Breathing-related sleep disorders
Subjects suffering from this type of disorder experience breathing difficulties during sleep. In this category of disorders we can find three types of different pathologies:
Obstructive Sleep Apnea and Hypopnea Syndrome (SAHS).
This syndrome implies that the upper airway is intermittently and repetitively obstructed during sleep. That is, breathing is altered and partially (hypopnea) or totally (apnea) obstructed while sleeping.
Sleep apnea / hypopnea syndrome or SAHS is quite common in the population. It carries negative consequences for the individual who suffers from it. It results in the sleep being unrefreshing and the individual falling asleep during the day.
“SASH is responsible for a large number of traffic accidents due to the daytime sleepiness that it entails.”
It can cause neuropsychiatric disorders in the medium-long term, as well as respiratory and cardiac disorders.
It is a pathology whose origin is multifactorial. It is very possible that these people present anatomical and / or functional alterations related to the respiratory system.
Your treatment usually consists of the use of certain medical treatments (for example, positive pressure pumps, known as CPAP, which allow you to breathe better) and establishing healthy habits. In more extreme cases, surgery may be recommended.
Central sleep apnea.
This type of apnea is different from obstructive sleep apnea. Breathing does not stop due to airway problems. In this case, it is the brain that sends the wrong signals to the muscles responsible for breathing. Treatment usually consists of devices that help you breathe during sleep.
It consists of a decrease in breathing during sleep and an increase in CO2. The causes of this disorder can be very diverse (obesity, drugs, medical syndromes, stroke, etc.).
Because of this, their treatment can be highly variable, from creating good habits to using mechanical ventilation.
Sleep-wake circadian rhythm disorders
In these types of disorders, the circadian rhythms and the sleep-wake cycle are altered. Due to this, the person does not rest as well as he should and there may be negative repercussions in his daily life. Within this type of disorder we can find:
-Type of delayed sleep phase: In this case the person usually takes more than two hours to fall asleep or wake up. Their sleep-wake hours do not coincide with their schedules, causing drowsiness and feelings of discomfort during the day.
“Of all sleep disorders, this type is the one that occurs the most in the population, especially in young people and adolescents.”
-Type of early sleep phases: This phenomenon is characterized by exactly the opposite of the previous case. Here the sleep-wake cycles are ahead of what the person wants. This can also lead to difficulties in the day-to-day life of the person to follow conventional schedules.
– Type of irregular sleep-wakefulness: The person lets go of having trouble resting properly. Sometimes he has insomnia at night, he cannot sleep soundly, his sleep is not restful, etc. This can cause excessive daytime sleepiness and discomfort.
-Type of sleep-wake not adjusted to 24 hours: The person has difficulties to adapt to the night-day cycles / schedules of their environment. The subject suffers irregularities in his rest due to this maladjustment.
-Type associated with work shifts: This type is usually characteristic of people whose work shifts do not coincide with a daytime schedule (from 6 in the morning to 6 in the afternoon). This dysregulation in your schedules can affect your rest (eg difficulty sleeping during the day). The consequences of this are symptoms of drowsiness during the hours in which they must be awake.
Parasomnias or non-REM / non-REM sleep arousal disorders.
These disorders involve undesirable sleep experiences. Within these we can find three main ones:
People affected by sleepwalking have complex behaviors during phase 3 of non-REM sleep. It usually implies that the subject wanders through the environment where he fell asleep in an altered state of consciousness.
These behaviors can be very varied (gesturing, walking, dressing / undressing, doing housework, etc.).
“The duration of sleepwalking episodes is highly variable, and can last from seconds to half an hour.”
The resulting consequences can lead to mental confusion, anxiety, injuries (in some cases), amnesia of the event, etc. Stress and anxiety have been shown to help trigger these episodes. Genetics also play a major role.
Treatment usually consists of creating good sleep habits, temporary use of benzodiazepines, etc.
