Sleep Disorder Therapy

Sleep disorders that persist long enough can negatively affect daily functioning and overall well-being. If you struggle with sleep, knowing the specific type of sleep disorder you have can be extremely helpful in learning to manage the symptoms and getting the appropriate treatment. Nonetheless, treatment for sleep disorders generally consists of a combination of medical therapies, psychotherapy and lifestyle changes.
Sleep-Disorders-Treatment-TherapyTribe
Overtime sleep disorders grow progressively worse and can be the initial signs of an underlying health disorder.

What Are Sleep Disorders?

Sleep disorders, also known as somnipathy, affect many people and come in a variety of forms. While it is common (and even normal) to occasionally experience difficulties falling asleep and/or staying asleep, it is not normal to experience struggles with sleep on a regular basis. Across the board, sleep disorders cause a disruption of restful sleep. Depending on the specific sleep disorder, this disruption can be anywhere from mild to severe (and even life-threatening). Most people who have sleep problems only suffer from one sleep disorder. But unfortunately, some experience multiple forms of sleep disorders simultaneously.

One third of US adults report that they usually get less than the recommended amount of sleep for their age. All too often, people try to treat sleep disorders on their own, with medication and sleep aids. However, sleeping pills carry various side effects, and should only be used under the guidance of a doctor. And while sleeping pills can be effective, they are only treating the symptoms of the sleeping disorder rather than the underlying cause. In some cases, they may even make the disorder worse in the long-term.

Growing Concerns about Sleep Deprivation

Many scientific studies have shown that sleep is crucial for good mental and physical health. In fact, in 2014 The US Centers for Disease Control and Prevention (CDC) deemed sleep deprivation a public health epidemic. Since the pandemic this concern has only grown as researchers around the world have documented a surge in sleep disorders. For adolescents in particular, chronic sleep loss has increasingly become the norm. So much so, that the American Academy of Pediatrics (AAP) had strongly encouraged high schools and middle schools to aim for start times after 8:30am.

Causes of Sleep Disorders

While there is no specific cause of sleep disorders, many factors may contribute to, or increase the likelihood of someone developing a sleep disorder. A range of physical issues, from something as simple as a vitamin/mineral deficiency, your circadian chronotype to a more complicated problem such as chronic pain, can lead to the development of a sleep disorder. Sleep disorders often appear in conjunction with other health issues, like bruxism, also known as teeth grinding (which has been linked to stress hormone imbalances).

Even food allergies and intolerances can trigger sleep disorders for some people. Research has shown gluten-related allergies can cause restless leg syndrome and periodic limb movement disorder for some. Mental health problems, such as depression, anxiety, or prolonged stress can also increase a person’s risk of suffering from sleep disorders. There are also a number of environmental factors such as pregnancy, jet-lag, and shift-work that may increase one’s chances of having one or more sleep disorders.

Signs and Symptoms of Sleep Disorders

Although sleep disorders can affect everyone differently, there are some common symptoms seen in the majority of cases. All sleep disorders involve some level of sleep disruption, decreasing the overall restfulness of the night, and contributing to fatigue.

Other common symptoms include:

  • Muscle tension and soreness.
  • Slowed or poor circulation, which can lead to difficulty staying warm.
  • Mental fog and difficulty thinking clearly. This includes difficulty making decisions and slow reaction times.
  • Vision problems, including blurry eyesight and trouble focusing the eyes.
  • Emotional imbalances, including feeling anxious, irritable, stressed, and simply having more difficulty controlling emotions than usual.
  • Hair loss – insufficient sleep tends to cause increased stress, which is shown to cause hair loss.
  • Weight gain – sleep disorders frequently cause a person to experience an increased appetite or urge to eat (especially sweet or caffeinated foods and drinks to help boost energy and wakefulness.)

Types of Sleep Disorders

Illustration of woman with a sleep disorder lying awake checking her alarm clock.

If you struggle with sleep, knowing the specific type of sleep disorder you have can be extremely helpful in learning to manage the symptoms and getting the appropriate treatment. If you think you may have a sleep disorder, it is important you speak with a doctor or mental health professional who can assess and diagnose your specific sleep disorder.

Insomnia

Insomnia is simply an inability to fall asleep, stay asleep, or get restful sleep. It can be triggered by stress, health problems, side effects of medications you are taking, other sleep disorders, such as the ones listed below, or psychological disorders such as depression or anxiety. Insomnia may be a short-term problem for many sufferers and is often treatable through lifestyle therapies rather than medication. Insomnia, chronic or short-term, affects two-thirds of adults and is one of the most common reasons to seek medical care.

