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Sleep Disorders |
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A normal man spends approximately 1/3rd part of his life span in sleep. Yet, we know so little about sleep. Utility of sleep is not satisfactorily known. Some persons sleep less, some more and yet both of them may be normal. Sleep not only rejuvenates but also other physiological activities takes place like, secretion of Growth Hormone of Pituitary rises (recall that the infants sleep more than the adults).
Before going about disorders of sleep it is important about knowing the major stages of sleep-
Stages of sleep
Slow wave sleep(SWS) or non-REM
Rapid eye movement(REM)
Slow wave sleep (SWS) : Once a person has fallen asleep, he or she sinks deeper and deeper into SWS, starting from awake to dozing to deep sleep. Breathing slow, pulse rate and body temperature drop and the muscle relax. (SWS) is non-dreaming sleep has characteristically large, regular, slow waves in EEG.
Rapid eye movement (REM) : The eye balls move frequently (thus giving an impression, that sleep is now light), the muscle relaxes more and the intensity of sleep is more. This is the period when the subject dreams. The eyeball movements are probably due to the fact the subject follows the objects in the dream.
REM sleep is important for it is in someway concerned with the consolidation of memory.
INSOMNIA
Insomnia is the subjective complaint of insufficient sleep, is used to describe a condition when there is inability to fall asleep or stay in sleep or there is reduction in total time of sleep. Insomnia may be secondary, due to causes like acute hostile environment, or due to severe pain or due to severe pain or due to some mental disease. Insomnia is a specialized subject and can have many causes. However, probably the most common is that of stress.
The theories behind insomnia are certainly varied. A psychoanalyst e.g., might be of the opinion that the condition is to do with repressed fears or wishes. Perhaps the individual associates sleep with death, or may be there is realization of the crude wishes that creep around in one?s dreams, either of which could result in an avoidance of sleeping.
Both types of insomnia can become habits. Under these circumstances, worrying about the insomnia is likely to make matters worse, as a vicious circle results. The less sleep, the more worry, which leads to less sleep.
In these instances, it is important to recognize the effect of this negative thinking and to change mindset.
Sleepwalking (somnambulism)
Occurs in stage 4 SWS. Episodes tend to last about 5-15 minutes, occasionally longer. It is usually impossible to attract the sleepwalker?s attention. Normally they stay in the bedroom and get back into bed themselves, but they can be guided back into bed if necessary.
Sleepwalking seems to have a genetic component. It is especially common in children, peaking during adolescence.Stress appears to increase its frequency.
It is clearly a dangerous condition and some cases of people falling from bedroom windows
Sleep-talking
Occurs in the earliest stages of SWS. It is not usually seen as a great problem. Most consists of a few words now and then, but some people can hold a conversation while asleep, with no recall of the episodes on waking.
Teeth-grinding(Bruxism)
Bruxism ? regular teeth -grinding or clenching of the jaw, most often in SWS but also sometimes unconsciously when the person is awake ? may make a loud, eerie sound. The jaw muscles can exert great power and for some people bruxism can be a severe problem, wearing away or loosening the teeth and possibly causing a stiff jaw and headaches.
This disorder is thought to be stress-related; psychologists assert that it is an expression of frustrated anger.
Bedwetting (Enuresis)
Enuresis tends to happen in stage 3 or 4 of SWS. Therapeutically, it is better to praise a child for a dry bed than to express disapproval of a wet bed.
Sleep terrors
In nightmares, the individual wakens from sleep feeling very fearful. They do not have the vivid, action packed qualities of a REM nightmare, and may consist simply of a single thought that horrifies the dreamer ? say, that he or she is the only person in the universe.
The person wakes suddenly in a state of panic, fear and disorientation. Children experiencing a sleep terror may scream and run about the house, clearly agitated. However, in the morning nothing is remembered of the incident.
Snoring
Caused by relaxation of soft palate at the back of throat so that a sonorous vibration occurs with breathing, especially when lying on one?s back. Alcohal can exacerbate the problem as it increases the relaxation.
A nose-clip may help if the air passage is significantly obstructed by the soft palate. in certain cases an operation may alleviate the condition.
Sleep apnea
People with this condition actually stop breathing when they fall asleep, due to a disruption of the respiratory system or because of an obstruction in the upper tract.
Eventually, after a minute or so, the build-up of carbon dioxide in the blood causes an emergency waking response. The person wakes briefly, perhaps making a big sudden movement, snorts or snores very loudly, then falls asleep again. The whole night consists of awful emergency automatic wakenings, but the person is unaware of what has been happening. The consequence is that the overall sleep of these people is reduced, so that in the daytime they are very sleepy. Parteners usually find sleeping with them intolerable. In severe cases, sleep apnoea may lead to heart problems or stroke.
In some surgery, required cases where there is some form of airway blockage, tracheotomy and partial reshaping of soft palate may be helpful.
Narcolepsy
This is an unusual condition, affecting perhaps one in a thousand people, where an irresistible desire to sleep comes over the individual several times a day. It may occur at any time - for example, at a meal, during a business meeting or while talking to someone.
Sufferers are often obese and there seems to be a genetic factor involved. The condition mainly strikes first in the 20s or 30s.
Narcoleptics, when they fall asleep, go straight into REM sleep instead of the various stages of SWS. Duration of these attacks is usually just a minute or two, although they can be as short as a few seconds or as long as an hour. Following an attack, narcoleptics move into SWS.
Unfortunately, because of ignorance by physicians, many narcoleptics are wrongly adjudged psychotic.
REM Nightmares
Some 96% of reported nightmares are dreams occurring in REM sleep. They differ from SWS terrors; heart rate and breathing-rate measures increase over a few minutes. The sufferer sweats profusely and eventually busts out of sleep ? perhaps screaming ? feeling extremely shocked and terrified.
Throughout the world, nightmares are a problem on a massive scale. Some unfor |
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