Sleep disorders

 Sleep disorders

Sleep disorders are broadly classified into dyssomnias, parasomnias, circadian rhythm sleep disorders involving the timing of sleep, and other disorders, including those caused by medical or psychological conditions.

Sleep is a state of rest that occurs in most animals, including humans. During deep sleep, most of the muscles that animals can otherwise control are inactive, but they regain energy for the next time they wake up. Animals during sleep are usually in an unconscious, relaxed state.

When the underlying cause of sleep problems is not immediately apparent, behavioural treatments are typically the first recommended. These range from patient education about sleep hygiene to cognitive behavioural therapy (CBT). Studies of both younger and older adults have compared CBT to medication and found that CBT should be considered a first-line and cost-effective intervention for chronic insomnia.

Behavioural therapies include progressive relaxation, stimulus control (to reassociate the bed with sleepiness), limiting time-in-bed to increase sleep efficiency, and debunking misconceptions about sleep. Pharmacotherapy is necessary for some conditions. Medication may be useful for acute insomnia and for some of the parasomnias. It is almost always needed, along with scheduled short naps and close follow-up, in the treatment of narcolepsy and idiopathic hypersomnia.

Chronic circadian rhythm disorders, the most common of which is delayed sleep phase disorder, may be managed by specifically timed bright light therapy, usually in the morning, darkness therapy in the hours before bedtime, and timed oral administration of the hormone melatonin. Chronotherapy has also been prescribed for circadian rhythm disorders, though results are generally short-lived. Stimulants may also be prescribed. When these therapies are unsuccessful, counselling may be indicated to help a person adapt to and live with the condition. People with these disorders who have chosen a lifestyle in conformity with their sleeping schedules do not need treatment, though they may need the diagnosis to avoid having to meet for appointments or meetings during their sleep time.

When sleep complaints are secondary to pain, other medical or psychiatric diagnoses, or substance abuse, it may be necessary to treat both the underlying cause and the sleep problems.

When the underlying cause of sleep problems is not immediately obvious, behavioural treatments are usually the first suggested. These range from patient education about sleep hygiene to cognitive behavioural therapy (CBT). Studies of both younger and older adults have compared CBT to medication and found that CBT should be considered a first-line and cost-effective intervention for chronic insomnia, not least because gains may be maintained at long-term follow-up.

Pharmacotherapy is necessary for some conditions. Medication may be useful for acute insomnia and for some of the parasomnias. It is almost always needed, along with scheduled short naps and close follow-up, in the treatment of narcolepsy and idiopathic hypersomnia.

 

Stages of sleep cycles	Rapid eye movement (REM) Quiescent sleep Slow-wave
Brain waves	Alpha wave Beta wave Delta wave Gamma wave K-complex Mu rhythm PGO waves Sensorimotor rhythm Sleep spindle Theta wave
Sleep disorders	Anatomical Mouth breathing Sleep apnea  Catathrenia Central hypoventilation syndrome Obesity hypoventilation syndrome Obstructive sleep apnea Periodic breathing Snoring Dyssomnia Excessive daytime sleepiness Hypersomnia Insomnia Kleine–Levin syndrome Narcolepsy Idiopathic hypersomnia Night eating syndrome Nocturia Sleep state misperception Circadian rhythm disorders Advanced sleep phase disorder Cyclic alternating pattern Delayed sleep phase disorder Irregular sleep–wake rhythm Jet lag Non-24-hour sleep–wake disorder Shift work sleep disorder Parasomnia Bruxism Nightmare disorder Night terror Periodic limb movement disorder Rapid eye movement sleep behavior disorder Sleepwalking Sleep driving Sleep-talking Benign phenomena Dreams  Lucid dreams Exploding head syndrome Hypnic jerk Hypnagogia / Sleep onset Hypnopompia Sleep paralysis Sleep inertia Somnolence Nocturnal clitoral tumescence Nocturnal penile tumescence Nocturnal emission Treatment Sleep diary Sleep hygiene Sleep induction  Hypnosis Lullaby Somnology  Polysomnography Sleep surgery Other Sleep medicine Behavioral sleep medicine Sleep study Melatonin Neuroscience of sleep

 

How to Get to Sleep Faster

A lot of people have trouble falling asleep, tossing and turning for what feels like hours, before finally drifting off into a fitful slumber. It can be an extremely frustrating problem, as it reduces your sleeping hours and can leave you feeling tired and grumpy the next day. Luckily, there are many things you can do to relax the body and mind, and to improve your ability to fall asleep faster in both the short-term and long-term.

