Sleep Disorders - The Types, Symptoms, Diagnosis & Treatments
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16 million adults in the UK deal with some kind of sleep issue.
Some sleep disorders come with serious risks, and a painfully high prevalence in the UK.
What Are Sleep Disorders and How Do They Develop?
Sleep disorders are any complication that impacts the quality or length of your sleep. You can have a sleep disorder from birth, but you can develop them later in life too.
There are many causes, including stress, neurological factors, illness, weight gain and more—we’ll break this down by disorder later on.
However, regardless of cause, 16 million adults in the UK deal with some kind of sleep issue according to a 2017 survey.
Around two-thirds of those feel their sleep is frequently disrupted, while almost a quarter struggle to get the recommended amount of sleep every night. The quarter often struggles by on less than five hours per night.
Given the prevalence, you need to be aware of each disorder so you can take the steps to recognize and combat it if it arises. In serious cases, it may save your life to catch and treat the disorder early.
Insomnia
Insomnia is probably the most well-known and widely-suffered sleep disorder there is. It’s where you’re not getting enough sleep on a regular basis—so, not just one bad night, but several days or weeks of it.
The disorder can be short-term and last days or months at a time, and it may happen once or never again. Other times it’s more long-term, defined as chronic once you’ve had six months straight of insomnia.
According to the study above, 31 percent of sleep issues in the UK are down to insomnia. Worldwide the issue might go as high as 60 percent of the population—different studies have varying results.
Causes
Often, insomnia accompanies a more serious health issue. This is usually when insomnia is chronic—the issue goes undiagnosed or untreated, so insomnia persists. There are some other cases to be aware of too, though.
According to experts at the Mayo Clinic, underlying conditions that may cause insomnia include:
- Cancer
- GERD
- Parkinson’s
- Alzheimer’s
- Chronic pain
- Heart disease
- Diabetes
- Overactive thyroid
- Sleep apnea
Mental Health Issues
Anxiety makes it harder to sleep, as do several other mental health disorders. Even some mild stress can make sleep harder to come by.
Stress and anxiety can easily cause short-term insomnia and may be the cause of yours if you notice it crops up around stressful times in your life.
If you have frequent bouts of insomnia, consider keeping a diary. That way you can look back and figure out if stress really is the cause.
A Bad Mattress
Sometimes the cause is as simple as a bad mattress. When your mattress is uncomfortable it creates restless sleeping and sometimes waking.
If you worry this is causing your insomnia, sleep elsewhere for a few nights. If you sleep better then your mattress is likely causing your insomnia and you should replace it.
Other unfavourable environmental causes include:
- Being too warm—Consider a fan or breathable bedding
- Noise—Consider earplugs
- Too much light in the room—Close all doors and windows and consider blackout curtains
- Bad pillow—Switch out your pillow before changing your mattress, in case that is the cause.
Harmful Habits
Drinking alcohol or coffee, eating too much or being around too many screens before bed can all negatively impact your sleep. That, and having an unhealthy sleep schedule and bedtime routine. If none of the above are causing your insomnia, this might be the culprit.
- Alcohol decreases REM sleep leading to unrefreshing sleep
- Caffeine keeps your mind too active
- Eating too much is uncomfortable when you lie down
- The blue light from screens keeps you awake
- An odd sleep/wake cycle may negatively impact your circadian rhythm.
Symptoms
- Difficulty getting to sleep
- Frequent waking at night
- Waking up and being unable to resume sleep during the night
- Feel unrested upon waking in the morning
- Experience irritability and fatigue while awaking
- Can’t nap even when exhausted
- Mood swings
Risks
Short-term insomnia doesn’t have terrible risks to start, more so inconvenient ones. They include:
- Decreased concentration;
- Subpar performance in school or work;
- Mental health issues.
However, you also have an increased risk of accidents while driving—almost the same as someone who drives while drunk.
Risks that accompany chronic insomnia are far worse as they include:
- Obesity;
- Diabetes;
- Heart attack;
- Hypertension;
- Stroke;
- Depression;
Any long-term loss of sleep can cause these effects.
