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Sleep disorders
There are a variety of sleep disorders that affect people in different ways. Some of these disorders can be short-term and will clear up quickly, but others can be life-changing for people and will require long-term monitoring and treatment. Many sleeping problems tend to improve if you start practising good sleep habits and manage your symptoms, while others may need to be treated with medication.
Contents
What are sleep disorders?
A sleep disorder is a type of condition that causes changes to your sleep. There are a wide range of sleep disorders that can affect your sleep in different ways, such as making it harder to fall asleep, making your sleep less restful, or even causing you to feel drowsy and fall asleep throughout the day. It’s very common to have trouble sleeping from time to time, but if you’re regularly finding it difficult to sleep well, and it’s affecting other areas of your life, you may have a sleep disorder.
Sleep disorders are caused by a range of different factors and can be a symptom of a completely different condition. Untreated sleep disorders can in turn also cause other health issues.
According to the UK Sleep Council, 40% of the population have issues with their sleep.
What are the different types of sleep disorder?
The different types of sleep disorders include:
- insomnia
- sleep apnoea
- restless leg syndrome (RLS)
- narcolepsy
- REM sleep behaviour disorder (RBD)
- parasomnias
- excessive daytime sleepiness (EDS; hypersomnia)
Insomnia
Insomnia is when you find it difficult to get to sleep and/or stay asleep. Problems you may have if you have the condition include:
- finding it hard to fall or stay asleep
- waking up early and not being able to go back to sleep
- waking up throughout the night
- feeling tired during the day
Sleep apnoea
Sleep apnoea is a condition that often affects men and causes your breathing to sound different while you sleep. The most common form is obstructive sleep apnea (OSA) which makes your breathing stop and start. This happens as your throat relaxes and narrows, which can be due to gaining weight, making it harder to breath.
The most common symptoms of OSA are waking up or slightly waking up frequently during the night, falling asleep during the day, and feeling tired regularly. It can also make you snore, but you may also choke, gasp, or hold your breath in your sleep.
Restless legs syndrome (RLS)
Restless legs syndrome (RLS), or Willis-Ekbom disease, is a condition affecting the nervous system. People with RLS have overpowering urges to move their legs, usually because of uncomfortable sensations in them.
The symptoms of RLS are more common after you’ve been resting, which means it often affects people when they sleep. You may also twitch or make jerky movements while you sleep which is known as periodic limb movement of sleep (PLMS). And this can make it hard to go to sleep or stay asleep.
Narcolepsy
Narcolepsy is a condition affecting the brain that makes it hard to stay awake for long periods of time. With this disorder your body is not making enough of a chemical called hypocretin which the brain uses to make your sleeping patterns regular.
If you have narcolepsy, you’re often extremely tired or drowsy during the day, and have ‘sleep attacks’ where you’ll fall asleep suddenly and without warning at any time. You may also temporarily lose control of your muscles, which is known as ‘cataplexy’.
REM sleep behaviour disorder (RBD)
REM sleep behaviour disorder (RBD) is a condition which makes you act out your dreams. REM, or rapid eye movement, is a stage of sleep where your body is usually still and your brain becomes more active and you dream.
If you have RBD, you’re able to move your body in this state and act out the dream, including moving your arms and legs, sometimes getting up and moving around, and also shouting and talking. The dreams are often violent or frightening.
Parasomnias
Parasomnias is the name for a group of sleep disorders that cause unusual behaviour while you’re sleeping, or while you’re going to sleep or waking up. These include nightmares, night terrors, sleepwalking, sleep talking, cramps, wetting the bed, and ‘confusional arousals’ which is when you wake up feeling very confused.
Excessive daytime sleepiness (EDS; hypersomnia)
Excessive daytime sleepiness (EDS), or hypersomnia, is when you feel extremely sleepy during the day and find it hard to stay awake. Rather than just feeling tired, if you have EDS you might fall asleep suddenly during the day, or need to nap frequently.
What are the signs and symptoms of sleep disorders?
The signs and symptoms of sleep disorders include:
- having trouble falling asleep
- waking up early and not being able to go back to sleep
- waking often during the night
- snoring
- making jerky movements while you sleep
- being very tired during the day
- falling asleep suddenly at unusual times
- nightmares
- sleepwalking or talking
- wetting the bed
- being very confused when you wake up
- feeling depressed
- lack of concentration
- weight gain
If you think you have a sleep disorder it’s important to talk to a doctor about it. Some sleep disorders are a symptom of other medical conditions so a doctor can help you to understand the exact cause of the problem and how to treat it.