 

Optimising Sleeping Environment

 

1 Keep your bedroom cool. 

2Keep your room clean. 

3Turn off all lights and electronic equipment. 

   

Make sure your pillows and mattress are comfortable. 

4 Lightly fragrance your bedroom with essential oils. - Sprinkle a few drops of the essential oil on a piece of cloth and slip it under your pillowcase.

5 Make your bedroom a noise-free zone. 

 

Preparing Your Mind and Body for Sleep

                 Soak in a hot bath. 

o  Have a snack and a warm drink. 

·       

o  Do some stretching. 

o  Read, write, or play a game before bed. 

o  Meditate. Part3

o  Use Distraction Techniques

 

Implementing Long-Term Solutions

 

1 Reduce your caffeine intake. 

2 Take a sleep supplement. 

·      Melatonin

·      Chlor - Trimeton, a type of antihistamine, i

·      Valerian root

3 Exercise regularly. 

4 Stick to a sleeping schedule. 

 

How to Fall Asleep and Stay Asleep

• Establishing a Nighttime Routine
• Optimising Your Sleep

Sleep is a vital part of staying happy and healthy, but for many people, quality sleep can be elusive, which affects their mood and ability to function. If you find it difficult to fall asleep and stay asleep, establishing a consistent nightly routine and managing factors that can disrupt your sleep may be the key to a restful sleep.

 Massage yourself with essential oils. Though there is no scientific evidence supporting the use of essential oils to aid in sleep, some people claim that they can be beneficial. Massaging essential oils into places such as your feet and temples may aid your sleep.

The best oils to aid your sleep are chamomile, lavender, marjoram, vetiver, and Valerian.

Dilute your essential oil with a carrier oil to minimise the risk of burning your skin. Examples of different carrier oils are: sweet almond oil, apricot kernel oil, avocado oil, olive oil, and sesame oil.

You can get the sleeping benefits of many essential oils in the form of tea. Most companies sell teas such as chamomile, lavender, and Valerian.

1.     

Take a sleep aid. If you are drowsy and can’t fall asleep, take a natural sleep aid such as melatonin or another over-the-counter sleep aid. This may put you to sleep quickly and help you stay asleep through the night. This should be a temporary solution, however. It is still important that you find out the cause of your sleep problem and treat it directly.

There is some clinical evidence that taking the hormone melatonin can help regulate your sleep-wake cycle and mildly reduce the time it takes to fall asleep. Melatonin may cause mild side effects such as headache and daytime drowsiness.

Although there is little clinical evidence to support it, Valerian supplements may help you fall and stay asleep. An added benefit is that Valerian doesn’t seem to cause any side effects.

Use full body relaxation. Running through a relaxation drill can relax your entire body. In turn, this can help you fall and stay asleep by putting your body into a state of true relaxation.

Tense each of your muscle groups for five seconds, beginning with your feet and ending with your head. Release each group after five seconds and take a deep breath if necessary.

 

Get into bed no matter what. Even if you are not tired, get into bed at the same time every night. Sliding into a comfy bed can help you relax and fall asleep, and also help maintain your circadian rhythms.

If you aren’t able to fall asleep within 20 minutes, get up for a few minutes and do something relaxing like listening to music or reading in dimmed light. Try going back to sleep after 20 minutes, repeating this pattern until you can fall.

Block out light. Just as light can stimulate your brain and make it difficult to fall asleep, it can also make it difficult to stay asleep throughout the night. Block out any sources of light that may be causing your insomnia.

Exercise early. Exercising elevates your body temperature and blood pressure, and it takes time for your body to come down from this. Get your exercise early in the day, which has the double benefit of helping you fall and stay asleep.

Exercise at least three hours before you begin winding down. This will help your temperature and cortisol levels return to normal.

An additional benefit to exercising in the morning: your body's metabolism is running a bit higher all day long, so you are burning more calories throughout the day than you normally would.

Limit caffeine and alcohol. Caffeine and alcohol are two primary causes of insomnia. Limit your intake of both and only consume them well before you begin your wind-down and go to bed.

Don’t drink caffeinated beverages after noon.

Limit yourself to no more than one alcoholic drink at least four hours before bedtime.

