Insomnia Disorder Types and Treatments

Sleep is a biological function that is still somewhat mysterious. We understand that sleep is restorative and that the majority of us require 7 to 8 hours of sleep every night to function at our best.

We haven’t been able to pinpoint the biochemical changes that occur during sleep that cause it to be restorative. We also know that many of us suffer from sleep disturbances, although the causes of some of these problems are unknown.

The disease must have been present for at least 3 months and occur at least 3 nights per week for an insidious diagnosis to be made. Chronic insomnia can be caused by a physical or mental disorder, such as drug addiction, depression, or a physical health problem. Normal sleeping patterns are likely to be restored if the primary problem is successfully treated.

Though repeated insomnia difficulties are more common in those over the age of 40, many teens and young adults are also affected. Patients with insomnia disorders express dissatisfaction with the quantity or quality of their sleep.

They are always battling to fall asleep, stay asleep, achieve restorative sleep (sleep that leaves them feeling alert and rejuvenated), or get up very early in the morning only to be unable to return to sleep.

They have trouble falling asleep, staying asleep, getting restorative sleep (sleep that makes you feel refreshed and awake), or waking up very early in the morning and not being able to get back to sleep.

Significant personal distress or impaired functioning in meeting daily responsibilities is associated with the disorder – complaints such as feeling tired, sleepy, or low energy on a regular basis; having difficulty with memory, paying attention, or concentrating at school or work; feeling down; or possibly exhibiting behavioral disturbances such as hyperactivity, impulsivity, or aggression.

Overall, the factors that cause insomnia can have a significant impact on your overall quality of life.

Young people who suffer from insomnia frequently say that falling asleep takes too long. People in their later years often complain about waking up frequently throughout the night or too early in the morning. Incredibly, many insomniacs underestimate the amount of sleep they get, believing they are sleeping while they are actually nodding off.

Type of Insomnia Disorder

Hypersomnolence Disorder

Patients with hypersomnolence may sleep for up to 9 hours each night yet might not feel refreshed when they wake up. They may have frequent moments throughout the day when they feel a strong desire to sleep, or they may take frequent naps, fall asleep while trying to stay awake, or they may even sleep while watching television.

The daytime naps can last up to an hour, but they do not make the person feel at ease. The problem is not caused by a lack of sleep at night, a physical or mental disease, or the use of medication or drugs.

Many of us experience periodic sleepiness and may even fall asleep while reading or watching television. Hypersomnolence disorders create prolonged spells of insomnia, which can lead to personal stress or problems with everyday activities, such as missing essential appointments.

According to a recent study, around 1.5 percent of the population can match the standard parameters of hypersomnia (oversleeping).

Narcolepsy

Narcolepsy patients have an uncontrollable desire to sleep or have had at least three sleep attacks or naps each week in the previous three months. When a person has a sleep issue, he or she falls asleep unexpectedly and sleeps for around 15 minutes. The patient could be chatting at a moment and then fall asleep quickly on the floor the next.

Narcoleptic symptoms are linked to a quick transition from being awake to REM sleep, which is the state of sleep most typically associated with dreams. Because the sleeper’s eyes are likely to move fast behind their closed eyes, the term REM sleep was invented.

When a person falls asleep, they usually go through several stages of sleep before entering REM. The most common form of narcolepsy, known as narcolepsy/hypocretin deficiency syndrome, is caused by a lack of hypocretin (also known as orexin), a protein-like molecule generated by the hypothalamus and involved in sleep-wake cycle regulation.

Cataplexy is the most common cause of narcolepsy. It is a medical disorder in which people have a loss of muscle tone that can range from modest leg weakness to complete muscle control, causing the patient to fall down.

Cataplexy is commonly (but not always) experienced by those who suffer from narcolepsy. Tears, joy or fear, wrath, or uncontrollable laughing can all provoke it.

Cataplexy is caused by a lack of the chemical hypocretin in the brain, just like narcolepsy and cataplexy. Cataplectic episodes cause one to fall to the floor and become motionless for a few minutes while remaining conscious.

People who are experiencing cataplectic episodes have a blurry vision but can still see and understand what is going on around them. In rare cases, a person who is suffering cataplectic may go into REM sleep.

Breathing-Related Sleep Disorders

Patients with breathing-related sleep disorders experience frequent sleep disturbances as a result of respiratory problems. Insomnia or excessive tiredness during the day might result from these frequent sleep interruptions.

