In detail

Everything you need to know about sleep disorders

Everything you need to know about sleep disorders

The sleep disorders They are divided into two large groups: dysomnias and parasomnias. Later we will see the causes and the main characteristics of these alterations.

Content

  • 1 Sleep disorders: Dysomnias
  • 2 Other sleep disorders: parasomnias
  • 3 References

Sleep Disorders: Dysomnias

This category of sleep disorders It is related to the duration, intensity and amount of sleep.

Insomnia

Insomnia is a sleep disorder that involves difficulty starting to sleep or staying asleep. Once the subject gets up he will be unable to go back to sleep, although it will cost him to be fresh and active in the morning. For a person to be diagnosed with the insomnia disorder It must meet the following characteristics:

  • That occurs at least 3 nights in the week and for 3 months
  • Discard any other sleep disorder
  • That is not related to the use of a substance
  • That is not explained by mental or medical disorders
  • It is a consequence of psychological, biological and / or environmental factors

Causes of insomnia

As usual, people suffering from insomnia have erroneous or unhealthy routines that affect the quality and quantity of your sleep, for example:

  • Irregular schedules
  • Dine copiously
  • Drinking alcohol before bed
  • Do intense exercise at night
  • Going to bed too soon
  • Perform jobs or activities that require high brain stimulation at night
  • Drink exciting drinks or stimulants before bedtime
  • Live in sectors with a lot of noise
  • The ambient temperature is extreme
  • They are living a stressful situation
  • Symptom that accompanies anxiety, depression, mania, or some dementia

Consequences of insomnia

The consequences of not fulfilling the 8 hours of sleep Daily can generate in the individual:

  • Functional impairment
  • Loss of productivity
  • Attention problems
  • Memory impairment
  • Less ability to interact at interpersonal level
  • Alterations in mood
  • Hormonal and metabolic problems
  • Stunted growth
  • Early aging
  • Weight gain

Primary insomnia

This type of insomnia is characterized because a particular cause cannot be attributed with certainty, although it is believed that stress could be a trigger. In many cases it arises in childhood and can be prolonged throughout life, increasing with age.

The symptom that will be presented in the subjects will be: fatigue, tiredness, headaches, muscle tension and gastric discomfort. The reason why this type of insomnia is prolonged is that the subject is constantly worried about his condition, that he will have difficulty falling asleep at night.

Thus, A state of anxiety and tension develops during the day that causes sleep disturbance at night. This disorder can also produce a kind of diurnal hypersomnia.

Hypersomnia

Hypersomnia is characterized by a excessive sleepiness that may be nocturnal (greater than or equal to 10 hours) or daytime (frequent naps that can last more than 1 hour). It usually starts around 15 and 35 years and tends to chronicity.

For this episode to be considered a disorder, must occur for at least 1 month. In addition, it will not be associated with another medical disorder or the effects of a substance, and narcolepsy will have been previously ruled out.

Patients suffering from this disorder they may fall asleep during the day but their sleep is not going to be restful. Your symptoms will be: low level of alertness, performance and concentration. This may have an impact on the person's work and social environment, in addition to being involved in accidents.

Narcolepsy

Narcolepsy is a syndrome of unknown origin characterized by abnormal attacks of sleep. It is also known as Gélineau syndrome and is a condition that affects both men and women.

It usually begins in adolescence, but is established specifically around the age of 25. Narcolepsy is made up of four symptoms that form the "narcoleptic tetrad" being drowsiness the most frequent symptom.

  1. Excessive daytime sleepiness: Patients have acute sleep attacks during circumstances that could be considered stimulants. This episode lasts between 10 and 15 minutes and there is usually a refractory period of several hours before the next episode.
  2. Cataplexy: It is an alteration of psychomotor skills by suddenly entering the REM phase. What the subject will experience is a sudden decrease in muscle tone (generalized or localized) being fully aware of it. Usually it will be triggered by intense emotions such as laughter, crying or anger and will last a few seconds. These episodes will begin years after the daytime sleepiness is established.
  3. Sleep paralysis: It is a state that maintains similarity with cataplexy since, the patient feels that he cannot move, speak or breathe naturally. The difference is that it will not have emotional triggers. Its duration will not exceed a few minutes, and may cease before external stimuli.
  4. Hypnagogic hallucinations: hallucinogenic episodes are pseudoperceptions of auditory or visual nature. They will not appear until adolescence and will tend to decrease over time. There are cases in which paralysis and hallucinations occur simultaneously becoming a terrifying event for the patient.

