An Ancient but overwhelmingly accurate Greek text states, “For what I am doing, I do not understand. For what I will to do, that I do not practice; but what I hate, that I do.”
In Greek that could be translated, “Video meliora proboque, deterioria sequor.” This conundrum is a unique situation in which people find themselves, when it comes to the issue of sleep.
The quality and quantity of sleep that they get is akin to the food in prison (The food you want, you don’t get it. The food you get, you don’t want it).
This article simply helps to shed light on certain common sleep disorders, explaining the reason for their existence and in some cases, how to manage them.
Poor Sleep Hygiene: Sleep hygiene is defined as behaviors that promote improved quantity and quality of sleep (eg, regular sleep and wake times, refraining from stimulating activities and caffeine prior to sleep). Inadequate/poor sleep hygiene is a sleep disorder due to performance of daily living activities that are inconsistent with the maintenance of good-quality sleep and full daytime alertness. For example after a promotion, an individual begins drinking more caffeine, starts smoking again, exercises late in the day, eats a late dinner, and works late on the laptop. These habits are inconsistent with a stable sleep pattern and consequently compromise the ability to effortlessly initiate sleep.
Shift work sleep disorder: This involves a recurrent pattern of sleep interruption due to shift work, causing difficulty in initiating and maintaining sleep and daytime sleepiness. This disorder is due to a work schedule that is incongruent with a normal circadian clock. This individual’s sleep difficulties usually do not predate the change in shift, and there may be a history of sleep problems with previous late shift jobs.
Delayed sleep phase syndrome: This is a circadian rhythm sleep-wake disorder characterized by sleep-onset insomnia and excessive morning sleepiness. Circadian rhythm sleep-wake disorders occur when the internal clock regulating sleep and wakefulness is misaligned with a person’s desired sleep time or social/professional schedule.These individuals may exhibit a lifelong pattern of sleep difficulties that worsen with early-morning start times. Typically on weekends, when they do not go to work and sleep well till late in the morning, they tend to awaken feeling rested. Individuals with delayed sleep phase syndrome commonly describe themselves as ”night owls” and have chronic problems going to sleep at a societally accepted time (ie, prior to midnight).
Sleep is normal when they are allowed to set their own schedule. The onset of the condition occurs in adolescence and may respond to treatments such as light or behavioral therapy.
Advanced sleep phase disorder: This is a circadian rhythm disorder characterized by inability to stay awake in the evening (usually after 7 PM), making social functioning difficult. These patients frequently complain of early-morning insomnia due to their early bedtime. Advanced sleep phase syndrome is also a circadian rhythm disorder.
People normally sleep between 10 pm and 12 am. That’s normally circadian rhythm. But in advanced sleep phase disorder, the sleep time occurs earlier like 7 pm unlike in delayed sleep phase disorder, the sleep time occurs later like 2 am.
Narcolepsy: Narcolepsy is characterized by the classic tetrad of excessive daytime sleepiness (EDS), abrupt attacks of muscular weakness and loss of muscle tone (cataplexy), hallucinations (just before falling asleep), and sleep paralysis.
Narcolepsy is thought to result from genetic predisposition, abnormal neurotransmitter functioning and sensitivity, and abnormal immune modulation.
EDS is the primary symptom of narcolepsy and must be present for at least 3 months to justify the diagnosis, severe EDS leads to involuntary somnolence during activities such as driving, eating, or talking, sleepiness may be severe and constant, with paroxysms of falling asleep without warning (ie, sleep attacks)
Concerning cataplexy, if severe and generalized, cataplexy may cause a fall. However, more subtle forms exist with only partial loss of tone (eg, head nod and knee buckling). Cataplexy is usually triggered by emotions (especially laughter, fear and anger). With respect to sleep paralysis, usually, the patient is unable to move upon awakening. Paralysis is often accompanied by hallucination but occurs less frequently when the person sleeps in an uncomfortable position and can be relieved by sensory stimuli (eg, touching or speaking to the person).
Academic deterioration, inattentiveness, and emotional lability are common consequences. It is noteworthy that the motor disturbances may resolve later in the course of the disorder
Restless leg syndrome: This condition is charcterised by an unpleasant deep discomfort inside the calves when sitting or lying down, especially just before sleep, producing an irresistible urge to move the legs. (It often affects talebearers when they have just heard the latest gist…you know I’m kidding. Right?)
Sleepwalking disorder: This disorder involves rising from bed and walking or doing other complex motor behavior during an apparent state of sleep. Besides dreaming, the sleepwalker is also using the part of the brain that stimulates walking. This usually occurs during the first third of the night and lasts for a few minutes to a half hour. The sleeper is relatively unresponsive and not easily awakened, and usually cannot remember the episode afterwards. It is most likely to happen during periods of emotional stress; if it recurs frequently, it is considered a sleep disorder also called somnambulism.