Sleep Disorders Center

A sleep disorders center is a healthcare center that aims to improve people's sleep quality and overall health. Sleep loss has harmful effects on quality of life and on almost every organ system. These centers diagnose and treat the various sleep disorders that people of all ages may experience. Specialist evaluations for common sleep problems such as sleeplessness (insomnia), sleep apnea, restless legs syndrome and narcolepsy are carried out in sleep laboratories. Polysomnography, which is used to monitor and analyze patients' sleep patterns, is one of the core tests widely used in sleep medicine. At a sleep disorders center, physicians from different specialties such as neurology, psychiatry and pulmonology work together to create treatment plans tailored to each patient. Non-invasive treatment methods such as behavioral therapy and lifestyle changes are also among the services offered at these centers.

What Are the Symptoms of Sleep Disorders?

The symptoms of sleep disorders may vary depending on their type and severity. Symptoms of common sleep disorders may include:

• Difficulty falling asleep

• Difficulty staying asleep

• Waking up too early

• Fatigue and low energy

• Loud snoring

• Pauses in breathing

• A choking sensation

• Night sweats

• Sudden need to sleep

• Sleep paralysis

• A constant urge to move in people with restless legs syndrome

Types of Sleep Disorders:

• Difficulty getting enough sleep (Dyssomnia)

• Physiological events occurring during sleep (Parasomnia) : Manifests with symptoms such as nightmares and sleepwalking.

Difficulty getting enough sleep (Dyssomnia):

1. Insomnia: It is one of the most common sleep disorders. This sleep disorder may be present in people who have difficulty falling asleep at night, who wake up frequently or wake up very early and cannot fall back asleep, or who still feel unrested despite getting enough sleep.

2. Hypersomnia: Manifests as sleeping too much. People with hypersomnia complain of being very sleepy. They also tend to doze off during the daytime. This excessive sleepiness causes significant distress and impairment in social, occupational and other areas of life.

3. Narcolepsy: In this sleep disorder of genetic origin, irresistible attacks of refreshing sleep occurring every day for at least 3 months are observed, accompanied by brief episodes of loss of muscle tone control. The most striking feature of narcolepsy is excessive sleepiness that can come on suddenly, regardless of how much sleep was obtained the previous night.

4. Breathing-related sleep disorder: Sleep-disordered breathing is a medical problem. During sleep, a range of breathing disorders may periodically occur, ranging from simple snoring to interruption of airflow (sleep apnea). People who have breathing problems during sleep wake up many times for short periods throughout the night and do not feel rested even after 8-9 hours of sleep. Some patients may be unable to breathe for short periods (10-30 seconds); this condition is called apnea. The affected person is barely aware of the breathing difficulty and does not associate their sleep problem with it. However, a bed partner can often notice loud snoring (a sign of this problem) or frightening episodes of breathing pauses. Other signs indicating that a person has difficulty breathing during sleep include:

• Excessive sweating at night,

• Waking up with a morning headache,

• Episodes of falling asleep during the day that are not refreshing.

​Circadian Rhythm Sleep Disorder / Sleep-Wake Cycle Disorder: There are several types of circadian rhythm sleep disorder. The best known is jet lag, which results from traveling across different time zones. When there is a sudden change in the sleep-wake pattern relative to the body clock, the person has difficulty adjusting their sleep schedule. Many people complain of malaise, fatigue and disturbed sleep after transoceanic or intercontinental flights.

Sleep-related movement disorders:

Restless Legs Syndrome: It can be described as a deep, unpleasant sensation in the legs that occurs at rest, when the person remains still for a long time, or while falling asleep. Because it affects sleep quality, it can also be described as a type of sleep disorder. This unpleasant sensation is not a form of pain; it is usually felt in the legs, and rarely in the arms, as itching, pins and needles, goosebumps, burning, pulling, stretching or tingling. An irresistible urge to move the legs arises to relieve this sensation, and movement eases it. This sensation often appears during long periods of immobility such as bus and plane journeys, and frequently at night before falling asleep. Restless legs syndrome affects approximately 3% to 10% of the population, equally in men and women. It usually appears in middle and older age, but it can also occur in childhood.

