Dr. Zahid QutabDr. Zahid QutabDr. Zahid Qutab
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Lahore & Gujranwala
Dr. Zahid QutabDr. Zahid QutabDr. Zahid Qutab

Sleep disorders

sleep disorder

Sleep disorders include conditions that result in changes in the way that you sleep.
Sleep deprivation or over sleeping can affect your ability to drive safely and increase your risk of other health problems.
Signs and symptoms of sleep disorders may include excessive daytime sleepiness, irregular breathing or increased movement during sleep.

How much sleep do one need?

This actually depends on your age.

  • Babies sleep for like 17 hours each day.
  • Older children need 9 or 10 hours each night.
  • Most adults need  8 hours sleep each night.

Older people mostly  need the same amount of sleep but they often have one period of deep sleep during the night, usually in the first 3 or 4 hours.

What happens if I don't sleep?

The one seldom night without sleep will make you feel tired the next day  but it would not affect your health.
However, after several sleepless nights or sleep deprived nights , you will start to find that you start:

  • feeling tired all the time
  • dozing off during the day
  • finding it difficult to concentrate
  • finding it hard to make decisions
  • starting to feel depressed
  • starting to worry about not being able to sleep.

This can be very dangerous if you are driving or operating heavy machinery. Many people are killed each year when they fall asleep while driving. Lack of sleep can make you prone to get high blood pressure, diabetes etc.

Sleeping too little (insomnia)

You mostly feel that you aren’t getting enough sleep daily or even if you do get the hours, you are not getting a good night’s rest.

There are many everyday reasons for not sleeping well:

  • bedroom may be too hot or too cold
  • bed may be uncomfortable 
  • you don’t have a regular sleep routine
  • you are not active physically
  • you are  eating too late  and find it hard to get off to sleep
  • you go to bed hungry 
  • cigarettes, alcohol and drinks containing caffeine, such as tea and coffee

More serious reasons include:

  • emotional problems
  • difficulties at work
  • having anxiety and worry
  • depression – you wake  early and can’t get back to sleep again
  • Over thinking  about problems 
  • physical problems including:

o heart disease

o breathing problems, such as chronic obstructive pulmonary disease or asthma

o neurological disease such as Alzheimer’s or Parkinson’s disease

o hormone problems like overactive thyroid

o joint or muscle problems

o gastrointestinal disease, such as gastoroesophageal reflux disease or irritable bowel syndrome

o genital or urinary problems, such as incontinence or an enlarged prostate

  • medications

o stopping tranquilizers and sleeping tablets

o melatonin – occasionally

o many medications can do this – need to check with your doctor.

Tips to help you sleep better:

 

Do’s

  • Make sure that your bed and bedroom environment are comfortable ( not too hot, not too cold, not too noisy.)
  • Make sure that mattress supports you properly, it’s not too soft or to hard.
  • Get some good exercise. The best time to exercise is in the daytime – particularly late afternoon or early evening. Later than this can disturb your sleep.
  • Some people find aromatherapy helpful.
  • If something has been troubling you and there is nothing much you can do about it right away, try writing it down before going to bed and then tell yourself to deal with it tomorrow.
  • If you can’t sleep without obvious reason, get up and do something relaxing. Read, watch television or listen to relaxing music. 

Don’ts

  • Go to bed when you feel tired and stick to a routine of getting up at the same time every day.
  • Stop drinking tea or coffee by mid-afternoon. If you want a hot drink in the evening, try something milky or herbal.
  • Don’t drink a lot of alcohol. It may help you fall asleep, but you will almost certainly wake up during the night.
  • Don’t eat or drink a lot late at night. 
  • Don’t use street drugs like Ecstasy, cocaine and amphetamines – they are stimulants, and like caffeine, will  keep you awake. 

If you have  tried these tips and you still can’t sleep, go and see your doctor.

What treatments are available for sleeping disorders?

 

Psychological Treatments therapy is a way of changing unhealthy and unhelpful ways of thinking that can make you more anxious and so stop you from sleeping.

  • Stimulus control helps you to:

o strengthening the link of being in bed with only sleeping .it is done by getting into bed when you feel tired, and only using your bed for sleep and sex;

o weakening the link of being in bed with doing things that are likely to keep you awake – like watching exciting TV shows etc 

o weakening the link of being in bed with worrying thoughts. If you can’t sleep, instead of lying in bed worrying, you get up and do something for a while until you feel tired again.

  • Bed time restriction helps you to go to bed later. Too much time in bed can stop you from sleeping.

