Sleep Disorders

What is a sleep disorder?

There are two major kinds of sleep disorders.

  • The first kind of sleep disorder is called dyssomnias. Dyssomnias are related to the total amount of time that a person sleeps, the quality of the sleep, or the time of day when the person sleeps. Dyssomnias may be present when a person has difficulty falling asleep, staying asleep, or when a person sleeps too much.
  • Parasomnias are sleep disorders which have to do with what happens while a person sleeps. There are five major dyssomnias.
  • Primary Insomnia. Insomnia is classified as a problem, if over a period of at least one month, a person has difficulty falling asleep or maintaining his/her sleep. To be diagnosed as primary insomnia, the sleep problem must cause difficulty in the person's social, school, work, or other significant area of life. Most often, people with insomnia complain of problems in falling asleep, or they complain of fitful sleeping or frequent awakening. Some people report that the quality of their sleep is poor, that they are restless during their sleep. This condition may turn into an aggravating cycle in that the more a person focuses on his/her sleep, he/she may be less likely to get good quality sleep. Insomnia can lead to difficulties with a person?s concentration, energy level, or mood.
  • Primary Hypersomnia. The major symptoms of this disorder are excessive amounts of sleep and excessive daytime sleepiness. Usually the person with hypersomnia has difficulty getting out of bed even after sleeping more than eight (8) hours. During normal daytime waking hours, the person finds himself/herself taking naps or falling asleep at inappropriate times. People with this disorder often report that no matter how much sleep they get they do not feel rested. Their sleepiness can cause problems in work or social settings. This condition does not include those who are just physically tired or weary.
  • Narcolepsy. Narcolepsy is the presence of sleep attacks. Sleep attacks are brief periods of sleep during the person's normal waking. In order for narcolepsy to be diagnosed, a person must have suffered from the sleep attacks for at least three months. The person with narcolepsy will have intermittent periods of feeling very sleepy followed by attacks of sleep that last from only a few seconds to minutes and from which they awaken feeling refreshed. Unfortunately, the sleep attacks are involuntary and can occur during periods of time when a person must be awake, such as when operating machinery or interacting with other people. The sleep episodes can last up to an hour, but more frequently last around fifteen (15) minutes. Many people with narcolepsy have several episodes of sleep during their normal waking period.
  • Breathing-Related Sleep Disorder. If a person has difficulty breathing during sleep, he/she may have breathing-related sleep disorder. For instance, some people have sleep apnea which is characterized by the person actually stopping breathing for a period of time. Some sleep apnea is caused by obstruction of the person's airway. Loud snoring or gasping is often noted with this type of sleep problem. However, there are other sleep apnea problems that are not associated with obstruction of the airway. Sleep apnea is potentially very serious and may lead to premature death if not treated.
  • Circadian Rhythm Sleep Disorder. Circadian rhythm sleep disorder can occur when there is a mismatch between an individual's sleep-wake schedule and his/her sleep-wake pattern. Sometimes this occurs when an individual's sleep desire or needs are different from the demands of life. For instance, if a person is scheduled to work the midnight shift and has difficulty getting enough sleep during the daylight hours, that person might develop a sleep disorder. Another example is jet lag phenomena where a person travels a great deal and is forced to cross several time zones or endure an erratic sleep-wake schedule. Parasomnias. The following parasomnias are problems that occur during a person?s sleep.
  • Nightmare Disorder. Frightening dreams that tend to recur frequently and awaken a person from his/her sleep may lead to nightmare disorder. These dreams usually contain terrorizing or threatening content. Usually, the person can recall the nightmare in detail. When the person awakens, he/she is full of anxiety and usually finds it very difficult to return to sleep. Children frequently complain of nightmares, but they almost always outgrow them.
  • Sleep Terror Disorder. When a person awakens from a dream crying or screaming, he/she might be experiencing sleep terror disorder. Usually the person is difficult to wake-up and the episode may last several minutes. Sometimes the person with sleep terror will sit in bed and scream or cry, but cannot be awakened for several minutes. Once awakened, the individual is confused and finds it difficult to relay the detail of his/her dream. Sleep terror usually only occurs once per night. Sometimes the person experiencing a sleep terror will attempt to punch or swing his/her fists at others. Sleep terror occurs in children and adults.
  • Sleep Walking Disorder. A person experiencing sleep walking disorder will get out of bed and walk around. Many times, he/she will not communicate and will have a blank stare on his/her face. Once awakened, the person seldom remembers the details of the episode. These individuals become fully awake quite easily. During the sleep walking, some people may negotiate stairs, go out of doors, or eat a snack. Children who experience sleep walking usually outgrow it. However, sleep walking in adults can be chronic and last for many years. What other characteristics can occur with sleep disorder?Other characteristics that can occur with sleep disorders include depression, decreased concentration, fatigue, anxiety, and irritability. People with chronic sleep problems tend to have other illnesses such as stomach problems, muscle aches, and headaches.

Are there genetic factors associated with sleep disorder?

There is some tendency for sleep problems to be found in families.

Do sleep disorders affect males, females, or both?

There is some tendency for females to have more sleep problems than males.

At what age do sleep disorders appear?

Sleep disorders can occur at any age. However, sleep problems increase with increasing age.

How often are sleep disorders seen in our society?

Sleep problems are very common in our culture. More than twenty percent (20%) of adults will complain of sleep problems at some period in their lives.

How are sleep disorders diagnosed?

In order to accurately diagnose a sleep disorder, the person may need to spend the night in a supervised sleep clinic. In the sleep clinic, various recordings are made measuring the quality and duration of sleep. This procedure is called polysomnography.

What happens to someone with sleep disorder?

Sleep problems frequently occur around periods of stress in a person's life. For example, it is not at all uncommon for a person's sleep to be disrupted following the death of a loved one or around the time of a major medical problem. Therefore, many sleep problems resolve once the stress is resolved or the medical condition subsides. However, some sleep disorders can begin with an acute problem and become a chronic sleep problem.

What can people do if they need help?

If you, a friend, or a family member would like more information and you have a therapist or a physician, please discuss your concerns with that person.

Author: John L. Miller, MD

Reviewed by athealth on February 7, 2014.