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Research Paper Common Sleep Disorders and Treatments

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    Sleep disorders affect more than one-quarter of the United States’ population occasionally, and almost 10 percent of Americans report chronic insomnia. Insufficient sleep can cause inattention at work or school and car and machinery accidents, injuries, and even deaths.

    Sleep disorders and treatments

     

    Sleep is considered by the Centers for Disease Control and Prevention as a vital necessity and a sign of good health. The main sleep disorders affecting Americans are insomnia, narcolepsy, restless legs syndrome (RLS), and sleep apnea (CDC, “Sleep and Sleep Disorders”). This sample research paper from the custom writing services at Ultius will examine an array of sleep disorders and their treatments.

    Insomnia

    Insomnia is the “inability to initiate or maintain sleep,” according to the CDC (“Key Sleep Disorders”). According to NPR, about 60 million people in American are affected by sleep disorders every year, and scientists differ in their approaches to these disorders. Insomnia can also come in the form of early morning awakening – this results in the individual being unable to return to sleep, and it may also manifest as excessive daytime sleepiness and functional impairment (CDC, “Key Sleep Disorders”). Many other symptoms or events can cause temporary insomnia, including:

    • Other sleep disorders
    • Substance abuse
    • Depression
    • Medication side effects
    • Previously undetected illnesses in an individual

    Thus, primary insomnia diagnoses can be difficult; chronic psychophysiological insomnia, also known as “learned” or “conditioned” insomnia may be caused by a fear of being unable to sleep combined with a particular trigger or stressor (CDC, “Key Sleep Disorders”). Gayle Green is the author of the book Insomniac, a book about chronic insomnia (NPR). Green noted that insomnia is often seen by non-sufferers as “a bad night.” Many don’t realize the ill effects of consistent sleep deprivation, which can drastically affect:

    • Work
    • Social life
    • Relationships
    • Health

    Green started SleepStarved, an insomnia blog for shared experiences and tips for other insomniacs (NPR). Dr. Ronald Chervin of the Sleep Disorders Center at the University of Michigan and Todd Arendt of the Insomnia and Behavioral Sleep Medicine Program at the same university noted that:

    "doctors are not taught enough about sleep during their educations; thus the disorders are often not diagnosed in primary care" (National Sleep Foundation).

    Specialty clinics are generally the only place where patients can find worthwhile and permanent solutions to disorders such as insomnia, mental illnesses and others.

    Treatment for insomnia

    The National Sleep Foundation in Arlington, Virginia recommends seeking treatment if insomnia becomes a pattern, if a person feels consistently fatigued or unrefreshed, or if insomnia interferes with life on a daily basis. Although many people have brief periods of insomnia, a consistent pattern is a sign of chronic insomnia. The first step in seeking and obtaining treatment is to ask or schedule a discussion session with a primary care provider.

    If a doctor is not knowledgeable about the subject, it may be best to ask for a referral to a sleep specialist (NSF). Testing for this disorder may include a sleep self-assessment or an assessment such as the Pittsburgh Sleep Quality Index (PSQI), which can also be used to detect other sleep disorders. Smyth noted that while self-reporting by patients can be “empowering,” the information reflected may be inaccurate if the patient is suffering from sleep deprivation. Referral to psychotherapists is also common if the insomnia is connected to anxiety, depression, or  major life adjustment or event.

    Behaviors for battling insomnia

    Some behavioral tips may help insomnia sufferers, as may medicine and medical treatment options. Sleep centers and clinics are scattered across the United States, which offer assessments, treatments, and testing; an Internet search may be in order if a primary care physician or a recommended specialist is not helpful (NSF). The main non-medical or cognitive and behavioral treatments for insomnia include:

    • Avoidance of work requiring late hours or night shifts
    • Relaxation training
    • Breathing exercises
    • Mindfulness
    • Meditation techniques
    • Guided imagery

    Stimulus control in the room where a person sleeps and cognitive behavioral therapy (based on eradicating irrational fears through self-education) are also commonly used for insomnia.

    Medications

    Drugs such as:

    • Benzodiazepine hypnotics
    • Non-bensodiazepine hypnotics
    • Melatonin receptor agonists
    • Common sleep aids available over-the-counter:
      • Nexium
      • ZzzQuil
      • Sominex

    Non medical aids for insomnia

    Alternative medicines are also popular as a solution or aid in sleeping, including:

    • Holistic treatments similar to those employed by cancer patients
    • Melatonin (which greatly benefits older people)
    • Valerian root (taper it down to prevent withdrawal symptoms when treatment is complete)
    • Acupuncture
    • Yoga
    • Meditation (Mayo Clinic)

    Narcolepsy

    According to the CDC, narcolepsy is characterized by:

    "excessive daytime sleepiness, episodes of irresistible sleepiness, and sudden muscle weakness (“Key Sleep Disorders”).

