Other Common Adult Sleep Disorders
- Insomnia – The patient is unable to fall asleep and/or remain asleep for a reasonable amount of time.
- Parasomnias – The patient experiences sleep walking, teeth grinding, and night terrors. These symptoms are sometimes associated with stress and depression.
- Narcolepsy – The patient has a chronic neurological condition caused by the brain’s inability to regulate the sleep–wake cycle normally. Patients with narcolepsy have uncontrollable urges to sleep at inappropriate times during the day. They may also experience muscle weakness after laughing or crying outbursts.
- Periodic leg movement disorder – The patient experiences sudden jerking or bending of the arms and legs during sleep. These symptoms can range from small shudders of the ankles and toes to leg kicks and flailing of arms and legs. These periodic movements often wake the sufferer, significantly disturbing the quality of the child’s sleep.
- Rapid eye movement (REM) sleep-related disturbances – The patient experiences dream-related abnormal sleep states including recurring nightmares, sleep paralysis, and REM sleep behavior disorder (RBD). Nightmares and isolated sleep paralysis are common and do not constitute an abnormality unless they occur several times a week and disturb the patient’s sleep. REM RBD is a serious disorder that involves patients acting out their dreams and can include punching, kicking, leaping, and running from the bed. The disorder is more common in middle-aged and elderly men. One sees a high statistical association with neurologic conditions such as Parkinson disease, Alzheimer dementia, stroke, and multiple sclerosis. RBD is due to the body’s inability to turn off the voluntary muscles during dream sleep, which manifests itself as the person “acting out” his or her dream mentation.
- Restless legs syndrome (RLS) – RLS often appears in otherwise healthy people and is not related to emotional or psychiatric disorders. As the name implies, this disorder affects the legs, but it can involve the arms as well. People experience a restless sensation in many different ways, but all describe a particularly uncomfortable sensation in the muscles of the affected limbs whenever they try to relax in either a sitting or lying position. The sensation is relieved by moving or walking or, in extreme cases, by application of warm soaks or a hot bath. The sensation can be painful and frequently leads to problems falling asleep because of the inability to “relax.” Careful questioning allows one to differentiate the pain of leg cramps and the pins-and-needles sensation that patients with diabetes or those with peripheral neuropathies experience.
- Circadian rhythm disturbances – Some people’s internal biologic clocks are out of alignment with the usual 24-hour cycle of light and dark. These people cannot fall asleep until very late at night or in the early morning hours and then have difficulty waking up in the morning and tend to stay asleep until late morning or early afternoon. Others go to sleep early in the evening and wake up well before daybreak, unable to fall asleep. These sleep problems are treated by exposure to bright light at certain times of the day or night, depending on the specific complaint. In some cases they are used in conjunction with medications that help control the body’s internal clock. People who work nights or rotating shifts as well as people who travel across two (2) or more time zones are especially prone to circadian rhythm disturbances.