Sleep Disorders

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Sleep disorders are conditions that prevent a person from getting restful sleep. There are approximately 80 different types of sleep disorders, the most significant being insomnia, sleep apnea, restless leg syndrome, and narcolepsy. Excessive daytime sleepiness, difficulty falling sleeping and abnormal sleep behaviours are just some of the symptoms of sleep disorders.

The following pages share information about sleep disorders – more specifically how lack of sleep can affect your health as well as how much sleep is recommended for different age groups. To learn more about the tests used to determine whether you have a sleep disorder, see Diagnosis.

If you are suffering from sleeping problems, this section also provides information about treatment options and tips for healthy sleep habits to allow you to make healthier decisions for you and your family.

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Sleep disorders are conditions that prevent a person from getting restful sleep. Excessive daytime sleepiness, irregular breathing or increased movement during sleep, difficulty sleeping and abnormal sleep behaviours are signs of sleep disorders. There are approximately 80 different types of sleep disorders, the most significant types being insomnia, sleep apnea, restless leg syndrome, and narcolepsy.

Sleep can often be a barometer of your overall health. In many cases, people in good health tend to sleep well, whereas those suffering from recurring sleeping problems might have an underlying health condition, be it minor or serious. With accurate diagnosis, most sleep disorders can be easily managed.

Sleep is absolutely essential for normal, healthy function. Even minimal sleep loss can take a toll on your mood, energy, efficiency, and ability to handle stress. The amount of sleep that a person needs to function optimally depends on several factors, including age. Infants require about 16 hours of sleep a day; teenagers should have approximately 9 hours a day; and adults need an average of 7 to 8 hours a day. Ignoring sleep problems and disorders can lead to poor health, accidents, impaired job performance, and relationship stress. If you want to stay healthy and feel your best – sleep is a necessity, not a luxury.

If you struggle when it comes to sleep, keeping a diary that tracks your sleep patterns and symptoms can be a great starting point. By gaining insight into your personal sleep habits, you can learn to make healthy changes to your day time and bed time routine. If you still need help finding ways to improve your sleep, a sleep specialist can identify any underlying factors that may be causing your sleep problems.

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According to Cleveland Clinic , there are approximately 80 different types of sleep disorders, which include night terrors, sleep walking and bed-wetting. However, the four most common sleep disorders are:

  • Insomnia: Insomnia is the most common sleep complaint, and is characterised by a difficulty to fall or stay asleep. Those suffering from insomnia are unable to get the amount of sleep they need to wake up feeling rested and refreshed. Insomnia is often a symptom of another problem, such as stress, anxiety, depression, or an underlying health condition. It can be short-term (known as acute or adjustment insomnia) or can last a long time (known as chronic insomnia).  Acute or adjustment insomnia can last from one night to a few weeks, while chronic insomnia is when a person has insomnia at least three nights a week for a month or longer.
  • Sleep apnea: Sleep apnea is a potentially life-threatening sleep disorder in which a person's breathing temporarily stops during sleep. These pauses in breathing momentarily interrupt sleep, leading to many awakenings each hour. While most people with sleep apnea don’t remember these awakenings, they might feel exhausted during the day, irritable and depressed. There are two types of sleep apnea: obstructive and central. Obstructive sleep apnea (OSA) is the more common of the two, and is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep. In central sleep apnea (CSA), the airway is not blocked but the brain fails to tell the body to breathe.
  • Restless Legs Syndrome (RLS): This disorder causes an intense and almost irresistible urge to move the legs. People with RLS experience uncomfortable, tingly, aching, or creeping sensations deep within their legs when they are resting or lying down. This causes those with RLS to want to walk around and shake their legs to help relieve the uncomfortable sensation. RLS typically occurs in the evening.
  • Narcolepsy: Narcolepsy is a sleep disorder that involves excessive, uncontrollable daytime sleepiness. It is caused by a dysfunction of the brain mechanism that controls sleeping and waking. Episodes of narcolepsy have been described as “sleep attacks” and may occur in unusual circumstances, such as in the middle of talking, walking, driving and other physical activities. Some patients with narcolepsy may also feel weak or lose control of their muscles with laughter or other strong emotions.
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If you suspect that you may have a sleep disorder, see your doctor. He or she will begin with a complete medical history, perform a physical exam, ask about your symptoms and document your sleep history. Your doctor may also ask you to keep a sleep diary for a number of weeks to bring to your next appointment.

During the diagnostic period your doctor may order one or more of several tests to further identify the type of sleep disorder you have. These tests help doctors determine which treatment will be most effective for your condition:

  • Actigraphy: Actigraphy tracks your sleep-wake cycles at home using a small device that is worn on the wrist.
  • Polysomnogram: Also known as sleep study, a polysomnogram is an overnight evaluation that measures your brain wave activity, eye movements, breathing function, oxygen levels, heart rate and muscle activity as you sleep. The recordings are then analysed by a qualified physician who can determine what, if anything, is wrong. A polysomnogram test is painless. In certain circumstances, the polysomnogram can be done at home.
  • Multiple sleep latency test (MSLT): This is a daytime sleep study that measures how sleepy you are and is particularly useful for diagnosing narcolepsy. Often, you take this test the day after a polysomnogram. It is conducted in a sleep laboratory while you are monitored as you nap. Technicians will note how quickly you fall asleep and how long it takes you to reach various stages of sleep, especially REM (rapid eye movement) sleep, during your naps. 
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There are many approaches to effectively treat sleep disorders. Your doctor will prescribe treatment based on the type of disorder you have. Your treatment may include:

