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Sleeping Disorders

Any medical condition creating disturbances or interruption in the normal sleep pattern of an individual may be termed as a sleeping disorder. Such sleep disturbances result in lack of sleep or sleep deprivation. A good night's sleep is essential to fight the daily battles of life, invigorating people to perform their tasks efficiently and to the best of their ability. It is vital to a healthy and successful life, equipping individuals to achieve academic and professional excellence by revitalizing them. But lack of sleep may obstruct the smooth flow of the most basic tasks. Acute or temporary sleeping disorders, stemming from stressful personal or career-related issues usually resolve with the positive turn of circumstances. Chronic or long-standing sleeping disorders may adversely affect the health of the sleep-deprived patients, potentially triggering high blood pressure, heart diseases or diabetes in them. Sleeping disorders affect the emotional well-being of the inflicted, by engendering irritability and moodiness. It aggravates the psychological maladies of the sleep deprived by augmenting anxiety and depression. Sleeping disorders adversely affect academic progress by enfeebling memory and concentration. In addition, physical energy and mental vigor is substituted with lethargy and lack of alertness. It is imperative to register and report the symptoms of sleeping disorders to an expert medical practitioner, so as to eliminate or minimize its harmful effects.

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Various sleeping disorders and their causes

There are various types of sleeping disorders, manifesting in different forms, disturbing the process of uninterrupted sleep. Some of these disorders are genetic, while some others are stress based and still others are related to a dissonance in the pattern of our internal circadian rhythm. Some are acute while others are chronic. Acute sleeping disorders are transient, while the chronic sleeping disorders are long standing, with a potentially damaging impact on one's health. Insomnia, a virtual synonym for sleeping disorder, is a disorder where sleep appears to elude the individual, making their sleep troublesome. An insomniac is liable to wake up more frequently at night, and has a considerable difficulty in falling back asleep. Acute insomnia results from temporary stress factors at the home front and workplace, from side effects of certain medications, from changes in circadian rhythm due to travel across time zones, or changes in work shifts. Chronic insomnia may result from long standing stress or underlying physiological or psychological health conditions, usually requiring treatment. Narcolepsy is a disease of the central nervous system, disrupting the normal nighttime sleep pattern, characterized by excessive sleep during daytime, frightening illusions and possible spells of cataplectic attacks, stimulated by intense emotions, generating muscle weakness or collapse. It is attributed to abnormalities in the brain chemicals that dictate the sequence of sleep and wakefulness. It also causes anomalies in the Rapid Eye Movement (REM) sleep, with erratic sleep episodes, all through the day. Hypersomnia is a sleep disorder, marked by uncontrollable bouts of sleep during the day. It may be associated with other sleep disorders, such as, Narcolepsy or other nervous disorders. Other contributory factors of Hypersomnia may be obesity, insufficient nighttime sleep, nerve-soothing medications or genes. Nightmare is a sleep disorder that may occur in adults as well as children, where the person's sleep cycle is disturbed due to unusual frightening dreams.

Nightmares may result from traumatic events, encountered in the past, or from side effects of medications impacting the neurotransmitters. Night terrors afflict young children and are characterized by fear attacks, with spells of acute crying, interrupting their sleep cycle at night. They may be caused by stress, medications affecting the nervous system and insufficient sleep. Sleepwalking is another type of sleep disruption that occurs in children, during deep sleep. Sleep walking may be a genetic disorder or may be caused by stress factors, irregular sleep routines or underlying medical conditions, such as, asthma, trauma, or nighttime seizures. Sleep apnea is a sleep disorder where, breathing stops for several seconds, multiple times a night. The breathing resumes with a pronounced jolt or pant, interrupting sleep. Obstructive sleep apnea typically occurs due to an obstruction in the nasal passage or abnormalities in the physiological structure /tone of the mouth or throat. Central sleep apnea occurs as a result of a serious neurological disorder, affecting the lower brain stem that regulates breathing, causing brief episodes of cessation of breath at night and sleep disruption. Sleep apnea may occur in obese, middle aged males. Some sleep disorders are also related to our internal circadian rhythm, which determines our sleep and wakefulness sequence, usually guided by the day-night cycle. Deviation in normal circadian rhythm may occur as a result of changes in time-zones, work shifts at night etc. Nocturia that leads to more frequent toilet trips at night, as a result of pregnancy or medical conditions, such as, diabetes, also causes interrupted sleep. Rapid Eye Movement (REM) sleep behavior disorder afflicts patients with pre-existing degenerative neurological diseases, causing them to vividly enact their dreams, in the REM phase of sleep, thereby disrupting sleep. Further, nocturnal enuresis indicating urination in bed, and sleep bruxism, manifested through involuntary and intense clenching and grinding of teeth, also cause sleep disruption.

Sleeping disorders: possible effects and treatment options

An uninterrupted good night's sleep is the key to smoother performance of various important activities, during the daytime. A sound sleep revitalizes our body and mind, energizing us to take on the responsibilities of various facets of our daily life. On the other hand, sleep deprivation make us weary and fatigued, stripping us of the physical energy and mental vitality, required to bear the onus of workload at work, home or school. The lack of alertness makes sleep deprived persons more susceptible to accidents and injuries. Sleep deprivation leads to memory, learning and concentration problems, hindering academic performance. Long-standing sleep disorders also compound stress, anxiety, depression and moodiness. In addition, chronic sleeping disorders may have a detrimental effect on our physical health, leading to cardiovascular problems, diabetes and hypertension. Due to their adverse impact on the general quality of life of the affected individuals, timely diagnosis and treatment of sleeping disorders is essential, opening the doors to a healthier, smoother and contented life. Treatment is based on types or category of the sleeping disorders. Chronic disorders like central sleep apnea are associated with other degenerative diseases of the nervous system - an approach addressing both the disorder and the underlying disease is often recommended. Periodic Limb Movement Disease, which causes involuntary limb movements during sleep, at frequent intervals, is sometimes associated with diabetes and renal diseases, requiring the treatment of the underlying ailments. For sleeping disorders, such as sleep paralysis, marked by the awareness of atonia preceding sleep and following wake-up, results from a disturbing overlap between the different phases of sleep, and is treated by inculcating good sleep habits, addressing any psychological condition underlying it, or sleep disorders associated with it. In some instances, sedatives are prescribed. For sleep disorders resulting from disruption in circadian rhythm, chronotherapy, implying gradual adjustments of sleep time/schedule is implemented.