Progressive muscle relaxation helps you to relax your muscles deeply. One by one, you tense and then release the muscles of your body, working up from your feet to face.

What about medication?

People have used sleeping tablets for many years but we now know that they:

  • don’t work for in longer run
  • make you  irritable the next day and cause day time sleep as well
  • lose their effect quite rapidly, so you have to take more and more to get the same effect
  • Sleeping pills are addictive. The longer you take sleeping tablets, you will be addicted on them

Sleeping tablets must only be used for short periods (less than 2 weeks.

 

  • Melatonin is a naturally occurring hormone that can help insomnia. It should not be taken for more than 3 weeks, and should not be used if you have liver or kidney problem.
  • Sleeping too much

You may tend to fall asleep during the day at times, when you want to stay awake.

If you are still falling asleep in the daytime, even after a week or two of getting enough sleep, see Best psychologist doctor.

 Physical illnesses such as diabetes, a viral infection, or thyroid problem  can cause this sort of tiredness.

There are other conditions which make people sleep too much.

Narcolepsy (daytime sleepiness)

This is an uncommon problem, so it’s quite easy for a doctor to miss it.

There are two main symptoms:

  • you feel sleepy in the daytime, with sudden uncontrollable attacks of sleepiness even when you are with other people
  • cataplexy – you suddenly tend to lose control of your muscles and collapse when you are angry, laughing or excited. 

You may also find that you:

  • can’t speak or move when falling asleep or waking up – (sleep paralysis)
  • hear odd sounds or see dream-like images (hallucinations)
  • ‘run on auto-pilot’ – you have done things, but can’t remember doing them 

The cause for this has recently been found – it happens due to a lack of a substance called orexin, or hypocretin.

Treatment consists of taking regular exercise and getting yourself into a regular night-time routine. 

 

If this approach does not work, medication may help. These include:

  • Modafinil it makes you more awake in the day-time;
  • Antidepressants, such as Clomipramine or Fluoxetine, can help with cataplexy.

Sleep Apnea (interrupted sleep)

  • You snore very loudly and stop breathing for short periods during the night.
  • This happens because the upper part of your airway closes. It is manifested by every time you stop breathing, you wake suddenly and your body or arms and legs may jerk.
  • You may tend to stay awake just for a short time, then fall off to sleep again. This can happen several times during the night. 
  • You may wake up having a dry mouth and a headache. You feel tired most time in the day and may have an irresistible urge to go to sleep.

You are more likely to get sleep apnea, if you are:

  • older 
  • overweight
  • a smoker
  • a heavy drinker.

The problem is often noticed by a partner.

 

 Treatment is usually very simple – cut down smoking and drinking, lose weight, and sleep in a different position.

 

 If your apnea is very bad, you may need to wear a Continuous Positive Airway Pressure (CPAP) mask.

Sleepwalking

When you suffer from  sleepwalking, you appear (to other people) to wake up from a deep sleep. Then get up and do things.

These can be quite complicated, like walking around or going up and down stairs. This can land you in embarrassing and dangerous situations.

Unless someone else wakes you up, you won’t remember anything about it. Sleepwalking sometimes happens after a night terror .

A sleepwalker should be guided gently back to bed and should not be woken up.

 You may need to take precautions to protect them or other people, such as locking doors and windows, or locking away sharp objects, like knives and tools.

Night terrors

These can happen on their own, without sleepwalking.

A person with night terrors will appear to wake up suddenly from a deep sleep.

They look half-awake and very frightened, but will usually settle back to sleep without waking up completely. All you can do is sit with them until they fall asleep again.

Night terrors are different from vivid dreams or nightmares as people don’t seem to remember anything about them the next morning.

Nightmares

Most of us have had experienced  frightening dreams or nightmares. They mostly happen during the later part of the night.

They don’t usually cause much problems unless they happen regularly, perhaps because of emotional distress. Nightmares often happen, after a distressing or life-threatening event such as a death, a disaster, an accident or a violent attack. Counselling can  be helpful.

Restless Legs Syndrome (RLS)

  • You feel like  you have to move your legs .
  • You may have uncomfortable or burning feelings in your legs.
  • These feelings only bother you when you try to rest.
  • They are generally worse at night.
  • You may not be able to sit still in the daytime or sleep properly.
  • It often runs in families.

RLS usually occurs on its own. Pregnancy or a physical illness (iron and vitamin deficiencies, diabetes or kidney problems) can occasionally be responsible.

If it is not caused by another physical illness, treatment depends on how bad it is. In mild RLS, the symptoms can usually be controlled by simple steps designed to help yourself through counseling and instructions to be followed.