More than 50 million Americans have a sleep disorder. Regularly having trouble sleeping can adversely impact your physical and mental health, leading to daytime sleepiness and disrupting your ability to function. There are more than 80 types of sleep disorders, including insomnia, obstructive sleep apnea (OSA), and restless leg syndrome.
1. Insomnia
Insomnia is when you cannot fall asleep or stay asleep. It is the most common sleep disorder.
Symptoms of insomnia include:
- Feeling tired during the day
- Trouble falling asleep at night
- Waking during the night and not being able to go back to sleep
Insomnia can have many causes, including:
- Anxiety/depression
- Breathing disorders
- Hormonal changes
- Neurological diseases like Alzheimer's disease or Parkinson's disease
- Stress
It's also possible to have insomnia alongside other sleep disorders, such as OSA.
Treatments for insomnia include:
- Lifestyle changes, like improving your diet, exercise, and sleep habits, can help you sleep better.
- Cognitive behavioral therapy (CBT) to help you address anxiety linked to insomnia.
- Prescription and nonprescription (over-the-counter or OTC) drugs that treat sleep disorders
2. Sleep Apnea
There are two types of sleep apnea: obstructive sleep apnea and central sleep apnea (CSA). OSA is more common than CSA and happens when you try to breathe but air doesn't move into or out of your nose or mouth. With central sleep apnea, the brain doesn't send the correct signals to the muscles that help you breathe.
With sleep apnea, your breathing could stop 30 or more times in one hour. Other symptoms include:
- Daytime sleepiness
- Frequent waking while sleeping
- Loud snoring or choking sounds when you sleep (although not everyone who snores has sleep apnea)
Causes of sleep apnea include:
- A misaligned jaw
- Having a large or wide neck
- Having a large tongue, tonsils, or adenoids which can block your airway
- Having obesity
Getting tested and treated for sleep apnea is vital as its effects can be serious or occasionally fatal. Two treatments for sleep apnea are:
- A mouthpiece designed to push the tongue and lower jaw forward to keep the airway clear
- Continuous positive airway pressure machine (CPAP) sends a constant pressure to the airways to help maintain respiration during sleep
3. Restless Legs Syndrome
Restless legs syndrome (RLS) is a neurological condition in which you have a strong urge to move your legs when lying down. This urge can make it hard to get restful sleep.
Symptoms of RLS include the following sensations in the legs:
- A creepy-crawly feeling
- Burning or achiness
- Tingling
- Twitching
Common causes of RLS include:
- Anemia (an iron deficiency)
- A genetic tendency toward RLS
- Kidney failure
- Pregnancy
Alcohol, caffeine, tobacco, and certain types of medications (like antidepressants and cold medicines with antihistamines) can make symptoms worse.
Treating RLS may require trial and error to find what works best. Sometimes, lifestyle changes can help, such as reducing alcohol or caffeine or implementing stress relief techniques. Certain medications, including anti-seizure drugs (antiepileptics), certain benzodiazepines, and iron supplements (if you have low iron), can aid with RLS.
4. Periodic Limb Movement Disorder
Periodic limb movement disorder (PLMD)—or periodic limb movements of sleep (PLMS)—is when you have repetitive limb movements, usually in the legs or arms, during non-rapid eye movement (non-REM) sleep. Researchers believe that PLMD is linked to restless legs syndrome.
Symptoms of PLMD include:
- Uncontrolled, repetitive movements of your limbs while sleeping
- Insomnia
- Feeling sleepy during the day
Causes of periodic limb movements of sleep include:
- Genetics
- Kidney disorders
- Nerve disorders
Treatment for PLMD includes:
- Magnesium supplements
- Medications, such as a group of drugs called alpha delta ligands (e.g., gabapentin)
- Regular physical activity
5. Narcolepsy
Narcolepsy is a neurological condition in which the brain is not able to control sleep-wake cycles normally. People with narcolepsy experience extreme sleepiness and an urge to sleep throughout the day. If the urge becomes overwhelming, they will fall asleep for periods lasting from a few seconds to several minutes. In some cases, they may remain asleep for an hour or longer.