Physiological events occurring during sleep (Parasomnia)

Sleep Anxiety Disorder / Nightmare Disorder: It usually occurs during the second half of the sleep period. In this sleep disorder, the person often has long and extremely frightening dreams involving threats to their survival or safety. Immediately after these frightening dreams, the person wakes up and remembers the dream vividly. Most commonly, these nightmares occur from the middle to the end of the night. Approximately 50 percent of children aged 3-5 and older have nightmares.

Sleep Terror Disorder (Night Terrors): This sleep disorder usually occurs early in the sleep period and begins with a panicked scream. In this disorder, seen in children between the ages of 5 and 7, the person often wakes up suddenly. During a sleep terror, severe autonomic and motor symptoms are observed, including a loud, piercing scream.

Sleepwalking Disorder: It manifests as getting out of bed and walking around during sleep. Sleepwalking is common in children between the ages of 5 and 12. It sometimes continues into adulthood or, rarely, begins in adulthood. A sleepwalking episode usually lasts less than 10 minutes. It is more likely to occur in people with a family history of sleepwalking. Injuries and violent incidents have been reported during sleepwalking; however, people can usually find their way around the room. The most important intervention for a sleepwalker is to make sure they do not trip over objects around them and injure themselves.

A sleep test (polysomnography) should be performed to diagnose all of these conditions.

Sleep test (Polysomnography)

A sleep test (polysomnography) is a sleep study. It includes parameters used to detect normal and abnormal events during sleep and to support the clinical evaluation and diagnosis of the patient, such as monitoring airflow through the mouth and nose, blood pressure, ECG activity, blood oxygen level, brain wave activity, eye movements, breathing, and recording changes in muscle and leg movements.

How is a sleep test performed?

You need to be at the hospital at least 2 hours before your normal bedtime. Since the whole night will be spent in the sleep room, the patient should bring personal items that may be needed, such as pajamas, slippers, a toothbrush and a towel. Electrodes are placed on the chin, scalp and the outer edges of the eyelids. These must stay in place while you sleep. Signals from the electrodes are recorded while you are awake (with your eyes closed) and during sleep. Monitors will be attached to the chest to record heart rate and breathing. Breathing pauses and their number will be measured. Nighttime oxygen levels, light and deep sleep stages, sleep depth, snoring and many other parameters will be measured. The data recorded throughout the night are evaluated and reported by a sleep specialist.

At our center, the following are performed:

• All-Night Polysomnography (PSG) + Respiratory Recordings + PLM

• All-Night Polysomnography + CPAP/BiPAP titration

• PSG + Nocturnal Penile Tumescence Test (NPT)

• PSG + Sleep Activation EEG

• MSLT (Excessive Daytime Sleepiness Test).

How Are Sleep Disorders Diagnosed?

Sleep disorders can be diagnosed through a combination of a detailed medical history, a physical examination and certain diagnostic tests. After the physical examination, the doctor may order diagnostic tests to help with the diagnosis. Some of the tests and procedures used in diagnosing sleep disorders are:

• Sleep diary: Patients are usually asked to keep a sleep diary for a period of time. In these diaries, patients record their bedtimes and wake-up times, awakenings during the night and other sleep-related events.

• Polysomnography (Sleep study): Polysomnography is considered the gold standard in diagnosing sleep disorders. This test involves overnight monitoring in a sleep laboratory and records many parameters during sleep, such as brain waves, eye movements, muscle activity, heart rhythm and breathing.

• Home sleep tests: In some cases, doctors may recommend home sleep tests. Although these tests are less comprehensive, they can be used particularly for the preliminary diagnosis of disorders such as sleep apnea. Home sleep tests usually monitor breathing and oxygen levels.