Sleep bruxism

Sleep bruxism is a sleep disorder in which you clench or grind your teeth. This can occur infrequently and may not require treatment; however, for some, it can be so severe that it leads to headaches, flattened or chipped teeth, and jaw problems such as tightness, soreness, and difficulties chewing. It’s associated with stress, aggressive personality types, and smoking. It occurs most often in kids, and children frequently grow out of it without any need for special treatments. However, dental treatment, medications, and psychotherapy may be necessary in more severe cases.

Sleep apnea

Sleep apnea occurs when your breathing frequently stops temporarily during sleep, jerking you awake. This can actually be life-threatening. The most common type, called obstructive sleep apnea, is caused by tissue in your throat blocking your airway. Though you may awake in the morning without any memory of this, the lost sleep may make you feel tired, irritated, and unfocused throughout the day. Your partner may also be aware of your loud snoring and sudden interruptions in breathing. It’s important to see a doctor to treat sleep apnea, as you may need a positive airway pressure device to help you breathe while you sleep. Alternative lifestyle treatments, such as weight loss and regular exercise, can also be extremely effective for treating obstructive sleep apnea.

Hypopnea

Hypopnea, also called “partial apnea,” is characterized by reduced airflow or shallow breathing during sleep. The airway is not fully obstructed, but breathing becomes much more difficult, and after a while, the lack of oxygen will still awaken you to gasp for air.

Narcolepsy

Narcolepsy is a sleep disorder characterized by “sleep attacks” in the middle of wakefulness, often caused by a strong emotional reaction to something. Narcolepsy is actually caused by dysfunction that disturbs the brain’s normal control over waking and sleeping. This can be especially dangerous when you are driving or operating machinery. Narcolepsy is commonly linked with depression and is often treated with a combination of lifestyle changes, psychotherapy, and medications.

Night terrors

Night terrors are not simply nightmares. They can start with a loud shout or scream, and though the sleeper may sit up in bed and appear awake and terrified, they are still asleep and may fight and thrash around. Night terrors are difficult to awaken people from, and often the person is very confused when they eventually are awakened. Sometimes, night terrors can lead to sleepwalking, fleeing, and aggressive behavior. While more common in children, night terrors can occur in adults, especially those with mood disorders such as anxiety, those with high stress or sleep deprivation, PTSD, or other sleep disorders like restless legs syndrome or sleep apnea. It may be treated with psychotherapy, stress reduction techniques, awakening a few minutes prior to when the event usually occurs, and, occasionally, medications.

REM Sleep Behavior Disorder (RBD)

REM Sleep Behavior Disorder (RBD) is a sleep disorder where a person enacts their dreams while in REM sleep. RBD predominantly affects older adults, and the associated behaviors are often violent in nature, in association with violent dream content. These behaviors are serious as they can cause harm to the person or their bed-partner.

Restless Leg Syndrome

Restless Leg Syndrome is a disorder that creates a powerful urge to move. This urge is often concentrated on the legs and/or arms, making it uncomfortable and almost impossible to lie still.

Unfortunately, most sleep disorders grow progressively worse. They can also be the initial signs of an underlying health disorder or psychological issue. Night terrors, bruxism, and rapid eye movement, for instance, are often associated with post-traumatic stress disorder. Sleep apnea, on the other hand, is frequently associated with obesity, diabetes, and heart problems. As the sleep disorder worsens, the other symptoms and disorders typically worsen as well.

Treatment for Sleep Disorders

Sleep disorders that persist long enough to negatively affect one’s daily functioning and overall well-being necessitate professional treatment. Initially, a medical or mental health professional will order a polysomnography (sleep study) to diagnose the specific sleep disorder(s) and possibly, the cause. Multiple factors may be responsible, and treatment may take an extended period of time.

Because of the variety of sleep disorders and range of symptoms, treatment may look different for everyone. Nonetheless, treatment for sleep disorders generally consists of a combination of medical therapies and psychotherapy.

Medications and Sleep Aids

There are numerous different medications and dietary supplements that are used to assist with falling asleep and/or staying asleep. Some sleep aids can be habit-forming, in that as a person uses them, they often begin to rely on them more and more. Before starting any medication or supplement, it is important to talk to a doctor about the possible side effects.

If there is a mood disorder linked to the sleep disorder, antidepressants or anti-anxiety medications are often prescribed to help improve sleep. Dietary supplements such as melatonin (a hormone naturally produced by your body) and chamomile (an herbal remedy) are helpful to some who struggle with sleep disorders.

Behavioral and Psychotherapy

In cases when sleep disorders are caused by or worsened by anxiety, depression, or PTSD, psychotherapy sessions can be extremely helpful and even essential. Therapy may be beneficial by helping you get to the root of the problem or find strategies to manage stress, negative emotions, and traumatic events that may be contributing to your sleep problems.

Through the Cognitive Behavioral Therapy (CBT) approach, your therapist can help you learn to change actions and thoughts that are harming your sleep. This is a very effective treatment for insomnia (called CBT-I sleep programs) and is often considered to be the first line of treatment.

