children and tends to run in families. It can also be triggered by other conditions, such as sleep apnea, heartburn, or periodic limb movement disorder (PLMD). A study conducted at Stanford University found that as many as one in seven people could suffer from the condition.

Symptoms: Slow speech, drunken behavior, appearing to be in a state between being asleep and awake, or exhibiting confusion or odd behavior immediately after waking up.

When to seek help: If episodes become more frequent or severe or attacks begin to effect your quality of sleep, get medical treatment.

Treatment: Establishing good sleep habits helps to decrease the instances of attacks. Medical intervention may include administration of the tranquilizer Clonazepam, which is most often taken at bedtime.

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Nightmares

Unpleasant dream sequences that rouse you from sleep. Nightmares often lead to feelings of anxiety, fear, anger, and even embarrassment.

Who it affects: Tends to afflict both men and women of all ages.

Symptoms: People with nightmares will experience unpleasant dreams that may wake them up. These dreams often cause fear, anger, or anxiety.

When to seek help: Although quite common, you should see a doctor or sleep expert if nightmares regularly disrupt your rest at night.

Treatment: Since nightmares can be associated with psychological trauma, therapy sessions with a mental health specialist are a recognized form of treatment, as are prescription medications like Prazosin, which is also used to treat PTSD.

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Sleep Terrors

Sleep terrors cause sitting up in bed, thrashing, perspiring, heavy breathing, screaming, and violent bursts of movement during sleep. Unlike nightmares, sufferers remain asleep and rarely remember the experience after waking.

Who it affects: They are most prevalent in young children, but also affect more than 2 percent of adults, particularly those who suffer with bipolar and anxiety disorders (equally split between males and females).

Symptoms: People with sleep terrors often sit up in bed. They may thrash around or experience violent bursts of movement while sleeping. Sometimes, screaming, heavy breathing, and sweating are also experienced.

When to seek help: Although fairly normal in children, sleep terrors in adulthood may require medical treatment if they begin to impact your sleep and daily life.

Treatment: Proper habits and practices related to good sleep, along with and stress management techniques. Antidepressants and benzodiazepines, including imipramine, may also be prescribed in certain cases.

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Sleep Talking

Sleep talking involves talking out loud during sleep, ranging from nonsensical mumblings to angry rants, which can occur alone or addition to sleep terrors, REM sleep behavior disorder, sleepwalking, and even sleep-related eating disorders.

Who it affects: Five percent of adults and half of all young children experience sleep talking, occurring at the same rate in both males and females. It appears to be hereditary.

Symptoms: Sleep talkers talk out loud while sleeping, either alone or in conjunction with other sleep disorders.

When to seek help: Though generally harmless, episodes that are often emotional or vulgar may warrant treatment with a sleep specialist.

Treatment: Despite having no cure, sleep talking generally decreases when you’re well rested, maintain a normal sleep schedule, and avoid consuming alcohol.

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REM Sleep Behavior Disorder (RBD)

RBD results in acting out dreams as your body enters REM-stage sleep with sudden and intense actions that can include shouting, swearing, flailing, grabbing, punching, kicking, and jumping.

Who it affects: The disorder tends to effect people 50 and older of both genders. When it occurs in young individuals, it’s usually the result of another condition.

Symptoms: Acting out dreams including intense physical actions.

When to seek help: As soon as symptoms occur. If RBD is ignored, the sufferer or their sleeping partner may be seriously injured.

Treatment: Medications including Klonopin (generic: clonazepam) are often used, as well as safety precautions, such as rearranging the bedroom, to keep potential dangers away from the bed.

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Bedwetting

Bedwetting is involuntary urination while sleeping. Experts say it usually isn’t a major concern in children since they may still be developing nighttime bladder control.

Who it affects: Bedwetting is fairly common, affecting 5 to 7 million children in the U.S., as well as adults of all ages with urinary issues, conditions, or diseases.

Symptoms: The physical signs of nighttime urinary incontinence.

When to seek help: Although the vast majority of cases require little more than patience and understanding, severe problems, particularly in older children and adults may require medical attention.