    It is possible that the sudden muscle weakness in narcoleptic patients is a result of strong emotion or strong feelings of surprise. Narcoleptics may refer to episodes as “sleep attacks” because they often occur under unusual sleep circumstances; these may include:

    • Walking
    • Physical activity
    • Driving
    • Eating
    • Any other daily activity during which sleep is not the usual response (CDC, “Key Sleep Disorders”).

    The National Institute for Neurological Disorders and Stroke defines narcolepsy as:

    "a chronic brain disorder involving poor control or sleep-wake cycles. People with the disease are unable to resist sleep, which can last from a few seconds to a few minutes in length" (NINDS).

    Because sleep can come at any time, daily life is greatly affected, and poor sleep quality often results because the sleeping bouts are short and frequent, preventing patients from entering the most restful period of sleep, known as REM (rapid eye movement) sleep (NINDS). Excessive daytime sleepiness, or EDS, is the most common narcolepsy symptom, and sleep paralysis and hallucinations are less common (NINDS).

    Cataplexy, the sudden loss of muscle tone while a person is awake can occur at any time, and usually begins after several weeks from EDS onset; however in 10 percent of cases, cataplexy appears before EDS, and is often diagnosed as seizure disorder (NINDS). Some narcoleptics suffer from disrupted nocturnal sleep and obesity, as well.

    Treatment for narcolepsy

    There is no cure for narcolepsy, but many symptoms can be treated with lifestyle changes and medications. Many people who suffer from narcolepsy have low levels of hypocretin, a neurotransmitter which helps with wakefulness. If cataplexy is present in the narcoleptic then hypocretin secretion is presumed to be life-long and irreversible. Both cataplexy and EDS can be controlled somewhat by medication such as modafinil and sodium oxybate.

    It is also common for doctors to prescribe amphetamine-like stimulants such as methylphenidate to reduce sleep attacks and alleviate EDS during daytime hours; the positive effects of these medications are often imbalanced by the negativity of their side effects, however. Amphetamines are highly addictive and can cause the reverse disorder in many: insomnia (NINDS).

    Additional forms of treatment

    Anti-depressants - Tricyclics such as imipramine and clomipramine, as well as some serotonin and noradrenergic reuptake inhibitors may also assist with narcolepsy symptoms. Gamma hydroxybutyrate or Xyrem can treat narcolepsy as well, and work by inducing nighttime sleep to reduce the occurrence of sleep attacks during the day (NINDS).

    Behavioral strategies - such as maintaining a regular sleep schedule, and avoiding alcohol, energy drinks and caffeine before bedtime; large, heavy dinners; and smoking are helpful for narcoleptics.

    In addition, maintaining a warm, comfortable bedroom and engaging in relaxing activities prior to bedtime seem to help (NINDS). Safety precautions are of paramount concern for narcoleptics, who must be careful when driving or operating machinery, as well as walking across a busy street or down a long flight of stairs.

    Restless leg syndrome (RLS)

    The CDC defines restless leg syndrome (RLS) as an unpleasant “creeping” sensation which is associated with aches and pains throughout the legs – it may begin in the lower legs and proceed upward. This feeling then causes difficulty sleeping and can only be relieved through walking, kicking, or other leg movement (CDC, “Key Sleep Disorders”). Dopamine neurotransmitter abnormalities are often associated with RLS, and a combination of drug therapy can correct the abnormality and result in sleep continuity. 

    Treatment for RLS

    Dopamine neurotransmitter abnormalities are often associated with RLS, and a combination of drug therapy can correct the abnormality and result in sleep continuity. The Restless Leg Syndrome Foundation recommends polysomnography for sufferer of this disorder, otherwise known as a sleep study. The study records bodily functions while the patient sleeps, including NREM and REM stages, and the electrical activity of muscles.

    Sleep apnea

    Sleep apnea may be indicated in many people as snoring while asleep. Characteristics of this disorder are periodic gasping or “snorting” noises during which sleep is disrupted; these disruptions should only be temporary, and the person goes back to sleep as soon as they are over. Excessive daytime sleepiness (EDS) may also affect those with sleep apnea, and their sleep is often interrupted and non-restorative (CDC, “Key Sleep Disorders”).

    Treatment for sleep apnea

    Sleep apnea treatment depends upon the cause of the disorder, which can vary from person to person. Often, congestive heart failure or a nasal obstruction may cause sleep apnea, and treatment of the underlying condition can solve the sleep apnea issue . Another treatment is gentle pressure administered during sleep using a continuous positive airway pressure device such as a nose strip may also help certain sufferers. Sleep apnea is not merely snoring, and should be taken seriously, as noted by the CDC (“Key Sleep Disorders”).

