What are sleep disorders?

One of the most common sleep disorders is insomnia which affects about 6-10% of the adult population. Insomnia often has high comorbidity, which means that insomnia can be accompanied by a number of other disorders or diseases. Insomnia is more common with depression (depressed people are twice as likely as non-depressed people) and anxiety disorders, but also with various physical illnesses. Insomnia typically occurs during periods of severe persistent stress and appears to be more common in women, the elderly, the psychologically disadvantaged, and those living in socio-economic disadvantage.

Insomnia is characterized by an unsatisfactory amount of sleep and / or its quality over a long period of time. When the amount and quality of sleep is poorer on some nights does not yet mean you have insomnia. It is normal that sometimes anxious past or upcoming events make it harder to fall asleep and make your sleep worse. However, if this pattern begins to recur and affect the quality of life, your sleep should be studied more closely and steps have to be taken to improve it.

Common complaints of insomnia:

• difficulty falling asleep
• intermittent sleep, frequent night awakening
• waking up too early in the morning after which you can no longer fall asleep
• sleep is not invigorating and restoring strength

It should be noted, however, that the degree of actual sleep disturbance cannot always be used to diagnose insomnia, as each person’s need for sleep is individual. Each person’s sleep must be observed and assessed individually, also the person’s own subjective assessment of sleep and satisfaction with it plays an important role.

What are the causes of insomnia?

Insomnia can have many different causes and can be very individual.

Somatic. Somatic symptoms include, for example, infectious diseases (influenza, HIV, hepatitis B, etc.), tumors, cardiovascular diseases, diseases of the endocrine system, various diseases that cause human discomfort, frequent nocturnal urination, and various respiratory diseases.

Physiological. Jet lag or moving to another time zone can cause short-term, but sometimes longer, insomnia. Apparently, many have experienced this when traveling to America or Asia. In most cases, jet lag is a few days to two weeks. However, if insomnia prolonges, it should definitely be addressed. Jet lag can also be prevented by practicing a new time zone rhythm before traveling. Insomnia can also be caused if the nature of the work has a changing schedule, for example, work is generally done during the daytime, but occasional night time shifts are also done from time to time.

Psychological. Stress, a disease that is severe for a person, or significant changes in a person’s life can also lead to insomnia.

Psychiatric. Alcohol abuse, alcohol dependence, anxiety disorders, generalized anxiety disorder, panic disorder, adjustment disorder and / or depression play an important role in making a person more vulnerable to insomnia and more persistent to its cure.

Drugs, substances such as alcohol, nicotine, caffeine, antihypertensives, steroids, etc. can have both excitatory and sedative effects, but in both cases they interfere with a person’s natural / normal physiology and thus sleep.

It is important to remember that insomnia can also be the result of a combination of very different factors – you should consult a healthcare professional to diagnose them!

Repeated insomnia can cause fear of insomnia and its consequences thus forming a closed circle which can intertwine with other problems.

When the time to sleep comes, people suffering from insomnia feel tension and anxiety, they feel worried or depressed and various disturbing thoughts circulate in their heads. Thoughts are often a mixture of disturbing thoughts related to poor sleep, personal problems, your health and sometimes even the fear of death. In the morning you feel both physically and mentally tired, and during the day you are characterized by a depressed mood, excessive worry, feeling tense, irritable, over-dealing with your problems.

People sometimes start using medication or alcohol to relieve excessive anxiety. However, this does not address the root of the problem and may actually exacerbate insomnia.

What should people suffering from insomnia know?

• Insomnia is a normal reaction to changes in life.
• Chronic sleep disorder can often be seen as a consequence of bad habits that are just as difficult to get rid of as other unwanted habits.
• Insomnia is not a sign that a person is weak or worse than others. Rather it reflects a person’s sensitivity and ambition.
• No one can be in the best shape every day. Even after insufficient sleep, a person’s general ability to function remains, although not at the top level.
• The time spent on a sleepless night is one’s own time. It should not be used to worry about work. It can be used to think about your things (or reading, listening to music) that you don’t have the opportunity to do during the day. You can deal with anything that is rewarding. No one can make demands on a person for their night time. The more pleasantly you are able to use your waking hours at night, the better you’ll feel during the day. The more pleasantly you use this time, the easier it will be to fall asleep.

Hypersomnia is persistent excessive daytime sleepiness or sleep thrusts (but not associated with insufficient nighttime sleep) or a noticable increase in the need for nighttime sleep. A person suffering from hypersomnia feels that even a good night’s sleep does not give enough rest, thus the quality of life suffers. Short-term excessive sleepiness is not hypersomnia, the abnormality must occur daily for at least one month or for shorter periods. It should also cause significant distress or social or professional disturbances to diagnose hypersomnia.

The most common causes of hypersomnia are organic brain damage and mental disorders such as the depressive phase of bipolar disorder; depressive episodes, recurrent depression and maladaptation (increased need for sleep due to excessive stress).

Sleep-wake arrhythmia is defined as the lack of synchronism between an individual sleep-wake cycle and the desired sleep-wake cycle, depending on environmental conditions, resulting in hypersomnia or insomnia. Sleep arrhythmia makes it difficult for a person to act normally and in the same rhythm as others, because the sleep mode is just so different from the average person’s mode in that environment.

