UNC Health Care
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Do You Have a Sleep Disorder?

Did you know about a third of the United States population suffers from some kind of sleep disorder? You may be one of those people, and you may be “tired” of not getting a good night’s rest. Sleep is important because not only do you need it to function and feel good during the day, but your body also needs it to carry out important biological processes.

Zheng (Jane) Fan, MD, a neurologist with UNC Hospitals Neurology Clinic, says there are many types of sleep disorders and other kinds of disorders that adversely affect sleep. Here, we break down some of the most common causes of sleeplessness.

Insomnia

Description: There are several types of insomnia, and they have one thing in common: They involve difficulty sleeping. Insomnia can result from a medical or psychiatric condition and can occur either randomly or repeatedly. Some common types include sleep-onset insomnia, in which it’s hard to fall asleep initially, or sleep-maintenance insomnia, in which it’s hard to stay asleep. Both types can be acute or chronic.

Causes of Insomnia: Stressful or exciting life events or situations, anxiety, depression, medical conditions that cause pain, dietary problems or other external factors can contribute to insomnia. Other sleep disorders, like sleep apnea, can also cause sleep-maintenance insomnia.

Insomnia Symptoms: Difficulty sleeping.

Insomnia Treatments: There are many things you can do to cope with insomnia. Try relaxation exercises, a strict sleep schedule or an optimized sleep environment. Cognitive behavioral therapy or over-the-counter or prescription medications may help in some cases. Talk to your doctor about what might work best for you.

Delayed Sleep-Wake Phase Disorder (DSWPD)

Description: If you have delayed sleep-wake phase disorder, you might consider yourself a “night owl,” with a sleep cycle that is a few hours off of the more typical sleeping hours of 10 p.m. to 6:30 a.m. If you have DSWPD, you might fall asleep at night three to six hours after your desired sleep time and have trouble getting up early in the morning. This is common in teenagers.

Causes of DSWPD: Sleep hygiene and social habits.

DSWPD Symptoms: Inability to fall asleep at preferred sleep times and trouble waking up at conventional morning times are common symptoms. Catching up on sleep during the weekends is also common.

DSWPD Treatments: Taking melatonin in the evenings can help kick-start sleep onset. Using light therapy and avoiding daylight in the evenings for a few hours before attempting to sleep may also help train your body to get on a regular sleep schedule.

Restless Legs Syndrome (RLS)

Description: This disorder causes uncomfortably strong desires to move your legs around instead of keeping them still during rest. In some cases, you might also feel the urge to move other body parts such as the arms, face and torso.

Causes of RLS: While there is no known cause for RLS, some studies suggest a genetic component or low iron storage as a factor. Other studies suggest a link between RLS and varicose veins.

RLS Symptoms: Symptoms vary for each person. Common ones include unpleasant sensations, such as itching or tingling in body parts, involuntary leg movements when sleeping and sitting still, and jerking motions that may awaken your bed partner while sleeping.

RLS Treatments: Cutting back on caffeine and alcohol consumption, taking hot baths and exercising daily can help lessen symptoms. It’s important to talk to your health care provider to customize a treatment plan that works for you.

Sleep Apnea

Description: Sleep apnea occurs when breathing during sleep is disrupted intermittently for short periods. There are two types:

  1. Obstructive sleep apnea: Occurs when relaxed throat muscles and the tongue block airways; in children, enlarged tonsils or adenoids might block the airways
  2. Central sleep apnea: Occurs when the brain stops communicating with breathing muscles

Causes of Sleep Apnea: Obstructive sleep apnea is most often associated with excessive weight and obesity, but it can also be caused by smoking, congestion, family history, sedatives and alcohol. Central sleep apnea is most often caused by congestive heart failure, opioids or history of stroke.

Sleep Apnea Symptoms: Uncontrollable, loud snoring and gasping for air are the main indicators. However, not everyone who snores has sleep apnea. Mild memory loss, fatigue throughout the day, irritability, and difficulty concentrating are also common symptoms. Untreated sleep apnea can cause many unintended consequences, including increased risk of stroke, heart attack and erectile dysfunction.

Sleep Apnea Treatments: Many people with sleep apnea use a continuous positive airway pressure device (CPAP) to help them breathe while sleeping. The CPAP is a mask that covers the nose and/or mouth and lightly pushes air into the airways to assist with maintaining airflow. This improves your ability to stay asleep and have better quality of sleep throughout the night.

Rapid Eye Movement Behavior Disorder

Description: REM behavior disorder (RBD) is a condition in which you act out your dreams while in the REM phase of sleep. During REM, muscles are usually temporarily paralyzed. In severe cases, RBD manifests as hitting, punching, kicking or injuring your bed partner or yourself.

Causes of RBD: The condition is not entirely understood but thought to be related to synucleinopathy—the cause of neurodegenerative diseases like Parkinson’s disease, dementia with Lewy bodies and multiple system atrophy.

RBD Symptoms: Acting out your dreams is the main symptom. That could include hitting your bed partner, shouting, kicking or punching.

RBD Treatments: The drug Clonazepam has proved successful in treating REM behavior disorder. The National Sleep Foundation also recommends removing dangerous objects from your bedroom to keep you and your bed partner safe. Talk to your doctor if you have safety concerns.


Think you may have a sleep disorder? Find a doctor near you or learn more about our sleep disorder services in Orange County and Wake County.

Sleep Disorders infographic