Treatment Options
Lifestyle Change
Making small improvements to your life can improve insomnia caused by environmental factors.
- Have a set bedtime and wake time;
- Avoid screens, alcohol, excessive food and caffeine before bed;
- Try to tire yourself out during the day, for example with exercise;
- Ensure you have comfortable bedding;
- Avoid napping so you’re more tired at night.
Medication
If it’s stress or mental health issue, treat that as a separate problem and work on it as needed. To get through insomnia while working on the underlying issue, you can turn to over-the-counter sleeping pills or melatonin supplements. A GP or capable pharmacist may be able to recommend an applicable substance for your situation.
GP Help
If it’s not a lifestyle or mental health issue, consult your GP. Your GP may prescribe stronger medications, send you to a sleep clinic or recommend cognitive behavioural therapy depending on what they think the cause is.
You may also require further testing to diagnose the root of your insomnia. Keeping the more serious underlying conditions that can cause insomnia in mind, this isn’t something you want to shy away from.
Hypersomnia
On the other side of the scale, people with hypersomnia sleep more than average but struggle to wake up. The number of people with hypersomnia is growing, with between 15 and 30 percent of the US population suffering from it.
Only one study took place including people from the UK, but the prevalence was much lower at 0.3 percent. You should note that the sample size was also much lower here.
However, narcolepsy which is a form of hypersomnia impacts one person in 2,500 according to narcolepsy.org.uk. This is far more common and depending on the type of narcolepsy you have, can be more deadly.
Causes
Right now, experts are unsure about idiopathic’s hypersomnia’s cause but can theorize that it’s neurological. All we know is about narcolepsy, which is one type of hypersomnia—both types of narcolepsy are neurological disorders.
Based on this, it makes sense that idiopathic hypersomnia would be one too. Unfortunately, the medical world’s lack of understanding the idiopathic version leads to a difficult time treating it, and the symptoms aren’t always too serious either.
Symptoms
Idiopathic Hypersomnia
Idiopathic Hypersomnia- Struggling to wake up;
- Feeling unrefreshed upon waking;
- Drowsy for long periods after waking;
- Excessive napping;
- Sleeping for 12–14 hours at night.
Narcolepsy Symptoms
There are two types of narcolepsy—some of these symptoms impact people with either type, some with only one.
- Daytime tiredness;
- Rapidly losing muscle tone;
- Disturbed REM sleep;
- Hallucinations;
- Sleep paralysis;
- Suddenly falling asleep in the daytime (sometimes called sleep attacks).
Risks
The main risk with any form of hypersomnia is falling asleep during the day. This is particularly prevalent in those with narcolepsy who have sleep attacks—it makes operating heavy machinery and driving incredibly risky, but it’s even risky to cross a road as the attacks can occur at any time.
It’s a good idea to walk with a friend if you have narcolepsy, and try to avoid driving if you can. This isn’t just for your safety, but the safety of those around you.
Some countries, particularly some states in the US, prohibit narcolepsy patients from driving. In the UK you can drive but only after the Driver and Vehicle Licensing Agency is satisfied that it’s safe for you to do so. This usually requires you to be medicated for your symptoms. It’s never a certainty that they’ll allow you a license even with treatment.
Treatment Options
There’s no cure for any of the forms of hypersomnia. Many people suffering from idiopathic hypersomnia use stimulates, such as caffeine, to remain awake as a substitute.
Caffeine pills with higher doses of caffeine may be more effective but there are no studies on this to date.
Doctors are more adventurous with narcolepsy instead, giving sufferers SSRIs and Ritalin that can, but won’t always, ease symptoms.
The likelihood of receiving this treatment depends on your location though—there are certain medications in use in other countries that the UK refuses to prescribe due to cost.
If you’re lucky enough to see a narcolepsy specialist there are many medications that can help with sleepiness in the daytime.
Anecdotally, narcolepsy patients struggle to be prescribed any of them and are rallying for change and improvements in treating the disorder.
