The Basics of Insomnia and Sleep Problems
The Basics of Insomnia and Sleep Problems
A:) Sleep can be divided into two types: rapid eye movement (REM) sleep and non-REM (NREM) sleep. NREM sleep has four stages of increasingly deep sleep. Stage 1 sleep is the lightest, while stage 4 is the deepest
During normal sleep, you cycle through these types and stages of sleep. But if your sleep is repeatedly interrupted and you cannot cycle normally through REM and NREM sleep, you may feel tired, fatigued, and have trouble concentrating and paying attention while awake. Sleepy individuals are at greater risk for driving and other accidents.
If you have trouble getting to sleep or sleeping through the night, if you wake up too early or have a hard time waking up at all, or if you are overly tired during the day, you may have one of the following sleep problems.
Typically, people sleep at night -- thanks not only to the conventions of the 9-to-5 workday, but also to the close interaction between our natural sleep and alertness rhythms, which are driven by an internal "clock."
This clock is a small part of the brain called the suprachiasmatic nucleus of the hypothalamus. It sits just above the nerves leaving the back of our eyes. Light and exercise "reset" the clock and can move it forward or backward. Abnormalities related to this clock are called circadian rhythm disorders ("circa" means "about," and "dies" means "day").
Circadian rhythm disorders include jet lag, adjustments to shift work, delayed sleep phase syndrome (you fall asleep and wake up too late), and advanced sleep phase syndrome (you fall asleep and wake up too early).
People who have insomnia don't feel as if they get enough sleep at night. They may have trouble falling asleep or may wake up frequently during the night or early in the morning. Insomnia is a problem if it affects your daytime activities. Insomnia has many possible causes, including stress, anxiety, depression, poor sleep habits, circadian rhythm disorders (such as jet lag), and taking certain medications.
Many adults snore. The noise is produced when the air you inhale rattles over the relaxed tissues of the throat. Snoring can be a problem simply because of the noise it causes. It may also be a marker of a more serious sleep problem called sleep apnea
Sleep apnea occurs when the upper airway becomes completely or partially blocked, interrupting regular breathing for short periods of time - which then wakes you up. It can cause severe daytime sleepiness. Evidence is building that, left untreated, severe sleep apnea may be associated with high blood pressure and the risk of stroke and heart attack
Women often experience sleepless nights and daytime fatigue in the first and third trimesters of their pregnancy. During the first trimester, frequent trips to the bathroom and morning sickness may disrupt sleep. Later in pregnancy, vivid dreams and physical discomfort may prevent deep sleep. After delivery, the new baby's care or the mother's postpartum depression may interrupt sleep.
Narcolepsy is a brain disorder that causes excessive daytime sleepiness. There is a definite genetic component, but most patients have no family history of the problem. Though dramatic and uncontrolled "sleep attacks" have been the best-known feature of narcolepsy, in reality many patients do not have sleep attacks. Instead, they experience constant sleepiness during the day.
In people who have restless leg syndrome, discomfort in the legs and feet peaks during the evening and night. They feel an urge to move their legs and feet to get temporary relief, often with excessive, rhythmic, or cyclic leg movements during sleep. This can delay sleep onset and cause brief awakening during sleep. Restless leg syndrome is a common problem among middle-aged and older adults
Nightmares are frightening dreams that arise during REM sleep. They can be caused by stress, anxiety, and some drugs. Often, there is no clear cause.
Both night terrors and sleepwalking arise during NREM sleep and occur most often in children between the ages of 3 and 5. A night terror can be dramatic: Your child may wake up screaming, but unable to explain the fear. Sometimes children who have night terrors remember a frightening image, but often they remember nothing. Night terrors are often more frightening for parents than for their child. Sleepwalkers can perform a range of activities -- some potentially dangerous, like leaving the house - while they continue to sleep
Insomnia may be temporary and stem from a simple cause, such as jet lag. Short-term insomnia may also be caused by an illness, a stressful event, or drinking too much coffee. Many medications have insomnia as a side effect.
Long-term insomnia may be caused by stress, depression, or anxiety. People can also become conditioned to insomnia: They associate bedtime with difficulty, expect to have trouble sleeping (and thus do), and become irritable (which can cause more insomnia). This cycle can be maintained for several years.
