Sleep Symptoms
Although sleep is very relaxing and considered “resting” it is actually an active process where your body cycles through different stages. This sets off a cascade of events (hormonal and physiological) that repair physical and mental damage from the previous day. The purpose of sleep is to prepare you for optimal function the following day.
Snoring
This is a common symptom that affects not only the snorer, but also the bed partner. In fact, it has been shown that your bed partner can lose up to 1 month of sleep a year if you snore.
Sleepiness
Severe sleepiness can significantly reduce your quality of life and is extremely dangerous. This is seen especially when there is difficulty in keeping alert when driving. In fact, sleep apnoea (choking and gasping when asleep) can triple the risk for being involved in car accidents. The reason is that your alertness (and hand-eye coordination) is impaired, which slows your response time when something goes wrong.
- Sleep apnoea, of which there are two main types – OSA (or Obstructive Sleep Apnoea), and CSA (Central Sleep Apnoea). OSA is where there is blocking of the upper airway when asleep, with an associated drop in oxygen level. CSA is when breathing stops because (temporarily) there is no message from the brain to continue breathing. For both types of apnoea there are many specific treatment options.
- Poor body clock with irregular sleep times (such as shift work or overseas travel).
- Medications (many types, especially antidepressants, sleeping tablets and pain killers).
- Various medical illnesses (especially those that disrupt sleep).
- Insomnia (can’t fall or stay asleep).
- Rarer disorders such as hypersomnia and narcolepsy. Narcolepsy is a disorder that is seen when the parts of your brain that is supposed to keep you awake, are damaged. Thus, you are always sleepy in spite of normal or long sleep.
Can't sleep (Insomnia)
Insomnia is the most common sleep disorder in our society. There are various types of insomnia.
Some people have difficulty in falling asleep, which is often due to a disrupted body clock. Sleep hygiene provides some benefit, as does appropriate medication.
Sleeping tablets are a poor choice, as they don’t improve sleep but rather make you forget how bad your sleep was! They are usually muscle relaxants, which worsen choking at night and thus exacerbate other sleep disorders. There is also the ever present danger of addiction and morning sleepiness.
Some people have difficulty in staying asleep. This can be due to performance anxiety about sleep (psychophysiological insomnia) or one of many sleep disorders that may not yet be diagnosed.
The science of insomnia has changed rapidly in recent years with new evidence based treatments available. One of the most powerful tools is sleep psychology intervention. This can be accessed via scientifically proven on-line websites, or by seeing an accredited sleep psychologist.
Restlessness at Night
This is often called restless legs syndrome (Willis-Ekbom Disease) and is often described as discomfort, cramps or burning of the legs, arms or neck. Some people are completely unaware that they have this Syndrome, which can lead to insomnia and poor sleep.
This is a sleep movement disorder with a few reversible causes. There are currently 7 medical therapies available, but is best managed by a sleep specialist due to possible side effects and interaction with other medications.
Shift work
In the modern world, shift work has become a necessary evil. Many can’t avoid it as their occupation depends on it. The first step in managing shift work disorder is to manage all other sleep disorders that may be present.
There are also smart ways to recover faster from shift work which include sleep schedule maintenance and tweaking the body clock with medication and a novel treatment - blue light. There is now medication that improves wakefulness safely, which can be prescribed by a sleep specialist.
Odd behaviours at night (Parasomnia)
Sleep walking, sleep talking and sleep eating are more common than you might think. They are important as they can put you in physical danger and prevent you from working safely in certain occupations.
In 70% of cases there is an underlying cause. Often the first step is to do a sleep study to investigate the trigger. There are certain medications which manage the behaviours, but therapy is best implemented under the supervision of a sleep specialist.