Colin Snow
Sleep disorders are conditions that affect the quality, amount, and timing of sleep, which can result in distress and impaired functioning during the day. Sleep disorders can affect both physical and mental health and can be a symptom of other mental health conditions. While the term pathologic sleep is not present in the dictionary, pathological sleepiness is a term used to describe patients with suspected idiopathic hypersomnia.
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What You'll Learn
Sleep terrors and nightmares
While nightmares and night terrors may sound like synonyms, they are actually two different experiences. Nightmares are intense dreams that may provoke terror, anger, or disgust. They are dreams tainted by stress and trauma from the outside world. They are very common, but they only qualify as a mental health condition if they disrupt your daytime life. Certain medications can increase your chances of having nightmares. These include beta-blockers, dopamine agonists, and selective serotonin reuptake inhibitors (SSRIs).
Nightmares commonly happen after trauma. Around half of people seeking treatment for post-traumatic stress disorder (PTSD) have repetitive nightmares. These recurrent dreams force them to re-experience the trauma and tend to be deeply disturbing. In children, nightmares often relate to developmental stages: toddlers may dream about separation from their parents, preschoolers may dream about monsters or the dark, and school-aged children may dream about death or real dangers.
Night terrors, also called sleep terrors, are episodes where you only partially wake up from sleep and may thrash, scream, or mumble. They generally involve signs of extreme stress and usually occur when you're deeply asleep. They can resemble other conditions or lead to problems for the child, but they are not harmful. Night terrors are less common than nightmares, with children experiencing them more frequently than adults.
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Sleep disorders and mental health
Sleep is a basic human need and is critical to both physical and mental health. Sleep disorders (or sleep-wake disorders) involve problems with the quality, timing, and amount of sleep, which result in daytime distress and impairment in functioning. Sleep-wake disorders often occur along with medical conditions or other mental health conditions, such as depression, anxiety, or cognitive disorders.
There are over 80 types of sleep disorders, including insomnia, sleep apnea, parasomnias, narcolepsy, and restless leg syndrome. Sleep disorders can be treated, and it is recommended that those experiencing them seek help from a medical professional. Sleep difficulties are linked to both physical and emotional problems. Sleep problems can both contribute to or exacerbate mental health conditions and can be a symptom of other mental health issues.
Some of the more common sleep disorders include insomnia, which is the most common sleep disorder and is characterised by difficulty falling and staying asleep. Obstructive sleep apnea is another common sleep disorder, where the brain does not properly control breathing during sleep, causing breathing to start and stop. This is diagnosed when a sleep study identifies five or more central apneas (pauses in breathing) per hour of sleep. Sleep apnea is more common in older adults and those with heart disorders or who have had a stroke. Central disorders of hypersomnolence are also common, where the sufferer has trouble feeling alert during the day.
There are also other parasomnias, which are pathological behaviours during sleep. These include sleep talking, sleepwalking, bed-wetting, teeth grinding, snoring, and nightmares. Sleep terrors, or night terrors, are another example of parasomnia, where the sleeper wakes abruptly, usually with a panicked scream or cry, and experiences intense fear and rapid breathing, an accelerated heart rate and sweating. Sleep terrors are more common in very young children, with only 2% of adults experiencing them.
Sleep disorders can be treated in a variety of ways, including medication, relaxation techniques, and cognitive and behavioural programs. It is important to establish a regular bedtime routine, including habits such as taking a warm bath, listening to soothing music, or reading. Regular exercise is also beneficial, but it is important not to exercise within four hours of bedtime if you have trouble sleeping.
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Sleep-wake cycles
There are several types of sleep-wake disorders, with insomnia being the most common. Insomnia is characterised by difficulty falling and staying asleep. Other sleep-wake disorders include obstructive sleep apnea, parasomnias, narcolepsy, and restless leg syndrome. Sleep apnea is a breathing disorder during sleep, with a central or obstructive form. Central sleep apnea is rare and occurs when the brain fails to control breathing during sleep, causing breathing to pause. Obstructive sleep apnea is more common and occurs when the airway becomes blocked during sleep. Parasomnias include sleepwalking, sleep talking, and night terrors, which are episodes of abrupt awakening with panic and fear.
Narcolepsy involves excessive daytime sleepiness and can be diagnosed using the Multiple Sleep Latency Test. Restless leg syndrome (RLS) is a disorder characterised by an irresistible urge to move the legs, which disrupts sleep. RLS can also cause periodic limb movements during sleep, which can be considered pathological if they disrupt sleep.