Narcolepsy symptoms can include:
- A sudden loss of muscle control (also called cataplexy)
- Feeling very sleepy during the day
- Nighttime sleep that's frequently interrupted
- Sleep paralysis, or not being able to move for a minute or so upon waking
It's not always clear what causes narcolepsy. Researchers believe it may result from the following:
- Low hypocretin levels (a chemical the brain makes to help us stay awake)
- Genetics
- An autoimmune reaction that causes the body to harm healthy tissue
Although there's no cure for narcolepsy, specific treatments can help manage it better or reduce symptoms. These include:
- Lifestyle changes such as a healthy diet and regular physical activity
- Medications for daytime sleepiness (e.g., central nervous system stimulants)
- Structured daytime naps
6. Circadian Rhythm Disorders
A circadian rhythm disorder happens when your body's internal clock doesn't match your environment. Your internal clock (also called the circadian clock) follows a 24-hour cycle and causes you to wake up or feel sleepy around the same time each day. Sunlight, food, and physical activity can all affect your internal clock.
Symptoms of a circadian rhythm disorder include:
- Falling asleep late and having trouble getting up in the morning
- Poor quality sleep
- Trouble sleeping
Some causes of a circadian rhythm disorder include:
- Aging
- Medical conditions like Alzheimer's disease and Parkinson's disease
- Travel, including when changing time zones
Treatment for a circadian rhythm disorder includes bright light therapy or chronotherapy, which can include adjusting your bedtime each night until you sleep at a more desired time.
7. Parasomnia
During parasomnia, you perform behaviors associated with being awake. However, you are actually in a state between sleep and wakefulness.
Disorders associated with parasomnia include:
- Confusional arousal, including states of mental confusion or confused behavior, when partially aroused from sleep
- Sleepwalking (somnambulism), which includes times of partial arousal highlighted by walking with limited consciousness
- Sleep terrors (also called night terrors), which are sudden partial arousals of intense fright or terror
Parasomnia is more common in children than adults. Other causes of parasomnia include:
- A family history of parasomnia
- Neurological diseases such as Parkinson's disease
- Psychiatric disorders like anxiety, depression, and post-traumatic stress disorder (PTSD)
A healthcare provider will screen you for other sleep disorders before treating parasomnia. Other treatment considerations include:
- Avoiding alcohol
- Certain medications
- Getting enough sleep
If you live with or care for someone with parasomnia, you may have to modify their environment to keep them safe if they are sleepwalking or engaging in other behaviors while sleeping.
8. Sleep Paralysis
Sleep paralysis is the uncomfortable feeling that you can't move your body while sleeping. It can occur while you're falling asleep or waking up. You can still breathe, but the rest of your body can't move. This sensation can last for a few seconds or a few minutes.
It's normal to experience sleep paralysis during REM sleep, when you're more likely to have dreams. However, it is more concerning to experience sleep paralysis outside of REM sleep.
Although anyone can experience sleep paralysis, it's more commonly associated with stress, drinking too much alcohol, and sleep deprivation.
Sleep paralysis may not need specific treatment. However, if it happens repeatedly and interrupts your sleep, see a healthcare provider.
How Sleep Disorders Are Diagnosed
A healthcare provider will use the following to help diagnose a sleep disorder:
- A physical exam
- A sleep history to find out other sleep issues you've had in the past
- A sleep study (polysomnogram), which tracks and records information about your sleep overnight
- Other types of sleep studies that measure daytime naps and your ability to stay alert
Lifestyle Tips to Improve Sleep Hygiene
There are a few strategies you can use to help improve your sleep hygiene:
- Avoid large meals before bedtime.
- Eat a generally healthy diet.
- Get regular physical activity.
- Keep your bedroom dark and cool.
- Know your caffeine limits so this stimulant doesn't keep you up at night.
- Try to go to bed and wake up at the same time every day.
- Turn off your screens a half hour before bedtime to give your brain a chance to relax.
See a healthcare provider if you regularly have trouble sleeping.
Summary
Sleep disorders are common, affecting more than 50 million Americans. There are more than 80 types of sleep disorders, resulting in disrupted sleep and daytime sleepiness. The causes of a sleep disorder can vary but include certain medical conditions, stress, and aging. A sleep study is a common way a healthcare provider will help diagnose a sleep disorder.