Do I have a sleep disorder if I want to sleep all the time?
If you regularly feel like you want to sleep all the time, you might have a sleep disorder. If you usually get 7 hours sleep a night or more, and still feel very sleepy during the day, you should talk to a doctor.
Some sleep disorders do not stop you sleeping but mean that you have disturbed sleep which then makes you feel sleepy during the day. Other sleep disorders actually stop you from sleeping which can make you feel extremely tired, irritable, and fatigued.
Conditions like excessive sleep disorder (hypersomnia) or narcolepsy cause you to fall asleep at unusual times. With these disorders, this may actually happen suddenly, rather than just experiencing the feeling that you want to sleep.
Other conditions, such as depression or low mood, may also affect your sleep patterns or cause a lack of motivation that makes it difficult to get out of bed in the morning. It’s always best to check in with a doctor if you notice that you are suddenly feeling more tired than usual.
What causes sleep disorders?
There are many different causes of sleep disorders. Some are caused by a change in your life like a period of stress, or starting to work shifts that may force you to change your sleeping routine. Some are specific conditions that affect the brain or nervous system, and some are symptoms of other medical conditions like Parkinson’s disease or depression.
If you think you have a sleep disorder, it’s best to talk to a doctor who will ask about your symptoms and help you work out what might be causing it.
Why can't I sleep?
There are many different reasons why you might find it hard to sleep. It’s normal to go through periods where you have trouble sleeping. You might have a specific sleep disorder, or you might be dealing with stress or changes in your life.
Common causes of sleep disorders
Insomnia:
- stress, anxiety or depression
- working shifts
- side effect of medications
- medical conditions like cancer or Parkinson’s disease
- caffeine
- drinking alcohol
- being overweight
- having narrow airways or a large neck or tonsils
- high blood pressure
- smoking
- drinking alcohol
- the exact cause is often unknown
- runs in families
- associated with low levels of the chemical dopamine and iron, and medical conditions like diabetes and kidney disease
- low amounts of a chemical called hypocretin which keeps your sleeping patterns regular
- the exact cause is often unknown
- can be a side effect of some medications, or a symptom of other conditions such as Parkinson’s disease
- some parasomnias run in families
- stress or mental health problems
- side effect of medications
- alcohol or drug use
- the exact cause is often unknown (in this case the disorder is known as idiopathic hypersomnia)
How are sleep disorders diagnosed?
Depending on your symptoms, and your medical history, your doctor is likely to look at different factors to diagnose your sleep problems. It’s particularly important for your doctor to consider whether any medical conditions you already have could be causing issues with your sleep.
If you have mild symptoms of a sleep disorder, it can help to try to improve your sleep yourself, before seeking a more specific diagnosis. If you find that your symptoms are very troubling, or you’ve had them for months, it’s a good idea to then discuss them with a doctor.
Your doctor may ask you to keep a diary of your sleep habits, the times that you sleep and how restful your sleep is. Doctors often also use the Epworth Sleepiness Scale to ask you about how sleepy you feel during the day.
Insomnia
To diagnose insomnia, a doctor will ask about your sleep patterns, your lifestyle, any changes you’ve recently been through, and why you think you might be having problems with your sleep. They’ll also consider your medical history and whether another condition could be causing your insomnia.
In most cases, a doctor may suggest blood tests, will check you over physically, and may refer you to a sleep clinic so a doctor can monitor your sleep
Sleep apnoea
If a doctor thinks you might have sleep apnoea, they will measure your weight, and ask about whether you smoke, drink, and if you have a family history of the disorder.They may ask you questions from the Epworth Sleepiness Scale and may refer you to a specialist who might suggest further tests to monitor your heartbeat and breathing.
