It may be tempting to think of fatigue as a minor inconvenience rather than an indicator of a serious health issue, but that assumption may be dangerous. The consequences of sleep disorders range from behavioral issues to heart attacks, and it is absolutely possible for a serious sleep disorder to fly under the radar for years. According to Dr. Mark Rasmus, a sleep specialist at Saltzer Health, “some people can wake up 20 times throughout the night and not remember at all in the morning.”
According to the American Sleep Association, 50-70 million Americans have a sleep disorder.
Insomnia is perhaps one of the most well-known sleep disorders. Most commonly characterized by difficulty going to sleep or staying asleep, approximately 30% of Americans show symptoms of insomnia. However, these symptoms are only classified as a disorder if they are having a distinct, negative impact on the patient’s quality of life. Insomnia can be acute — a short-term type of insomnia that is usually caused by environmental factors, such as stress — or chronic, which is when the issues are persistent.
If the insomnia is not subsiding on its own, or is recurring, it is likely in your best interest to see a doctor. Your doctor will be able to create a unique treatment plan based on your medical history and symptoms. In many cases, Cognitive Behavioral Therapy (CBT) is as effective as medication in treating insomnia; as such, your doctor may recommend medication, CBT, or a combination of the two.
Sleep apnea is a disorder that causes a person to repeatedly stop breathing throughout the night. This in turn often wakes them up, resulting in episodes which they may not remember. Common symptoms of this disorder are snoring and daytime grogginess, but it can have more severe effects, such as cardiovascular issues and GERD (gastroesophageal reflux disease). Therefore, these seemingly minor symptoms should be taken seriously.
In fact, Dr. Rasmus states in no uncertain terms that “obstructive sleep apnea is a disease that kills.” With that in mind, he also remarks that independent research at Saltzer Health supports the theory that “snoring is rarely normal,” and it is very often indicative of an underlying sleep disorder. At least 25 million American adults suffer from sleep apnea.
There are three common forms of sleep apnea:
Obstructive sleep apnea: This is caused by muscles in the throat relaxing, which obstructs the airway. This can be the result of many things, such as obesity or a small airway.
Central sleep apnea: This is caused by a malfunction in communication between the brain and any muscles related to breathing. This may occur due to brain trauma, painkillers, or a variety of other factors.
Complex sleep apnea syndrome: This is a combination of obstructive and central sleep apnea.
There are a number of lifestyle changes, large and small, that can reduce the symptoms of sleep apnea, such as sleeping on your side, reducing alcohol intake, quitting smoking, and losing weight. However, the root causes of sleep apnea, such as a small airway, are often biological in nature, and therefore require more intensive treatment. These treatments may include a mouth guard, a continuous positive airway pressure (CPAP) machine, or jaw surgery.
Restless Leg Syndrome (RLS)
Restless Leg Syndrome, or Willis-Ekbom Disease, is characterized by uncomfortable sensations in the legs, accompanied by an overpowering impulse to move one’s legs in order to alleviate these sensations. This often temporarily works, but the sensations will usually recur when the movement stops. RLS is classified as a sleep disorder due to the fact that the symptoms commonly worsen at night, which can impact the ability to sleep. Approximately 10% of American adults suffer from this condition.
RLS is often a side effect of an underlying condition, and therefore, your doctor may need to diagnose this pre-existing condition in order to effectively treat a case of RLS. As a result, the medications used to treat RLS can vary widely. There are also some measures you can take at home, such as stretching, exercises, and baths.
Additionally, RLS and fatigue can be part of a self-perpetuating cycle. RLS increases fatigue and fatigue aggravates the symptoms of RLS. It is important for RLS sufferers to do what they can in terms of relaxing before bed and getting enough rest. Some good practices would be to establish a consistent sleep schedule, avoid caffeine past midday, and leave phones, tablets, and similar devices at the bedroom door.
Hypersomnia, or Excessive Daytime Sleepiness (EDS), is characterized by unusual fatigue during the daytime. In many cases, it is caused by another sleep disorder, or other underlying causes, such as drug use. Approximately 4-6% of Americans suffer from hypersomnia.
Your doctor will first need to determine what the root cause of the disorder is in order to recommend the most effective treatment. Treatments for hypersomnia often include changing or adding medications to your routine, and/or making lifestyle changes such as reducing caffeine or alcohol consumption.
Circadian Rhythm Disorder
Circadian rhythms are colloquially referred to as a “biological clock.” It refers to the mechanisms which regulate behavior and biological processes on a daily basis, most notably sleep/wake cycles. Due to the biological nature of this regulatory system, circadian rhythm sleep disorders (CRSD) are one of the only examples of a genetic sleeping disorder. Dr. Rasmus comments on this unique status: “It’s really rare to see by somebody who’s a true night owl who doesn’t have a parent or a sibling with the same disorder.”
Essentially, a circadian rhythm disorder refers to when a person’s circadian rhythm is desynchronized or does not correlate with the normal pattern for day-night cycles. Some circadian rhythm disorders are, as mentioned, genetic, such as delayed sleep phase disorder or narcolepsy, whereas others may be temporary and have an environmental cause, such as jet lag. It is approximated that 3% of Americans suffer from chronic forms of circadian rhythm disorder, but data may be skewed due to circadian rhythm disorders being commonly misdiagnosed as insomnia.
Parasomnia refers to a wide range of abnormal sleeping patterns, events, and behavior. These include: sleepwalking, night terrors, REM Sleep Behavior Disorder, and nocturnal leg cramps. The prevalence of parasomnia is difficult to measure due to the scope of the issues it refers to.
The unique issues are highly variable, and therefore the treatments for parasomnia are also highly variable. Treatments may involve anything from relaxation techniques, to counselling, to medication.
Beyond these very serious physical and mental repercussions, not getting enough sleep can take a toll on anyone. Dr. Rasmus maintains that according to modern studies, almost no one can function fully with less than seven hours and twenty minutes of sleep. As he states, “there’s always been a myth that you’re more successful if you can get away with sleeping less and functioning. But people don’t realize they’d certainly be sharper and more efficient if they were fully rested.