For sleeping disorders related to intake of medications or withdrawal from tranquilizers or nicotine, appropriate measures, including gradual dosage regulation to treat the disorders are prescribed. In some cases sedatives and nerve soothing drugs are prescribed to eliminate sleep disruption. For sleeping disorders such as Narcolepsy and Hypersomnia, a polysomnography test, for charting the nighttime sleep cycle and multiple sleep latency tests, for documenting the day time sleeping patterns/tendencies, are performed. Treatment of obstructive sleep apnea, may involve therapies such as Continuous Positive Airway Pressure, (CPAP), where the patients are required to wear a mask, where continuous air pressure is supplied to the upper respiratory tract through an artificial blower. In some cases, dental devices are prescribed to eliminate the possibility of the tongue obstructing the upper respiratory tract, causing cessation in breathing. In extreme cases surgery is prescribed for obstructive sleep apnea, to correct the structural abnormalities of the upper respiratory tract. For parasomnias, such as nightmares, behavioral therapies such as imagery rehearsal therapy are adopted, involving the enactment of the patient's nightmares in a positive way, heralding positive changes in the subconscious mind, with regular positive reinforcement. Hypnotherapy is combined with behavioral therapies for a changing the patient's attitudes and expectations through positive imagination. Some sleeping disorders such as insomnia are diagnosed by maintaining a sleep journal, reflecting the sleep schedule, sleep patterns/cycles of the patients. Primary insomnia is treated through gradual lifestyle changes, whereas secondary insomnia, caused by underlying medical conditions or diseases is treated by treating the diseases. Sometimes, a combination of appropriate medications, behavioral therapies and lifestyle changes may need to be implemented, to achieve the desired results.

Sleep hygiene for managing sleeping disorders

Developing good sleeping habits and incorporating lifestyle changes to enhance the quality of sleep is known as sleep hygiene. Establishing a sleep routine with a fairly regular or predictable sleep-wake up time is the first step towards building sleep hygiene. Restricting day time sleep and eliminating erratic sleep episodes, pay dividends towards ensuring a sound, uninterrupted sleep at night. Avoiding caffeinated beverages or alcohol, close to bedtime may eliminate the risk of stimulating the brain cells and prepare the ground for a smooth undisturbed sleep at night. Avoiding a heavy dinner just before bedtime is also recommended for uninterrupted sleep. Lifestyle changes to incorporate an exercise regimen, enhance the body metabolism and result in better sleep quality. Research has also demonstrated the association between exercise and the release of serotonin in the central nervous system, promoting feelings of general well-being. Reduced stress levels are also conducive to uninterrupted sleep. Also, meditation and yoga have a soothing effect on our mind and body, helping us to relax, facilitating undisturbed sleep at night. Creating a sleep ritual such as a hot shower followed by soft soothing music and a good book, concluded with a short meditation or prayer may be a good way to unwind. Focusing on constructive things and happy thoughts may help to keep anxieties at bay, enabling us to sleep better. Stimulus control by shutting off distractions such as, noise, light, or chaos from the bedroom may aid us to fall asleep faster and ensure a sound sleep at night. A congenial bedroom ambiance, along with physical and mental preparedness is the ideal foundation for a sound, undisturbed sleep through the night.

Conclusion

Sleeping disorders can interrupt the smooth operation of our daily tasks and impede the productivity or efficacy of our various endeavors, by draining our physical energy and mental vitality. It is detrimental to our emotional health, for sleep deprivation can exacerbate anxiety and depression, depleting our mental vigor, adversely affecting the faculties of memory and alertness. Chronic sleeping disorders may render people socially incompatible, for sleep deprivation tends to make people moody and irritable, forming a barrier to pleasant social interactions. Long-standing sleeping disorders may lead to diseases, such as hypertension, cardiovascular diseases, and diabetes in some patients. Therefore, it is essential to notice and report the symptoms of the sleeping disorders so as to circumvent its harmful effects, through timely diagnosis and treatment. A treatment regimen compromising of a thorough investigation of the patient's medical history, appropriate sleep-inducing or nerve-soothing drugs, behavioral therapies, sleep-aiding devices and surgical corrections of the abnormalities of the upper respiratory tract, if needed, is likely to change the anomalies in the sleep cycles, facilitating a good night's sleep. Further, practicing good sleeping habits may reduce stress, soothe our mind and eliminate unwanted obstacles, causing sleep disruptions. However, it may be improbable to reverse serious sleeping disorders, such as, central sleep apnea, caused by chronic medical or neurological conditions. It is vital for the sleeping partners, to be empathetic towards the patient's mental agony and learn to develop coping mechanisms, so as to reduce the impact of these long standing sleeping disorders.

References

1. Various sleeping disorders and their causes http://www.helpguide.org/life/sleep_disorders.htm

2. Sleeping disorders: possible effects and treatment options http://sleep-deprivation.com/sleep-disorder-symptoms/sleep-disorder-effects/

3. Sleeping disorders: possible effects and treatment http://bodyandhealth.canada.com/channel_section_details.asp?text_id=6297&channel_id=1044&relation_id=107394

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