Restless legs syndrome (RLS)
Restless legs syndrome is diagnosed by a doctor asking you questions about your symptoms. This will include asking about:- the urges you have to move your legs and arms
- how long you’ve had the urges
- when you get them
- how unpleasant they are
- how much they affect your sleep
Narcolepsy
A doctor will usually try to rule out other sleep disorders before looking at whether you have narcolepsy. If they think it’s possible, they’ll refer you to a sleep specialist who is likely to want to watch you sleep to analyse your sleep patterns. They may also suggest a test to measure the level of hypocretin in your body.REM sleep behaviour disorder (RBD)
As well as asking about your sleep patterns, medical history and any medications you’re taking, to diagnose REM sleep behaviour disorder (RBD) your doctor is likely to refer you to a specialist who will want to analyse your sleep at a clinic.Parasomnias
If you think you have a parasomnia, your doctor will talk through any unusual sleep behaviours you may have and consider your health and medical history, sleep patterns, lifestyle and mental health to give you a diagnosis.Excessive daytime sleepiness (EDS; hypersomnia)
Your doctor is likely to refer you to a specialist if they think you might have excessive daytime sleepiness (EDS; hypersomnia). A specialist may suggest having your sleep monitored at a clinic.
How do you manage a sleep disorder?
Most sleep disorders can be managed by making changes to your sleep habits and your lifestyle. More severe sleep disorders might be treated with therapy or medication while some will be managed as a side effect of a separate medical condition you may have.
Your doctor will discuss any treatment options with you when they offer you a diagnosis.
How do I treat a sleep disorder?
When treating most sleep disorders, a doctor will advise general good sleep behaviours such as:- having regular sleeping patterns, like going to bed and waking up at the same time
- not using devices like mobile phones 3 hours before bed
- exercising during the day but not too close to when you go to bed
- avoiding caffeine, alcohol and nicotine
Insomnia:
- avoiding naps
- cognitive behavioural therapy (CBT)
- melatonin (if you’re over 55)
- losing weight
- sleeping on your side
- using a CPAP machine (a mask you wear when you sleep to improve your breathing)
- medication that increases your dopamine levels (such as ropinirole)
- short term medication that helps you sleep (known as a hypnotic)
- keeping to a nap and sleep schedule
- counselling or therapy
- medical stimulants to keep you awake, like modafinil
- antidepressants
- medication that helps you sleep (known as a hypnotic)
- addressing any underlying mental health, or drug and alcohol issues
- using various medication, depending on the disorder
- medical stimulants to keep you awake, like modafinil
How can I stay awake with a sleep disorder?
If you have a sleep disorder that means you fall asleep during the day, or feel like you want to, it can help to:- plan a nap schedule
- eat small, regular meals
- avoid alcohol and large portions of carbohydrates
- spend time outdoors doing light exercise during the day
How can I fall asleep with a sleep disorder?
If you have trouble falling asleep, try to:- make sure your bed is comfortable
- sleep somewhere quiet, dark and between 16C and 18C
- avoid alcohol, caffeine and nicotine at least 6 hours before you go to bed
- avoid drugs
- avoid using devices like a mobile phone at least 3 hour before you go to bed
- go to bed and wake up at the same time each day
- avoid napping
- exercise during the day but not close to the time you go to bed
- do a guided sleep meditation when you go to bed
Can I buy sleeping pills online?
Some sleeping pills are available from online pharmacies and doctors. These include:- antihistamines, which are usually used to treat allergies but can also make you drowsy
- melatonin, a hormone that regulates your sleep cycles
- other prescription sleeping pills, for which you’ll need to be assessed by a doctor
Sources
About Idiopathic Hypersomnia Hypersomnia Foundation [accessed 18 August 2020]
About Narcolepsy Narcolepsy UK [accessed 18 August 2020]
Diagnosis and treatment of chronic insomnia (2010) Annals of Indian Academy of Neurology [accessed 18 August 2020]
Excessive daytime sleepiness (hypersomnia) (2017) NHS [accessed 18 August 2020]
Insomnia (2018) NHS [accessed 18 August 2020]
Insomnia (2020) NICE [accessed 18 August 2020]
Narcolepsy (2019) NHS [accessed 18 August 2020]
Obstructive sleep apnoea (OSA) British Lung Foundation [accessed 18 August 2020]
Parasomnias: A Comprehensive Review (2018) Cureus [accessed 18 August 2020]
Parasomnias in adults (2020) BMJ [accessed 18 August 2020]
Restless legs syndrome (2018) NHS [accessed 18 August 2020]
Restless Legs Syndrome Fact Sheet (2020) National Institute of Neurological Disorders and Stroke [accessed 18 August 2020]
Sleep apnoea (2019) NHS [accessed 18 August 2020]