Sleep is an important daily physiological activity which is necessary for rest of our Nervous system.A normal person should get 7-8 hours of sleep to maintain daily normal activity.
Getting less than 5.5 hours sleep is termed as insomnia and more than 9 hours of sleep is called hypersomnolemce .
In all around the many people are suffering from many sleep disorders.Various sleep disorders are:
●Insomnia
●Sleep related breathing disorders
●Narcolepsy
●Circadian rhythm disorder
●Parasomnias
●Sleep related movement disorders
Insomnia:-
It is the inability to sleep or maintain sleep,despite the patient having adequate opportunity and circumstances to sleep,when associated with impairment of daytime functioning or mood symptoms.
Patients may complain of difficulty in falling asleep(sleep onset insomnia) or difficulty remaining asleep(sleep maintenance insomnia) with frequent awakenings .
Causes:-
-Depression,anxiety
-Psychiatric or psychological disorder
-Work shift or environmental causes like noise,heat
-Medicine or substance use like steroids,caffeine,alcohol
-Painful medical conditions or respiratory diseases like asthma
-Unkwnon cause may be there
Treatment:-
-Cognitive behavioural therapy
-Meditations ,yoga
-Peaceful environment
-Drug therapy =Triazolam ,zolpidem for sleep onset insomnia
=Esatazolam ,eszpiclone for sleep maintenance insomnia
P.S.Drugs should be taken on Physicians advice.
Narcolepsy:-
It is the sudden,irresistible sleep attacks in inappropriate circumstances that patient can't resist.
Diagnosis requires sleep study with sleep latency testing.
Patients may show other symptoms like
-Cataplexy-sudden loss of muscle tone triggered by surprise,laughter ,strong emotion etc.
-Hypnogagic hallucinations-frightening perceptions
-Sleep paralysis -brief paralysis on waking
Treatment:-
Patient should get proper sleep at night to prevent sleep on day.
Drugs -Sodium oxybate,Modanafil,Selegiline,Clomipamine
Circadian Rhythm Sleep Disorders:-
It is chronic or recurring sleep disorder because of misalignment between their endogenous circadian timing and external influences.
Diagnosis based on sleep history ,actigraphy(wrist mounted device to quantify sleep)
Treatment:-
Bright light therapy -2-3 hours in morning
Chronotheraphy
For jetlag - behavioural strategies (good sleep,shifting wake sleep time )
Melatonin administration
Parasomnia:-
It is the undesirable behaviours that occur around sleep.
There may be either REM or non-REM sleep,with characteristic features and timing.
Non-REM parasomnias- due to incomplete arousal from non-REM sleep,and manifest as night terrors,sleep walking and confusional arousals.But they don't recollect any of their activity.
REM parasomnia- patients act out theirs dreams during REM sleep,due to failure of usual muscle atonia.
Treatment:-
Avoid drugs like MAO inhibitors
Removes dangerous objects from the sleep environment.
Avoid caffeine,alcohol
Take durga -Clonazepam,TCA antidepressants,melatonin,levodopa
Sleep Related Movement Disorders:-
It includes restless leg syndrome and periodic limb movement disorder.
Restless leg syndrome -It is common with prevalence of up to 10%,bt many patients never seek medical attention .It is characterised by unpleasant leg movements due to unpleasant sensation .It may disrupt sleep initiation.
Cause-Pregnancy,renal disease ,use of drugs like antihistaminics ,antidepressants .
Treatment -Dopamniergic Medications (Ropinirole,pramiprexole),Gabapentin,benzodiazepins
Periodic limb disorder -It is repetitive ,stereotyped limb movements occuring in sleep in every 20-30seconds.
Treatment similar to restless leg syndrome .
Are suffering from any of the SLEEP DISORDERS?Don't feel reluctant to contact your Doctor.
Thank you