Circadian Rhythm Issues
Circadian rhythm issues usually cause a sleep-wake disorder. The disorder usually has you feeling tired and waking up at the “incorrect” times compared to the rest of society.
For instance, the regular rhythm usually follows the sun’s rising and setting schedule but those with these sleep-wake disorders have a different experience.
This doesn’t sound so bad depending on the disturbance—it’s simple enough to go to bed in the early evening and wake up in the early morning, though it will put a damper on your social life.
However, the disorder could cause any new sleep rhythm so it’s not always that convenient.
Your quality of life with this disorder can also be subpar, as your circadian rhythm also impacts your appetite, hormone levels and your temperature at any time.
Symptoms of these disruptions vary case to case, but it’s often stressful for the person.
People describe the disorder as having constant jet lag, which is never a fun experience.
Causes
Although anyone can be born with or develop a circadian rhythm sleep-wake disorder, it usually impacts someone with inadequate exposure to sunlight.
This could be nightshift workers, those who can’t process light properly, or blind people. Frequent travellers who have almost constant jetlag may also suffer.
If you’re in these situations, you don’t have adequate access to natural sunlight and darkness, so your circadian rhythm has no influence resulting in it being out of balance.
Symptoms
- Difficulty concentrating in the daytime
- Lack of energy at inconvenient times
- Difficulty falling or staying asleep
- Fatigue
- Cognitive difficulties caused by inadequate sleep
Many people with the disorder have all the typical symptoms of inadequate sleep which you can see listed for insomnia towards the top of the article.
Risks
The risks with this disorder aren’t terrible—basically the same as those for lacking adequate sleep. However, this makes driving a risk.
The longer the condition goes on, the worse your symptoms become and you may be at risk of diseases associated with long-term subpar sleep. These are listed above in the insomnia section, but include atrocities such as heart attack and stroke.
You’re also at risk of damaged relationships and difficult social life as you won’t be energized at the same times as your friends.
If your appetite is badly impacted, too, you could either have excessive weight gain or malnutrition depending on which way it goes.
Treatment Options
Treatment for this disorder is relatively straightforward—it’s about resetting your circadian rhythm to match everyone else’s.
During the day you’ll have to sit by a lightbox that mimics strong sunlight, to help your cycle reset.
When it’s time to sleep, patients with the disorder are often prescribed melatonin supplements. Melatonin is the hormone released when it’s time to sleep.
Parasomnia
There are several types of parasomnia, which may or may not be long-term symptoms. Healthcare experts say parasomnia can impact one in three people in the UK.
The parasomnias are often called “odd behaviour at night” disorders which is quite an accurate description when you consider what the parasomnias are.
Here are the most common ones:
- Sleepwalking: Walking around during NREM sleep, mainly in the early hours of the night
- Night terrors: Horrific dreams that are rarely remembered, usually occurring as you transition from NREM to REM
- REM behaviour disorder: Violent moving or yelling during REM sleep, some people report hallucinations during this
- Sleep paralysis: You’re fully awake but trapped in your own body, unable to move
- Exploding head syndrome: As you begin to fall asleep or wake up, a loud noise forces you to wake suddenly
- Bedwetting: Urination during sleep, mainly occurring in childhood and not caused by a physical condition or another external factor
- Sleep talking: Speaking or groaning while asleep
These parasomnias can happen at any time of life and may persist long or short term. There are also several more parasomnias including sleep texting, confusion when awoken and screeching during sleep.
One of the rarest forms of parasomnia is sleep-driving—this one requires immediate intervention and measures taken to prevent it. Locking the afflicted person indoors is helpful.
Causes
Right now we don’t fully know what causes parasomnias. Here are a few theories that doctors and other medical experts have:
- Genetics, as parasomnias can run in families;
- Neurological disorders;
- Mental health issues;
- Side effects of medications;
- Stress;
- Caused by other sleep disorders
These theories and observed potential causes can vary depending on the parasomnia in question.
