Sleep Disorders

Insomnia is characterized by an ongoing difficulty to fall or remain asleep despite wanting to sleep and having enough time to sleep. People with insomnia also experience daytime sleepiness and may have difficulty functioning while they are awake. Chronic insomnia is diagnosed when someone has these symptoms at least three times per week for at least three months. 

• Up to two-thirds of adults periodically experience some form of insomnia. 
• Insomnia is more likely to occur with older age, lower socioeconomic status, and anxiety or depression. 
• Therapy, sleep aids, and other approaches can reduce or resolve insomnia symptoms.

Sleep apnea is a common sleep-related breathing disorder that disrupts breathing at night. People with this condition often snore heavily and may wake up choking or gasping for air. There are two types of sleep apnea. Obstructive sleep apnea occurs when tissues in the mouth and throat relax, frequently blocking the upper airway. Central sleep apnea occurs when the brain temporarily stops sending signals to the muscles that control breathing.

• Obstructive sleep apnea affects at least 30 million Americans, but many cases go undiagnosed.
• People with sleep apnea often experience daytime sleepiness and fatigue, as well as morning headaches and dry mouth.
• Treatment options for sleep apnea include CPAP therapy, oral appliances, and, in some cases, surgery.

Narcolepsy is a sleep disorder that makes people feel excessively tired during the day despite getting an adequate amount of sleep. This can lead to an irrepressible urge to sleep, culminating in “sleep attacks” that typically last for a few minutes. These sleep attacks and other symptoms of narcolepsy are caused by disruptions in the brain’s ability to regulate the sleep-wake cycle.

• Narcolepsy affects roughly 1 in 2,000 people in the United States.
• Sleep attacks can be accompanied by cataplexy, a sudden loss of muscle tone that causes people to slump over as they nod off.
• People with narcolepsy are at a high risk for accident or injury, but treatment with medication and lifestyle changes can help.

People with restless legs syndrome (RLS) experience tingling or crawling sensations that create an irresistible urge to move their legs. The sensations and urge to move tend to get worse when sitting or lying down, making it difficult to sleep. RLS is linked with pregnancy, Parkinson’s disease, iron deficiency, and other factors, but the cause of most RLS cases is unknown. 

• Up to 15% of people have RLS, but only around 2% to 3% experience significant symptoms.
• RLS symptoms are not only triggered by rest, they may also worsen with caffeine intake and use of certain medications. 
• Healthy sleep habits, dietary changes, exercise, medical devices, and medications are effective treatment strategies for RLS.

Parasomnias are a group of unusual sleep behaviors that can occur before falling asleep, during sleep, or in the transition between sleep and wakefulness. Parasomnias are most common in children, but they affect adults as well. They include sleepwalking, bedwetting, night terrors, and more unique ones like exploding head syndrome. 

• Parasomnias occur in up to 20% of children.
• Parasomnias are categorized based on when in a person’s sleep cycle they arise. 
• Managing parasomnias typically involves maintaining the safety of the sleeper and any bed partners and promoting sufficient healthy sleep.

It is normal to feel sleepy after a night of sleep loss. But excessive daytime sleepiness (EDS) is a medical term that describes extreme grogginess occurring almost every day for at least three months. EDS makes it difficult or impossible to stay awake during the day. A wide range of medical and psychological conditions can lead to EDS, including sleep apnea, narcolepsy, hypothyroidism, chronic pain, depression, and anxiety. 

• EDS is believed to occur in up to 25% of the population.
• EDS is not a sleep disorder itself but rather a symptom of many sleep disorders and other health conditions. 
• To determine the cause of EDS, a doctor may recommend a sleep study or other tests.

Shift work disorder develops in some people whose jobs require them to work late at night or early in the morning. Sleeping during the day and working at night can cause misalignment between a person’s daily schedule and the circadian rhythms that guide their body to feel alert or sleepy in response to light or darkness. People with this condition often feel excessively tired at work and struggle to get enough sleep during their allotted daytime rest period. 

• At least one-third of shift workers meet the criteria for a shift work disorder diagnosis.
• People with shift work disorder get, on average, 90 minutes less sleep compared with people who work day shifts. 
• Treatment for shift work disorder focuses on strategies that encourage alertness while at work and quality sleep between shifts.

For most adults, the circadian rhythms that guide the sleep-wake cycle reset approximately every 24 hours. This is why many people start to get sleepy around the same time each night. In contrast, people with non-24-hour sleep wake disorder have circadian rhythms that are either shorter or longer than 24 hours. Affected individuals progressively shift their sleep and wake times one to two hours earlier or later each day. 

• Non-24-hour sleep wake disorder primarily affects people who are blind and unable to see light.
• People with this condition cycle through days or weeks of sleeping during the day and days or weeks of sleeping at night. 
• Non-24-hour sleep wake disorder is one of the six circadian sleep-wake rhythm disorders.