Circadian rhythm disorders are an important but less common cause of insomnia. People who abuse alcohol or drugs often suffer from insomnia
When you fall asleep, many muscles in your body relax. If the muscles in your throat relax too much, your breathing may be blocked and you may snore. Sometimes, snoring is caused by allergies, asthma, or nasal deformities that make breathing difficult.
Apnea means "no airflow." Obstructive sleep apnea was thought to be a disorder primarily of overweight, older men. But abnormal breathing during sleep can affect people of any age and either sex, and at least 30% of those affected are not obese. Researchers now know that in many cases of sleep apnea, the obstruction in the airways is only partial. Most people with sleep apnea have a smaller-than-normal inner throat and other subtle bone and soft-tissue differences.
Drops in blood oxygen during sleep -- once thought to be the cause of waking up due to obstructive sleep apnea -- may or may not be present. Most likely, awakening occurs with the body's increased effort required to overcome the obstruction of the airway.
Drinking alcohol can make obstructive sleep apnea worse because it relaxes muscles.
A rare form of sleep apnea called central sleep apnea occurs when signals from your brain to your muscles decrease or stop for a short time. You may not snore if you have central sleep apnea.
Fatigue during the first trimester of pregnancy is likely due to changing levels of hormones, such as progesterone. Toward the end of pregnancy, some women find it difficult to sleep due to the uncomfortable size of their abdomen. Some women are too excited, anxious, or worried about becoming mothers to sleep well. Other women who are pregnant complain that vivid dreams prevent them from getting restful sleep. Sleep apnea, especially if it's severe and causes your blood oxygen level to drop during sleep, is a risk to the fetus.
The cause of narcolepsy is not clear. Genetic and environmental factors likely play a role, although the data on genetic factors is still speculative and not well studied. There are some rare nerve disorders that may be linked to narcolepsy.
There are many possible causes of restless leg syndrome, including kidney failure, nerve disorders, vitamin and iron deficiencies, pregnancy, and some medications (such as antidepressants). About 50% of those who have restless leg syndrome have relatives with the same condition.
Nightmares can be triggered by a frightening or stressful event, a fever or illness, or use of some medications or alcohol. Night terrors are most common in children but can affect adults who are experiencing emotional or psychological problems.
A:) Young age. Infants may sleep up to 16 hours a day. But most won't sleep through the night without a feeding until 4 months of age. School-aged children may sleep 10 hours a day. Their sleep may be disturbed by an illness or fever. Call your doctor if your child has a fever and is sluggish when waking up.
Old age. People over 60 may not sleep as deeply as younger people. Sleep apnea is more common among older people.
Lifestyle. People who drink coffee, smoke cigarettes, or drink alcohol are more likely to have sleep problems than people who do not.
Medication. Many medications can cause sleeplessness. Others can cause daytime fatigue.
Depression and anxiety. Depression and anxiety often cause insomnia.
Heart failure and lung problems. Some people find it difficult to sleep at night because they become breathless when they lie down. This can be a symptom of heart failure or a problem with the lungs.
WebMD Medical Reference
Reviewed by Jonathan L Gelfand, MD on June 01, 2007
© 2005 WebMD, Inc. All rights reserved.
A:) Young age. Infants may sleep up to 16 hours a day. But most won't sleep through the night without a feeding until 4 months of age. School-aged children may sleep 10 hours a day. Their sleep may be disturbed by an illness or fever. Call your doctor if your child has a fever and is sluggish when waking up.
Old age. People over 60 may not sleep as deeply as younger people. Sleep apnea is more common among older people.
Lifestyle. People who drink coffee, smoke cigarettes, or drink alcohol are more likely to have sleep problems than people who do not.
Medication. Many medications can cause sleeplessness. Others can cause daytime fatigue.
Depression and anxiety. Depression and anxiety often cause insomnia.
Heart failure and lung problems. Some people find it difficult to sleep at night because they become breathless when they lie down. This can be a symptom of heart failure or a problem with the lungs.
WebMD Medical Reference
Reviewed by Jonathan L Gelfand, MD on June 01, 2007
© 2005 WebMD, Inc. All rights reserved.
Q:) What Are Sleep Problems?
