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Sleep Disorders & The Remedies

Have you ever wondered what we were longing for, after a back-breaking day at the office? It is nothing else than a good sleep. We love the warmth and soothe our bed gives. The relaxing and rejuvenating feel will put us to sleep in minutes. One-third of our day is spent sleeping, although it sounds unbelievable. Did we ever think about this rejuvenating refreshing state of the body that we follow every day? So what is sleep, why do you sleep and why is it that important to our overall health? What are sleep disorders? This article is an insight into the interesting facts about sleep.

Sleep is a condition of body and mind that recurs for several hours every night in which the nervous system is relatively inactive, the eyes are closed, muscles relaxed and consciousness practically suspended. Sleep is very essential for our mental health. It also helps in muscle relaxation, repairing and building of our muscles, improve our immunity, detoxify our system and brain, improve learning and sharpening skills which you got trained during the day. Sleep helps to create new memories and helps it to get stored in the brain. Sleep reduces the risk of getting diseases like diabetes, high blood pressure, cardiovascular disease, obesity, and depression.

So why do we need sleep?

Deep inside our brain, there is a small structure called the hypothalamus that basically controls sleep and sleep arousal. There are light-sensing cells in the brain called the suprachiasmatic nucleus in the hypothalamus, these cells along with the biological 24-hour clock in our body (circadian rhythm) control the sleep and wake cycle. When daylight ceases and darkness fills the night, the pineal gland in the brain secretes a hormone called melatonin. An increased level of melatonin in the blood causes fatigue in the body and lowers our body temperature and thus prepares our body for sleep.

There are mainly two sleep mechanisms, the circadian rhythm is one of the mechanisms that regulate the sleep-wake cycle, which is actually a 24-hour biological clock that has its daily routine. It synchronizes the light exposure, temperature with the actual time of the day. Whereas the sleep-wake homeostasis mechanism quantifies the need for sleep. It reminds your body to sleep after a certain time and regulate the intensity of sleep. This mechanism drives you to sleep deeply and make you sleep longer after a period of sleep deprivation.

What happens when you sleep?

To know that you should know about the stages of sleep. Sleep can be divided into Non REM and REM sleep. Non REM sleep is a period of light sleep where your muscles get relaxed, eye moments, heartbeat, and breathing become slow. Brain activity slows down. REM sleep occurs about 90 minutes after you fall asleep. You will have rapid eye moments breathing, heartbeat, and blood pressure increases. Brain activity wave shows a close resemblance to wakefulness. During REM sleep dreaming occurs.

Benefits of getting proper sleep.

It will be helpful to point out the benefits of sleep discovered by various studies conducted on sleep. Studies on sleep noted that people who sleep or who restrict their sleep to a period of 5 to 6 hours have 40 percent less able to learn and create new memories in their brain compared to those who sleep for seven to eight hours. This is because of a structure in your brain situated on your left and right side called the hippocampus.

Hippocampus has the role of a collecting bag that keeps collecting the new memories that you get over the day. If you are sleep-deprived, the hippocampus shuts itself and prevents the entry of new information. That’s why students who sleep before and after a learning process tend to get a maximum understanding of the subjects. Sleep affects the cardiovascular system. Studies conducted globally over 1.6 billion people from different parts of the world showed about a 21% reduction in heart attack rate if one gets enough sleep. The chances of getting a heart attack increase to 24% if you are deprived of sleep. Your immunity to fight against diseases will function effectively if you have proper sleep. Studies have noted that immune cells, mainly the natural killer cells drops 70% of their activity if you were deprived of sleep just for four hours. These itself can increase the risk of cancer. Sleep has a directly proportional relationship with sex. Men who sleep for seven hours have bigger testicles than those who have less sleep. People who have sleep difficulty often have a problem in their sexual life. Suppression of sex hormones like estrogen and testosterone and an increase in stress hormones such as cortisol were noted in people who have sleep disorders which eventually lead to decreased sex drive, infertility, and erectile dysfunction. Adequate sleep can help you to reduce your weight, drive, and motivates you to exercise, increases the levels of a hormone called leptin which suppresses your appetite which in turn helps you to control obesity. Sleep improves your speed, efficiency, and mental health. Sleep helps to maintain your blood sugar level and maintains the cell sensitivity towards insulin which keeps you safe from diabetes. Good sleep is a vital way to save yourselves from suffering a mental depression, studies have noted decreased sleep quality in people with mental depression. Poor sleep may drive some to have increased suicidal thoughts. Sleep excels your productivity at work due to increased concentration and it maximizes your performance. People who get adequate sleep tends to be more interactive and could lead a healthy emotional life with their partners.

Sleep Disorders

Sleep disorders are conditions that alter the normal pattern of sleep. These disorders have a catastrophic effect on the normal life of a person. It is extremely important to diagnose these disorders at its primary stage itself. There are about 80 types of sleep disorders reported. The common sleep disorders are insomnia, breathing-related sleeping disorders like obstructive sleep apnea, central sleep apnea, sleep-related hyperventilation, hypersomnolence disorder, circadian rhythm disorder, restless leg syndrome, substance/medication-induced sleep disorder, and narcolepsy.

