Darrick Robles A sleep disorder is an impairment of the quality of sleep, the duration of sleep or the time of falling asleep and the associated reduction in performance on the following day.
A distinction is made between organic and non-organic sleep disorders. As the name suggests, an organic sleep disorder is based on a physical illness. Examples are Restless Legs Syndrome (a condition in which the patient has the urge to move their legs during phases of inactivity, particularly when at rest or asleep) or sleep apnea syndrome.
Non-organic sleep disorders are changes in the state of sleep that have no organic causes and lead to sleep deprivation. These include insomnia (difficulty falling asleep or staying asleep) and parasomnia (abnormal events during sleep such as sleepwalking or nightmares).
Since insomnia is one of the most common symptoms patients seek medical attention for, the subject is explained in more detail below.
Peculiarities of sleep: how much sleep do we need?
Sleep is essential for balanced physical and mental health. In addition, sleep is important for the development of our cognitive abilities and the immune system. Therefore, children need longer sleep periods than adults. In the following list you can see the recommended daily sleep duration for the different age groups:
- At 6 months about 14 hours
- At the age of 3 about 12 hours
- At the age of 6 about 10.5 hours
- At the age of 10 about 10 hours
- At the age of 14 about 9 hours
- At the age of 16 about 8 hours
- From 17-18 years approx. 7-8 hours
Symptoms of insomnia
Difficulty falling asleep and staying asleep are the main symptoms of a sleep disorder. Those affected often complain about waking up early, disturbed sleep-wake rhythm, as well as insufficient quality and quantity of sleep despite ideal sleeping conditions.
Rested adults take 10 to 20 minutes to fall asleep and spend less than 30 minutes awake during the night’s sleep. Adults with insomnia, on the other hand, take over 30 minutes to fall asleep and spend more than 30 minutes awake during nighttime sleep. They also wake up at least 30 minutes earlier than the set wake-up time.
Causes of a sleep disorder
Sleep disturbance can be an expression of psychological or psychosocial stress such as losing a job, the death of a loved one, a divorce, fear of a big lecture or an important exam. Symptoms may improve on their own as exposure passes or as habituation occurs.
If the symptoms of the sleep disorder persist for more than 3 months despite a lack of stress, this is referred to as chronic insomnia. Chronic insomnia can be related to depression , anxiety, or post-traumatic stress disorder (PTSD). Another cause can be neurological diseases such as restless legs syndrome .
Other causes can be the consumption of caffeinated beverages or the misuse of digital media, especially in children and adolescents. Side effects of certain medications are also possible causes (e.g. thyroid medication, steroids).
Organic diseases such as bronchial asthma , reflux , neurodermatitis , rheumatic diseases, tinnitus and many more can lead to sleep disorders.
sleep disorder in children
Depending on the child’s age, various strategies help to establish good sleeping habits. For children under the age of 5, creating a positive bedtime routine can have a sleep-enhancing effect.
For slightly older children, a short nap of no more than 20 minutes during the day (before 3:00 p.m.) and avoiding sleep phases after 3:00 p.m. helps.
Nowadays, the excessive consumption of digital media, especially among children and adolescents, as well as the excessive consumption of “energy drinks” play a significant role in sleep disorders. Therefore, education about healthy sleep behavior and the effects of sleep-inhibiting substances such as caffeinated drinks, smoking and alcohol can lead to improved sleep phases.
Diagnosis: How can a doctor diagnose a sleep disorder?
A sleep disorder can be diagnosed if you have problems falling asleep and staying asleep 3 times a week for at least a month and are accompanied by one or more of the following symptoms:
- daytime sleepiness
- lack of concentration
- social retreat
- Irritable or depressed mood
- tendency to sleep during the day
- Lack of motivation and lack of energy
- Increased error rate and accidents
- forgetfulness
In children, intellectual disability could be a sign of sleep deprivation.
When do I have to go to the doctor?
If the sleep disorder causes you distress and interferes with your everyday life, you need to see a doctor.
The doctor will help you to identify the underlying disease and can suggest a therapy recommendation.
Attacks of shortness of breath that occur at night can be a sign of inadequate drug therapy for bronchial asthma. However, it could also be a sign of serious medical conditions, especially if you feel heart palpitations, chest tightness, or pain. In that case, you need to see a doctor as soon as possible.
Therapy: what can I do myself?
Healthy sleeping habits, known in technical terms as sleep hygiene, help you sleep better:
- Sufficient night sleep (sleep in until you are rested)
- Maintain regular bedtime and wake-up times, including weekends
- Avoid caffeinated drinks after lunch
- Avoiding alcohol before bed
- Avoid smoking (especially in the evening)
- Only go to sleep when you are tired
- Avoiding hunger and thirst
- Quiet, darkened, pleasantly tempered sleeping environment
- Sufficient activity during the day
- Avoiding media consumption in the evening, especially in the hour before bed
- Only use the bed for sleeping (and for sexual intercourse).
Another therapy recommendation is a so-called “stimulus control”. Because some people associate bedtime with being alert, Stimulus Control aims to break that association by using the following steps:
- If you spend more than 20 minutes in bed trying to fall asleep, get up and go to another room
- Do a simple activity like reading until you feel tired
- If you’re tired, go back to bed and try to fall asleep within 20 minutes. If you don’t succeed, repeat steps 1 to 3
- Set an alarm for the same time every day, even on weekends
- Try to avoid afternoon naps
You might lack some sleep the first night. However, you will sleep better the next few nights, because tiredness increases and naps are not allowed.
Therapy: What is drug therapy (are there over-the-counter drugs)?
Drug therapy should only be given after all behavioral therapy methods have been exhausted. Over-the-counter preparations that support behavioral changes include phytopharmaceuticals (e.g. valerian) and antihistamines (e.g. doxylamine and diphenhydramine). Antihistamines are anti-allergic drugs that have a dampening and calming side effect due to their central mechanism of action.
Other non-over-the-counter preparations are benzodiazepines (triazolam, lorazepam), hypnotics (zolpidem), antidepressants (doxepin) and neuroleptics (melperone). Because of their high addiction potential, benzodiazepines are only used for short-term treatment.
This is how Med-Healths can help with insomnia
A detailed discussion with one of our Med-Healths doctors can help you to find the cause of your sleep disorder in order to initiate the right therapy. If an organic disease is suspected, you will be referred to the right specialist. In addition, our Med-Healths Doctor may provide you with a sick leave and prescription at their discretion.
