Sleep Disorders
Getting the right amount of sleep is fundamental to mental health. Whether you’re sleeping too much or too little, our providers can help.
Is Treatment Available In My State?What Are Sleep Disorders?
Sleep disorders are conditions that impair a person’s quality and timing of sleep. As a result of poor sleep, people with these disorders experience distress and impaired functioning when they are awake. Sleep is essential for overall well-being, serving as a vital component in maintaining cognitive function, emotional stability, and overall mental health. When sleep is disrupted or inadequate due to a sleep disorder, it can have profound effects on an individual’s mental and emotional state. While everyone can have a restless night sometimes, sleep disorders signify a pattern of sleep issues that require intervention.
Insufficient or poor-quality sleep can contribute to the development and exacerbation of mental health disorders. Chronic sleep deprivation has been linked to an increased risk of conditions such as Anxiety, Depression, and Mood Disorders. The interplay between sleep and mental health is bidirectional. Mental health issues can contribute to sleep disturbances, i.e. someone with an Anxiety disorder may have trouble falling asleep, at the same time, sleep problems can also worsen existing mental health conditions.
Sleep disorders may not be classified as mental health disorders per se, but they are closely intertwined. Disruptions in sleep patterns can lead to cognitive impairments, difficulty concentrating, irritability, and emotional instability. Moreover, the chronic nature of some sleep disorders can contribute to a vicious cycle, further compromising mental well-being.
Recognizing the importance of addressing sleep in the context of mental health is crucial for comprehensive healthcare. Treating sleep disorders can be a vital aspect of managing and improving mental health outcomes, emphasizing the need for a holistic approach to well-being that encompasses both sleep and mental health considerations.
Sleep disorders are exceedingly common. Some experts estimate that as many as 70 million adults in the United States live with a sleep disorder. The most common sleeping disorder is insomnia.
Types of Sleep Disorders
The International Classification of Sleep Disorders (ICSD) categorized sleep disorders based on the symptoms, how it affects a person (pathophysiology) and the body system it affects. The brand-new revision to the third edition, ICSD-3R includes the following categories:
- Insomnia: Experiencing challenges in both falling and remaining asleep.
- Sleep-related breathing disorders: Observable alterations in breathing patterns occur during sleep.
- Central disorders of hypersomnolence: Difficulty in maintaining alertness during daytime hours.
- Circadian rhythm sleep-wake disorders: Internal clock disruptions make it challenging to adhere to regular sleep and wake schedules.
- Parasomnias: Sleep-related activities, such as walking, talking, or eating, manifest through physical actions or verbal expressions.
- Sleep-related movement disorders: The presence of physical movements or an urge to move complicates the process of falling asleep and/or staying asleep.
The most common types of sleeping disorders that can be treated by mental health care professionals are:
- Insomnia
- Hypersomnia
- Restless Leg Syndrome
- Narcolepsy
- Sleep Terror
Insomnia Symptoms and Causes
Insomnia, the difficulty falling or staying asleep, can be caused by various factors. Stress and anxiety are common culprits, as racing thoughts hinder relaxation. Underlying mental health issues, like Depression and Anxiety, may disrupt sleep patterns. Poor sleep hygiene, irregular schedules, or excessive screen time before bed can also negatively impact sleep. Medical conditions such as chronic pain, respiratory problems, or hormonal imbalances may also induce insomnia. Certain medications and substances, like caffeine or nicotine, can interfere with sleep. Identifying and addressing the specific cause is crucial for effective management, as insomnia can significantly impact overall well-being and daily functioning.