Symptoms
Symptoms of parasomnias vary depending on which one you have. Usually, you won’t remember it, with the exclusion of sleep paralysis and bedwetting.
The symptoms are the activities themselves that are more easily noticed by a partner or someone else sharing the afflicted person’s home.
Risks
There are no real risks with parasomnias other than dangers caused by the activities—for example, walking somewhere dangerous or falling over while sleepwalking and of course, sleep driving.
REM behavior disorder poses the most risk of the grouping, as during REM you’re supposed to be in restorative sleep. A lack of adequate REM sleep can leave you feeling unrested.
Treatment Options
The main treatment for parasomnia is cognitive behavioural therapy if your GP suspects parasomnia is linked to a mental health factor.
You can also treat parasomnias with medications, usually prescribed by your GP or a specialist.
Movement Disorders
There are three main movement disorders you’ll only find during sleep.
- Restless leg syndrome: Painful, uncomfortable or itchy sensations like “pins and needles” when unmoving and lying down.
- Sleep bruxism: Teeth grinding while sleeping.
- Periodic limb movement disorder: Repeatedly moving the legs unconsciously in NREM sleep.
Causes
Most of the time, movement disorders are caused by issues with your nerves and muscles. Sometimes medications or comorbid, underlying conditions can be the culprit, too. The only way to know for sure is to contact your GP or a sleep specialist.
Symptoms
The symptoms of these disorders mainly occur during sleep, but you may also find you have toothache or limb fatigue during the day thanks to your nighttime activities.
If you have a toothache or limb fatigue and your dentist/doctor can’t figure out why, it would be worth looking into these disorders. Consider filming yourself while sleeping to figure out if you may have one.
Risks
The disorders often kick in as soon as you lie down or try to get to sleep, making finding sleep difficult. This can lead to sleep deprivation, especially with restless leg syndrome, as you try to fall asleep but need to keep moving to eliminate the horrible sensation.
The one with the worst impact outside of sleep deprivation is sleep bruxism, which can cause some serious damage to your teeth if you’re not careful.
Treatment Options
These disorders are rarely medicated, instead they’re treated by dental devices in the case of sleep bruxism, or weighted blankets for restless leg syndrome.
Some specialists recommend psychotherapy to avoid stress worsening your disorder—particuarly with sleep bruxism.
Apnea (Apnoea) and Snoring
Sleep apnea occurs when the soft tissue of the throat collapses during sleep, cutting off the airways. In some cases it’s caused by the tongue relaxing and blocking the airway.
The disorder makes you wake up frequently during the night to keep breathing. It often causes snoring, which isn’t quite as bad but snoring even on its own can disrupt your sleep if it’s loud.
There are three types of this disorder, central and obstructive.
Causes
The leading cause of the obstructive version of the disorder is obesity—the excess pressure on your airways causes them to collapse
With the central version, it’s your brain’s fault—it’s not transmitting signals to keep your breathing healthy in sleep.
Some medical conditions also cause the disorder, including diabetes, Parkinson’s and cognitive heart failure.
Symptoms
- Snoring
- Coughing while sleeping
- Gasping after waking up or while sleeping
- Waking with a headache or dry mouth
- General symptoms of sleep deprivation
- Insomnia
Risks
This is quite a serious condition and can cause:
- Fatigue
- Heart issues
- Diabetes, usually type 2
- Liver issues
- Metabolic problems
- High blood pressure
Treatment Options
Treatment will depend on the severity of the disorder. Often weight loss is recommended if it’s a factor in the disorder’s development. Alongside that, there are several devices that can keep your airways open or supply the brain with oxygen.
In extreme cases, you may need surgery to further open your upper airways.
Final Thoughts
Sleep disorders plague most of the UK’s population, with the most common being insomnia.
They all pose something of a risk from fatigue to dangerous health complications. The common types of sleep disorders are:
Always consult a GP or specialist if you fear you have one of the disorders.
Disclaimer – The advice above should not be considered medical advice and is meant to provide an overview of the kind of sleep issues children can face. If you are at all concerned about your child, no matter what age, always consult your GP.