The root causes of the respiratory problem are used to classify the subtypes of this illness. The most well-known variant, hypopnea-hypnea obstructive sleep disorder (also known as obstructive sleeping apnea), is characterized by recurrent gasping or snorting, breathing pauses, or rapid and short breathing.

Snoring is the most common cause of obstructive sleep apnea. It’s a widespread problem that affects around 28,5 million Americans. Breathing problems during sleep are caused by a total or partial blockage of breathing during sleeping.

The issue also causes excessive morning sleepiness, tiredness, or complaints of sleep that isn’t as rejuvenating, despite the fact that you obtain enough sleep.

Obstructive sleep apnea is most common in middle age, and it is more common in men until around the age of 50, after which it is equally prevalent in both men and women. Obese people are more likely to develop the illness because their airways shrink as a result of an increase in the size of their soft tissues.

The restriction of airflow in the upper airways causes difficulty breathing. A structural condition, such as an extremely big or thick palate, or overly large adenoids or tonsils, might cause this. If there is a full obstruction, the sleeping person may cease breathing for fifteen to ninety seconds, up to 500 times per night!

When these breathless intervals occur, the person sleeping may wake up, breathe in air, and take several deep breaths before returning to sleep without recognizing that their breathing has been affected.

While a biological reaction causes an exhale after these brief delays in breathing, the constant disruptions in sleep caused by apneas can leave sufferers exhausted the next day, making it difficult to function normally.

Central sleep apnea is another sort of sleep-related respiratory disease. Breathing difficulties during sleep are not changed by respiratory resistance (blocked airways) in this disease and may be linked to cardiac problems or opiate usage.

Another type of sleep-related hypoventilation (hypoventilation literally means “low breath”) is characterized by breathing difficulties caused by lung illnesses or neuromuscular issues that affect lung function.

Parasomnias

The average sleep cycle lasts around 90 minutes and progresses through stages of light sleep, deep sleep, and eventually REM sleep, which is when the bulk of dreams occur. However, for some people, sleep is disrupted by partial or total awakenings.

Individuals may appear dizzy, confused, or disconnected from their environment during partial arousals. Others’ attempts to wake or calm the sleeping person may be ineffective. The sleeper frequently wakes up the next morning with no recollection of these arousal episodes.

The term “parasomnia” literally means “around the time of sleep,” and it refers to abnormal behavior marked by total or partial arousals that occur between sleep and waking. Parasomnia, like other sleep-wake problems that induce parasomnia, can cause significant distress or impair an individual’s ability to fulfill expected professional, social, or other important life duties.

We’ll look at the most prevalent parasomnias that come from non-REM sleep (sleep terrors, sleepwalking), as well as REM sleep (rapid eye movement sleep disorder as well as nightmare disorder).

Sleep Terrors

Sleep terrors are characterized by repeated experiences of terrifying awakenings that usually begin with a loud scream. The sound of a loud, acute screaming or wailing in the dark frequently initiates arousal.

Even the sound sleeping parent may be dragged to their child’s room like a cannon shot. The youngster (in most cases, children) may be sitting up in fright and exhibiting indicators of acute arousals, such as excessive sweating, rapid heartbeat, and respiration.

The baby may start talking in a tinny voice or fumble around uncontrollably, but he or she may not be really awake. If the kid is completely awake, they may not recognize or even try to avoid the parent.

After a brief length of time, the kid returns to sleep and forgets about the encounter when they wake in the morning. These horrific attacks or sleep nightmares are far more terrifying than ordinary dreams. Sleep terrors, unlike nightmares, usually occur in the first third of a night’s sleep and during deep, nonREM sleep.

When someone awakens after a sleep terror attack, they are usually confused and disoriented for a few minutes. The person may feel scared and have a few random dreams, but they will not be able to recollect the vivid dreams that are prevalent in nightmares. Most of the time, the person falls asleep and forgets about the occurrence the next morning.

Sleep terror disorders in children are usually overcome by the time they reach adolescence. Although there are more boys than girls affected, the gender ratio in adulthood is roughly equal. The disease tends to develop over time in adults, with the intensity and frequency of episodes increasing and then decreasing with time.

Individual sleep terror episodes can be seen in 37 percent of children aged 18 months, 20 percent of children aged 30 months and older, and around 2 percent of adults, according to data on the disorder’s prevalence. The cause of night terrors is unknown.