Insomnia manifests through various symptoms, delineating occasional and chronic patterns. Individuals with occasional insomnia may experience transient difficulty initiating sleep, sporadic nocturnal awakenings, or brief episodes of early morning awakenings. In contrast, chronic insomnia symptoms are characterized by persistent and enduring challenges, occurring for at least three nights a week over three months. Chronic sufferers often grapple with prolonged difficulty staying asleep, leading to a consistent reduction in sleep quantity and quality. Both occasional and chronic insomnia share common manifestations, including heightened irritability, daytime fatigue, impaired concentration, and memory lapses. However, the distinction lies in the regularity and duration of these symptoms, highlighting the disruptive and enduring nature of chronic insomnia on sleep patterns and overall daily functioning. Recognizing these differences is pivotal for tailoring effective interventions to address the specific challenges posed by each category of insomnia.
Hypersomnia Symptoms and Causes
Hypersomnia, a sleep disorder characterized by excessive daytime sleepiness, is marked by a range of symptoms affecting an individual’s wakefulness. People with hypersomnia often struggle to stay awake during the day, regardless of sufficient nighttime sleep.
Hypersomnia may result from various causes. Primary hypersomnia, like narcolepsy, often has a genetic component. Secondary hypersomnia may stem from conditions such as sleep apnea, where interrupted sleep patterns lead to daytime fatigue. Hormonal imbalances, neurological disorders, or head injuries can contribute. Certain medications, substance abuse, or psychiatric conditions like depression may also induce hypersomnia. Key symptoms include prolonged and unrefreshing naps, difficulty concentrating, and a pervasive sense of drowsiness. Unlike occasional tiredness, hypersomnia involves an ongoing pattern of excessive sleepiness, leading to disruptions in daily activities and responsibilities. Individuals may find it challenging to maintain alertness, impacting cognitive function and overall productivity. Additionally, hypersomnia may lead to extended sleep durations at night, yet individuals wake up feeling persistently fatigued.
Lifestance Health specializes in Sleep Disorders treatment with multiple locations in 33 states. Services and available treatments vary by location.
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Restless Leg Syndrome Symptoms and Causes
Restless Legs Syndrome (RLS) is a neurological disorder characterized by an irresistible urge to move the legs, often accompanied by uncomfortable sensations.
It is a neurological disorder with elusive origins, likely influenced by genetic, environmental, and physiological factors. A strong genetic link exists, with specific gene variants associated with RLS. Dysregulation of dopamine, vital for muscle movement, plays a role, and iron deficiency may disrupt dopamine function. Pregnancy-related hormonal changes and conditions like peripheral neuropathy or kidney disease can contribute. Medications, age, and gender also impact RLS. Diagnosis relies on symptom presentation, and management involves lifestyle adjustments, medications affecting dopamine, iron supplementation, and addressing underlying conditions. Ongoing research explores novel treatments, emphasizing the intricate relationship between genetics and environmental triggers in RLS development.
Individuals with RLS typically experience these sensations during periods of inactivity, such as when sitting or lying down, and the symptoms are more pronounced in the evening or at night. The sensations are often described as tingling, crawling, or itching, compelling the person to move their legs for relief. This disruptive condition can lead to difficulty falling asleep and staying asleep, resulting in daytime fatigue and impaired quality of life. Managing RLS involves lifestyle adjustments, addressing underlying medical issues, and sleep disorder treatment with therapy and medications.
Narcolepsy Causes and Symptoms
Narcolepsy is a chronic neurological disorder characterized by excessive daytime sleepiness and a tendency to fall asleep suddenly and unexpectedly.
The exact cause of narcolepsy is not fully understood, but it is believed to involve a combination of genetic and environmental factors. Narcolepsy is associated with a deficiency in hypocretin, a neurotransmitter that regulates wakefulness and REM sleep. This deficiency is often linked to an autoimmune response, where the body’s immune system mistakenly attacks the cells producing hypocretin. Viral infections, hormonal changes, and certain genetic factors may contribute to the development of narcolepsy.
