Sleep apnoea and other disorders

27 July 2020

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As a nation we’re not getting enough sleep. According to The Sleep Council, more than 19% of us go to bed after midnight,1 meaning we’re unlikely to be getting the recommended 6-9 hours a night, especially if we’re getting up early for work. For some of us though, it’s a sleep disorder that’s keeping us awake. Insomnia, for example, affects around 37% of the UK adult population and the more alarming condition obstructive sleep apnoea (OSA) affects an estimated 1.5 million or nearly 8% of adults in the UK, according to a report from the British Lung Foundation.2

But what is a sleep disorder and what are the different types that can affect some people? We’re exploring some of the most common sleep disorders and the treatments recommended for each.

What is a sleep disorder?

Sleep coach Carolyn Burke from The Sleep Advisor, reports that 16 million adults are suffering from sleep problems.3 At some point in our lives we may all experience a lack of sleep and can put it down to stress, travel, a new baby or other disruption in our normal routine. But when it’s a regular occurrence and it interferes with your daily life, you may be suffering with a sleep disorder.

A sleep disorder is a condition that frequently impacts your ability to get enough quality sleep. While it’s normal to occasionally experience difficulties sleeping, it’s not normal to regularly have problems getting to sleep at night, to wake up feeling exhausted, or to feel sleepy during the day.

How sleep disorders affect your health

Short term effects of a lack of sleep can cause irritability, trouble focusing and decision making and feeling sluggish throughout the day. It can also affect your memory. And the long term, cumulative effects can be more serious. Says AXA PPP Physiologist, Daniel Craig, “untreated sleep disorders can result in more than half of the leading causes of death, including cardiovascular disease, diabetes and hypertension.”

Common sleep disorders and how they can be treated

You may have already heard of these sleep disorders by name but not know what they actually are, or how they can be treated. We’re taking a look:

Insomnia

Affecting 1 in 3 people in the UK4, insomnia is difficulty in falling asleep, or staying asleep long enough to feel refreshed the next day.

If you have insomnia, you may:

  • find it difficult to fall asleep
  • lie awake for long periods at night
  • wake up several times during the night
  • wake up early in the morning and not be able to get back to sleep
  • find it hard to nap during the day, despite feeling tired.

It’s not always clear to find the cause but it’s said that stress and anxiety, a poor sleeping environment, depression and caffeine or alcohol can make it worse.

Treatment for insomia

With the aim of getting a good night’s sleep there are a number of options for sufferers to try:

  • Set regular times for going to bed and waking up
  • Taking a warm bath or listening to calming music before bed to relax
  • Making sure any light or noise is blocked out in the bedroom
  • Avoiding caffeine, nicotine, alcohol, heavy meals and exercise for a few hours before going to bed
  • Not napping during the day.

As well as trying these steps, it’s advised to speak to your GP. The first step they might recommend is a special type of cognitive behavioural therapy (CBT) designed for people with insomnia. It involves a talking therapy that aims to help you avoid the thoughts and behaviours affecting your sleep.

Prescription sleeping tablets are normally only considered as a last resort, as they can have some side effects and become less effective over time.

Obstructive sleep apnoea (OSA)

This is where a person’s breathing starts and stops throughout the night, caused by their throat tissue and muscles relaxing and collapsing. It’s this collapsing that results in a blockage of their airway, and when it’s blocked for 10 seconds of more it’s called an apnoea.

NHS Inform explain that during an episode, the lack of oxygen triggers your brain to pull you out of deep sleep – either to a lighter sleep or to wakefulness – so your airway reopens and you can breathe normally.5

Sleep apnoea usually results in snoring and laboured breathing and being woken throughout the night when the breathing stops, which leaves the sufferer exhausted the following day, but often with no recollection of why. For this reason it’s estimated that some 85% of OSA cases go undiagnosed, and it’s often f not until a close friend, partner or family member picks up the symptoms that the condition is recognised.

And it’s important that it is. According the British Lung Foundation report referenced above, undiagnosed OSA is closely associated with serious health problems, including hypertension, diabetes, stroke and heart disease. It can shorten life expectancy, lead to road collisions caused by undiagnosed sleepy drivers, and affect relationships. So if you think you may be affected, it’s important to seek help.

Treatment for sleep apnoea

Sleep apnoea can be managed. Treatments can include:

  • Lifestyle changes – being overweight can put a strain on your neck, as it increases the amount of soft tissue in that area, so losing excess weight can help. Also cutting down on alcohol, especially before bed, can help, as well as trying to sleep on your side.
  • Using a continuous positive airway pressure (CPAP) device can be effective for sufferers. A CPAP is a simple machine that pumps air through a mask you wear at night. It’s designed to hold your airway open while you’re asleep by sending air at pressure into your upper airway to stop it collapsing or narrowing.
  • Wearing a gum shield device called a mandibular advancement device (MAD), that fits around your teeth, holding your jaw and tongue forward to increase the space at the back of your throat while you sleep.

Restless legs syndrome (RLS)

Described as having an uncontrollable urge to move your arms or legs when resting or lying down, restless legs syndrome is a sleep disorder that can repeatedly impact your sleep.