It is a set of nocturnal experiences where the person feels a significant panic. This is accompanied in addition to screams of terror, sudden movements, excessive body activation, etc.
Night terrors appear during the first third of nighttime sleep (non REM / non REM). It usually leads to states of confusion, anxiety, panic, and difficulty waking up. These episodes are often not remembered.
They should not be confused with nightmares. These usually occur during REM / REM sleep (so it is normal to remember them) and do not give rise to so many spasms, vocalizations, etc.
It is the inability to make voluntary movements during the initiation, course or awakening of sleep.
“The person in these episodes suffers intense panic and stress. He is aware of everything that happens around him, but he cannot move or make any sound ”.
In addition, the appearance of hallucinations of a threatening or creepy nature during these events is normal. The factors that favor its appearance are highly variable: sleep deprivation, irregular schedules, psychological disorders, etc.
REM / REM sleep behavior disorder
REM / REM sleep behavior disorder involves the person waking up repeatedly during this sleep phase. This awakening is usually accompanied by complex motor behaviors and vocalizations.
This type of behavior usually responds to the content of the subject’s dreams. For example, if the person is dreaming of a flight, his movements will correspond to those we make when running. As for the vocalizations, they are usually loud and alarming.
These behaviors can be a problem both for the subject and for those who share a bed or room with him. It is also not uncommon for their behavior to be aggressive or potentially harmful during the episode (jumping, slapping, kicking, pushing…).
When the person wakes up from this state, they usually feel disoriented, agitated and alert. It is very normal for you to be able to remember what you were dreaming about.
The discomfort caused by this disorder is highly variable from one subject to another. It depends mainly on the frequency, intensity and experience of the episodes and if they affect other people or not.
“The consequences of these episodes can lead to injuries, feelings of shame and general discomfort (both in the case of the subject and other members of the household).”
Regarding treatment, if there is a risk of injury and discomfort, clonazepam or melatonin is usually prescribed. Some people do not need it due to the low intensity and repercussions of such behaviors. You can also modify the environment (sleeping separately, moving furniture, placing something padded on the floor …) as a possible solution.
In this disorder the person has repeatedly nightmares during sleep.
“Nightmares are dream creations (dreams) of a terrifying and / or threatening nature for the subject. Their content is experienced in a very intense way, as if it were a real experience ”.
Normally, nightmares often involve unpleasant emotions. Normally, the person experiences anxiety and panic in these types of dreams. Its content is usually associated with situations where the person must face some danger.
Sometimes, the situations that have been a trauma for the subject are relived in the form of nightmares. But not everyone has to experience this phenomenon.
The subject can usually remember the nightmare (they occur during the REM / REM phase) and describe it in great detail. Once the subject awakens his alertness and negative emotions tend to subside. However, there may be difficulties when it comes to going back to sleep due to the intensity of the dream experience.
It may even happen that the person carries the negative emotions that invaded him in the dream during the rest of the day. This can cause drowsiness, malaise, irritability, etc. Nightmares end up being a problem when it affects the person in their day to day.
Treatment for nightmares can be very variable. In psychology, various methods can be used to reduce the negative impact that the person has on the person. For example, through systematic desensitization.
Relaxation together with the progressive exposure of stimuli related to the nightmare (whether in imagination or not), usually helps the nightmares disappear. Similar techniques such as flooding or self-exposure have been just as helpful as systematic desensitization.
Strategies based on relaxation or hypnosis have proven to be effective in this type of treatment as well.
Restless legs syndrome
Restless leg syndrome is characterized by the fact that the person feels the need to move their legs. Normally, the person gets up and walks to respond to this need.
All this is accompanied by discomfort in the legs, which make the person uncomfortable. Once the person is able to move, the sensations gradually subside. They usually reappear when the when the person is again in a state of rest or resting.
These types of sensations can be experienced at any time of the day. There are people who only suffer it in the afternoon or at night.
It is a problem of the Nervous System that induces the person to have these movements.