Individuals with narcolepsy often experience sudden and overwhelming bouts of sleep during the day, regardless of the quality and duration of nighttime sleep. Cataplexy, a sudden loss of muscle tone triggered by emotions like laughter or surprise, is a distinctive symptom of narcolepsy. Sleep paralysis, where a person temporarily cannot move or speak while falling asleep or waking up, and vivid hallucinations may also occur. Fragmented nighttime sleep, frequent awakenings, and difficulty maintaining a consistent sleep schedule contribute to the overall disruption in sleep patterns. Narcolepsy significantly impacts daily functioning, leading to challenges in maintaining alertness and engaging in routine activities. Proper diagnosis and treatment, often involving medications, therapy and lifestyle adjustments, are crucial for improving the quality of life for individuals with narcolepsy.
Sleep Terror (Night Terror) Symptoms and Causes
Sleep terror, also known as night terror, is a sleep disorder characterized by sudden episodes of intense fear, screaming, and flailing while still in a state of partial arousal from deep sleep. Unlike nightmares, which usually occur during the REM (rapid eye movement) stage of sleep and are often recalled, sleep terrors typically occur during non-REM sleep and are usually not remembered by the individual.
Sleep terrors are more common in children, and the episodes can be quite alarming for both the person experiencing them and any witnesses. The episodes generally last for a few minutes and may involve behaviors such as sitting up in bed, thrashing, or running around the room. The person may appear confused and disoriented during the episode.
Sleep terrors are considered a sleep disorder rather than a mental disorder. They are thought to result from an over-arousal of the central nervous system during sleep. While sleep terrors can be distressing, they are generally not associated with underlying psychological problems. However, in some cases, they may be linked to factors such as stress, sleep deprivation, or other sleep disorders.
Most children outgrow sleep terrors, and treatment is typically not necessary. In adults, if sleep terrors are causing significant distress or disruption, a healthcare or a mental health care professional may explore strategies to improve sleep hygiene or, in some cases, consider sleep disorder treatments including medication.
Dr. Ujjwal Ramtekkar is a double board-certified pediatric and adult psychiatrist. He is also an accomplished physician executive and established thought leader in care model innovation, with extensive experience leading diverse clinical teams and integrating a continuum of care to drive clinical outcomes in academic, community practice and managed care settings.
Sleep Disorders FAQ
Yes, there is a notable genetic component in sleep disorders. Many sleep-related conditions, including insomnia, sleep apnea, and narcolepsy, exhibit familial patterns. Specific gene variants have been identified in research, indicating a hereditary influence. However, genetic predisposition doesn’t guarantee the development of a sleep disorder; environmental factors and lifestyle also play significant roles. Understanding the genetic basis helps identify at-risk individuals and supports research for targeted interventions. If a family history suggests a propensity for sleep disorders, individuals may benefit from proactive sleep hygiene practices and regular health assessments for early detection and management.
Yes, therapy can be highly beneficial in addressing various sleep disorders. Cognitive Behavioral Therapy for Insomnia (CBT-I) is particularly effective in treating insomnia by addressing negative thought patterns and behaviors related to sleep. Therapy can also help manage stress, anxiety, and underlying emotional factors contributing to sleep disturbances. For conditions like narcolepsy or hypersomnia, therapy can be part of a holistic approach, complementing other treatments. Mental health professionals, such as those at LifeStance, can provide tailored therapeutic interventions to improve sleep quality and address the psychological aspects contributing to sleep disorders.
Yes, sleepwalking is considered a sleep disorder known as somnambulism. It falls under the category of parasomnias, abnormal behaviors that occur during sleep. Sleepwalkers typically engage in activities like walking, talking, or even eating while in a state of partial arousal from deep sleep. Sleepwalking episodes are more common in children, often diminishing with age. The exact cause is multifactorial, involving genetics, sleep deprivation, and certain medications. While many cases are benign, severe or persistent sleepwalking may require medical evaluation and intervention to ensure safety and address underlying factors contributing to this sleep disorder.
