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sleep disorder

prepared by /

  1. Mohammed Elbaz
  2. Ahmed Elbaz

To /

Dr. abdelkareem rodwan

Insomnia: The most common type of sleep disorder

Insomnia, the inability to get the amount of sleep you need to wake up feeling rested and refreshed, is the most common sleep complaint. Insomnia is often a symptom of another problem, such as stress, anxiety, depression, or an underlying health condition. It can also be caused by lifestyle choices, including the medications you take, lack of exercise, jet lag, or even the amount of coffee you drink.

Common signs and symptoms of insomnia include:

  • Difficulty falling asleep at night or getting back to sleep after waking during the night.
  • Waking up frequently during the night.
  • Your sleep feels light, fragmented, or unrefreshing.
  • You need to take something (sleeping pills, nightcap, supplements) in order to get to sleep.
  • Sleepiness and low energy during the day.

Whatever the cause of your insomnia, being mindful of your sleep habits and learning to relax will help you sleep better and feel better. The good news is that most cases of insomnia can be cured with lifestyle changes you can make on your own—without relying on sleep specialists or turning to prescription or over-the-counter sleeping pills.

Putting a stop to the problem of sleepless nights

Insomnia takes a toll on your energy, mood, and ability to function during the day. But you don’t have to put up with insomnia. Simple changes to your lifestyle and daily habits can end sleepless nights.

Some Drugs to Treat Insomnia:

  • Lunesta: Lunesta also helps you fall asleep quickly, and studies show people sleep an average of seven to eight hours. Don't take Lunesta unless you are able to get a full night's sleep as it could cause grogginess.
  • Rozerem: This is a new sleep medication that works differently than the others. It works by targeting the sleep-wake cycle, not by causing central nervous system depression. It is prescribed for people who have difficulty falling asleep. Rozerem can be prescribed for long-term use and the medication has shown no evidence of abuse and dependence.
  • Sonata: Of all the new sleeping pills, Sonata stays active in the body for the shortest amount of time. That means you can try to fall asleep on your own. Then, if you're still staring at the clock at 2 a.m., you can take it without feeling drowsy in the morning. However, if you tend to wake during the night, this might not be the best choice for you.
  • Silenor : In 2010, this sleep medicine was approved for use in people who have trouble staying asleep. Silenor may help with sleep maintenance by blocking histamine receptors. Do not take this drug unless you are able to get a full seven or eight hours of sleep. Dosage is based on your medical condition, age, and response to therapy

Narcolepsy:

Narcolepsy is a chronic neurological disorder, affecting the part of the brain that regulates when you sleep and when you’re awake. This can cause you to experience excessive daytime sleepiness and sudden loss of muscle control, often triggered by strong emotions. As a result, you may fall asleep while working, cooking, or even driving.

Narcolepsy affects about 1 in 2,000 people, so you’re far from alone in suffering from this disorder. While narcolepsy is a lifelong condition, if you make positive lifestyle changes and seek approved medical treatment, you can help reduce symptoms, improve alertness, and enjoy a full and active life.

Signs and symptoms of narcolepsy

Most sufferers experience their first symptoms of narcolepsy between the ages of 10 and 25. However, those symptoms can vary greatly from one person to another. The main narcolepsy symptoms are excessive daytime sleepiness (with or without sudden sleep episodes) and abnormal REM sleep. Some other, unusual symptoms of narcolepsy may be related to your abnormal REM sleep, including hallucinations, sleep paralysis, and cataplexy (sudden loss of muscle control).

Two of the most common narcolepsy symptoms—excessive daytime sleepiness and cataplexy—are often connected to your emotional state. You may tend to exhibit these symptoms when you experience intense emotions, such as laughter, sadness, surprise, or frustration

Common narcolepsy symptoms include:

  • Cataplexy (loss of muscle control). Often, narcolepsy may cause you to have a sudden loss of muscle control while awake, usually triggered by strong emotions, such as laughing or crying.
  • Hallucinations. Some people with narcolepsy experience vivid, sometimes frightening, visual or auditory sensations while falling asleep or upon awakening.
  • Sleep paralysis. You may be unable to move or talk at the beginning or end of sleep.
  • Microsleep is a very brief sleep episode during which you continue to function (talk, put things away, etc.), and then awaken with no memory of the activities.
  • Nighttime wakefulness. If you suffer with narcolepsy, you may have periods of wakefulness at night, with hot flashes, elevated heart rate, and sometimes intense alertness.
  • Rapid entry into REM sleep. Narcoleptics have unique sleep cycles. You may enter the REM or dream phase of sleep right after falling asleep, whereas most people take about 90 minutes to enter REM. Therefore, you’ll experience the characteristics of REM sleep (vivid dreams and muscle paralysis) at the beginning of sleep, even if that sleep is during the day.

