Sleep and sleep-wake rhythms are found in humans. Too much sleep or too little sleep is harmful to us. There are many people who suffer from sleep disorders. Insomnia, narcolepsy, breathing-related sleep disorders, sleep-related movement disorders, Parasomnias, and Circadian rhythm sleep disorders are the most common sleep disorders. Sleep disturbance causes significant impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning. But there is hope to solve those problems. The field of sleep disorders therapy and medicine has progressed.
STAGES OF NORMAL SLEEP
We need to know about the stages of normal sleep before knowing about sleep disorders. The stages of normal sleep are given below:
- Sleep normally cycles through a pattern of stages. The different stages of sleep may be seen in polysomnography, as revealed by EEG.
- Sleep is divided into Rapid Eye Movement (REM) and Nonrapid Eye Movement (NREM) sleep. REM and NREM sleep alternate every 90-100 minutes throughout the night.
- NREM sleep is further subdivided into 4 stages of decreasing arousability:
- Stage 1 is viewed as a transitional sleep stage.
- Stage 2 occupies the majority of NREM sleep.
- Stage 3 and 4 are “deep” sleep.
- Normal sleep stages, as characterized on PSG:
- Wakefulness: low-voltage, fast frequency EEG pattern, voluntary eye movements, tonic muscle
- Stage 1 NREM sleep: small increase in EEG amplitude. Slow rolling eye movements in EOG channels.
- Stage 2 NREM sleep: increase amplitude and further slowing of EEG frequencies.
- Stage 3 NREM sleep: large-amplitude, slow EEG activity also known as “ delta” or “ slow-wave sleep” that comprises 20-50℅ of a 30- second epoch, low muscle tone.
- Stage 4 NREM sleep: same as stage 3 sleep, except delta activity constitutes >50% of an epoch.
- REM sleep: the return of fast-frequency, mixed voltage EEG activity similar to stage 1 NREM sleep. Phasic rapid eye movements are characteristically seen. Muscle tone is essentially absent aside from muscle twitches.
Common sleep problems:
Insomnia- Insomnia is a sleep disorder in which people have trouble falling asleep. People have low energy, irritability, and depressed mood.
Sleep apnea- Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. It’s a disorder in which someone faces snoring, gasping, or breathing pauses during sleep.
Narcolepsy- Narcolepsy is a sleep disorder in which a person suffers from recurrent daytime naps, irrepressible need to sleep, daytime drowsiness, and sudden attack of sleep.
Circadian Rhythm sleep-wake disorders- Circadian rhythm sleep disorders involve either difficulty falling asleep, waking up during the sleep cycle, or waking up too early and being unable to fall back to sleep. It occurs due to an alteration of the circadian system or one’s biological clock system.
Non-Rapid Eye movement sleep arousal disorder- It is a type of disorder in which a person experiences recurrent episodes of incomplete waking from sleep such as sleepwalking, sleep, terrors. It usually occurs during the first third of the major sleep episode.
Restless legs syndrome- It is a condition that causes an uncontrollable urge to move the legs, usually because of uncomfortable and unpleasant sensations in the legs. It typically happens in the evening or nighttime hours when one’s sitting or lying down.
So these are the most common sleep disorders which hamper our social, occupational even family life. That’s why we have to fix them. Otherwise, people suffer a lot with them.
Although there are many disorders, each disorder has a different treatment. But some treatments can be helpful to rid of those common sleep disorders.
TREATMENT FOR SLEEP PROBLEMS
1) Breathing Relaxation:
Deep breathing is one of the best ways to lower stress and anxiety. This is because when we breathe deeply, it sends a message to our brain to calm down and relax. The brain then sends this message to our body. For doing this we have to seat comfortably. Then take a long deep breath through our nose, hold the air in our chest. Then slowly exhale the air from our chest through the nose. It is very helpful to reduce sleep problems.
2) Reducing day-time sleeping:
Reduction of daytime sleeping may be achieved by helping people to cut down on the number of daytime naps they take or the duration of daytime naps. Napping may be replaced by activities that the person finds enjoyable.
3) Developing a bed-time routine:
Routine can vary from person to person. Establishing a sleep routine that works for a person to get the recommended amount of sleep each night. A good routine can improve the quality of sleep. It keeps us healthy. It includes bedtime, comfortable dress, lights off, etc.
4) Managing food intolerance:
A person should avoid caffeine, alcohol, and nicotine in the four to six hours before bedtime. Physical discomfort associated with cow’s milk intolerance was identified as an important factor causing sleep difficulties in about 10 percent of referrals to a pediatric sleep clinic, and these cases showed normalization of sleep patterns after five weeks when milk products were removed from the children’s diets (Kahn et al., 1989). So we have to be very careful about food tolerance. We should take lite meals before sleep. Heavy meals can make sleep disturbance.
5) Avoid stimulants
coffee, tea, soda/cola, cocoa and chocolate, and heavy meals should avoid for at least four hours before bedtime. Light carbohydrate snacks such as milk, yogurt, or crackers may help you fall asleep easier.
6)Sleep schedule & hygiene
The term ‘sleep hygiene was first used by Dr. Peter Hauri around 20 years ago to describe what patients themselves can do to eliminate sleep-interfering factors, and to promote good sleep. Sleep hygiene refers to things about lifestyle and preparation for bed that can be changed to improve sleep patterns.
Component of sleep scheduling and their Implementation issues:
- Restrict your time in bed
- Establish your rising time
- Establish your “threshold time” for bed
- Go to bed only when sleepy
- Follow a 7-night-per-week schedule
- Observe the 15-minute rule
- Make adjustments to the schedule
- Make the connection between bed and sleep
- Avoid daytime naps
7) Exercise
Studies have found that regular aerobic exercise for prolonged periods can improve sleep quality and reduce excessive daytime sleepiness. Exercise regularly, but not within four hours of bedtime if you have trouble sleeping.
8) Create an optimal sleep environment
When we go to sleep we should make the bedroom comfortable, cool, quiet and dark. Keep the room noise-free and try a sleep mask or blackout curtains. It would be very helpful.
9) Try to clear your mind before bedtime
Making a to-do list earlier in the evening is helpful. If anyone has a tendency to worry and think too much in bed at night. One’s should do every work and keep himself free before going to bed. It helps to make a sound sleep.
10) Therapy
If the disorder is more serious then therapy is required. Cognitive-behavioral therapy techniques are used to reduce anxiety about getting enough sleep.
11) Medication
Medicines, including sleeping pills, are used for temporal relief. Usually, providers recommend that using sleeping pills for a short period of time. In the case of sleep apnea, CPAP (continuous positive airway pressure) machine is used.
12) Avoid Electronics before going to bed
It’s a very bad habit to use a mobile phone or watch TV before going to bed. It can give us migraine headaches or other serious problems for its rays. So electronics must be avoided at least one hour before sleep.
So these are the ways to fix sleep problems. We should follow these to maintain a healthy sleep. Having healthy sleep is crucial for a healthy lifestyle. There is a famous quote of Socratic – “ A sound mind is a sound body”… Here, I add that “A sound sleep is a sound mind”.
