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Living in the Dark: Are You Unknowingly Suffering From a Sleep Disorder?
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Living in the Dark: Are You Unknowingly Suffering From a Sleep Disorder?
by Dr. Reut Greuber
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Sleep disorders are conditions that interrupt and degrade your sleep, preventing you from sleeping restfully. Since you're asleep when the problem happens, you can suffer from sleep disorders without even knowing it! You may be left in the dark about your sleep disorder robbing you of a good night’s sleep and making it difficult for you to get through the day.

How Can You Tell if You Suffer From an Undiagnosed Sleep Disorder?

Here are some questions you can ask yourself:

  • Do you have a hard time staying awake, even if you slept through the night?
  • Do you doze off when you’re inactive but should be staying awake? For example, during a work meeting, while watching a movie, or (worse and dangerously) when you drive?
  • Has your mood plummeted, but you don’t know why?
  • Are you irritable and reactive for no apparent reason?
  • Are you forgetful or do you find it difficult to focus?
  • Do you need to take naps often?
  • Do you snore most nights?
  • Does your bed partner hear pauses in your breathing when you sleep?

These are all possible signs of an undiagnosed sleep disorder.

Sleep disorders are also common in children and teens. Kids with a sleep disorder may seem overactive and irritable rather than sleepy. Adolescents who are excessively sleepy might look and feel depressed or anxious.

You may misinterpret your or your child’s daytime symptoms as signs of other disorders, like depression, attention deficit-hyperactivity disorder, or a cognitive decline. These signs and symptoms could suggest you suffer from an emotional or behavioral disorder, but they could also point to an undiagnosed sleep disorder. If these challenges sound familiar and you don’t know what’s causing them, you may want to consider having your (or your child’s) sleep assessed.

What Are Some Common Sleep Disorders?

Over 60 specific sleep disorders have been identified. Although their causes may differ, the end result of these disorders is the disruption of the body's natural sleep and wakefulness cycle.

Common sleep disorders include:

  • Insomnia: difficulty falling asleep or staying asleep throughout the night combined with daytime impairments.
  • Circadian rhythm sleep disorders: problems with the brain’s biological clock that create a “mismatch” between the individual’s sleep-wake schedule (their Circadian rhythm) and their work or social schedule.
  • Sleep apnea: a medical condition in which a person stops and starts breathing repeatedly throughout the night, resulting in micro arousals (very short increases in heart rate.)
  • Restless legs syndrome (RLS): a condition that causes an uncontrollable urge to move the legs because of an uncomfortable sensation. RLS usually begins in the evening, making it difficult to fall and stay asleep.
  • Narcolepsy: a neurological condition characterized by sudden attacks of sleep during the day and overwhelming daytime drowsiness, even though the person is getting enough sleep at night.
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What Causes Sleep Disorders and How Are They Diagnosed?

Sleep problems can be caused by a variety of physical, neurological, emotional, environmental, genetic and/or lifestyle factors.

Different sleep disorders require different evaluation methods and treatments. Suspected sleep apnea or narcolepsy should be assessed in a sleep clinic. A sleep specialist will review the patient’s symptoms and ask them to undergo a sleep study (called polysomnography). The study records data about brain wave changes, eye movements, breathing patterns, blood pressure, heart rate and rhythm, and leg movements. Typically, doctors will also make audio and video recordings of the patient sleeping to capture sounds like snoring, talking, teeth grinding, or abnormal movements.

Insomnia and biological clock issues should be assessed by a healthcare provider who will take a detailed history of the problem and monitor the patient’s sleep for about two weeks. This could involve using a sleep diary or a sleep watch that objectively records bedtime, wake-up time, and the amount of time it takes to fall asleep.

How Are Sleep Disorders Treated?

Sleep disorders like insomnia can be resolved by making specific changes to your behavior and thoughts. Treatment involves counseling and education and, in some cases, lifestyle changes, like addressing alcohol or caffeine misuse.

Some sleep disorders (like sleep apnea or narcolepsy) require medical care, such as medication, sleep-specific devices, or in some cases, surgery.

Circadian rhythm sleep disorders can be treated using light therapy, melatonin, or chronotherapy (changing sleep and wake-up times to reset the patient's biological clock.)

Who Is (and Isn’t) Qualified to Help Diagnose and Treat Sleep Disorders?

Various healthcare providers can help address sleep problems, including:

  • Sleep physicians: medical doctors who are trained in sleep medicine and are licensed to practice by a medical board.
  • Family physicians, general physicians, pediatricians, and psychiatrists: these healthcare providers may or may not have specialized sleep training. If needed, they will refer their patient to a specialist. Licensure for this practice is provided by a medical board.
  • Clinical psychologists: some (but not all) of these mental health experts have special expertise in behavioral interventions for sleep disorders. They must be fully licensed to practice independently and should have documentation of specialized training to be considered a sleep expert.

It’s important to note that certifications from institutes or organizations that aren’t part of a professional society usually aren’t regulated. Some people who offer their services for evaluation or treatment of sleep disorders, like sleep coaches or consultants, might not hold a professional license to practice as a health care provider. For more information, please visit The Society of Behavioral Sleep Medecine’s position statement on sleep coaching.

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How Can I Start Improving My Sleep Tonight?

It’s always important to practice healthy sleep habits. You can start resolving your sleep challenges and prevent sleep problems by following these tips:

  • Regulate your light exposure: in the evening, help your brain know it’s nighttime by ensuring your bedroom is quiet, dark and maintained at a comfortable temperature. Help your brain know it’s morning by exposing yourself to natural sunlight and by being active.
  • Have a consistent sleep and wake schedule: your bedtime and wake-up time should be similar every day.
  • Exercise: moderate to vigorous exercise during the day is important for good sleep. Avoid intense exercise within 3 hours of bedtime.
  • Caffeine: avoid caffeine within 6 hours of bedtime.
  • Decrease cognitive stimulation at bedtime: avoid bringing your electronic devices into the bedroom; simply having them close by will make you more likely to over-use them.
  • Decrease emotional stimulation before bed: use meditation and other relaxation techniques to disengage and calm down.

Learning to recognize the symptoms of sleep disorders is the first step to beating them. Remember to be mindful and check in with yourself to ensure everything is as it should be. If you’re concerned about yourself or a family member’s sleep, consult a primary care provider or a sleep expert so they can provide you with the support you need.

“There is a time for many words, and there is also a time for sleep.” ― Homer

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