The causes of narcolepsy

While researchers continue to seek out the root cause of narcolepsy, the general consensus is that your genetics, accompanied by an environmental trigger of some sort—a virus, for example—may affect your brain chemicals and cause narcolepsy.

Scientists have discovered that people with narcolepsy are lacking in hypocretin (also called orexin), a chemical in the brain that activates arousal and regulates sleep. Narcoleptics generally do not have as many Hcrt cells (neurons that secrete hypocretin), which inhibits your ability to fully control your alertness and accounts for your tendency to fall asleep. Scientists are working on developing treatments to supplement hypocretin levels to reduce narcolepsy symptoms

Medications for the treatment of narcolepsy

Medication can be helpful in treating the major symptoms of narcolepsy: sleepiness and cataplexy. Commonly prescribed drugs for narcolepsy are stimulants, antidepressants, and sodium oxybate. All medications have side effects so talk with your doctor. Even if your narcolepsy symptoms require the use of prescription medication, experts recommended combining a drug regimen with lifestyle changes and counseling or therapy.

Common medications used to treat narcolepsy symptoms include:

  • Stimulants. Stimulants are the mainstay of drug treatment for narcolepsy. These include modafinil (Provigil), a stimulant used during the day to promote wakefulness and alertness. Side effects of modafinil may include headache, nausea, dry mouth, and diarrhea. Psychiatric side effects, such as anxiety, mania, hallucinations, and suicidal thinking have also been reported, so the drug should be avoided if you have a history of depression, mania, or psychosis.
  • Sodium oxybate (Xyrem). This strong drug may be prescribed if you have severe cataplexy.Sodium oxybate is also known as GHB, or the "date rape drug," but is considered safe for treating narcolepsy when used responsibly to promote sound sleep, diminish daytime sleepiness, and reduce incidences of cataplexy. However, the side effects can be serious and may include nausea, bed-wetting, and worsening of sleepwalking. Too high a dose can even lead to difficulty breathing, coma, and death.
  • Antidepressants. Selective serotonin reuptake inhibitors (SSRIs) used to treat depression may also be used to help suppress REM sleep, and alleviate symptoms of cataplexy, hallucinations, and sleep paralysis. These include fluoxetine (Prozac), sertraline (Zoloft), and newer antidepressants such as venlafaxine (Effexor). While the most common side effects of antidepressants include decreased sexual desire, digestive problems, restlessness, headache, and insomnia, there can also be dangerous side effects.

Other common types of sleep disorders

In addition to insomnia, the most common sleep disorders are sleep apnea, restless legs syndrome (RLS), and narcolepsy.

Sleep disorder 1: Sleep apnea

Sleep apnea is a common sleep disorder in which your breathing temporarily stops during sleep due to blockage of the upper airways. These pauses in breathing interrupt your sleep, leading to many awakenings each hour. While most people with sleep apnea don’t remember these awakenings, they feel the effects in other ways, such as exhaustion during the day, irritability and depression, and decreased productivity.

Sleep apnea is a serious, and potentially life-threatening, sleep disorder. If you suspect that you or a loved one may have sleep apnea, see a doctor right away. Sleep apnea can be successfully treated with Continuous Positive Airway Pressure (CPAP), a mask-like device that delivers a stream of air while you sleep. Losing weight, elevating the head of the bed, and sleeping on your side can also help in cases of mild to moderate sleep apnea.

Symptoms of sleep apnea include:

  • Loud, chronic snoring
  • Frequent pauses in breathingduring sleep
  • Gasping, snorting, or chokingduring sleep
  • Feeling unrefreshedafter waking and sleepy during the day, no matter how much time you spent in bed
  • Waking up with shortness of breath, chest pains, headaches, nasal congestion, or a dry throat.

Sleep disorder 2: Restless legs syndrome (RLS)

Restless legs syndrome (RLS)is a sleep disorder that causes an almost irresistible urge to move your legs (or arms). The urge to move occurs when you’re resting or lying down and is usually due to uncomfortable, tingly, aching, or creeping sensations.

Common signs and symptoms of restless legs syndrome include:

  • Uncomfortable sensations deep within the legs, accompanied by a strong urge to move them.
  • The leg sensations are triggered by rest and get worse at night.
  • The uncomfortable sensations temporarily get better when you move, stretch, or massage your legs.
  • Repetitive cramping or jerking of the legs during sleep.

and waking. If you have narcolepsy, you may have “sleep attacks” while in the middle of talking, working, or even driving.

Circadian rhythm sleep disorders

We all have an internal biological clock that regulates our 24-hour sleep-wake cycle, also known as our circadian rhythms. Light is the primary cue that influences circadian rhythms. When the sun comes up in the morning, the brain tells the body that it’s time to wake up. At night, when there is less light, your brain triggers the release of melatonin, a hormone that makes you sleepy.