Eat an early and light evening meal. Finish eating your dinner several hours before your bedtime. Heavy, late, and spicy meals can cause indigestion and insomnia.

Avoid napping. Many people enjoy taking a nap during the day to recharge. Although naps can be great, they can also cause insomnia. If you’re having difficulties staying asleep, reduce or quit napping during the day. If you absolutely need a nap, take a thirty-minute catnap before 5 pm.

What are some tips for falling asleep faster? Drinking a cup of chamomile or valerian tea can help you relax. Also, keep the temperature between 60–75°F (15.5–23.9°C). In addition, open a window or run a fan to help cool and ventilate your room.

Are there any unique ways to fall asleep? The military developed a really interesting way to fall asleep and stay asleep, although it does take 6 weeks of practice before it will work. It's called systemic relaxation. You start by thinking about the muscles in your shoulders, eyes, and jaws. Focus on relaxing those muscles while doing some deep breathing. Then, keep breathing slowly and visualise something relaxing. The military recommends picturing yourself lying back in a canoe with a clear blue sky, but you can picture whatever you'd like.

How to get to sleep faster if you're not tired?

• Go to bed even if you’re not tired. Go to bed at the same time every night, whether or not you’re tired. Sticking to a consistent sleep routine will help you fall asleep and stay asleep throughout the night. Getting into a comfortable bed with the lights dimmed may help you get to sleep faster, even if you don’t feel tired.

Sleep is integral to good physical health and mental well-being. Occasionally, it may be difficult to get to bed on time and to fall or stay asleep. By optimising sleeping conditions and maintaining a bedtime routine, also known as practising good “sleep hygiene,” you can train yourself to go to bed on time and get a good night’s sleep. You can also turn all the lights off, make sure your phone is off, and reduce noise in your bedroom.

Find out how much sleep you need. Everyone needs adequate sleep to function properly and to stay healthy, but sleep requirements vary by age and activity level. Understanding how much sleep you need can help you plan for a good night’s sleep.

·        Newborns 0-3 months old require 14-17 hours of sleep every day.

·        Infants 4-11 months old need 12-15 hours of sleep every day.

·        Toddlers 1-2 years old need 11-14 hours of sleep every day.

·        Preschoolers 3-5 years old need 10-13 hours of sleep every day.

·        School-age children 6-13 years old need 9-11 hours of sleep every day.

·        Teenagers 14-17 need 8-10 hours of sleep every day.

·        Adults, aged 18-64, need 7-9 hours of sleep every day.

·        Older adults above 65 years need 7-8 hours of sleep every day.#*Anyone who is very active, stressed, or sick may need to take short, daytime naps to rest and recharge.

 

Recognise the importance of a good night’s sleep. Regardless of age and general sleep recommendations, your body requires adequate rest to function at its best.

·        Make sleep a priority in your life. It contributes to your body and mind’s optimal functioning.

·        Numerous negative consequences of insufficient sleep include disease, chronic inflammation, high blood pressure and stress, diabetes, obesity, and mood disorders.

·        Lack of sleep also affects mental performance, such as the ability to focus. It may affect your ability to do your job well.

Adjust your sleep patterns as necessary. There will be circumstances in which you need to adjust your sleeping habits. From high-stress events to illness and even to just identifying problems in your sleeping habits with a sleep diary, adjusting your sleep to these situations will help you get enough sleep and maintain your health.

·        Accommodate situations that require you to change your sleep. Be flexible in your schedule and sleep habits to accommodate events that will disrupt your sleep. By adjusting your sleep plans before and after the event, you can make sure you aren’t negatively affected by the change.

·        If you know that you’re about to enter a particularly stressful time at work, home, or school, you would also want to adjust your sleep patterns to make sure that a lack of sleep doesn’t cause you more stress 

Optimising the Conditions for Sleeping

Avoid naps if you have trouble sleeping. Naps are a popular way to take a break and recharge during the day. But they can also have the side effect of keeping you from falling and staying asleep. Avoiding naps during the day may help you fall and stay asleep.

·        If you find that you need a nap or naps, take it before 5 pm and keep it short. Thirty minutes is enough to help you refresh and recharge.

·        If you find that you need multiple naps during the day or are just generally exhausted at times when you should be awake, consult your doctor to rule out medical conditions.

  

Set a fixed bedtime. Establish a reasonable time to get to bed on most days, including weekends. Having this designated bedtime will help regulate your circadian rhythms, or body clock, and may also help you fall asleep and stay asleep throughout the night.

