Symptoms
Sleep disorder refers to an undesirable change in the usual sleep rhythm. This manifests itself in difficulty falling asleep or staying asleep, insomnia, a change in sleep profile, sleep length, or inadequate rest. Sufferers are unable to fall asleep for long periods in the evening, wake up at night or early in the morning, and find it difficult or impossible to return to sleep. Sleep disorders can lead to insufficient recovery the following day, fatigue, sleepiness, lack of energy, concentration problems, irritability, a depressive mood and a reduced quality of life, among other symptoms. Too little sleep can also promote the development of diseases such as depression, coronary heart disease, and medication overuse and alcohol abuse. Conversely, depression can also cause sleep disturbance.
Causes
Sleep disorders can be acute (less than 4 weeks) or chronic. The following is a selection of possible causes and risk factors. Individual and physiologic factors:
- Sleep disturbances are more common with age and in women, especially after menopause, because of flushing, or in late pregnancy. Genetics may also play a role.
- Heavy food in the evening, causing stomach burning (reflux).
- Disturbance of the circadian rhythm, for example, due to shift work or a jet lag, change in sleep rhythm.
- Poor sleep habits
Environmental factors:
- Sensory overload, light (including from screens, smartphones), noise, sounds, heat, cold, low humidity.
- Snoring partner, family members or bed neighbors.
- Uncomfortable bed, mattress too soft or too hard
Psyche:
- Stress
- Emotions such as anger, excitement, agitation, sadness, circling of thoughts, states of tension, anxiety of expectation.
- Mental illnesses such as anxiety disorders or depression, post-traumatic stress disorder.
Diseases:
- Pain, infectious diseases, fever, irritable bladder, prostate enlargement, cardiac arrhythmias, itching, allergies, lung diseases.
- Sleep apnea, with respiratory failure.
- Narcolepsy
- Restless Legs Syndrome
- Parasomnia, e.g. intense dreams, sleepwalking.
Stimulants:
- Caffeinated beverages such as coffee, energy drinks, cola, black tea.
- Alcohol, nicotine
Drugs and intoxicants:
- Selection: Amphetamines, cocaine, glucocorticoids, stimulants, sympathomimetics, antiasthmatics.
Diagnosis
When making a diagnosis, it must be clarified whether objectively there is actually a sleep disorder. Often the complaints are overestimated and the actual sleep duration underestimated. Short-lasting and unproblematic sleep disorders can be self-treated for about two weeks. In case of longer duration, medical help should be sought. Diagnosis is made on the basis of the patient’s history, with a sleep diary, with a physical examination, and in the case of suspected diseases also with laboratory methods as well as in the sleep laboratory.
Drug treatment
Various sleep medications (hypnotics) are available for symptomatic drug treatment of sleep disorders. The detailed information on the subject can be found under this article. Strongly effective sleep aids such as the benzodiazepines and Z-drugs should be administered only for a short time, if possible, for a maximum of four weeks. In contrast, herbal medications such as valerian, dietary supplements such as tryptophan, and sedative antidepressants such as trazodone and mirtazapine can be taken for longer periods.