Also known as Willis-Ekbom disease, restless legs syndrome is a common condition of the nervous system, which can also result in a crawling or creeping sensation in the feet, calves and thighs. According to the NHS, in the majority of cases, there’s no obvious cause but some neurologists believe the symptoms of restless legs syndrome may have something to do with how the body handles a chemical called dopamine, the chemical that controls muscle movement.6

Treatment for restless legs syndrome

Mild cases are said to not be linked to any underlying health condition, so treatment would be down to making some lifestyle changes. In some cases, however, the syndrome is caused by a lack of iron, so being prescribed supplements to regulate iron levels can help.1

Some other things that can help include:

  • Making sure you’re following a regular bedtime routine – avoiding caffeine and alcohol late at night.
  • Regular exercise during the day – although it’s advised not to do heavy exercise before bed.
  • Trying to manage stress levels – RLS can be worse if you are feeling stressed or anxious.
  • Reducing caffeine –this is said to help some sufferers.

Narcolepsy

Narcolepsy is a chronic sleep disorder that affects the part of your brain that regulates sleep. People with this condition experience excessive sleepiness during the day and often have sudden episodes where they fall asleep during normal activities.

“Ordinary daily activities such as driving, cooking, or even walking can become dangerous, and extreme daytime sleepiness can put a strain on work, school, and intimate relationships,” says Dan.

Affecting 1 in 2,000 people, there is yet to be a cure for narcolepsy, but there are ways to manage the condition.

Treatment for narcolepsy

It’s very common for those with narcolepsy to suffer from depression, as many symptoms of narcolepsy, particularly sleep attacks, can impact your ability to live a normal life. “These episodes can be frightening, and you may become depressed because of the sudden lack of control. Fear of falling asleep or collapsing suddenly leads some people to become reclusive and withdrawn. Reaching out to a psychologist, counsellor, or narcolepsy support group can help you cope with the effects of the disorder.”

They also highlight some lifestyle changes that can help:

  • Schedule your sleep periods – take a few brief, scheduled naps during the daytime (10-15 minutes each). Try to get a good night’s sleep during the same hours each night. Planned naps can prevent unplanned lapses into sleep.
  • Avoid caffeine, alcohol, and nicotine – these substances interfere with sleep when you need it.
  • Avoid over-the-counter medications that cause drowsiness – some allergy and cold medications can cause drowsiness, so they should be avoided.
  • Involve your employers, co-workers, and friends – alert others to your condition so they can help when needed.
  • Relax and manage emotions – narcolepsy symptoms can be triggered by intense emotions, so you may benefit from practicing relaxation techniques, such as breathing exercises, yoga, or massage.

Parasomnias

Parasomnias is the name given to a group of sleep disorders, including sleepwalking, sleep terrors, sleep eating disorder, sleep paralysis, nightmares, bedwetting, teeth grinding (or buxism) and sleep talking or groaning (known as catathrenia).

All of these disorders involve unwanted events or experiences when you are falling asleep or waking up. Sleep parasomnias may be triggered by stress or anxiety, certain medications, irregular sleep schedules or sleep deprivation and neurological conditions, like Parkinson’s disease or ADHD. They tend to be more common in children than adults.

Treatment for parasomnias

Treatment for parasomnias varies depending on the particular condition, severity and the cause, but will in the first instance include improving sleep hygiene and making the sort of lifestyle changes discussed throughout this article, to help mitigate harm caused by a long-term lack of good quality sleep. It’s also important to safeguard parasomnia sufferers against harm, for example in the case of sleepwalkers, locking windows and doors and where possible sleeping on the ground floor; or wearing a mouth guard to prevent wear and tear caused by teeth grinding.

Other more general measures may include:

  • Keeping a sleep diary to identify triggers
  • Steps to reduce stress and anxiety where these are a contributing factor
  • Medication to treat the underlying cause
  • Counselling, including cognitive behavioural therapy for insomnia (CBTi)

Getting help for sleep problems

If a lack of sleep is affecting your daily life and you’ve tried some self-help tips that aren’t working then speak to your GP. They can offer advice and point you in the direction of support groups or different types of therapies; as well as look at whether you have a deficiency in something that’s causing your disorder.

The NHS also recommends contacting your GP if you have insomnia that lasts for more than 4 weeks.

Further information

Sleep hub – AXA PPP healthcare

Ten top tips for a better night’s sleep – AXA PPP healthcare

Can diet affect sleep? – AXA PPP healthcare

Sleep tips for all ages – AXA PPP healthcare

References

  1. The Sleep Council. Time for bed, time for sleep - Sleep stats. 4 July 2018.
  2. British Lung Foundation. Obstructive Sleep Apnoea. Toolkit for commissioning and planning local NHS services in the UK 2015.
  3. The Most Common Sleep Disorders Explained.
  4. NHS Inform Insomnia.
  5. NHS Inform Obstructive sleep apoea.
  6. NHS conditions Restless legs syndrome.
  7. Chattu et al. (2018) Insufficient Sleep Syndrome: Is it time to classify it as a major noncommunicable disease? Sleep Science, 11(2): 56-64.
  8. Dye TJ, Jain SV, Simakajornboon N. Outcomes of long-term iron supplementation in pediatric restless legs syndrome/periodic limb movement disorder (RLS/PLMD). Sleep Med. 2017;32:213-219. doi:10.1016/j.sleep.2016.01.008