Understanding sleep and sleep disorders.

Introduction:

Sleep is one of the few topics poorly discussed in medical practice, only few people have an in-depth knowledge about it. Every day we go to bed and fall asleep with little or no idea of its benefits, It is also not surprising to see that these days some people even take sleep for granted because they simply do not know how valuable sleep is. This write up will try to address some of the questions that might be troubling you about sleep generally and its disorders.

WHAT IS SLEEP?

The definition of sleep hasn’t changed; it still remains ‘state of unconsciousness from which a person can be aroused by sensory or other stimuli’
The truth remains that in life we spend nearly one-third of our lives sleeping! The amount of sleep required gradually reduces from birth from (16hrs -20hrs) to about 8hrs in a normal adult.

The normal sleep pattern is controlled by our biological clock which is influenced by environmental factors such as light-dark, noise, temperature, Hormones etc. This is called the circadian rhythm.

Sleep hygiene refers to a variety of practices necessary to have normal, quality nighttime sleep and full daytime alertness. Unfortunately, Sleep hygiene in the 21st century is a disaster! Some people cannot strike a balance with their jobs, social media chats, movies etc to have the recommended hours of sleep. Stress and anxiety have now taken a back seat in the leading causes of poor sleep.

These poor sleep hygiene practices eventually result in sleep disorders.

Sleep studies have been on-going for a period of time now, it was discovered that inasmuch as the recommended sleep duration was about 8-9hrs, there were still people who had to be further categorized because they did not elicit any symptoms from poor sleep.

LONG SLEEPERS– These are the people who can sleep for more than 9 hours at night without eliciting any symptoms or body dysfunction.

SHORT SLEEPERS– These are the people who attain enough sleep less than 6hrs at night without having any symptoms or body dysfunction.

Studies have shown that after 4-5 days of sleep deprivation, some psychological symptoms become evident.

It usually starts with a decreased attention span, then it may progress to inability to get focused, feeling of drowsiness, disorientation, and confusion.
There may also be presences of hallucinations and illusions which may gradually progress towards a psychiatry disorder.

IMPORTANCE OF SLEEP
The importance of sleep cannot be overemphasized, some of them worthy of note are listed below:

• It acts as an immune booster to the body.
• sleep helps to improve mental state.
• It helps regulate the blood pressure in the body.
• It helps in normal growth and development. especially in children
• sleep can help prevent a migraine
• Sleep reduces the level of body stress
• It helps improve the cognitive function of the brain

SLEEP DISORDERS
There are also disorders associated with sleep, for the purpose of this write-up, I will like to group these sleep disorders into the four classes for easy comprehension.

I – Disorders of Initiating and Maintaining Sleep (DIMS).
This is also known as insomnia which might be very popular due to its wide usage. An individual with insomnia has difficulty in falling asleep (initiating sleep) or staying asleep (maintain sleep). The individual with this sleep disorder could be reported to be waking frequently at nights or early mornings; such individual may actually seek medical help for a solution. I have seen a couple of them in practice.

some of the causes of insomnia could be due to:

• Medical illness e.g. old age, heart diseases
• Alcohol/Drug usage e.g. taking caffeine, chronic alcoholics etc.
• Psychiatric disorders e.g. depression, anxiety disorders etc.
• It can also be hereditary.

It is always important not to confuse a person with insomnia with a short sleeper who needs less than 6hrs of sleep to be alright.

II – Disorders of Excessive Somnolence (DOES).
This is medically known as hypersomnia, which simply means excessive daytime sleeping. This means that people with this condition fall asleep during the daytime frequently or they are very deep sleeper who needs much more time to be awakened. The causes of hypersomnia are almost the same as that of insomnia so you can quickly glance through them again.

An important type of hypersomnia I would want to point out is Narcolepsy.

Narcolepsy-It is a type of sleep disorder characterized by daytime sleep, individuals with this conditions are also said to have sleep attacks where they may fall into a dream during the day, it may even occur during driving at daytime. There might be an associated muscle weakness (cataplexy) which may make the individual result in a fall.( This is usually confused with somebody that fainted)

III – Disorders of the ‘sleep-wake cycle’ ( Jet lag/work shift change)
Jet Lag is associated with a change in time zone. This occurs when an individual travels and crosses many time zones while on an international flight. At the point of destination, there might be an alteration of the sleep cycle, making the individual be awake when others are asleep and vice versa.

• Work-shift: This is peculiar to professionals that have no option but to run a shift at work eg doctors, nurses,nursing mothers etc, they usually have an altered sleep pattern too depending on the change.
  IV – Dysfunctions associated with sleep, sleep stages or partial arousals (parasomnias)
  These are sleep disorders common in childhood; unfortunately, some may persist till adulthood.
  Examples of parasomnias include
• Sleep-walking (somnambulism) – This occurs when a sleeping individual leaves the bed and walk around the house without waking up, the said individual may carry out some activities while asleep without knowing too which may lead to accidents.
• Sleep terrors/Night terrors– In this case, the individual suddenly screams in his sleep, there is evidence of sweating, but when awake, he might not recall what happened while asleep. This is different from Nightmare where activities are remembered.
• Bed-wetting(enuresis)- This is self-explanatory.

Others are teeth grinding during sleep (Bruxism), sleep-talking (somniloquy) etc.

CONCLUSION
It won’t be wrong to assume that at a particular point in life; almost everybody has experienced a sleep disorder which might have been embarrassing. Having trashed out the importance of sleep and the different sleep disorders, it is important to note that the management of sleep disorder needs a thorough medical and psychiatry assessment. Treatment is done based on the underlying causes.

To achieve good sleep hygiene it is pertinent to

• Avoid caffeinated drinks e.g. coffee, before sleeping hours.
• Avoid watching/ reading during sleep time.
• Avoid alcohol use.
• Ensure a regular time to sleep and wake.

This will help us not to miss out on important events in life when they occur naturally! Many people have slept away opportunities when they tried to cheat sleep. Sleep was designed to make us healthy.

If you have any questions, I will be glad to help out from the comment section.