• Actigraphy: Actigraphy monitors the sleep-wake cycle with a small device worn on the wrist. This method is particularly useful in diagnosing sleep-wake rhythm disorders. By recording the patient's movements, the device helps evaluate sleep duration and quality.

• Blood tests and other laboratory tests: Some sleep disorders may be caused by other underlying medical conditions. For this reason, doctors perform various blood tests and other laboratory tests to evaluate health indicators such as thyroid function and iron levels.

• Psychological evaluation: Sleep disorders are often associated with psychological conditions such as stress, anxiety and depression. For this reason, psychological evaluations may also be part of the diagnostic process. By assessing patients' mental health, doctors investigate the psychological origins of sleep disorders.

• Electroencephalography (EEG): EEG is a test that measures the electrical activity of the brain and plays an important role in diagnosing sleep disorders. This test is used particularly in the diagnosis and evaluation of neurological conditions such as epilepsy.

• Multiple sleep latency test (MSLT): The multiple sleep latency test (MSLT) is a test used to evaluate daytime sleep tendency. This test is used in the diagnosis of narcolepsy and other disorders of excessive daytime sleepiness. The MSLT is performed in a sleep laboratory by giving the patient short opportunities to sleep at set intervals. During each nap, how long it takes the patient to fall asleep and which sleep stage they enter are recorded.

What Are the Treatment Methods for Sleep Disorders?

Treatment methods are planned by specialist physicians according to the underlying causes and symptoms of the sleep disorder. Various treatment options may be used for sleep disorders, which may include:

• Medication

• Cognitive behavioral therapy (CBT)

• Sleep hygiene improvements

• Lifestyle changes such as regular exercise, healthy eating and stress management

• CPAP (Continuous positive airway pressure) device

• Uvulopalatopharyngoplasty (UPPP)

• Light therapy

How Are Sleep Disorders Treated?

The goals of treating sleep disorders are to relieve symptoms and improve quality of life. Treatments are planned by specialist physicians depending on the specific type and severity of the condition. Some treatment methods may include:

• Cognitive behavioral therapy (CBT): Cognitive behavioral therapy (CBT) is an effective approach, especially in the treatment of chronic insomnia. This therapy aims to change negative thoughts and behaviors related to sleep. It includes strategies such as sleep restriction, stimulus control and relaxation techniques. CBT improves sleep quality by addressing worries and false beliefs that make it difficult to fall asleep. In the long term, CBT has the potential to provide lasting sleep improvements and can offer a drug-free solution.

• Medication: In the treatment of sleep disorders, medications are used under medical supervision, particularly as a short-term solution. Sleeping pills such as benzodiazepines and non-benzodiazepines may be prescribed for insomnia (sleeplessness). In conditions such as sleep apnea, medications that help keep the airways open are preferred. Dopaminergic drugs can be effective in treating restless legs syndrome (RLS), while stimulants such as modafinil and methylphenidate are used to reduce excessive daytime sleepiness caused by narcolepsy. However, they should be used with caution, as long-term use may lead to dependence.

• Sleep hygiene improvements: Sleep hygiene means healthy sleep habits and improving the sleep environment. Staying away from electronic screens before bed and keeping regular sleep hours can be beneficial. Avoiding caffeine and heavy meals is also an important factor in sleep hygiene. Sleep hygiene improvements applied under medical supervision can be effective in managing insomnia and other sleep disorders.

• Lifestyle changes: Exercising regularly under medical supervision, practicing stress management techniques and eating a balanced diet can improve sleep quality. Avoiding stimulants such as alcohol, caffeine and nicotine can help establish a regular sleep pattern. In the long term, these changes can contribute to the natural management of sleep disorders without side effects.

• CPAP (Continuous positive airway pressure) device: A CPAP device is an effective method recommended by doctors, especially for the treatment of sleep apnea. It applies continuous positive pressure to keep the airways open throughout sleep. By preventing breathing pauses, CPAP provides uninterrupted sleep and improves sleep quality. This method can significantly reduce sleep apnea symptoms and improve the patient's quality of life.