Treatment: Motivational therapy, the use of moisture alarms, and the drug Desmopressin, which increases the amount of urine that the bladder can hold or decrease the amount of urine released by the kidneys.

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Sleep Paralysis

Sleep paralysis is the inability to move your head, arms, or legs when falling asleep (hypnagogic) or waking up (hypnopompic). Episodes lasting between 30 seconds to five minutes or more and are often accompanied by hallucinations.

Who it affects: Sleep paralysis routinely affects less than eight percent of the general population, but roughly 25 percent of people may have experienced it at some point.

Symptoms: Inability to move head, arms, legs, or speak when falling asleep or waking up.

When to seek help: Consult a doctor if you experience repeated episodes of sleep paralysis, since it is often a sign of narcolepsy and can lead to sleep-related anxiety and even panic attacks.

Treatment: Behavior-focused treatments include changing sleep positions and avoiding taking daytime naps. Tricyclic antidepressants can also be prescribed, especially if you suffer from narcolepsy.

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Circadian Rhythm Disorders

Circadian rhythm disorders are timing-based disorders marked by disruptions in an individual’s internal body clock. These disorders are a continual or occasional disruption in sleep patterns and result from difficulty with a person’s internal body clock and their environment. People with circadian rhythm disorders typically experience insomnia and excessive sleepiness.

Delayed Sleep Phase Syndrome (DSPS)

DSPS keeps people from falling asleep until late into the night and causes difficulty waking up in the morning, making it hard to keep a normal work or school schedule.

Who it affects: DSPS affects people of all age groups and of both genders, but is believed to impact at least seven percent of teenagers, according to some estimates.

Symptoms: Falling asleep before nightfall and waking up much earlier than expected, throwing off your normal daily routine.

When to seek help: If this problem is affecting your work or school life, see your doctor.

Treatment: A sleep specialist will be able to determine factors that may make matters worse, such as not getting enough natural light during the day. Treatments range from taking melatonin to behavioral counseling. Bright light therapy and chronotherapy as well as shifting bedtimes daily until you reach a normal sleep schedule, are commonly used.

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Advanced Sleep Phase Syndrome (ASPS)

ASPS leads to falling asleep early in the evening and rising well before dawn.

Who it affects: Although ASPS can be a problem for people in every stage of life, it primarily affects middle aged and older adults and tends to get worse over time.

Symptoms: Falling asleep too early and waking up earlier than desired.

When to seek help: If this problem is affecting your work or school life, see your doctor.

Treatment: As with DSPS, light therapy, chronotherapy, melatonin and therapy may be helpful in breaking the odd sleep patterns of ASPS.

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Jet Lag

Jet lag is a disorder that forms in reaction to traveling between time zones, throwing off the body’s naturally developed sleep-wake cycle that is tied to the patterns of everyday life.

Who it affects: Every day, millions of travelers of all ages struggle with jet lag, which can have a serious effect on both sleep and alertness.

Symptoms: The inability to sleep or excessive drowsiness after traveling across time zones domestically or internationally.

When to seek help: If jet lag impacts your ability to focus, keep your usual schedule or to normally go about your daily professional and personal life.

Treatment: Exercise, exposure to sunlight, and taking melatonin or sleeping pills are commonly used to combat jet lag.

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An Expert Guide to Sleep Disorders

Common Sleep Disorders

Insomnia

Sleep Apnea

Hypersomnias

Narcolepsy

Sleep Related Moving Disorders

Bruxism (Teeth Grinding)

Sleep Starts (Hypnic Jerks)

Restless Legs Syndrome (RLS)

Parasomnias

Sleepwalking

Confusional Arousal

Nightmares

Sleep Terrors

Sleep Talking

REM Sleep Behavior Disorder (RBD)

Bedwetting

Sleep Paralysis

Circadian Rhythm Disorders

Delayed Sleep Phase Syndrome (DSPS)

Advanced Sleep Phase Syndrome (ASPS)

Jet Lag

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