Insomnia is the most common sleep disorder where one finds difficulty in falling asleep and lacks sleep throughout the night. About 30 to 50% of adult experiences insomnia each year. Insomnia was found to be more in males than in females. Insomnia can be of two type’s, acute, and chronic insomnia. Acute insomnia occurs due to stressful events in life like relationship failure, or the sudden demise of one’s family member. It can happen due to a stressful night shift where your sleep cycle is hampered and you find it difficult to sleep during the day.

Acute insomnia may be experienced only for one or two nights.

Chronic insomnia is difficulty in falling asleep and maintaining sleep for a period of at least one month. You may feel terribly exhausted throughout the day. Chronic insomnia may be intermittent too where you may get good sleep for one or two nights followed by many nights of insomnia.

Apnea is a period where breathing is stopped.

Obstructive sleep apnea is a breathing-related sleep disorder which causes involuntary stopping of breath for a brief period of time while sleeping. This condition is mostly seen in the male population. It occurs as a result of the temporary relaxation of muscle over the throat, tongue, soft palate causing narrowing or closing of the airway causing snoring and waking up from sleep.

Obstructive sleep apnea can cause serious health issues such as heart disease, hypertension, diabetes, and stroke if left untreated. If you have Obstructive sleep apnea then you may experience headache, drowsiness loss of libido, and poor performance.

Other types of sleep apnea are central sleep apnea where there is no airway block but the brain does not give signals to the respiratory muscles to breathe. Mixed sleep apnea is a combination of both obstructive and central sleep apnea. Obstructive sleep apnea can be diagnosed with the help of polysomnogram, electroencephalogram (EEG), electromyography (EMG), and pulse oximetry.

Narcolepsy is extreme daytime sleepiness with sudden sleep attacks where one can’t resist his or her need to sleep. The patient may experience this Invictus need to sleep at least three times a week for a period of at least three months. In some cases, episodes of cataplexy, i.e. total or partial loss of muscle control can occur.

Hypersomnolence disorder is a condition where a person experiences episodes of sleepiness even after getting a good quality sleep of more than seven hours. This is due to the excessive tiredness one had experienced from his/her work. These individuals won’t have the feeling of rest even after sleeping for more than nine hours. It can be of three types, acute hypersomnolence (that lasts for one month or lesser periods), subacute hypersomnolence (that lasts for one month to three months periods), and persistent hypersomnolence (that last for more than three months). Hypersomnolence seems similar to narcolepsy but differs from it by its gradual onset.

Circadian rhythm disorder happens when your sleep cycle and the biological clock is disturbed. The one who suffers from it may have insomnia or excessive sleepiness or a combination of both.

Restless leg syndrome is also known as Wills-Ekbom disease. It is a condition where one has an extreme urge to move their leg while lying down. This condition is mostly noted at night time causing disruption of sleep that results in poor performance at day time.
Substance/medication-induced sleep disorder is where one may experience insomnia due to the use of certain substances use such as alcohol, caffeine, opioids, cocaine, tobacco, amphetamines certain medications such as antihistamines, corticosteroids, and anxiolytic drugs.

Management of sleep disorder

The first rule in the management of sleep disorder is getting diagnosed with your sleep disorder. Your doctor will take a detailed history regarding the onset of the condition, your lifestyle, your medical conditions, and drug history. A thorough physical examination will be carried out to know whether you have any factors such as a deviated nose, enlarged tonsils, and narrowed airway, collar size (in obstructive sleep apnea, a person with a collar size of 17 inches have an increased risk of getting sleep apnea episodes). You will be asked by your doctor to keep a record of your sleep where you have to record how good your sleep was at night, day time performances, fatigue, sleepiness which will help your physician to make decisions on how to treat you. A sleep study will be done with help of a polysomnogram which helps doctors to know about your sleep stages, how often you may come across apnea episodes. You have to undergo other lab tests such as iron tests in blood, thyroid profile, multiple sleep latency tests (test determines your degree of sleepiness), and maintenance wakefulness test (test measures your ability to stay awake).

Actigraphy is a test where a device called an actigraph is worn on the wrist like a watch. Signals are recorded when movement is detected. There are few to no signals recorded during sleep or inactivity. 

There are various medications to treat sleep disorders.

Zolpidem belongs to a category of drugs called sedative-hypnotics. Zolpidem is a non-benzodiazepine hypnotic which has been greatly promoted as a sleep aid, in other words, a sleeping pill.

Clonazepam is a drug that is used to treat anxiety disorders. They are commonly used as sleeping pills. Clonazepam helps your brain relax. It will often put you to sleep. There are various uses for Clonazepam such as prophylactic use for seizures in children and adults, preventing panic attacks, treating insomnia (a type of sleep disorder), and management of stress.

Zopiclone belongs to the category of drugs called as hypnosedatives. Zopiclone can make you sleepy and hence it should only be taken before sleep. Always take a full glass of water along with the tablet. Zopiclone shouldn’t be crushed or chewed. Your doctor will recommend the lowest effective dose for you. Never take more than what is recommended by your doctor.

Doxepin helps you to get sleep by blocking the histamine receptors.

Lemborexant medication is given to patients who have trouble falling asleep and staying awake. It gives you sleep by suppressing the parts of the brain that keep you awake.

Ramelteon works by modifying the sleep cycle rather than affecting the brain.

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