• Uvulopalatopharyngoplasty (UPPP): Uvulopalatopharyngoplasty (UPPP) is a surgical method used in the treatment of sleep apnea. This procedure involves removing part of the soft palate, the uvula and the tonsils. The surgery widens the airway, improving airflow and reducing breathing pauses during sleep.

• Light therapy: Light therapy is a type of therapy designed to treat certain health conditions by exposure to artificial light. During a light therapy session, the person is indirectly exposed to artificial light from a device known as a light therapy box, which emits bright artificial light similar to natural sunlight. Light therapy may be recommended by doctors for the treatment of conditions such as circadian rhythm disorders and seasonal affective disorder (SAD). This treatment can help regulate the biological clock. Light therapy can be especially effective for night-shift workers or people experiencing jet lag.

Frequently Asked Questions

Which Department Treats Sleep Disorders?

Sleep disorders are usually evaluated by specialists in neurology, psychiatry and pulmonology (chest diseases). The neurology department examines sleep disorders related to the nervous system, while psychiatry examines those caused by psychological factors such as stress, anxiety or depression. In addition, for breathing-related sleep disorders such as sleep apnea, the pulmonology department can plan the necessary treatment.

Which Department Should I Visit for a Sleep Disorder?

People with sleep disorder complaints can first apply to the neurology or psychiatry departments. The neurology department evaluates sleep disorders related to the nervous system, while the psychiatry department addresses sleep problems caused by psychological factors. In addition, for breathing-related sleep disorders such as sleep apnea, patients can apply to the pulmonology department.

What Disease Is Inability to Sleep at Night a Symptom Of?

Being unable to sleep at night is usually a symptom of a sleep disorder called insomnia (sleeplessness). Insomnia can arise from many different causes, such as stress, anxiety, depression or chronic pain. In addition, breathing disorders such as sleep apnea or neurological conditions such as restless legs syndrome can also lead to difficulty sleeping at night.

What Deficiency Causes Sleep Problems?

Sleep problems can often be caused by a deficiency of the hormone melatonin. Melatonin is a hormone that controls the sleep-wake cycle. In addition, deficiencies of vitamin D or iron can also affect sleep quality and lead to sleep disorders such as restless legs syndrome.

Which Vitamin Deficiency Causes Sleep Disorders?

Sleep disorders can be caused especially by vitamin D deficiency, because vitamin D has an effect on the central nervous system and stress hormone levels. Vitamin B12 deficiency can also affect nervous system function and lead to fatigue and sleep problems. In addition, iron deficiency can cause restless legs syndrome, which can negatively affect sleep quality.

Does B12 Deficiency Cause Sleep Disorders?

Vitamin B12 deficiency can lead to sleep disorders. Vitamin B12 is critical for nervous system health and energy metabolism; its deficiency can cause fatigue, weakness and irregular sleep.

Does Magnesium Deficiency Cause Insomnia?

Magnesium deficiency can lead to various sleep problems, including insomnia. Magnesium is an important mineral involved in more than 300 biochemical reactions in the body. It plays an important role in regulating nervous system and muscle function. Its deficiency can make it difficult to fall asleep and reach deep sleep.

Does Vitamin D Deficiency Cause Sleep Disorders?

A deficiency in vitamin D levels can play a role in the development of sleep disorders. Vitamin D receptors are found throughout the body, including the central nervous system. These receptors control the sleep cycle and help you get deep sleep. However, due to vitamin D deficiency, these receptors may not work properly. In addition, vitamin D deficiency can cause an increase in levels of cortisol, also known as the stress hormone, which can also make sleeping difficult.

A person's sleep quality may deteriorate due to factors such as an underlying condition, poor lifestyle habits or genetic predisposition. This can make daily life extremely difficult. People with sleep disorders can begin treatment for healthy sleep by making an appointment at a sleep disorders center.

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