Sleep disorders are medical disorders where the sleep patterns of a person is disrupted. A French scientist, Henri Pieron wrote a book entitled “Le problem physiologique du sommeil” which first examined sleep from a physiological perspective. Then, Dr. Nathaniel Kleitman also known as ‘Father of American sleep research’ questioned the regulation of sleep and wake and of circadian rhythms. His work delved into studies of sleep deprivation. Soon after, Kleitman and his student, Dr. Eugene Aserinsky discovered rapid eye movement (REM) during sleep. Dr. Kleitman’s research was further extended by another one of his students, Dr. Willaim C. Dement who discovered the connection between REM sleep and dreaming.
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Sleep disorders effect a person’s sleep cycle which can be life disrupting where it disturbs a person’s social and psychological state. These disorders vary from more common disorders such as snoring to life threatening disorders such as narcolepsy. There are three broad classifications of sleep disorders; dyssomnias, parasomnias and medical-psychiatric sleep disorders. Dyssomnias are disorders which involve excessive sleepiness and are associated with disturbed sleep. Disorders such as primary insomnia, narcolepsy, obstructive sleep apnea and restless leg syndrome are disorders categorized under dyssomnias. Parasomnias are disorders which involve undesirable physical phenomena which occur during sleep and generally are disorders or arousal, partial arousal, and sleep stage transitions. Disorders such as sleepwalking, night terrors and rhythmic movement disorders are examples of parasomnias. Medical-psychiatric sleep disorders are relations between psychiatric and sleep disorders. People who suffer from depression tend to wake up early and are unable to fall back asleep. This makes their depression worse as the amount of sleep effects one’s illness. Likewise, treatment and medication used in psychiatric disorders can cause sleep disorders such as insomnia.
There are many types of sleep disorders which vary between the three broad classifications of sleep disorders. Here are a few brief descriptions on some more commonly known sleep disorders. Insomnia is the condition where one finds it difficult to fall asleep whether it may be in the beginning of the night, after waking up in the middle of the night or waking up much earlier in the morning. This will cause lack of sleep which will bring about complaints of non-restorative sleep, sleepiness during the day or fatigue. Sleep apnea is where one has difficulty breathing and sometimes stops breathing over a period of time while sleeping. This condition can range from 10 pauses per hour to 30 pauses per hour. Loud snoring, daytime sleepiness and tiredness are common effects of sleep apnea and most people complain of hypersomnulence and loud snoring to the extent where it can be heard from outside of the house. Narcolepsy is another disorder of excessive sleepiness and hypersomnulence which is associated with cataplexy and other REM phenomena. A person suffering from narcolepsy may just fall asleep instantly without their own awareness. Such a disorder can be very life threatening as falling asleep in certain conditions like behind the wheel can prove to be fatal. Night terrors are severe and frightening partial arousal from sleep. Most people scream and cry while showing fear and anxiety.
When experiencing sleep disorders, it is vital to seek medical treatment to cure this condition. Most doctors recommend sleep clinics for diagnosis of the sleep problem. The doctor will study one’s history, lifestyle and habits before diagnosing one’s condition. Generally, sleep disorders can be treated by self-care regimes such as the “Good sleep hygiene” regime. This habit advices that one should stick to a regular bedtime schedule, avoid napping during the day, avoid substances which contain caffeine, alcohol and nicotine and also sleeping in a surrounding where it is dark, comfortable and relaxing.
Dead man walking – Somnambulism
Ever heard of horror stories where someone wakes up in the middle of the night, walks up to someone else or something else and acts out or mumbles? More often than not, these cases are mistaken for some supernatural happening. The more skeptical group of people believes that this was caused because that someone was possessed. The punch line for this whole situation is that there is a perfectly reasonable scientific explanation where this whole phenomenon is actually a sleep disorder; Somnambulism. Somnambulism is defined as a series of complex behaviors which arise during slow wave sleep (REM) and result in walking during sleep. This condition is also referred to as sleepwalking.
Somnambulism or a more common term, sleepwalking, occurs mostly in children but there are cases which can last to adulthood. When the brain has trouble with the transition from non-REM to REM sleep, sleepwalking occurs. The hypothalamus in the brain controls the sleep-wake cycle of the body. When one sleeps, the hypothalamus blocks a part of the brain so that it does not perform any action and blocks off certain nerves that brings impulses to the brain while sleeping. During REM, our body has a mechanism which keeps us still so we do not act out our dreams. When this feature is missing, people experience REM sleep behavior disorders which include sleepwalking.