Different types of sleep-wake arrhythmias:

Delayed sleep syndrome (DSS)

While most people fall asleep between ten and twelve in the evening, this syndrome is 2-4 hours later than usual. In typical cases, people fall asleep at 3-4 o’clock at night. The duration and structure of sleep have not changed if it is possible to sleep longer in the morning so that the duration of sleep is sufficient for rest (7-8 hours).

Delayed sleep syndrome is not a medical condition. This is a human characteristic, as are other physiological characteristics. The most natural way to address this characteristic would be to organize one’s life according to a personal sleep-wake cycle. Problems with DSS occur when you are forced to wake up in the morning at the same time as people usually do. If DSS natural sleep occurs at 4 o’clock at night and a person is persistently forced to go to work (study) by eight o’clock in the morning, a permanent sleep deficit and general exhaustion develops, which can contribute to the development of both mental and physical illnesses.

If it is not possible to maintain a rhythm suitable for the body, the use of opiates should be avoided. Such activities are inefficient and harmful to health. Light therapy has more positive effects but unfortunately it is  not permanent. The use of melatonin and its analogues is considered promising, although the effect of long-term use of melatonin is currently unclear. The use of melatonin does not have a lasting effect, DSS recovers after discontinuation.

Early sleep syndrome (ESS)

Sleep arrives a few hours earlier than usual. While DSS is an individual characteristic where sleep arrives later due to a person’s physiological factors, in the case of ESS the mechanism is the same, but simply the opposite. As a rule, ESS should not cause significant problems in regulating work and leisure.

Irregular sleep-wake cycle

• The ever-changing arrival of sleep at night. Sleep arrives every day, for example, 1 hour later. If you fall asleep at 11 pm in the evening on a certain day, then after 1 week 7 hours later, that is at 6 am, and 2 weeks later 14 hours later, that is 1 pm afternoon.
• Completely disorganized rhythm of sleep-wakefulness. The daily cycle has a spontaneously variable length.

Irregular sleep rhythms can leave a person perplexed and cause very significant distress to the person themselves and others with whom they come into contact due to family or work relationships.

24-hour sleep disorder

The human sleep cycle has shifted by 12 hours compared to the average sleep cycle of other people living in the same environment. For example, you wake up at 9 pm in the evening and go to bed at 12 pm in the afternoon, while others wake up at 9 am in the morning and go to bed at 12 am at night.

Working with a variable schedule

Working with a variable time schedule, which includes sleep time, can significantly impair the physiological processes involved in the regulation of the sleep-wake cycle. Insomnia-type sleep disorders can result. People’s ability to adapt to a variable schedule can be very different. Light therapy and the use of melatonin or its analogues may be beneficial in the development of sleep-wake cycle disorders.

Jet-lag syndrome

Jet lag, or moving to another time zone, can cause short-term, but sometimes longer, insomnia. Apparently, many have experienced this when traveling to America or Asia. In most cases, the jet lag lasts a few days to two weeks.  However, if insomnia prolonges, it should definitely be addressed.Jet lag can also be prevented by practicing a new time zone rhythm before traveling. The use of melatonin or its analogues may accelerate adaptation to the new time zone.

Sleepwalking

The sleepwalking episode usually occurs in the first third of sleep and is associated with waking up from the third / fourth phase of sleep. This awakening is not complete – consciousness is deeply clouded, there is no reactivity to external stimuli, and motoric skills are low. A person usually gets out of bed and walks around. Sleepwalkers might leave the bedroom and sometimes even leave the home. Therefore, there’s a significant risk of serious injury during this episode. More often sleepwalkers return to bed on their own or with someone’s help. When one wakes up, he/she usually doesn’t remember anything neither immediately after the episode nor the next morning.

Sleep panic attacks

Intensive panic attacks with strong vocalizations, restlessness and vegetative reactions are characteristic of sleep panic. When you wake up, you usually don’t remember anything. During a panic attack, a person is at high risk of self-harm.

Sleep anxiety

Sleep anxiety means that a person experiences dreams that cause fear and anxiety which are later remembered in great detail. Dreams are very vivid and usually involve a threat to a person’s life, security or dignity. Often the same topic with the same or similar scary content is repeated. When awakened, a person remembers what he/she has experienced and is able to awaken quickly.

Narcolepsy

A chronic neurological disease in which a person loses consciousness for 10-15 minutes a day due to an uncontrollable need for short-term sleep. During this time, the person falls into a deep sleep, which makes it very difficult to wake him up. In this condition, a person’s night’s sleep is also disrupted. During a seizure of narcolepsy, a person has very low muscle tone and therefore has no control over their body. People with narcolepsy are often excessively sleepy during the daytime.

Sleep apnea

In sleep apnea, a person experiences shortness of breath during sleep, which can be life-threatening. Snoring with breathing pauses is a sign of possible sleep apnea, because during snoring the body is deficient in oxygen, which the person is unaware of because he is sleeping. However, this persistent deficiency is very debilitating and harmful to the body and sleep apnea should be treated.