“The causes of this syndrome are still not entirely clear and what factors can cause it is still being investigated.”
However, it has been seen to affect the elderly to a greater extent. It is also comorbid with other diseases such as diabetes, multiple sclerosis, or Parkinson’s disease.
It can also appear at specific moments in the life of the subject, such as pregnancy. This syndrome often makes it difficult to get a good night’s sleep. The consequences that can be derived from this are: lack of energy, alteration in the person’s schedules, physical discomfort, low mood, etc.
All this can imply a deterioration in the affective, social, work and behavioral areas of the subject.
Treatment of restless legs syndrome is based primarily on trying to implement sleep hygiene measures.
It is not recommended to take substances such as alcohol or caffeine that could further aggravate the problem. In this case, it is not advisable to take antidepressant drugs either.
If the person has vitamin or iron deficiencies, it is important to take measures to compensate for this deficit. Pharmacological treatments can also be prescribed to help reduce the problem (dopamine agonists, some antiepileptic drugs …).
Substance / Drug-Induced Sleep Disorder.
This disorder involves sleep disturbances due to the use and pharmacological effect of a substance. These alterations occur due to intoxication of the substance, withdrawal syndrome or during the administration of the drug.
Benzodiazepines and sleep-inducing drugs.
Drugs are necessary on some occasions, but these must always be controlled by health personnel. As discussed above, taking sleep-inducing drugs without a prescription can be dangerous.
“Some drugs with hypnotic effects are highly addictive and can create dependence, tolerance and withdrawal.”
Also, some people may suffer side effects from taking them. Benzodiazepines, for example, as well as some sedatives, antihistamines, hypnotics, etc. they can have such effects.
Its use is indicated for short periods. That is, for emergencies or as a substitute while another type of treatment is implanted whose effect is not so immediate. Medications such as antidepressants or antihistamines are also not recommended as the first treatment option for a sleep disorder. They are usually contraindicated for pathologies such as obstructive sleep apnea-hypopnea syndrome.
Other types of more commonly used substances (alcohol, caffeine, stimulant drinks, cannabis) are not good at trying to solve the problem either. They can hide the sleep problems that the subject suffers. Due to the negative consequences of these substances, they can even aggravate it. They can also cause another series of contraindications (dependence on physical and psychological disorders due to their consumption, insomnia, fatigue …).
Many times, other types of treatments are more recommended in the medium-long term. In the case of some sleep disorders, the implementation of healthy habits, education on sleep hygiene, psychological therapy, etc. they have been very useful and effective. Although these measures are insufficient when the problem has a rather physiological basis. If medical treatment is needed, professionals should review the patient’s condition at all times.
Sleep disorders are a group of pathologies of a very diverse nature. In general, they prevent the person from having a satisfactory rest during the hours of sleep.
Sleep is known to be one of the most important vital functions for the proper functioning of the body. Without it, the resulting consequences can even be deadly.
“That is why it is important that we attend to our rest hours. Our sleep should be as restorative as possible, as our performance will depend a lot on its quality ”.
Psychology and medicine have investigated these disorders and both have tried to develop treatments to cope with them. Some of them have a rather biological origin, while others depend more on our habits and life experiences.
What is clear is that a good rest is essential. Our rhythm of life often prevents us from having a good night’s sleep. What’s more, the intensity and frequency of sleep disorders is increasing in the population at an alarming rate. Sleep definitely influences our quality of life and a good rest can save us many pathologies (physical and psychological) in the future.
Alexa Clark specializes in Cognitive Behavioral Therapy. She has experience in listening and welcoming in Individual Therapy and Couples Therapy. It meets demands such as generalized anxiety, professional, love and family conflicts, stress, depression, sexual dysfunction, grief, and adolescents from 15 years of age. Over the years, She felt the need to conduct the psychotherapy sessions with subtlety since She understands that the psychologist acts as a facilitator of self-understanding and self-acceptance, valuing each person's respect, uniqueness, and acceptance.