  • Risk factor modification: In mild cases of sleep disorders, you may be able to treat it by minimising your risk factors. This can include losing weight, avoiding alcohol and the use of certain medications, changing your sleep position and quitting smoking.
  • Behaviour and lifestyle modification: Making changes to your behaviour and lifestyle can go a long way to treat sleep disorders. Common modifications include establishing a regular sleep schedule, reducing caffeine consumption, engaging in physical exercise early in the day, and carefully timing exposure to bright light. Relaxation techniques, such as yoga, meditation, and guided imagery may be especially helpful in preparing the body to sleep.
  • Counseling or psychotherapy: If an aspect of your sleep disorder is psychological, the use of stress management techniques and treatment of underlying emotional conditions may improve your quality of sleep. For example, cognitive therapy is a common form of therapy for sleep disorders and helps you learn to develop positive thoughts and beliefs about sleep.
  • Medications: Your doctor may prescribe sedatives to improve the quality of your sleep or stimulants to improve wakefulness. According to the National Sleep Foundation , sleep-promoting medications called hypnotics are the most common treatment for insomnia. But before you take any medications, make sure you are aware of the potential side effects.
  • Medical devices: Various devices, such as continuous positive airway pressure (CPAP), can improve your sleep by keeping your airways open during sleep. CPAP is a treatment in which a mask is worn over the nose and/or mouth while you sleep. The mask is hooked up to a machine that delivers a continuous flow of air into the nose. This air flow helps keep the airways open so that breathing is regular. CPAP is considered by many experts to be the most effective treatment for sleep apnea.
  • Surgery: Your doctor may recommend throat surgery and related ear, nose and throat procedures to address the causes of your airway obstruction during sleep.
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Regardless of your sleep problems, following healthy sleep habits can help you to dramatically improve your sleep. Try making these simple changes to your daytime and pre-bedtime routine:

  • Keep a regular sleep schedule: To regulate your body clock, go to sleep and get up at the same time each day, including on weekends.
  • Create a relaxing bedtime ritual: A relaxing, routine activity right before bedtime tells your body it’s time to wind down and helps separate your sleep time from activities that can cause excitement, stress or anxiety. This might include taking a warm bath or shower, reading a book, or listening to soothing music.
  • Set aside enough time for sleep: Most people need the recommended seven to eight hours each night in order to feel good and be productive.
  • Avoid electronics before bed: Make sure to turn off your TV, smartphone, iPad, and computer a few hours before your bedtime. The type of light these screens emit can stimulate your brain, suppress the production of melatonin, and interfere with your body’s internal clock.
  • Exercise early in the day: Exercise is a great way to reduce stress and can help you fall asleep faster, as well as sleep more soundly. However, if you exercise too close to bedtime, you might be too energised to fall asleep. If this seems to be an issue for you, exercise earlier in the day.
  • Don’t nap through the day: Eliminate napping as much as possible to improve sleep at night. If you must nap, it’s better to keep it short and before 5 p.m.
  • Sleep on comfortable bedding: Good bedding can contribute to better sleep. Make sure your mattress and pillows are comfortable and supportive, and that your bed looks and feels inviting for sleep.
  • If you can't sleep, don’t stay in bed: The National Sleep Foundation recommends using your bed only for sleep and sex to strengthen the association between bed and sleep. If you can’t fall asleep after 20 minutes, go to another room and do something relaxing, such as reading, until you feel tired.
  • Avoid large meals before bedtime: Finish dinner several hours before bedtime and avoid foods that cause indigestion.
  • Use light to your advantage: Natural light keeps your internal clock on a healthy sleep-wake cycle. So let the light in as soon as you wake up and take sun breaks during the day if possible.
  • Avoid alcohol, cigarettes, and caffeine: If you’re having trouble getting to sleep at night, try cutting out alcohol, cigarettes or caffeine. All three are known to disrupt sleep.

Children

Sleep is essential to a child’s growth, development and emotional wellbeing. Yet sleeping difficulties are some of the most common problems parents face with their kids. Here are some tips on how to improve your child’s sleep:

  • Make your child’s bedroom an ‘electronic-free’ zone: The bedroom is no place for tempting electronics that actively stimulate the brain. Set it up as a relaxed environment for sleep. Experts say that bedrooms are strongly associated with sleep, but that certain things weaken the association. These include TVs, smartphones, video games and other electronic gadgets.
  • Have a bed time routine: Babies and children like to know what to expect. A bed time routine helps your child to transition from the day's activities to sleep. It might include a few simple, quiet activities, such as taking a bath or reading a story. The kinds of activities in the routine will depend on the child’s age.
  • Have a regular daily routine: Keep to a regular daily routine as much as possible. Try to maintain the same waking time, meal times, nap time and play times. This will help your child, especially if you have a baby, to feel secure and comfortable and feel ready for bedtime when it comes around. 
  • Use light to your advantage: Use curtains and lighting to keep your place dim in the evening as bed time approaches. In the morning, let in some bright light, and, if possible, take your kids outside. Light helps signal the brain into the right sleep-wake cycle.
  • Make the bedroom a relaxing and comforting place: According to the Sleep Council , a comfortable bed has a huge impact on restfulness, and can help children and adults alike get longer and more restful sleep.
  • Don't do anything energising close to bed: Winding down before sleep is essential for your child, so stay away from stimulating activities right before bed time.
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