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WFNR


Sleep is essential to life and proper functioning of the brain, regulation of hormones, weight and mood. Hence, problems associated with sleep are important to a person’s health and overall wellbeing.
Symptoms:

  • Sleeping too much during the day
  • Difficulty falling asleep
  • Irregular pattern of sleep-wake cycle
  • Increase in movements while sleeping
  • Irregular breathing
  • Grinding of teeth

The sleep and wake cycle of the body is coordinated by a complex system in the brain. Any problem in that connection can cause a form of sleep disorder. They are majorly classified into dyssomnia, parasomnias, circadian rhythm sleep disorders and those caused by medical or psychological conditions. Most times however, disorders of sleep are cause by an underlying factor – medical or otherwise.

  1. Insomnia
    Insomnia is defined as any "difficulty initiating or maintaining sleep, or both" or the perception of poor quality sleep. Insomnia may therefore be due to inadequate quality or quantity of sleep. Insomnia is the commonest form of sleep disorder and is usually precipitated by an underlying condition. These causes may be divided into
    • Situational factors caused by environmental factor that might not be a persistent factor like jet lag, noise, uncomfortable room temperature (too hot or too cold), Stressful situations in life (exam preparation, loss of a loved one, unemployment, divorce, or separation) or changes in shift work
    • Medical or psychiatric conditions which are due to the presence of an acute medical or surgical illness or hospitalization (pain, angina etc.), withdrawal from drug, alcohol, sedative, or stimulant medications, anxiety, depression, schizophrenia etc.
    • Primary sleep problems: nocturnal asthma and Obstructive sleep apnea.
  2. Bruxism
    This involves teeth grinding or clenching involuntarily while sleeping. Asides its impact on sleep, it could also lead to aches in the jaw muscles, headache, restricted mouth opening (trismus) wearing of the tooth (tooth fracture, hypersensitivity) and affect the tongue (burning sensation, indentation)
  3. Narcolepsy
    This is when someone has problem of regulating their sleep-wake cycles. The person could sleep too much during the day (daytime somnolence) or have short episodes of involuntary sleeps. They might have loss of muscle strength. A few might have vivid hallucinations.
  4. Restless leg syndrome
    This is a type of periodic leg movement disorder where the person feels an unresistable urge to move their legs.
  5. Obstructive Sleep apnoea
    This is cause by repetitive collapse of the airway tract particularly the upper airway during sleep. This will cause insufficient sleep and snoring.
  6. Sleep paralysis
    This is a transient state of paralysis observed before or after sleep. There may or may not be hallucinations (auditory, visual or tactile). It is usually not so serious but might be terrifying initially.
  7. Hypersomnia
    This is excessive sleepiness that might pose a distress and affect productivity and general functioning. It is usually difficult for them to wake up from sleep.

Diagnosis is made following the patient’s pattern of complaint and a physical examination followed by indicated investigations.
Examples of those investigations are:

  • Electroencephalography
  • Polysomnography
  • Multiple sleep latency test
  • Actigraphy
  • Sleepiness scale

Treatment for sleep disorders entails finding the cause(s) and then treating the cause(s).
Generally, treatment of sleep disorders entails both non-pharmacologic (non-medical) like behavioural or rehabilitative therapy and pharmacologic (medical). Studies have shown that combining medical and non-medical treatments typically is more successful.