Causes and Treatment of Sleep Disorders

Many a person may be startled to find, as a sixty-year-old, that he has been a sleepyhead for twenty years of his life, and may get the idea that he could have accomplished much more if he had not slept so much time away. This thought would be a mistake, for without this one-third sleeping life he could not have enjoyed the two-thirds waking life. Sleep is a naturally necessary active process that protects our bodies from exhaustion.

Healthy sleep is important – sleep types

Sleep disorders affect the joy of life and increase the displeasure to irritability. The healthy person sleeps an average of eight hours a day, the chubby infant far more (up to eighteen hours) and the old man less. There are probably some sleep artists who are proud to get by on six or even four hours of sleep, although they sometimes forget to include the afternoon nap. These sleep artists, by the way, are usually found only among men, while many women are honest enough to admit that they like to sleep a lot when they have the time. It should be common knowledge that there are different types of sleepers: for example, those who go to bed early, quickly sink into the deepest sleep – “sleep before midnight is the healthiest,” says the popular saying – and slumber a bit more superficially towards morning. Or others, who only become more awake and fresh in the evening, therefore go to rest late, but now have trouble falling asleep and only reach their deepest sleep towards morning. It is certainly wrong and unfair to judge early and late sleepers morally, to regard type I as the good ones and type II as the lazy ones. In addition to antecedent conditions, social milieu, occupation, and lifestyle habits may play a decisive role. The farmer is induced and forced by his work program to go to sleep with the chickens in order to take full advantage of the light of the day for his activity. The intellectual artist of the metropolis will prefer precisely the silence of the evening, the stillness of the night for his possibly creative occupation.

Sleep disorders at a glance

Decisive for the steady recovery cure of the organism is the depth of sleep. So you could say that amount of sleep equals depth of sleep times duration of sleep, so the fast-deep sleeper is best off. Those who sleep well get more out of life. This can best be confirmed by those who suffer from sleep disorders; after all, they experience firsthand how agonizing and grueling a prolonged irregularity of restful night sleep can be. Those who have lost their sleep are sleepless. Of course, this can’t be a matter of a strolled-through night like everyone experiences once or twice in their calendars. Nor is it a question of occasionally working through the day and night, for example during exams, because such gaps in sleep are quickly filled in again, and hardly anyone will consider it necessary to make up for this deficit by visiting a doctor. However, if an average normal sleeper sleeps badly for several weeks without any reason and against his will and starts to suffer unrecovered from his pierced nights, then he should, then he must seek medical advice. Sleep disorders can be quite different: Falling asleep can be difficult; the person concerned tosses and turns restlessly in bed, the morning sun is already shimmering through the windows when he finally finds sleep; after a short time the alarm clock rings and he has to get up dead tired. Or waking up occurs much too early; after a relatively good start into the realm of dreams, one wakes up much earlier than the alarm clock commands, without being able to fall back asleep, or the sleep is superficial, interrupted several times, chopped up into quarters by every smallest noise, the cracking of furniture, the barking of a distant dog, so that this half-sleeper finds the morning almost a salvation, although he gets out of bed just as tired as he got into it. It hardly needs further words about the fact that such sleep torments can impair the joy of life, diminish the working power and increase the displeasure up to irritability. Therefore, sleep disorders can be divided into different subtypes and assessed in more detail. In the language of the medical profession these are:

1. organic sleep disorders,

2. endogenous sleep disorders,

3. psychogenic sleep disorders and

4. the peristatic sleep disorders

Now, what is to be understood by these?The first includes all sleep disorders that are an expression of an organic disease. They can occur as antecedent symptoms or as concomitant symptoms of metabolic diseases, for example diabetes, of vascular diseases, for example arteriosclerosis, of chronic intoxications such as alcohol abuse, of nervous diseases and others. In such cases, of course, it is not enough to treat the sleep disorder, which may also consist of an increased need for sleep, in isolation; it must, of course, be included in the therapy of the underlying condition.

