General Overview of Sleeping Disorders

Sleeping disorders plague millions of people each night. Everything from insomnia, to restless movements during sleep to sleep apnea to inability to stay awake. All these manifestations of a disruption of the normal sleep patterns can be considered a sleeping disorder.

In itself, sleep deprivation is not a sleeping disorder, but is often a result of having trouble sleeping. Sleep deprivation can occur even when there is no clinical diagnosis of sleeping disorders. In other words, the person just is unable to obtain the recommended amount of time spent in restful sleep.

Sleeping disorders can be categorized by any of the following manifestations.

• Falling asleep at times which are not considered to be appropriate, i.e. while standing, or speaking
• Difficulty falling asleep or having trouble staying asleep
• Unusual behaviors while asleep such as sleep walking, rhythmic limb movements or enuresis
• Requirement of excessive or abnormal amounts of sleep

Any disruption of the normal sleeping state can have both physiological and neurological impact on the sufferer. However, sleeping disorders are commonly associated with one or more of the following causes.

• A change in life style - often a switch to shift work where the sufferer is sleeping during the day instead of at night.
• Pain - Back pain, neck pain, sciatica, or other chronic pain can create sleeping disorders
• Incontinence - whether adult or child, disrupting the sleeping patterns to prevent bed wetting or to clean up after an accident means a negative change in sleeping patterns.
• Babies - a new baby in the house will often result in a major problem with sleeping.
• Drugs - various types of medications will interfere with normal sleep and can sometimes rise to the level of diagnosed sleeping disorders.

Diagnosis of clinical sleeping disorders is usually accomplished through a number of methods. Often the patient who complains of one or more of the symptoms of sleeping disorders will often be asked to keep a sleep journal. The most common diagnostic test is usually done in a hospital or sleep lab setting and involves being wired up so sleeping patterns can be monitored and recorded electronically. The instrument is called a polysomnogram. Multiple channels on the polysomnogram measure such factors as an EEG, air flow, chin movements, leg movements, eye movements, heart rate and rhythm, oxygen saturation, abdominal wall movement and chest movement.

The polysomnogram is helpful in determining whether in fact the subject is suffering from any type of disruption in the sleeping patterns. Often a person will feel that they were awake, when in fact the EEG reflects they were sleeping.

Once the character of the sleeping disorder has been determined, the physician will proceed with treatment. Treatments for sleeping disorders typically fall into one or more categories: pharmacological, psychotherapeutic, or other somatic interventions. The treatment plan will vary depending upon the type of sleep disorder present. Although certain forms of sleeping disorders such as narcolepsy are commonly treated with medications, recent evidence shows that the most effective treatment over time includes behavioral modifications. Treatment which combines behavioral modifications with other treatments produces better results and is recommended in almost all treatment plans.