Sleepwalking

People that sleepwalk have multiple instances of walking around the house while sleeping. The person may be partially awake at these times and capable of performing complex motor motions such as getting out of bed and walking to another room.

These motor acts are carried out while the person is unconscious, and the occurrence is unlikely to be remembered until the next morning. Sleepwalking occurrences are not assumed to include the recreating of a dream because they often occur during the deep (non-REM) phases of sleep when there are no dreams.

Sleepwalking is the most common sleep disturbance in children, affecting up to 5% of them. Sleepwalking is known to affect between 10% and 30% of children at some point in their lives.

The incidence and causes of this illness in adults are unknown. The occurrence of sleepwalking episodes is not rare. The sleepwalking condition might be diagnosed if episodes occur often or repeatedly.

We don’t know what causes sleepwalking, but researchers believe it’s a combination of environmental and genetic variables. Sleepwalkers have sympathetic expressions on their faces. Accidents do happen, even if people try to avoid bumping into things.

Sleepwalkers are typically insensitive to others and difficult to awaken. When people wake up in the morning, they usually have little or no memory of what happened while they were sleeping.

If they are startled awake by an incident, they may be puzzled for a short time (as happens when they have sleep terrors), but their attentiveness recovers quickly. There is no reason to suppose that waking up sleepwalkers’ bodies during episodes is harmful to them.

Violent acts have been linked to sleepwalking in rare cases, but they are highly unusual and could indicate other types of psychopathology.

Rapid Eye Movement Sleep Behavior Disorder (RBD)

RBD is characterized by reenacting dreams in the form of singing or moving about during REM sleep. During REM sleep, muscles are normally restricted to the point that all muscles in the body are disabled except those essential to regulate breathing and other important body functions.

This is beneficial because muscle paralysis prevents injuries from occurring if a dreamer reacts to the dream too quickly. Muscle paralysis is absent or insufficient in the case of REM sleep disorder, and the patient may shake or kick their arms while sleeping, potentially injuring themselves or the person sleeping next to them.

RBD affects about 0.5 percent of adults and is most common in the elderly, usually as a result of neurological illnesses such as Parkinson’s disease. It could happen as a result of alcohol withdrawal or certain drugs. In fact, RBD may be a precursor to the start of Parkinson’s disease. RBD can be controlled with the help of medication.

Nightmare Disaster

In REM sleep, individuals with nightmare problems have frequent experiences of extremely upsetting and easily remembered dreams. The nightmares are extended, story-like dreams in which the person dreaming is attempting to avoid immediate hazards or bodily dangers, such as being pursued, attacked, or even injured.

When the person wakes up, they frequently remember the nightmare vividly. While fear is the most typical emotional response, frightening nightmares can also elicit other negative feelings such as wrath, sadness, shame, contempt, and even uncertainty.

The individual who dreams may awaken in the middle of a nightmare, yet find it difficult to fall back asleep owing to worries from the terrifying dream. The nightmares that cause insomnia or disrupted sleep can create great stress for the individual and have a negative impact on crucial parts of daily life.

While many people have occasional nightmares, the number of people who have the kind of frequent, intense nightmares that can lead to a diagnosis of nightmare disorder remains unknown. Nightmares are frequently related to traumatic events and occur when a person is agitated.

Nightmares are most common during REM sleep, the stage of sleep in which the bulk of dreams occurs. The dreams that occur during REM sleep tend to continue longer, and the dreams that occur during REM sleep are more intense during the last half of nighttime sleep, which is why nightmares usually occur late at night or early in the morning.

While nightmares can include a lot of movement and excitement, such as fleeing from a scary attack, the dreamers show very little movement.

Biochemical mechanisms that cause dreams, such as nightmares, stop the body from moving, causing it to become paralyzed. It’s lucky since it prevents the dreamer from jumping from the bed and smashing into a dresser or a wall in order to flee the enemies.

Treatment of Sleep Disorders

When we can’t sleep or wake up frequently, or when sleep isn’t enough to restore our energy and vitality, it’s time to seek help. To help people reap the benefits of a good night’s sleep, a variety of psychological and biological therapies are being developed and evaluated.

Medical Treatments

Patients who see their doctor with insomnia are likely to be prescribed one of the various benzodiazepine and related medications. Long-acting medications may not stop functioning in the morning, and patients report increased sleepiness over the day, thus these drugs are preferred.

