Sleep Disorders Sleep Disorders

Sleep Disorders

What is insomnia?

Insomnia is considered to include problems related to falling asleep, and maintenance and termination of sleep, and non-relaxing sleep. During the day, a feeling of tiredness, changes in the emotional domain (such as restlessness, irritability), decreased productivity, and even impaired cognitive functions may accompany the clinic picture.

Are there stages of sleep?

Five different stages of sleep are considered. One of these stages is REM (Rapid Eye Movement), which is characterized by rapid eye movements, while the others are called non-REM. Non-REM stage can be divided into two main parts:
Superficial sleep (stage 1 and partly stage 2) 
Deep sleep (stages 3 and 4). If a definition is made to include these stages, it can be said that sleep is the periodic transition between wakefulness and 5 stages of sleep.
Usually after a short period of wakefulness, people enter the stages 1, 2, 3 and 4. Approximately 90-120 minutes after the onset of sleep, the first REM stage occurs. Then, at intervals of 90-120 minutes, people pass through 3-5 REM stages in one night. Of the sleep of a young adult, approximately 5-10% consists of the stage 1, 45-60% consists of the stage 2, 20-25% consists of the stages 3 and 4, and 20-30% consists of the REM stage. In general, the first third of sleep mostly consists of Non-REM sleep and the last third of sleep mostly consists of REM sleep.
Superficial sleep constitutes the period between sleep and wakefulness, and people can easily be awakened during this period. A more intense stimulus is needed to awaken a person during deep sleep. Changes in this period are considered to serve for physical rest and regeneration. Since people cannot rest in cases where deep sleep is not adequately experienced or experimentally eliminated, they complain that they wake up tired in the morning and that they are not able to carry the burden of a new day.

When do people dream?

It is known that 80% of dreams occur during REM. Changes in this period are similar to wakefulness in terms of physiological activities. There are two basic explanations about the function of REM: forgetting what has happened during the day and arranging the information received during wakefulness. It can be said that REM serves to prepare emotionally and ideationally for the next day by deleting the records that are not necessary for the individual and arranging the necessary ones. In addition, animal experiments reveal a close relationship between learning and REM.

Are sleep disorders common?

The prevalence of sleep disorders in the general population is around 15-35%, and 10-20% suffer from severe and persistent insomnia. 50% of people suffer from insomnia at some time in their lives. The fact that half of these people state that their problems are serious can be considered as an indication that insomnia is important and quite common. 

Do sleep problems differ by age or gender?

Studies show that women are more likely to suffer from insomnia. With increasing age, the need for sleep decreases. It is noteworthy that young people have more difficulty falling asleep, and the elderly have problems related to maintenance of sleep. The contribution of diseases that increase with old age to insomnia cannot be denied. 

How does insomnia affect people?

Insomnia means more than not being able to sleep for the patient and also causes problems in psychosocial and occupational areas. Studies indicate that people with insomnia have more problems in their daily lives and in general health areas, their quality of life decreases gradually and they tend to seek more help in terms of time/energy.

Are sleep problems more common in mental disorders?

It is noteworthy that the complaint of insomnia is found to be 75% in psychiatric disorders. Of these, sleep disorders that occur in depression are specific. Changes in the sleep patterns of people with depression are considered as biological indicators. Typical features in this pattern can be summarized as entering the REM stage in a short time, waking up frequently at night, and waking up early in the morning. In cases of anxiety, problems with falling asleep are often at the forefront. Some of these patients can hardly fall asleep because they cannot have enough relaxation due to tension.

What are the causes of insomnia?

It can be said that insomnia can be caused by all factors that lead to stimulation. Therefore, short-term or persistent psychological/biological changes may underlie insomnia.
Physical diseases and some medicines appear as biological factors.
It can be said that experiences such as tension and anxiety as psychological factors prevent the expected relaxation at the beginning of sleep, and even sleep or sleeping appears as an anxious experience. Thus, the patient's falling asleep is delayed or the patient is unable to fall asleep, or even if the patient falls asleep, his/her sleep is interrupted.

What is hypersomnia?

Cases of hypersomnia, in which daytime sleepiness is the main complaint, constitute half of all sleep disorders. Cases of hypersomnia include two important disorders: The first is sleep apnea and the second is narcolepsy.
Sleep apnea is more than five breathing disturbances lasting longer than 10 seconds during one hour of sleep. It is a life-threatening condition that is asserted to cause sudden night deaths and can lead to various psychiatric symptoms such as fatigue, loss of motivation, unproductiveness, impaired cognitive functions, and emotional instability.
Narcolepsy is a condition characterized by daytime sleep attacks, nightmares and other additional symptoms. Its diagnosis is possible with studies in sleep laboratories. 


Why do sleep talking, sleepwalking and nightmares occur?

Parasomnia, which includes sleep talking, sleepwalking, sleep bruxism, nightmares, fears, and bedwetting, are behavioral disorders between sleep and wakefulness and constitute 15% of all sleep disorders. It generally occurs in childhood and adolescence. Parasomnia is seen in approximately one quarter of children and adolescents. This percentage decreases to 1% in adulthood. It is noteworthy that cases of parasomnia that usually occurs during Non-REM sleep at the beginning of sleep are based on psychological reasons. Therefore, psychological models constitute the basis of treatment.

What are sleep pattern disorders?

Sleep pattern (cycle) disorders constitute 2.9% of all sleep disorders. This group includes conditions of those who work at night, those who travel by plane, and those whose daily cycle is shorter or longer than 24 hours. The treatment is cause-specific and regulation of the rhythm is based on.
In order to diagnose sleep disorders, detailed interviews and psychological evaluations should be made and physical examinations and laboratory tests should be performed to identify the complaint and investigate how it appears and the related factors. However, as a result of the interviews and examinations, patients who have not responded to the appropriate treatment, are thought to have problems indicating a specific sleep disorder, or whose treatment results are to be monitored, are examined in sleep laboratories. 


How are sleep problems treated?

In order to cope with the physical and psychological tension considered as the origin of insomnia, tension is attempted to be eliminated with relaxation techniques. Short-term medication is also used in some cases of insomnia.
For some of the sleep-deprived people, significant benefits can be achieved only by regulating sleep hygiene. The following points should be considered for sleep hygiene: 
•    Not to be very hungry or full,
•    To avoid drinking caffeinated, alcoholic or cola beverages and smoking,
•    To do regular exercises, but to avoid activities that lead to excitement in the evening,
•    Not to go to bed before feeling sleepy,
•    To use the bedroom only for sleeping, 
•    No to try to sleep when being unable to sleep and to leave the bed and bedroom, spend time elsewhere and return to bed when feeling sleepy, 
•    To wake up at a specific time in the morning, no matter how long you sleep, 
•    Not to sleep during the day and to isolate the bedroom in terms of sound, light and heat.

In fact, these are the rules that everyone should consider for a healthy sleep.