At least 30% of the population is generally likely to experience sleep problems, some of which can even lead to serious psychological and physical complications. Sleep disorders have become a major problem affecting public health and can lead to reduced work capacity, accidents, educational and social problems, and poor health status. The latest international classification of sleep disorders describes about 100 sleep disorders. However, a person may suffer from more than one sleep disorder, so care must be taken when making a diagnosis, which, if incorrect, usually leads to failure of treatment and may even make the condition worse. For example, prescribing sleeping pills to someone presenting with obstructive sleep apnea symptoms may make their breathing worse. The following are some of the common clinical sleep disorders.
1. Insomnia
This is the most common sleep disorder, with about one-third of the world’s population experiencing insomnia to a greater or lesser extent, and one in twenty of these people having to resort to medication to aid sleep. This condition has many triggers and usually manifests itself as difficulty falling asleep or waking up easily and not easily falling back to sleep after waking. Because of the inability to recover from sleep, it can lead to short-term symptoms such as fatigue, lack of energy, irritability, and long-term insomnia may also lead to cardiovascular disease. There is also a familial acute insomnia can even be fatal.
2. Snoring and sleep apnea syndrome
Severe snoring may lead to throat blockage, which may be life-threatening if not relieved in time. Snoring is often accompanied by sleep apnea syndrome, which refers to the recurrence of respiratory arrest during sleep, lasting 10 seconds or more each time. This disorder can cause a drop in blood oxygen, which can cause or worsen diseases such as hypertension, heart failure, and diabetes. Sleep apnea syndrome has a great impact on the quality of sleep and the performance of the patient during the day.
3. Heterosomnia
It refers to abnormal, unconscious and complex behaviors during sleep that are usually meaningful or important to the patient. It includes sleep violence, nocturnal sleepwalking, nocturnal eating disorder, and all behaviors that occur during sleep. It can be clinically useful to ask a reliable third party (the patient’s family, as the patient himself often cannot say what symptoms occur) to help diagnose and select a treatment plan. Many heterosomnias are prone to occur at certain characteristic times of the night, occurring during certain stages of sleep, so a good history should include the timing of the episodes.
Try to identify other factors associated with heterosomnia. For example, in people with a tendency to sleepwalk, factors like systemic illness, sleep deprivation, stress, and some medications can lead to episodes. Traumatic experiences may interfere with sleep and frequently induce nightmares. Laypersons may not be aware that some commonly prescribed medications may induce heterosomnia. Be careful to distinguish nocturnal seizures from other oversleeping disorders.
4. Sleep paralysis
This is often referred to as “ghost sleep”. It refers to a brief period of immobility when falling asleep or just waking up. There is no commonly known horror, this situation will most likely be within a few minutes of their own slowly or suddenly restore the ability to move the body. Because of the feeling of panic at the time of the attack, many people feel scared after waking up and think that they are being suppressed by some unknown object, which is why the term “ghost bed press” is used. In fact, it is just a mechanism that keeps the body from moving during sleep to protect itself, and some studies suggest that it is related to the stress of life. It is very important to explain this symptom to the patient in a correct and scientific way. It can be recommended to live a regular life, going to bed on time, getting up on time and eating on time. Exercise in moderation, but do not exercise vigorously before bedtime. Avoid staying up late and keep enough sleep.
5. Restless legs syndrome
This is a neuromotor disorder resulting in restlessness in the feet during sleep, manifested as pain, burning, tingling, etc. These sensations make the patient have to move the feet frequently to relieve the symptoms. It mainly occurs during prolonged rest, drowsiness or just before sleep. It can be familial and is often associated with nocturnal myoclonus. Patients often have the pain relieved by tapping on the lower extremities, walking, and massaging, and the symptoms disappear when they fall asleep, with no symptoms associated with them during the day. It usually indicates that the patient is obese or pregnant, iron deficiency, etc.
6.Disorder of circadian biological rhythm
The body’s biological clock and the external time inconsistency led to sleep disorders, manifested as the time to sleep can not fall asleep or should not sleep than anyone sleep. That’s right, the most common cause of this disorder is jet lag. Totally blind patients or people who do circadian work, such as nurses, are also prone to this disorder. Treatment is based on adjusting and restoring biorhythms.
7. Episodic sleeping sickness
It is characterized by four features: fainting (when subjected to strong emotional stimuli, such as excessive fright or happiness), sleep paralysis, sleep hallucinations (dream-like hallucinations of hearing, seeing or touching while sleeping), and excessive daytime sleep. Once an attack occurs, the patient falls asleep immediately regardless of time and place and cannot be stopped, which is very dangerous for working life. The onset of the disease is usually in childhood or young adulthood, and the incidence is similar in both sexes. Some patients may have a history of encephalitis or craniocerebral trauma. The pathogenesis of the disease is not yet clear, but it may be related to the reduced function of the brainstem reticular upstream activation system or the hyperfunction of the pontocerebrocaudal reticular nucleus. The main focus is to regulate the sleep time and rest pattern, but for severe daytime sleepiness, sudden collapse, etc., drug-assisted symptomatic treatment is needed.
8.Chronic fatigue syndrome
This refers to patients with unexplained fatigue, which cannot be relieved by rest, and the symptoms are aggravated by doing physical or mental activities. Patients can only reduce daytime activities to preserve energy. It is important to note that other diagnoses need to be ruled out beforehand in order to diagnose this disease, otherwise it will delay the treatment of the patient.
9. Seasonal sleep disorder
The persistent depressed, excessive sleep state in winter is generally thought to be caused by a lack of sunlight making the biological species of the supraoptic nucleus function poorly. The opposite condition may occur in summer, when higher temperatures and longer days and shorter nights make it difficult to fall asleep and cause insomnia. The indoor environment can be adjusted to improve the situation.
The key recommendations for achieving healthy sleep are as follows.
1. High quality sleep is essential for good health and overall quality of life.
2. Too little sleep (≤6h/24h) is associated with negative transitions, including death.
3, Too much sleep (>9-10h/24h) may also be associated with negative health transitions.
4. At the group level, the optimal sleep duration for adults is 7-9 hours, but there are individual differences.
Given that drowsy driving is a significant cause of fatal and non-fatal motor vehicle crashes, all drivers, both professional and non-professional, should be educated on how to recognize symptoms of drowsiness and its consequences.
6. The general public and medical workers need to be better educated about the impact of work hours and shifts on sleep duration and quality, and the correlation between sleepiness and workplace injuries.
7. Sleep disorders are common, can cause significant symptoms, impose a significant financial burden, and are also treatable. However, many individuals suffering from sleep disorders remain undiagnosed and untreated.
8. For children, age-based recommendations for sleep duration should be developed. With these recommendations, children should be able to wake up naturally at the desired time by implementing a regular wake-up and sleep schedule.
9. For minors, school start times should be delayed to align with the physiological rhythmic tendencies of the age group.
10. Medical professionals should receive more education about sleep hygiene and encourage patients to sleep for as long as possible.
11, Educational programs for the public should be developed to emphasize the importance of sleep for health.
12. People need better education/awareness about the importance of early detection of high risk groups for obstructive sleep apnea in children and adults.
13, People should be better educated by physicians about the effectiveness of cognitive behavioral therapy (CBT) for insomnia rather than the immediate use of sedative sleep aids; we also need to make structural changes to increase exposure to this treatment.