When persons taking short-acting pharmaceuticals have side effects like daytime anxiety, long-acting treatments are sometimes chosen. Newer drugs are also being developed to assist individuals to fall and staying asleep, such as those that operate directly with the melatonin system.

Although people of all ages, including young children, have been prescribed drugs for insomnia, those over the age of 65 are the most likely to use them.

Treatment for insomnia that is medically based has a number of drawbacks. The first is that benzodiazepine medications can make you sleepy. Secondly, individuals can also become addicted to these medications and abuse them, whether purposefully or unintentionally.

The third reason is that these medications are only intended for short-term treatment (less than four weeks). Longer periods of use may lead to reliance and insomnia relapse.

Some medications have recently been linked to an increased risk of sleepwalking-related illnesses, such as eating disorders linked to sleep. As a result, while some drugs can help with short-term sleep disorders (for example, sleeplessness caused by anxiety connected with hospitalization), they are not designed to cure long-term issues.

Doctors usually give stimulants like methylphenidate or modafinil to those who suffer from Narcolepsy or hypersomnolence. Antidepressants can be used to treat cataplexy, which is a loss of muscle mass. Antidepressants block REM sleep, which is why people with narcolepsy are depressed. Additionally, sodium oxybate may be prescribed to alleviate cataplexy.

The goal of treating sleep-related breathing issues is to assist the patient breathe more easily while sleeping. For some, this may imply that they should advocate for weight loss. The soft tissues of the neck constrict the airways in some overweight people.

However, voluntary weight loss does not work in the long run, and as a result, it is not an effective treatment for sleep disorders involving breathing.

A machine-based device known as the continuous positive air pressure (CPAP) machine that improves breathing is the gold standard in the treatment of obstructive sleep apnea. Patients wear a mask that permits gently compressed air to be drawn into their sleep, allowing them to breathe more freely throughout the night.

Many sufferers, however, have difficulty using the device due to worries about comfort or even an anxiety-like condition known as anxiety or claustrophobic phobia. Surgery to eliminate

obstructions in the airways may be required for the most severe breathing problems.

Researchers collaborated with a Swiss didgeridoo instructor to develop an exciting treatment for persons with mild apnea. A didgeridoo is a long instrument made from hollowed-out tree limbs by termites.

The instructor noticed that persons who practiced this instrument were less sleepy during the day. Evidence suggests that several months of daily practice with this instrument can help persons with intermittent breathing sleep better.

Environmental Treatments

Because the medication is rarely recommended as a primary treatment, Other approaches to getting people to return to their normal sleeping patterns are also considered.

The general rule that can be applied to treating circadian rhythm problems is that delays in phase are easier to treat than advances in phase. That is, staying up a few hours longer than usual is preferable to forcing yourself to sleep an hour earlier.

Workers appear to acclimate better when shift changes are scheduled in a clockwise orientation. Going to bed several hours later each night until bedtime is at the desired hour is the greatest way to read people’s sleep habits.

This method has the disadvantage of requiring the user to sleep during the day for several days, which is problematic for persons who have regularly scheduled obligations.

Another method for assisting persons with sleep issues is to use a bright light to fool the brain into resetting the biological clock. A bright light has been shown to assist persons with circadian rhythm disorders to readjust their sleeping habits.

Psychology Treatments

Because of the limitations of applying medication to help individuals sleep better, psychological treatments have emerged.

Certain psychotherapy therapies for insomnia have been demonstrated in studies to be more effective than others. Adults with sleep problems should use stimulus control. The individual is told to utilize their bedroom only for sleeping and sexual activities, and not for any other stressful activities (e.g. watching news programs on TV).

For certain persons, sleep hygiene or relaxation techniques (changing routines that may interfere with sleep) may not be as helpful as stimulus control alone. Because sleep disorders are so common, researchers are increasingly interested in developing online-based therapies to test how far sufferers may help themselves by following the right instructions.

Adults were randomly assigned to a control group or an internet-based education group in one study. The internet group received online training on how to apply different psychological treatments properly (e.g., sleep restriction, stimulus control, sleep hygiene, cognitive restructuring, and relapse prevention).

The results were striking, indicating that not only could the treatment be given via the internet, but that sleep in this group had improved even six months later. Evidence-based training can help persons with a variety of psychological issues in certain circumstances.