A:) Sleep can be divided into two types: rapid eye movement (REM) sleep and non-REM (NREM) sleep. NREM sleep has four stages of increasingly deep sleep. Stage 1 sleep is the lightest, while stage 4 is the deepest
During normal sleep, you cycle through these types and stages of sleep. But if your sleep is repeatedly interrupted and you cannot cycle normally through REM and NREM sleep, you may feel tired, fatigued, and have trouble concentrating and paying attention while awake. Sleepy individuals are at greater risk for driving and other accidents.
If you have trouble getting to sleep or sleeping through the night, if you wake up too early or have a hard time waking up at all, or if you are overly tired during the day, you may have one of the following sleep problems.
Circadian Rhythm Disorders
Typically, people sleep at night -- thanks not only to the conventions of the 9-to-5 workday, but also to the close interaction between our natural sleep and alertness rhythms, which are driven by an internal "clock."
This clock is a small part of the brain called the suprachiasmatic nucleus of the hypothalamus. It sits just above the nerves leaving the back of our eyes. Light and exercise "reset" the clock and can move it forward or backward. Abnormalities related to this clock are called circadian rhythm disorders ("circa" means "about," and "dies" means "day").
Circadian rhythm disorders include jet lag, adjustments to shift work, delayed sleep phase syndrome (you fall asleep and wake up too late), and advanced sleep phase syndrome (you fall asleep and wake up too early).
Insomnia
People who have insomnia don't feel as if they get enough sleep at night. They may have trouble falling asleep or may wake up frequently during the night or early in the morning. Insomnia is a problem if it affects your daytime activities. Insomnia has many possible causes, including stress, anxiety, depression, poor sleep habits, circadian rhythm disorders (such as jet lag), and taking certain medications.
Snoring
Many adults snore. The noise is produced when the air you inhale rattles over the relaxed tissues of the throat. Snoring can be a problem simply because of the noise it causes. It may also be a marker of a more serious sleep problem called sleep apnea
Sleep Apnea
Sleep apnea occurs when the upper airway becomes completely or partially blocked, interrupting regular breathing for short periods of time - which then wakes you up. It can cause severe daytime sleepiness. Evidence is building that, left untreated, severe sleep apnea may be associated with high blood pressure and the risk of stroke and heart attack
Pregnancy and Sleep
Women often experience sleepless nights and daytime fatigue in the first and third trimesters of their pregnancy. During the first trimester, frequent trips to the bathroom and morning sickness may disrupt sleep. Later in pregnancy, vivid dreams and physical discomfort may prevent deep sleep. After delivery, the new baby's care or the mother's postpartum depression may interrupt sleep.
Narcolepsy
Narcolepsy is a brain disorder that causes excessive daytime sleepiness. There is a definite genetic component, but most patients have no family history of the problem. Though dramatic and uncontrolled "sleep attacks" have been the best-known feature of narcolepsy, in reality many patients do not have sleep attacks. Instead, they experience constant sleepiness during the day.
Restless Leg Syndrome
In people who have restless leg syndrome, discomfort in the legs and feet peaks during the evening and night. They feel an urge to move their legs and feet to get temporary relief, often with excessive, rhythmic, or cyclic leg movements during sleep. This can delay sleep onset and cause brief awakening during sleep. Restless leg syndrome is a common problem among middle-aged and older adults
Nightmares
Nightmares are frightening dreams that arise during REM sleep. They can be caused by stress, anxiety, and some drugs. Often, there is no clear cause.
Night Terrors and Sleepwalking
Both night terrors and sleepwalking arise during NREM sleep and occur most often in children between the ages of 3 and 5. A night terror can be dramatic: Your child may wake up screaming, but unable to explain the fear. Sometimes children who have night terrors remember a frightening image, but often they remember nothing. Night terrors are often more frightening for parents than for their child. Sleepwalkers can perform a range of activities -- some potentially dangerous, like leaving the house - while they continue to sleep
Q:) What Causes Sleep Disorders?
A:) Insomnia
Insomnia may be temporary and stem from a simple cause, such as jet lag. Short-term insomnia may also be caused by an illness, a stressful event, or drinking too much coffee. Many medications have insomnia as a side effect.
Long-term insomnia may be caused by stress, depression, or anxiety. People can also become conditioned to insomnia: They associate bedtime with difficulty, expect to have trouble sleeping (and thus do), and become irritable (which can cause more insomnia). This cycle can be maintained for several years.