·        When you set your bedtime, make sure that you consider factors like exercise, eating, and alcohol consumption. You want to make sure your body has at least two to three hours to process these activities before you go to bed.

·        The best way to set your internal body clock is to wake up at the same time every day, even if you had a bad night’s sleep.

·        Don’t set a bedtime that is too late or one that corresponds to when you feel tired, so that you don’t stay alert and, in turn, not get tired.

·        Stick to this schedule as much as possible and adjust it if necessary.

 

Create a comfortable sleeping environment. You won’t want or be able to sleep if your bedroom isn’t comfortable. By controlling factors such as the temperature and darkness, having comfortable bedding, and removing stimulating electronics, you will help yourself get to bed on time and fall and stay asleep. Alternatively, use software and features like Night Shift and F.lux.

·        Set the temperature in the bedroom to between 60 to 75 °F (15.6 to 23.9 °C) for optimal sleeping conditions.

·        Keep computers, TV, and work materials out of the room to strengthen the association between bedroom and sleep.

·        Light stimulates you to be awake, so make sure that your room is dark enough to sleep. You can use curtains or eye masks to help with rooms that are exposed to a lot of light.

·        Noise will also keep you from getting to sleep. Keep your room as quiet as possible and consider a white noise machine to combat any loud noises that may filter into your bedroom.

·        A comfortable mattress, pillows, and bedding can make you want to get to bed on time.

4.     

Exercise early in the day. Exercising early in the day can help you fall and stay asleep because it tires your body and will also relax you. But avoid exercising too close to your bedtime, which may stimulate you and keep you from sleeping.

·        Exercise at least three hours before bed so that your body temperature and cortisol levels can return to normal. Higher body temperature can make it difficult to sleep, and having more cortisol in your system from exercise may stimulate you.

·        Vigorous exercise is best, but any activity is better than nothing.

·        Don’t exercise at the expense of your sleep.

5.     

Avoid caffeinated and alcoholic beverages and cigarettes. Caffeine, alcohol, and cigarettes are stimulants that will interrupt your sleep. Avoiding them before bedtime will help you get to and stay asleep.

·        If you consume nicotine or caffeine, avoid them within four to six hours of your bedtime.

·        Limit yourself to one to two alcoholic drinks per day or less and avoid drinking within three hours of bedtime.

·        Even though alcohol might help you fall asleep, after a few hours, it acts as a stimulant.

 

Avoid late or heavy meals. Eating too close to your bedtime or having heavy meals can affect your ability to sleep. Plan to eat lighter fare at dinner and within a few hours of your bedtime to ensure that you can get and stay asleep.

·        Try to eat two to three hours before your bedtime.

·        Big or spicy meals can cause discomfort and indigestion.

·        If you’re hungry before bedtime, have a snack about an hour before you turn out the lights.

Start winding down. Your body needs time to shift into sleep mode. Taking an hour or so to begin winding down before bed will signal your body and brain that it’s time to sleep and help you get the best night’s rest.

·        Avoid electronics such as televisions, laptops, tablets, and smartphones within an hour of your bedtime. Not only can shows, work, or social media stimulate your brain, but the light from these devices also makes it difficult for your body to fall asleep.

·        Dim the lights in your home and bedroom. Light will stimulate you, so dimming the lights within an hour of your bedtime signals your brain that it’s time to slowly go to bed.

·        Having a calming bedtime ritual will help you wind down for a good night’s sleep.

8.     

Create a bedtime ritual. Once you’ve begun to wind down and are close to bedtime, having a set ritual will further signal to your body that it’s time to go to bed. There are different activities you can do as a part of your ritual, such as having tea or a warm bath.

·        Reading a book in bed with the lights dimmed will relax and entertain you while not overstimulating you.

·        A warm cup of herbal tea, such as lavender or chamomile, will relax you and help you sleep.

·        A warm bath is not only relaxing, but the rise and fall in body temperature it causes will promote drowsiness

Go to bed even if you’re not tired. Go to bed at the same time every night, whether or not you’re tired. Sticking to a consistent sleep routine will help you fall asleep and stay asleep throughout the night.

·        Getting into a comfortable bed with the lights dimmed may help you get to sleep faster, even if you don’t feel tired.

·        If you can’t fall asleep within 20 minutes of going to bed, go to another room and do something relaxing until you feel tired enough to sleep.