It’s God’ grace if we have sound sleep. Often now-a-days we find it very difficult to have sound sleep. We need to have at least 7 to 9 hours of sound sleep everyday. Sleep deprivation and sleep related disorders have many untoward effects in our physical and mental health. It may affect our memory, concentration abilities, change our mood and may even cause accidents. Our body needs sleep as we need food to survive. Francesco P Cappucio study revealed poor sleep to mortality in a systemic review.
Insomnia
Sleep deprivation is called as insomnia. Insomnia may hamper our physical health and aggravate the underlying health conditions. It is difficult to initiate sleep, maintain sleep, frequent arousal and daytime sleepiness.
Causes
• Primary insomnia– The causes are not related to any health related conditions. Mostly it is related to stress. Stress may be related to trauma like loss of any family member, divorce, unemployment, financial loss, bad habits like late night watching TV, playing video games, alcohol.
• Secondary insomnia– Due to some underlying diseases like cancer, Hyperthyroidism, Myocardial infarction, renal failure, cirrhosis, cerebral tumors.
Prevention–
• Go to sleep at a fixed time everyday
• Avoid late night watching television, movie, playing video games,
• Avoid late night taking alcohol, coffee
• Do some regular exercise
• Regular meditation calms our mind and relaxes our body.
2. Snoring- It occurs during sleep due to obstruction of air passage in the mouth or nose making a vibrating loud sound. The obstruction in the nasopharynx, oropharynx or laryngopharynx may be due to growth of soft tissues in soft palate, tonsil, adenoids or floor of mouth.
3. Obstructive sleep apnea– It is a dangerous condition causing sudden respiratory distress, apnea. The growth of soft tissues in neck partially closes the airway which is more pronounced during the time of sleep.
4. Restless leg syndrome- The inability to control the movement of legs causing restlessness. Also caled as Willis-Ekbom disease. It occurs mostly in nights whet body lies flat in rest. The cause isn’t known. The prevalence of symptoms are more common in below 40 years. It usually starts at night especially when the body is at rest. The urge for movement of legs starts with an uncomfortable feeling.
It can be managed by changing lifestyle like cessation of alcohol drinking, smoking tobacco, relaxing exercises and maintaining a regular sleep pattern. US FDA recommended a foot wrap for alleviating the symptoms. For patients with low transferrin saturation, iron therapy can be started.
Luigi-Ferini-Strambi study showed the dramatic improvement with dopa agonists like pramipexole and ropinirole suggest some dopaminergic pathway in etiopathogenesis.
5. Bruxism- Grinding of teeth while sleeping. It is an involuntarily sleep movement disorder. It is a stereotype disorder characterized by clenching or grinding of teeth. It occurs in around 13% normal adults. Repeated activities may cause temporomandibular fatigue, teeth wear. Sleep bruxism is regulated centrally not peripherally. F lebbezoo study highlights the central nervous system role in bruxism. G M Macaluso showed bruxism episodes are equally distributed between NREM and REM sleep. It is more frequent in stage-1 and 2 than in slow wave pattern. The great majority were seen in NREM sleep with cyclic alternating pattern.
Butler described an occlusal adjustment procedure for treatment of bruxism. Frumker described a set of principles for a successful occlusal therapy.
6. Narcolepsy
Narcolepsy is excessive daytime sleepiness. Proper sleeping history is essential for its diagnosis. A part of the history requires filling out the Epworth Sleepiness Scale. The sleeping pattern is recorded for a week or two.
Polysomnography measures a variety of signals by placing electrodes on the scalp.
Multiple sleep latency test measures the time required to fall asleep during day.
7. Jet lag
It occurs in persons travelling in air to multiple time zones. Our body has an internal time zone called as circadian rhythm. Our internal circadian rhythm responds only to own time zone to which our body is habituated. Beyond this, our body sends signal to fall asleep. Travelling in multiple time zone causes body fatigue, anxiety, mood changes, day time sleepiness or insomnia.
8. Somnambulism and somniloque
Somnambulism is sleep walking and somniloque is sleep talking.