Sleep paralysis is a sleep phenomenon where a person temporarily experiences an inability to move or speak while falling asleep or waking up. This occurs due to a temporary disconnect between the brain and body during transitions between sleep stages. During an episode, individuals may feel conscious but are unable to control their voluntary muscles, often accompanied by hallucinations and a sense of pressure on the chest. While usually brief and harmless, sleep paralysis can be distressing. It’s commonly linked to sleep disorders like narcolepsy, irregular sleep patterns, and high-stress levels. Improving sleep hygiene and addressing underlying issues can mitigate sleep paralysis occurrences.
The optimal amount of sleep varies depending on age, individual needs, and overall health. The American Academy of Sleep Medicine and the Sleep Research Society recommends the following sleep durations:
- Newborns (0-3 months): 14-17 hours per day
- Infants (4-11 months): 12-15 hours per day
- Toddlers (1-2 years): 11-14 hours per day
- Preschoolers (3-5 years): 10-13 hours per day
- School-age children (6-12 years): 9-12 hours per day
- Teenagers (13-18 years): 8-10 hours per day
- Adults (18-64 years): 7-9 hours per day
- Older adults (65 years and older): 7-8 hours per day
It’s important to note that individual variations exist, and some people may feel well-rested with slightly more or less sleep than the recommended ranges. Consistency in sleep patterns and addressing individual needs is key for optimal well-being.
Circadian rhythm sleep disorders (CRSDs) involve a misalignment between an individual’s natural circadian rhythm and their desired sleep-wake schedule. Types include Delayed Sleep Phase Syndrome (DSPS), Advanced Sleep Phase Syndrome (ASPS), Irregular Sleep-Wake Rhythm, Non-24-Hour Sleep-Wake Disorder, and Shift Work Sleep Disorder. These conditions disrupt sleep patterns, impacting daily functioning and well-being. Treatment may include behavioral interventions, light therapy, and medications to regulate the sleep-wake cycle.
Delayed Sleep Phase Disorder (DSPD) is a circadian rhythm sleep disorder characterized by a persistent inability to fall asleep until late at night, making it challenging to wake up early. Individuals with DSPD often have a delayed sleep-wake pattern, leading to difficulties aligning with societal schedules. Despite having a regular sleep pattern once asleep, DSPD can cause significant disruption to daily life, affecting academic, occupational, and social responsibilities. Treatment approaches may include adjusting sleep hygiene, light therapy, and, in some cases, melatonin supplementation to help shift the circadian rhythm to a more typical sleep schedule.
While related, sleep disturbance and sleep disorder have distinctions. Sleep disturbances refer to disruptions in the normal sleep pattern, such as occasional difficulty sleeping due to stress or environmental factors. They are often temporary and may not qualify as a clinically recognized condition. In contrast, a sleep disorder involves persistent, often chronic, disruptions in sleep patterns, impacting overall health and daily functioning. Disorders like insomnia, sleep apnea, or narcolepsy are formally diagnosed conditions requiring medical attention. Sleep disturbance is a broader term encompassing temporary disruptions, while sleep disorders involve more prolonged and severe deviations from healthy sleep patterns.
REM Sleep Behavior Disorder (RBD) is a sleep disorder where the normal paralysis that accompanies REM (Rapid Eye Movement) sleep is absent, allowing individuals to physically act out their dreams. Instead of the typical muscle atonia during REM sleep, people with RBD may engage in complex and sometimes violent movements. This disorder is associated with vivid, often action-packed dreams and can lead to injuries for the affected individual or their sleep partner. RBD is often linked to neurodegenerative conditions like Parkinson’s disease. Diagnosis involves sleep studies, and treatment may include medications and safety measures to prevent injuries during sleep episodes.
If you suspect a sleep disorder, seek a thorough health evaluation to identify the specific condition. For sleep disorders related to neurological conditions like insomnia, RLS, hypersomnia, or narcolepsy, contact LifeStance mental health professionals. Their expertise spans therapy, holistic approaches, and medications, offering a comprehensive strategy for managing these sleep-related issues.