Sleep Disorders

Sleep is as important as diet and exercise for good health, yet many Americans do not get the 8 hours of daily sleep that most of us need for a healthy life. Women can especially feel the added pressures of work and home responsibilities that allow less time for sleep, and have more stress causing sleep problems. Sleep disorders can have long-term health impacts, so be sure to talk to your doctor if you think you have any of these problems, or even if you just need help managing life to sleep better.
There are a lot of conditions that both cause sleep problems or are caused by sleep problems. Keep in mind that in many cases, the problems listed below are caused by an underlying problem that needs to be addressed in order to solve the sleep issues as well.
The most common sleep problem is insomnia, or not being able to sleep as much as you need. It is more common in women than in men. You may have trouble getting to sleep, or staying asleep the whole night, even if you have enough time to fit in the sleep you need. 
  • difficulty falling or staying asleep
  • variable sleep, including some nights of good sleep
  • tiredness or sleepiness during the day
  • forgetfulness, irritability, anxiety or depression
  • low energy or motivation
  • poor concentration, more errors
  • worry about sleep
There are many causes of long-term insomnia, including:
  • menopause
  • mental health problems such as depression or anxiety
  • illness
  • neurological problems such as Parkinson and Alzheimer diseases, or restless legs syndrome
  • circadian (daily) rhythm problems that make it hard to sleep on a normal schedule
  • medications or drug use
Sometimes, though, no specific cause can be found.
Insomnia relief usually starts with behavioral therapy. For example, a therapist can help you learn better sleep habits and relaxation techniques, or break cycles of worry causing lack of sleep and vice versa.   For insomnia caused by circadian rhythm or internal clock problems, sometimes light therapy or chronotherapy (teaching your body to feel sleepy at the right time of day) can be helpful.
If these treatments don't work, there are some medications such as sedatives or hormones that can help you sleep. (See the resource list below for more information.)
You have sleep apnea if your airway becomes blocked during sleep and you do not get enough oxygen. This can cause you to wake up repeatedly during the night in order to start breathing properly again. This can happen hundreds of times in a night, yet we don’t remember it. It can lead to daytime fatigue and other health problems such as high blood pressure or stroke. You are at higher risk for sleep apnea if you:
  • are male
  • are middle aged or older
  • are overweight or obese
  • snore
  • have a small jaw and throat
Treatments include:
  • weight loss
  • less or no alcohol drinking
  • devices you can wear at night to keep your airway open
  • surgery (which is a last resort because of its low rate of success)
Restless legs syndrome (RLS) is a neurological disorder in which you feel an overwhelming urge to move your legs when they are at rest, and often have unpleasant feelings in your legs as well. This may often be misdiagnosed as insomnia (which it can cause) or depression. It runs in families, and so probably has a partially genetic cause.
There is no specific test, but if you think you may have RLS you should talk to your doctor, so that tests can be done to rule out other potential causes for your symptoms (such as iron deficiency or kidney disease). 
There are several medications that can be used to treat RLS:
  • Requip or Mirapex (also used for Parkinson's disease)
  • other drugs that increase or decrease your brain's response to the hormone dopamine
  • sedatives, including opiates which also reduce pain
There are coping strategies which can help too, including:
  • yoga, Pilates, or stretching late in the day
  • adjusting sleep schedule to avoid times of day with the worst symptoms
  • planning travel to include time for breaks to move around
About 20% of Americans have shift jobs in which they work nontraditional hours. This has a negative impact on sleep, because it can be difficult both to fall asleep and to get high quality sleep during the day. Changing shifts are especially problematic because we sleep best on a regular schedule. It is not surprising that shift workers tend to have more sleep-related problems than people who work regular daytime hours. There are other health problems that an irregular schedule can lead to, such as menstrual cycle irregularities or infertility. Talk to your doctor if you are a shift worker, as there are strategies to help prevent these problems.
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