Other Sleep Disorders
The various forms of sleep apnea and other types of sleep disordered breathing are not the only physiological intrusions on a good night. Sleep researchers have assembled a compilation of sleep disorders that offers 44 pages of apneas and other problems with breathing buttressed by 179 pages of other interferences with slumber.
Some of the disorders are familiar, at least in name, such as sleep-walking and bed-wetting. Others are rare and alarming, such as "exploding head syndrome," in which the sufferer hears a loud bang inside the head just as he or she is falling asleep or awaking during the night.
Here are some of the most significant disorders.
CIRCADIAN RHYTHM SLEEP DISORDERS
Under normal circumstances, the waking and sleeping patterns of human beings, like those of animals, are established by an internal clock that is set by the continuing cycle of daylight and darkness. Humans, however, began long ago to tinker with the natural cycle, first by introducing artificial light, first firelight, candles and oil lamps, more recently, electric lights. People in developed countries are now so swathed in artifice that they are virtually cut off from zeitgebers, environmental signals to the body. One study suggests the average American is in contact with sunlight only 21 minutes a day. In some people, circadian rhythms are further challenged by rapid travel across times zones, creating jet lag, and by jobs in which the work-shift times constantly change. Two of the most common CR disorders are advanced and delayed circadian rhythm, the one leading to early morning insomnia, the other to an inability to get up on time. Talk About Sleep offers more information about circadian rhythm and its challenges. Wikipedia and the American Academy of Sleep Medicine are also useful resources.
Half of all adults are said to have wrestled at some time during their lives with insomnia, that is, difficulty with initiating sleep or staying asleep as long as they felt they needed to. According to some experts, 10 percent of adults suffer from chronic insomnia, insomnia that affects them most of the time for a month or more. By most accounts insomnia is a symptom rather than a disease in itself. Improving one's sleep hygiene by following the 10 Commandments of Healthy Sleep can often quell insomnia, and if it's worry that's keeping you awake, one recommendation is that you write down your worries in a journal before bed. Then they're on paper rather than churning around in your head. PubMed Health, emedicinehealth.com, and Wikipedia offer more useful information about insomnia.
Narcolepsy is an incurable neurological disease perhaps genetic in origin. Its primary symptom is excessive daytime sleepiness, sleepiness sometimes so overwhelming that the patient cannot resist falling asleep. The sleep that ensues may last less than a minute to in rare cases up to an hour. The onset of the disease generally occurs in adults in their 20s and 30s, although narcolepsy is occasionally seen in children. In rare cases it may appear in adults in their 50s.
As the disease progresses, attacks may be accompanied by cataplexy, a sudden, severe muscular weakness; by hallucinations, often alarming, as the patient falls asleep or awakens; and by sleep paralysis, a condition in which the patient is unable to move while falling asleep or awakening--and is fully aware of the situation. Some researchers believe narcoleptic hallucinations and paralysis may lead some patients to believe they have seen ghosts or been abducted by aliens.
While narcolepsy is incurable, it can be managed by drugs and alterations in life style. Some patients experience fewer symptoms after they reach their 60s. Other sources of useful information are the Narcolepsy Network, Mayo Clinic and the National Institute of Neurological Disorders and Stroke.
RESTLESS LEGS SYNDROME
Restless legs syndrome, also known as Willis-Ekbom Disease, an overwhelming urge to move one's legs, sometimes accompanies sleep apnea. In most cases the urge is immediately relieved by movement. The urge most frequently sets in during the evening, especially upon going to bed, and thus it can interfere with going to sleep. The Restless Legs Foundation was organized specifically to raise awareness of the syndrome and improve the available treatment for it. More information is available at the National Institute of Neurological Disorders and Stroke and at Wikipedia.
NIGHT TERRORS AND OTHER PARASOMNIAS
Parasomnias comprise a wide variety of undesirable physical and emotional reactions that occur during sleep or at the intersection of sleeping and awakening. Night terrors, or sleep terrors, can be quite troublesome, especially when they lead the sufferer, often a child, to leap up and run around wildly, possibly injuring himself or herself. It is impossible to console the sleeper during the event, and usually no recollection of it survives until morning. More familiar parasomnias are enuresis (bed-wetting) and somnambulism (sleep-walking), which tend to be more common among children. A particularly disturbing parasomnia is rapid-eye-movement sleep behavior disorder, a phenomenon in which the sleeper freed from the normal paralysis of REM sleep is able to act out dreams and nightmares. The disorder can lead to the sleeper's injuring himself or a sleeping companion or damaging the surroundings. Victims of the disorder are usually older men; its onset is sometimes a first symptom of dementia. Wikipedia, the Cleveland Clinic, and eMedicine offer useful additional information about parasomnias.