    Lesser-known sleep disorders and treatments  

    Besides these common sleep disorders, there are a few uncommon and rare sleep disorders of note. Some of these are:

    • Kleine-Levin syndrome (KLS) - KLS is primarily found in young men near or at the age of 15, and their symptoms usually prevail for eight years or more. Women may experience longer periods of symptoms. Sufferers of KLS may sleep for up to 23 hours per day, three weeks in a row. It is extremely difficult to wake these sleepers up, and they may exhibit unusual behavior when awakened such as:
      • Compulsive behaviors
      • Heightened sex drive
      • Binge eating
      • Sociopathic behavior
      • Confusion
      • Apathy
      • Childlike behaviors
      • Hallucinations) (Phillips)
    • Sleep paralysis - happens when people awake during REM sleep when their muscles have shut down for the night; at this time, they are unaware of their surroundings and unable to move or speak (Phillips). Many sufferers of this malady may also have visual and auditory hallucinations and intense fear or panic – some report a presence in the room and the feeling that someone is on top of them, “crushing the wind from their lungs” (Phillips).

    • REM sleep behavior disorder - occurs when, instead of being paralyzed, the sleeper acts out his or her dreams – this can be uncomfortable and even dangerous for the sleeper and anyone in bed with him or her. The disorder is frequently associated with other brain disorders such as Parkinson’s disease, dementia, and atrophy (Phillips).

    • Sexomnia - is a rare disorder during which sufferers engage in sexual acts, often violent in nature, while asleep (Phillips). Some defendants use sexomnia as a defense against violent crimes in a court of law (Phillips).

    • Exploding head syndrome (EHS) - sufferers experience hynagogic auditory hallucinations as they are beginning to fall asleep, or are startled awake by extremely loud noises (explosions, gun shots, a door slamming shut, loud shouts, or cymbals) – at time, visual flashes of light are present as well (Phillips). All are hallucinations. This disorder can lead to insomnia due to a fear of the sounds occurring when the person is trying to get to sleep.

    • Fatal familial insomnia -  is a condition which starts with trouble falling asleep, and the trouble increases until the sufferer is no longer able to sleep at all. Since sleep is required for health, emotional and physical well being, the symptoms of this disorder lead to abnormal autonomic nervous system functioning such as the person’s bodily control of blood pressure, heart rate, and body temperature (Phillips). The symptoms often progress in the following order:
      • Sleeplessness
      • High blood pressure
      • Rapid heart rate
      • Excessive sweating
      • Difficulty walking
      • Muscle twitches
      • Hallucinations
      • Weight loss
      • Dementia
      • Death 

    This condition is untreatable and very aggressive; it can last from 6 months up to 3 years with an average life span after diagnosis of 18 months (Phillips).

    Conclusion

    Sleep disorders are no laughing matter, and the normal functioning and health of human bodies and minds is dependent upon this necessary function and recharge session. Recently, researchers have found that the function of sleep affects all the functions of the human body. If sleep is disrupted, chances are that other disruptions and disorders will rapidly follow.

    Many people suffer from one or two sleep disorders during their lifetimes, but people who suffer more often should see a physician, specialist, or sleep clinic in order to determine a solution before sleep aid addiction occurs, or other difficulties emerge due to a lack of or too much sleep. The health of the body and the proper functioning of the both the mind and the body depend upon it.

    Works Cited

    Centers for Disease Control and Prevention. "Sleep and Sleep Disorders". CDC. U.S. Department of Health & Human Services, 2015. Web. 13 November 2015.

    Cleveland Clinic (2014). “Common Sleep Disorders.” Cleveland Clinic. Cleveland Clinic, 2014. Web. 13 November 2015.

    Hall, Alena. “The Truth about Over-the-counter Sleep Aids.” The Huffington Post. The Huffington Post.com, Inc., 2015. Web. 13 November 2015.

    Mayo Clinic. "Insomnia: Alternative Medicine". Mayo Clinic. Mayo Foundation for Medical Education and Research, 2015. Web. 13 November 2015.

    National Institute of Neurological Disorders and Stroke. “Narcolepsy Fact Sheet.” National Institute of Neurological Disorders and Stroke, 2015. Web. 13 November 2015.

    National Sleep Foundation. "Insomnia Treatment". National Sleep Foundation. National Sleep Foundation, 2014. Web. 13 November 2015.

    NPR. “Can’t Sleep? Neither Can 60 Million Other Americans.” NPR. NPR, 2015. Web. 13 November 2015.

    Phillips, Kevin. “6 Strange and Terrifying Sleep Disorders.” Alaska Sleep Clinic, 2015. Web. 13 November 2015.

    Smyth, Carole. “The Pittsburgh Sleep Quality Index (PSQI).” The Hartford Institute for Geriatric Nursing. Consultgerirn, 2012. Web. 13 November 2015.

     
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