Types of Sleep Disorders:
- Difficulty in getting enough sleep (Dyssomnia)
- Physiological events occurring during sleep (Parasomnia): They are manifested by nightmares and the symptoms like drowsiness.
Difficulty in getting enough sleep (Dyssomnia):
- Insomnia: This is one of the most commonly encountered sleep disorders. This sleep disorder could be said to be present in the persons having difficulty in falling asleep in the nights, in the persons waking up very frequently or waking up too early and being unable to sleep again or, in the persons feeling not rested despite sleeping for a sufficient duration.
- Hypersomnia: It presents as excessive sleep. The persons with the hypersomnia complain about being excessively sleepy. The daytime drowsiness is also observed in such persons. This condition of excessive sleep causes significant problems and troubles in social, professional and other fields.
- Narcolepsy: Being of genetic origin, this sleep disorder manifests with irresistible restful sleep attacks accompanied by short term loss of muscle tone, occurring every day for at least 3 months. The most noticeable characteristic of narcolepsy is the sudden overwhelming state of excessive sleepiness irrespective of the amount of sleep in the previous night.
- Respiratory sleep disorder: The breathing-related sleep disorder is a medical problem. Some breathing disorders ranging from simple snoring to stop of breathing (sleep apnea) may be observed to occur periodically during the sleep. The persons with breathing problem during sleep wake up for a short time many times a night and do not feel rested even after 8-9 hours of sleep. Some patients may be unable to breathe for a short time (10-30 seconds), which is a condition referred to as breathlessness (apnea). The person affected by this problem is quite unaware of and does not attribute the sleep problem to the breathing difficulty. However, the partner sharing the same bed may usually notice the loud snoring (a sign of a problem) or the conditions of frightening interruption in breathing. Other signs indicating that a person has difficulty in breathing in sleep are the following:
- Excessive sweating in the night,
- Waking up with a headache in the morning,
- Attacks of sleep not providing rest during the daytime.
Circadian (Daily) Rhythm Sleep Disorder/Sleep-Wake Cycle Disorder: Circadian (daily) rhythm sleep disorder has various types. Of these, the most commonly known is the condition called jetlag caused by travelling through different time zones. When a sudden change occurs in the sleep-wake routine with respect to the body clock, the person faces difficulty in adjusting the sleep. Many people experience fatigue, weariness and disturbed sleep after interoceanic or intercontinental flights.
Sleep-related movement disorders:
Restless Leg Syndrome: It may be described as a deep, uncomfortable sensation in the legs during the rest where the person remains still for a long time or during when the person is falling asleep. It is possible to identify also as a type of sleep disorder as it affects the quality of sleep. This unpleasant sensation is not a form of pain; it is usually experienced as the sense of itching, pin prick, goose bump, burn, pull, tension and tingling usually in the legs and rarely in the arms. An irresistible urge to move the legs develops in order to eliminate the sensation and the sensation lessens after the movement. This sensation emerges in the bus and aircraft travels where the person remains still for a long time and frequently in the night before falling asleep. The restless leg syndrome is observed in about 3 to 10% of the population with equal rates of incidence in men and women. Although usually occurring in the middle and advanced ages, it may be encountered also in the children.
Physiological events occurring during sleep (Parasomnia)
Sleep Anxiety Disorder/Nightmare Disorder: It usually occurs during the second half of the sleep period. A person with this sleep disorder experiences long and terrifying dreams, most of the time involving the life security threats. The person wakes up immediately after these frightening dreams and remembers them vividly. These nightmares most commonly occur in the period from the midnight until the end of the night. About 50% of the children of 3-5 years of age and older has nightmares.
Sleep Terror Disorder: This sleep disorder usually occurs early in the sleep and the panic begins with a scream. In this disorder seen in the children of 5 to 7 years of age, the person frequently wakes up abruptly. Severe automatic and motor symptoms, including a loud and piercing scream, is noticed in the person during the sleep terror.
Sleepwalking Disorder: It manifests in the form of getting out of the bed and walking around while asleep. The sleepwalking is common among the children of 5 to 12 years of age. Sometimes it persists until adulthood or it rarely begins in the adulthood. The duration of sleepwalking is generally less than 10 minutes. The probability of occurrence is higher in the persons with sleepwalking in the family history. Incidences involving injury and violence were reported during the state of sleepwalking; however, the persons are usually able to find their way around the room. The most important intervention in a sleep-walking person is to ensure that he/she does not injure himself/herself by tripping the objects around.
The sleep test (polysomnography) should be conducted in order to diagnose all these disorders.
Sleep test (Polysomnography)
Sleep test (Polysomnography) is a sleep study. It involves the parameters like monitoring the air flow through the mouth and nose, blood pressure, EKG activity, blood oxygen level, brain wave movements, eye movements and respiration, and recording the movement changes in the muscles and legs of a patient in order to be used in the detection of the normal and abnormal conditions experienced during the sleep and in the diagnosis for the patient undergoing clinical evaluation.
How the sleep test is performed?
The person should be at the hospital at least 2 hours before the normal time of sleep. Since the entire night will be spent in the sleep room, the patient should bring with them the personal belongings that may be necessary, such as sleepwear, slippers, toothbrush and towel. The electrodes are positioned on the chin, scalp and outer edge of the eyelids. These should remain in place during the sleep. The signals received from the electrodes while awake (with eyes closed) and during the sleep are recorded. The monitors to measure the heart rate and respiration are placed on the chest. The occurrence and the number of respiratory standstills will be measured. Night oxygenation, shallow and deep sleep periods, sleep depth, snoring and many other parameters will be measured. The data recorded during the night are assessed and concluded by a sleep specialist.
The following are performed in our center:
- Full-Night Polysomnography (PSG) + Breathing Records + PLM
- Full-Night Polysomnography + CPAP/BiPAP titration
- PSG + Nocturnal Penile Tumescence Test (NPT)
- PSG + Sleep Activation EEG
- MSLT (Multiple Sleep Latency Test)
