common mental health disorders, Disorders

SLEEPING PROBLEMS

Sleep is one of the most important human behaviour occupying roughly one third of Human Life.

It serves restorative & homeostatic function and is crucial for normal thermoregulation, energy conservation and immunity. Sleep is important for various aspects of brain function like -Cognition, concentration, productivity, and performance. Good sleep can maximize problem-solving skills and enhance memory. In contrast, poor sleep has been shown to impair brain function and decision making skills.

Good sleep has been shown to improve many aspects of athletic and physical performance. 6-8 hours of sleep can improve our immune function and help fight the common cold. 

Sleep disturbance is linked to higher levels of inflammation. Over time, this can increase our risk of developing chronic conditions like heart disease, diabetes, hypertension, depression, weight gain, Inflammation and Alzheimer’s disease. Sleep disturbance occurs in almost all psychiatric illnesses.

Normally we require 6-8 hours of sleep. People who require less than 6 hours of sleep are called SHORT sleepers and those who require more than 9 hours are called LONG sleepers.

Sleep disorders are classified as :

1. Insomnia

2. Hypersomnia

3. Narcolepsy

4. Breathing related sleep disorder – Obstructive sleep apnea, Central sleep apnea

5. Circadian rhythm sleep-wake disorder

6. Parasomnias
i) Non-REM sleep arousal disorder : sleep walking, sleep terror,
Confusional arousal, sexsomnia, sleep related eating
ii) REM sleep behaviour disorder : Nightmares, Recurrent sleep
paralysis, status dissociatus
 
7. Restless leg syndrome

8. Substance/ Medication induced sleep disorder


TYPES OF SLEEP DISORDERS-

 
1. INSOMNIA- it is the most common sleep disorder, it may be transient or
persistent.
It is defined as dissatisfaction with quantity or quality of sleep along with
1) Difficulty in initiating sleep
2) Difficulty in maintaining sleep with frequent awakenings

3) Early morning awakening with difficulty in going back to sleep


2. HYPERSOMNIA -There is excessive daytime sleepiness or sleep attacks which cannot be explained by inadequate amount of sleep.

3. NARCOLEPSY – There are episodes of irresistible sleepiness leading to 10-20 minutes of sleep after which the person feels refreshed, at least briefly. It represents intrusion of REM sleep into waking state. It can occur at inappropriate times like talking, eating, driving etc. and hence can be dangerous. It includes cataplexy, sleep paralysis and hypnagogic/hypnopompic hallucinations. Sleep attacks are most common symptom

4. Breathing related sleep disorder : It includes –
i) Obstructive Sleep Apnea (OSA) -There are episodes of sleep apnea which is defined as cessation of breathing for 10 seconds or more during sleep. Repetitive collapse/partial collapse of upper airway occurs during sleep. Affected people suffer from excessive sleepiness during daytime, obesity, snoring, nocturnal awakenings with choking or gasping for breath, heavy sweating, headache etc.
ii) Central Sleep Apnea : It results from periodic failure of CNS mechanisms that stimulate breathing. It includes Idiopathic CSA, Cheyne-Stokes Breathing, CSA due to substance abuse etc.

5. Circadian rhythm sleep-wake disorder :
i) Delayed sleep phase type- Night owls
ii) Advanced sleep phase type- Early birds or Larks
iii) Irregular sleep wake cycle- 3 or more episodes of fragmented sleep
iv) Non 24 hour sleep -wake type- circadian rhythm is not reset each morning. Periodic insomnia & periodic excessive sleepiness occur.
v) Shift work tyme
vi) Jet-lag type

6. Other Sleep related Parasomnias :

i) Sleep Enuresis

ii) Sleep related groaning (Catathrenia)
iii) Sleep related hallucinations
iv) Sleep related Eating disorder

7. Restless Leg Syndrome (RLS or Ekbom syndrome) : There is uncomfortable, creepy sensation in the legs . It’s followed by irresistible urge to move the legs. It may feel like ants walking/ crawling on skin. It may be related to many medical conditions & substance abuse and hence requires thorough assessment & treatment.
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