Sleep difficulties can contribute to or worsen mental health issues and can also be a symptom of these conditions. Sleep is critical for both physical and mental health, and it is important to seek treatment for sleep disorders to ensure adequate rest. Treatment options for insomnia, for example, include cognitive and behavioural programs that have proven to be more effective than pharmacological interventions.
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Sleep pathologies
Sleep disorders or sleep pathologies are conditions that affect sleep quality, timing, and amount, resulting in daytime distress and impaired functioning. There are over 80 types of sleep disorders, which can be classified into four groups: dyssomnias, parasomnias, sleep disorders associated with mental, neurological, or other conditions, and proposed sleep disorders. Sleep disorders can affect both children and adults, although some disorders are unique to childhood.
Insomnia is a common sleep disorder characterised by difficulty falling and staying asleep. It can be treated with drugs, but these can be potentially addictive and dangerous in the long term. Cognitive and behavioural programs, such as relaxation techniques, temporary sleep restriction, and gradual reinstatement of sleep, have been found to be more effective in the long-term treatment of insomnia.
Other sleep-wake disorders include obstructive sleep apnea, central sleep apnea, parasomnias, narcolepsy, and restless leg syndrome. Sleep apnea is a breathing disorder during sleep, with central sleep apnea being less common and more prevalent in older adults and people with heart disorders. Parasomnias include sleep terrors, or night terrors, which are episodes of abrupt waking from sleep with intense fear and associated physical symptoms. Nightmare disorder involves distressing and well-remembered dreams that cause anxiety and fear.
Restless leg syndrome (RLS) is a sleep disorder characterised by an irresistible urge to move the legs, which is more common at night and can disrupt sleep. Episodes of teeth grinding, sleep talking, sleepwalking, bed-wetting, and snoring are also considered pathological if they disrupt sleep. Sleep disorders can be linked to physical and mental health problems and can contribute to or exacerbate mental health conditions. Treatment is available to help individuals manage their sleep disorders and improve their rest.
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Pathological sleepiness
Sleep is a basic human need and is critical to both physical and mental health. Sleep disorders (or sleep-wake disorders) involve problems with the quality, timing, and amount of sleep, which result in daytime distress and impairment in functioning. There are over 80 types of sleep disorders, including insomnia, restless legs syndrome, narcolepsy, and sleep apnea. Sleep disorders can affect your mental health and physical health, and they can be a symptom of other mental health conditions.
The clinical criteria for sleep pathologies are outlined in the International Classification of Sleep Disorders (ICSD), which categorises sleep disorders based on symptoms, their impact on individuals, and the body systems they affect. The ICSD includes dyssomnias, parasomnias, sleep disorders associated with mental, neurological, or other conditions, and proposed sleep disorders.
Episodes that are sometimes considered problematic in sleep include somniloquy (sleep talking), somnambulism (sleepwalking), enuresis (bed-wetting), bruxism (teeth grinding), snoring, and nightmares. While these episodes may be distressing or disruptive, they are not always indicative of a sleep disorder. For example, sleep talking and teeth grinding are common occurrences that typically do not affect the overall sleep pattern.
The evaluation of pathological sleepiness often involves the use of the Multiple Sleep Latency Test (MSLT) and 24-hour polysomnography (24-hour PSG). These tools help identify markers of pathological sleepiness, such as prolonged sleep duration and high sleep propensity. Treatment options for sleep disorders include cognitive and behavioural programs, such as relaxation techniques, temporary sleep restriction, and gradual reinstatement of healthy sleep patterns.
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Frequently asked questions
Pathologic sleep, or pathological sleepiness, is a condition where a person experiences prolonged sleep or an increased tendency to fall asleep during the day.
Signs of pathologic sleep include frequent body movement, enhanced levels of autonomic functioning, reduced levels of REM sleep, and the intrusion of waking rhythms (alpha waves) throughout the various sleep stages.
Pathologic sleep is diagnosed using the International Classification of Sleep Disorders (ICSD), which categorizes sleep disorders based on symptoms, pathophysiology, and the affected body system.
Treatment options for pathologic sleep include cognitive and behavioral programs such as relaxation techniques, temporary sleep restriction, and gradual reinstatement of sleep.
Common sleep disorders include insomnia, restless legs syndrome, narcolepsy, sleep apnea, and sleep terrors.