Sleep disturbances in depression

Endogenous sleep disorders are perhaps the most difficult to understand for the nonphysician. There are mental disorders that, for lack of better knowledge, are still referred to as endogenous, that is, arising from within. In our context, endogenous depression should be mentioned here, a mood disorder that seems to come over a person without any motivation. The patient feels sadly disgruntled, makes unfounded self-reproaches, finds no more joy in anything, has fear of the future and life-denying thoughts. He loses his appetite, his weight curve drops, he is unable to work. Above all, he complains of poor sleep. One may even say that there is no endogenous depression without a sleep disorder or, seen the other way around, that the physician should think of depression in every case of persistent insomnia. Again, the underlying condition must be identified and treated, which is best done in a specialized clinic.

Mental sleep disorders

The psychogenic, i.e. purely mental, sleep disorders coincide with those that are also readily summarized as nervousness. They are undoubtedly the most frequent and are often regarded as a disease of our hasty times. Everybody has experienced that the excitement of the day can creep into the sleeping time and rob the person of a good night’s rest: Professional conflicts, existential angst, remorse, sexual dissonance fly past tired eyes. Speeches are made, letters are written, missed punch lines are found, previously unsaid arguments buzz through the brain, discussions chase through the mind, and the more one thinks about sleep, the worse one can find it. The patient begins his work in the morning, shattered and despairing, and is unable to concentrate and is reluctant to do so, already filled with anxious fears about how he will sleep the next night and whether he will sleep at all. Certainly, in such cases a sleeping pill can occasionally have a beneficial effect, but it is decisive that the person is treated in his contradiction, that he must be helped to overcome the contradiction in his environment. In addition to a constructive physical therapy, the main emphasis here is on the mental treatment of the sick (psychotherapy). Let us not misunderstand each other: Anyone who has ever been annoyed with his boss or his master, with an authority or his teacher, with his girlfriend or wife (or boyfriend or husband, respectively), will not immediately go for a sick bill; but anyone who is physically run down by a nervous sleep disorder, becomes unenjoyable and cannot enjoy anything, seek out his doctor, who will certainly help him to discover and harmonize the not infrequently hidden source of the evil.

Sleep disturbances due to external influences

A soothing spruce needle bath often brings the necessary calming, and then fall into a deep sleep in bed. Peristatic means caused by external circumstances. Peristatic sleep disorders are therefore those that can be easily explained by the environment of the bedroom. The hygiene of the bedroom is a gentle resting pillow. It should be not too dry, not too damp, not too hot and not too cold and always well ventilated. If next to the bed an old dining room clock gongs sixteen times at midnight, don’t be surprised if the tired man or woman can’t sleep. The detective story on television is not a sleeping pill, and the squealing streetcar is not a sedative. There is also an inner milieu of the sleeper: bladder and bowels should be emptied, night clothes should be light and the bedspread should not be too heavy. Some woman, for example, can not fall asleep because of cold feet, and often the advice to provide warm feet every night has eliminated her insomnia.Certainly, there are robust sleepers who can sleep on a nail board or snore in a noisy waiting room just as they do in the comfort of their own home, but there are also sensitive fellow citizens who only get used to a vacation bed when they leave again. How one beds, so one sleeps.

Treatment and therapy of sleep disorders

So there are very different sleep disorders by type and cause, and it is understandable that they require different therapeutic methods. However, we also know that a large number of people treat such restlessness states in the self-service store of medications. There is nothing at all wrong with the overtired secretary taking a few valerian drops or a soothing sleep bath in the evening, but the real sleeping pills are available only on prescription for a reason, so they must be prescribed by a doctor with strict instructions. There is no point in presenting a huge list of light over-the-counter sedatives or heavy hypnotics to our readers. Rather, we want to warn against the senseless use of such pills in excessive doses. It is all too easy to become habituated and, beyond that, addicted, so that one has cast out the devil with Beelzebub. We prefer the patient who puts his “magic tablet” on the bedside table, forgets to take it because it is good to fall asleep, and in this way gets along with one tablet for four weeks. Also, one should not forget the harmless, but nevertheless quite effective application of hydrotherapeutic measures: Calf compresses, alternating baths, moist packs, spruce needle baths often create a soothing calming effect. And if a bad sleeper doesn’t know anything better, read this essay, which could be soporific for this or that person. Good night!