Causes of narcolepsy

It is believed that narcolepsy has a strong hereditary basis, being one of the few disorders of DSM-5 in which a biological mechanism has been identified. It has been observed that in half of narcoleptic patients there is a first-degree relative who also suffers from it. As for its physiological explanation, it is presumed that there is a hypocretin neurotransmitter deficiency in these patients.

Sleep disorders related to breathing

The sleep apnea syndrome It is a disturbance of breathing that is characterized by repetitive interruption (more than 10 seconds) of naso-buccal airflow during sleep. Three types of apneas can be distinguished from polysomnographic studies: obstructive, central and mixed.

  • Obstructive sleep apnea: It consists of cessation of air flow, starting again suddenly. This is the most common apnea. During sleep, the muscles relax and the airways narrow so that breathing becomes inadequate for 10 to 20 seconds. The brain detects the abnormality and awakens the subject. The most characteristic sign will be snoring, since the throat walls collapse.
    • Consequences: As respiratory cessation is going to happen overnight, the subject will not be able to enter phases III and IV becoming a little restful sleep. On the other hand, there will not be an adequate gas exchange, causing different degrees of nocturnal hypoxemia and hypercapnia.
  • Central sleep apnea: consists of the partial cessation of respiratory rate because the efferent neurons of the brain prevent the muscles that control breathing from acting correctly. This will happen only in cases where the CNS has been injured.
  • Mixed sleep apnea: It will be the combination of the two apneas mentioned above. Sometimes the respiratory system will be paralyzed and at other times there will be an obstruction.

Circadian rhythm disorders

They are sleep disorders due to a sleep-wake disorder. That is, the corresponding hours are asleep, but sleep schedules are altered. Humans are governed by circadian rhythms, which are linked to temperature, genetics and exposure to light.

Further, The body has a hormone called melatonin that is released during the night and is the one that induces sleep. All these elements will cause the patterns by which the person wakes up and falls asleep. Within this group we find the following disorders:

  • First, the type of delayed sleep phases: arises for a delay when going to sleep (more than 2 h)
  • Next, the type of advanced sleep phases: Its circadian biomarkers have been programmed 2 to 4 hours earlier than usual since they have become accustomed to getting up early.
  • Finally the type associated with work shifts: It happens to people who have unusual work schedules, for example, one week works during the night and another week works during the morning. This interferes with maintaining a normal sleep-wake schedule.

Other sleep disorders: parasomnias

They are abnormalities occur in REM and NO REM phase of sleep.

Nightmares

Nightmares are episodes that occur during REM sleep and has to do with the content of what you are dreaming about, which can be scary, distressing or threatening.

Anxiety can cause a motor reaction that awakens the individual. However, anxiety will dissipate to the extent that you recognize that you were only dreaming.

You can experience nightmares regardless of age, although they are more common in children. Its cause is not known exactly, but there are theories that they consider have an important meaning for the person.

Night terrors

Night terrors usually occur in phases III or IV of sleep. They start with a distressing and heartbreaking scream in the middle of the night. Generally, the person will get up with a diffuse distressing sensation, without knowing exactly what has happened or remember anything. Its etiology is believed to be related to emotional tension and fatigue.

Somnambulism

Sleepwalking is characterized by a sequence of body movements that the subject performs during slow wave sleep. The person can get up and perform various activities such as walking around the house or moving things.

Too could articulate some words. During this state, the person does not react to environmental stimuli. his duration can be from 1 to 30 minutes and can occur several times a week throughout life. This disorder is going to be triggered even more in times of stress.

References

Peña-Herrera, B. (2018) General Psychopathology. Samborondón: Espiritu Santo University - Ecuador.

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