When circadian rhythms are disrupted or thrown off, you may feel groggy, disoriented, and sleepy at inconvenient times. Circadian rhythms have been linked to a variety or sleeping problems and sleep disorders, including insomnia, jet lag, and shift work sleep difficulties. Abnormal circadian rhythms have also been implicated in depression, bipolar disorder, and seasonal affective disorder, or the winter blues.

Jet lag sleeping problems

Jet lag is a temporary disruption in circadian rhythms that occurs when you travel across time zones. Symptoms include daytime sleepiness, fatigue, headache, stomach problems, and insomnia. The symptoms typically appear within a day or two after flying across two or more time zones. The longer the flight, the more pronounced the symptoms. The direction of flight also makes a difference. Flying east tends to cause worse jet lag than flying west.

In general, it usually takes one day per time zone crossed to adjust to the local time. So if you flew from Los Angeles to New York, crossing three time zones, your jet lag should be gone within three days. However, jet lag can be worse if you:

  • lost sleep during travel
  • are under a lot of stress
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  • drink too much alcohol or caffeine
  • didn’t move around enough during your flight

Shift work sleeping problems

Shift work sleep disorder is a circadian rhythm sleep disorder that occurs when your work schedule and your biological clock are out of sync. In our 24-hour society, many workers have to work night shifts, early morning shifts, or rotating shifts. These schedules force you to work when your body is telling you to go to sleep, and sleep when your body is signaling you to wake.

While some people adjust better than others to the demands of shift work, most shift workers get less quality sleep than their daytime counterparts. As a result of sleep deprivation, many shift workers struggle with sleepiness and mental lethargy on the job. This cuts into their productivity and puts them at risk of injury.

There are a numbers of things you can do to reduce the impact of shift work on sleep:

  • Take regular breaks and minimize the frequency of shift changes.
  • When changing shifts, request a shift that’s later, rather than earlier as it’s easier to adjust forward in time, rather than backward.
  • Naturally regulate your sleep-wake cycle by increasing light exposure at work (use bright lights) and limiting light exposure when it’s time to sleep. Avoid TV and computer screens, use black-out shades or heavy curtains to block out daylight in your bedroom.
  • Consider taking melatonin when it’s time for you to sleep.

Delayed sleep phase disorder

Delayed sleep phase disorder is a sleep disorder in which your 24-hour cycle of sleep and wakefulness—your biological clock—is significantly delayed. As a result, you go to sleep and wake up much later than other people. For example, you may not get sleepy until 4 a.m., at which time you go to bed and sleep soundly until noon, or at least you would if your daytime responsibilities didn’t interfere. Delayed sleep phase disorder makes it difficult for you to keep normal hours—to make it to morning classes, get the kids to school on time, or keep a 9-to-5 job.

It’s important to note that this sleeping problem is more than just a preference for staying up late or being a night owl.

  • People with delayed sleep phase disorder are unable to get to sleep earlier than 2 to 6 a.m. no matter how hard they try. They struggle to go to sleep and get up at socially acceptable times.
  • When allowed to keep their own hours (such as during a school break or holiday), they fall into a regular sleep schedule.
  • Delayed sleep phase disorder is most common in teenagers, and many teens will eventually grow out of it.
  • For those who continue to struggle with a biological clock that is out of sync, treatments such as light therapy and chronotherapy can help. To learn more, schedule an appointment with a sleep doctor or local sleep clinic.

Simple tips for better sleep

The cure to sleeping problems and daytime fatigue can often be found in your daily routine. Making some simple lifestyle changes can help ensure you get the sleep you need.

Do sleeping pills help sleep disorders and sleeping problems?

When taken for a brief period of time and under the supervision of your doctor, sleeping pills may help your sleeping problems. However, they are just a temporary solution. Insomnia can’t be cured with sleeping pills. In fact, sleeping pills can often make insomnia worse in the long run.

In general, sleeping pills and sleep medications are most effective when used sparingly for short-term situations, such as traveling across many time zones or recovering from a medical procedure. If medications are used over the long term, they are best used “as needed” instead of on a daily basis to avoid dependence and tolerance.

Safety guidelines for sleeping pills

  • Only take a sleeping pill when you will have enough time to get a full 7 to 8 hours of sleep. Otherwise, you may be drowsy the next day.
  • Read the package insert that comes with your medication. Pay careful attention to the potential side effects, dosage instructions, and list of food and substances to avoid.
  • Never mix alcohol and sleeping pills.Alcohol disrupts sleep and can interact dangerously with sleep medications.
  • Never drive a car or operate machinery after taking a sleeping pill, especially when you first start taking a new sleep aid, as you may not know how it will affect you.