For circadian rhythm sleep disruption (often occurring from jet lag or shift-work) or individuals with delayed sleep phase syndrome (DSPS), light therapy is often used. This technique—also called phototherapy—can help individuals “re-set” their internal clock, which can help re-establish a healthy sleep pattern.

Lifestyle Changes

Sleep disorders are often best managed through lifestyle changes in conjunction with other medical and psychological treatments.

These 8 healthy lifestyle practices can help with almost any sleep disorder:

  1. Eat a healthy diet, and avoiding foods that irritate your digestive system. If you are concerned that you may have a food allergy or intolerance, you may consider seeing a registered dietitian and keeping a food diary to see if there are any patterns linking what you eat with how you feel and how well you sleep. Eating a balanced diet including plenty of protein, fruits, vegetables, and whole grains is especially important in ensuring that you get the nutrients that you need to sleep well and repair your body while you sleep.
  2. Quit smoking and drink less alcohol. Smoking has been linked to sleep apnea, and alcohol use has been linked to night terrors. Most of all, using tobacco and overusing alcohol is detrimental to overall health and can lead to vitamin and mineral deficiencies, which can also contribute to poor sleep.
  3. Exercise every day. Getting plenty of exercise, whether it’s walking, running, swimming, biking, weight lifting, yoga, or gardening, has been shown to help people fall asleep more quickly and get better quality sleep.
  4. Lose weight. Being overweight can contribute to the development of sleep apnea, and may lead to other health issues such as heart disease that are linked to sleep disorders.
  5. Learn to relax. Meditation, mindfulness practices, yoga, and deep breathing are a few helpful ways to get your body and mind into a relaxed state, ready for a restful night’s sleep.
  6. Cut down on—or cut out—caffeine. While caffeine seems essential when you’re exhausted, it may also be worsening your sleep the next night.
  7. Keep a regular sleep schedule. Try to go to bed and wake up at approximately the same time each day, including on weekends. Skip the nap.
  8. Remove electronics (such as laptops, smartphones, tablets) at least thirty minutes before bed.

Find a Therapist for Help with Sleep Disorders

Sleep disorders can significantly impact one’s life. But with treatment, getting restful sleep is possible.

Search TherapyTribe for a psychologist or mental health professional who specializes in sleep disorders and learn more about treatment options. TherapyTribe can connect you with therapists online or to professionals located near where you live.

Post-Pandemic Impact on Sleep

Since the start of the COVID-19 pandemic, sleep disorders have been on the rise. Research shows 2 out of 3 people experienced changes in sleep habits during the pandemic – some were sleeping for significantly longer periods of time while others suffered from some form of insomnia, struggling to fall asleep and/or stay asleep. Lack of structured schedules, more screen time, increased alcohol consumption, and stress are all factors that may have contributed to sleep disturbance.

Some studies also reveal that individuals with “long COVID syndrome” are reporting persistent night sweats, sleep apnea, and insomnia. Thankfully, through lifestyle changes, behavioral interventions, and/or medication, it is possible to reestablish a healthy sleep routine.

References

  1. Campbell, S., Terman, M., Lewy, L., Dijk, D., & Eastman, C. (1995). Light treatment for sleep disorders: Consensus Report. Journal of Biological Rhythms. 10(2), 151-154.
  2. Espie, C. (2002). Development, persistence, and treatment of sleep disorder in adults. Annual Review of Psychology, 53, 215-243.
  3. Ferracioli-Oda, E., Qawasmi, A., & Bloch, M. (2013). Meta-analysis: Melatonin for the treatment of primary sleep disorders. PLOS Medicine.
  4. Schenck, C. H., & Mahowald, M. W. (2002). REM sleep behavior disorder: Clinical, developmental, and neuroscience perspectives 16 years after its formal identification in SLEEP. Sleep: Journal of Sleep and Sleep Disorders Research, 25(2), 120-138.
  5. Sriharsha P, Gujjari AK, Dhakshaini MR, Prashant A. Comparative Evaluation of Salivary Cortisol Levels in Bruxism Patients Before and After Using Soft Occlusal Splint: An in vivo Study. Contemp Clin Dent. 2018 Apr-Jun;9(2):182-187. doi: 10.4103/ccd.ccd_756_17. PMID: 29875558; PMCID: PMC5968680.
  6. Scott AJ, Webb TL, Martyn-St James M, Rowse G, Weich S. Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials. Sleep Med Rev. 2021 Dec;60:101556. doi: 10.1016/j.smrv.2021.101556. Epub 2021 Sep 23. PMID: 34607184; PMCID: PMC8651630.
  7. Abrams, Z. (2021). Growing concerns about sleep. American Psychological Association. 52(4). Retrieved from: https://www.apa.org/monitor/2021/06/news-concerns-sleep