There are many elements which can lead to sleepwalking. Most of these factors are categorized into three main factors; genetics, medical conditions and environmental factors. Genetics plays a vital role in one’s sleepwalking condition. When a person is diagnosed with sleepwalking, it is a possibility that they have inherited that specific gene. If there is a family member with that abnormality, it is ten times the chances of that person inheriting the sleepwalking disorder. Identical twins also have a higher chance in becoming sleepwalkers. There are also many medical conditions which lead to sleep walking. Conditions such as fevers which directly impact the nervous system, nighttime asthma, obstructive sleep apnea, night time seizures and psychiatric disorders have a great impact towards sleepwalking. Adults with psychiatric disorders often consume drugs like anti-seizure medicines and stimulants which cause sleepwalking. A person’s environmental surroundings can also induce sleepwalking. When someone experiences hormonal changes induced by pregnancy, menstruation or puberty it can lead to sleepwalking. Also, sleep deprivation, alcohol intoxication and unusual sleep schedules bring about the said disorder.
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So, what actually happens when one sleepwalks? In some cases, the sleepwalker sits up from their laid position. Some cases have the sleepwalkers run from their beds. The sleepwalkers’ actions vary depending on the type of dream. If someone is dreaming about being chased by a hungry wild animal, that someone is more likely to run as fast as they can. One can only imagine the outcome when a sleepwalker is dreaming about using the bathroom. While sleepwalking, the sleepwalkers’ eyes can be open or closed and appear glassy. Even though their eyes are open, their vision is not permitted as they are still in a state of sleep. Most people stereotype sleepwalkers to have their hands propelled out as if they were zombies and their eyes rolled back. In actual fact, these sleepwalkers perform daily life tasks. Some may cook meals and some have ended up behind the car wheel. Lucky for them, they couldn’t find the car keys. It is not advised to awaken a sleepwalker as it is possible for them to go into a state of shock. After all, they are not controlling their actions at this moment in time. As soon as the sleepwalker wakes up from their dream, they experience amnesia where they cannot recall what they did previously when sleepwalking. The danger of sleepwalking can not only affect the sleepwalker but also the people around them. There have been over 20 cases where people have performed murders while sleepwalking. Also, many sexual assault and rape cases have been related to sleep walking. It is hard to justify these cases as most of it is performed when the person is not conscious of their actions.
Sleepwalking is a serious sleep disorder and has to be resolved as soon as it’s diagnosed. Of course the best solution is prevention. In order to prevent sleepwalking, one should get adequate sleep. Never allow yourself to experience sleep debt. One should also cultivate a stress-less lifestyle. Meditation and relaxation exercises help provide a tranquil and serene sense of thought. However, if one has already succumbed to the sleepwalking disorder, there are many solutions to resolve this problem. Medication is a common treatment for sleepwalking. Medications are necessary if sleepwalker is at risk of injury, causes disruption to the family household, and other treatment option are not effective. Other treatment options are non-drug based and are preferred treatment for a long term. Anticipatory awakenings are when the patient is woken up approximately 15-20 minutes before the anticipated attack and is kept awake through the time of the attack. Relaxation and mental imagery are more natural techniques and can be very effective if it is carried out by an experienced behavioral therapist or hypnotist. Hypnosis also helps reduce sleepwalking. In order to protect the sleepwalker from the risk of injury, a safe environment should be preserved where it is free from harmful objects. Also, the doors and windows should be locked and an alarm bell should be installed at the door of the sleepwalkers’ bedroom. This is to alarm the family when the sleepwalker is on the move.
Conclusion
Sleep disorders are a medical condition where the sleep pattern is disrupted. Most disorders occur when there is a dysfunction with the REM sleep. Sleep disorders are categorized into three broad classifications which are dyssomnias, parasomnias and medical-psychiatric sleep disorders. Dyssomnias disorders involve excessive sleep, parasomnias involve undesirable physical phenomena and medical-psychiatric sleep is correlated where the psychiatric conditions of a person effects the sleep conditions and vice versa. Most sleep disorders can affect one’s daily life whether it may be the person experiencing the sleep disorder or the person around them. Sleep disorders vary from mild conditions such as bruxism to dangerous, life-threatening conditions such as sleep apnea. It is vital for people who suffer from sleep disorders to seek medical help in order to contain this condition from getting worse whether it may be from medication or just adapting a healthy lifestyle. Somnambulism (sleepwalking) is when a person gets up and walks about during the deep sleep stages. A person experiencing sleepwalking is acting out a dream or a vision in their heads. The sleepwalker does not realize they are sleepwalking and after each episode they experience a mild case of amnesia. The sleepwalking syndrome is usually caused by three main factors which are genetics, medical conditions and environmental surroundings. A sleepwalker experiences episodes where they wake up in the most unlikely places and in some cases end up in embarrassing situations. When sleepwalking, one does not realize their actions and are in no control of it. Some sleepwalking cases can be very dangerous as they attempt things which are fatal when the conscious mind is not at play. In order to end accidents by sleepwalking, this disorder needs to be treated. Methods such as medication, anticipation awakenings, relaxation and mental imagery are effective when treating sleepwalking.
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