Circadian rhythm disorders are an important but less common cause of insomnia. People who abuse alcohol or drugs often suffer from insomnia
Snoring and Sleep Apnea
When you fall asleep, many muscles in your body relax. If the muscles in your throat relax too much, your breathing may be blocked and you may snore. Sometimes, snoring is caused by allergies, asthma, or nasal deformities that make breathing difficult.
Apnea means "no airflow." Obstructive sleep apnea was thought to be a disorder primarily of overweight, older men. But abnormal breathing during sleep can affect people of any age and either sex, and at least 30% of those affected are not obese. Researchers now know that in many cases of sleep apnea, the obstruction in the airways is only partial. Most people with sleep apnea have a smaller-than-normal inner throat and other subtle bone and soft-tissue differences.
Drops in blood oxygen during sleep -- once thought to be the cause of waking up due to obstructive sleep apnea -- may or may not be present. Most likely, awakening occurs with the body's increased effort required to overcome the obstruction of the airway.
Drinking alcohol can make obstructive sleep apnea worse because it relaxes muscles.
A rare form of sleep apnea called central sleep apnea occurs when signals from your brain to your muscles decrease or stop for a short time. You may not snore if you have central sleep apnea.
Pregnancy and Sleep
Fatigue during the first trimester of pregnancy is likely due to changing levels of hormones, such as progesterone. Toward the end of pregnancy, some women find it difficult to sleep due to the uncomfortable size of their abdomen. Some women are too excited, anxious, or worried about becoming mothers to sleep well. Other women who are pregnant complain that vivid dreams prevent them from getting restful sleep. Sleep apnea, especially if it's severe and causes your blood oxygen level to drop during sleep, is a risk to the fetus.
Narcolepsy
The cause of narcolepsy is not clear. Genetic and environmental factors likely play a role, although the data on genetic factors is still speculative and not well studied. There are some rare nerve disorders that may be linked to narcolepsy.
Restless Leg Syndrome
There are many possible causes of restless leg syndrome, including kidney failure, nerve disorders, vitamin and iron deficiencies, pregnancy, and some medications (such as antidepressants). About 50% of those who have restless leg syndrome have relatives with the same condition.
Nightmares and Night Terrors
Nightmares can be triggered by a frightening or stressful event, a fever or illness, or use of some medications or alcohol. Night terrors are most common in children but can affect adults who are experiencing emotional or psychological problems.
A:) Young age. Infants may sleep up to 16 hours a day. But most won't sleep through the night without a feeding until 4 months of age. School-aged children may sleep 10 hours a day. Their sleep may be disturbed by an illness or fever. Call your doctor if your child has a fever and is sluggish when waking up.
Old age. People over 60 may not sleep as deeply as younger people. Sleep apnea is more common among older people.
Lifestyle. People who drink coffee, smoke cigarettes, or drink alcohol are more likely to have sleep problems than people who do not.
Medication. Many medications can cause sleeplessness. Others can cause daytime fatigue.
Depression and anxiety. Depression and anxiety often cause insomnia.
Heart failure and lung problems. Some people find it difficult to sleep at night because they become breathless when they lie down. This can be a symptom of heart failure or a problem with the lungs.
WebMD Medical Reference
Reviewed by Jonathan L Gelfand, MD on June 01, 2007
© 2005 WebMD, Inc. All rights reserved.
Q:) What Other Factors Contribute to Sleep Disorders?
A:) Young age. Infants may sleep up to 16 hours a day. But most won't sleep through the night without a feeding until 4 months of age. School-aged children may sleep 10 hours a day. Their sleep may be disturbed by an illness or fever. Call your doctor if your child has a fever and is sluggish when waking up.
Old age. People over 60 may not sleep as deeply as younger people. Sleep apnea is more common among older people.
Lifestyle. People who drink coffee, smoke cigarettes, or drink alcohol are more likely to have sleep problems than people who do not.
Medication. Many medications can cause sleeplessness. Others can cause daytime fatigue.
Depression and anxiety. Depression and anxiety often cause insomnia.
Heart failure and lung problems. Some people find it difficult to sleep at night because they become breathless when they lie down. This can be a symptom of heart failure or a problem with the lungs.
WebMD Medical Reference
Reviewed by Jonathan L Gelfand, MD on June 01, 2007
© 2005 WebMD, Inc. All rights reserved.
