Sleep disorders at a glance: causes, symptoms & treatment

The most common types of sleep disorder and their causes

Sleep disorders can severely impair our well-being and occur in many differing forms. The six main groups include insomnia, sleep apnoea, hypersomnia, sleep-wake cycle disorders and parasomnia. Most people are affected by insomnia and sleep apnoea.

Insomnia

Symptoms: people with insomnia have trouble falling asleep and staying asleep or they wake up early and can’t get back to sleep again. Insomniacs have sleep-related difficulties that last for more than three months, occur more than three times a week and impair their performance during the day.

Causes: insomnia has no clear organic causes and is relatively common. It can occur in combination with mental disorders such as depression. Possible causes include personal worries, conflicts, tendencies to brood, negative thoughts, work pressure, high performance demands, high expectations of sleep quality, traumatic experiences, anxiety and severe tension.

Sleep-related breathing disorders

Symptoms: the most common sleep-related breathing disorder is sleep apnoea. With this condition, the patient frequently stops breathing while still asleep. Due to short reactionary moments of wakefulness, their sleep can be interrupted and they get less deep sleep. This leads to severe tiredness and performance impairment during the day and can result in the person unintentionally falling asleep in resting situations (e.g. when waiting at a red traffic light).

Causes: risk factors are obesity, age > 35 years, male gender, alcoholism and loud, routine snoring.

What are the consequen­ces of sleep disorders?

The effects of sleep disorders on health are diverse and vary depending on the type of disorder. Possible effects are:

• Increased tiredness and irritability during the day
• Reduced performance during the day
• Lower quality of life
• In the event of long-term sleep problems, greater risk of obesity, heart disease, diabetes, depression and anxiety
• Weakened immune system resulting in increased infections
• Greater risk of dementia in old age if sleep is chronically insufficient or disturbed
  

Treatment of sleep disorders

If you suffer from sleep disorders that occur frequently over a long period of time and severely impair your performance during the day, you should seek professional help. Treatments vary according to the disorder.

Cognitive behavioural therapy and sleep medication for insomnia

Cognitive behavioural therapy for insomnia (CBT-I) is the leading and most sustainable therapy method for insomnia. Its effectiveness has been proven in a large number of studies, also when the therapy is accessed through an online app. Although sleep medication is also effective, it should only be used regularly over shorter periods of time (e.g. 1-3 weeks) due to the side effects and risks of addiction.

Breathing mask for sleep apnoea

In the case of sleep apnoea, treatment with a breathing mask (CPAP) is usually recommended, which can prevent the patient’s breathing being interrupted as they sleep. This enables many patients to lead a life in which they feel “awake” again. Weight loss, moderate alcohol consumption or abstaining from alcohol, mouth splints or strengthening the throat muscles (e.g. by playing the didgeridoo) can also be effective approaches.

Dealing with sleep difficulties and insomnia

Many people have difficulty sleeping but don’t necessarily have a diagnosable “sleep disorder”. Acknowledging certain principles makes it easier to deal with sleep problems:

1. Sleep is individual. It’s difficult to say how long and how well someone should sleep. Also, some people tend to be light sleepers, while others can sleep anytime and anywhere. It’s therefore important to accept your own sleep patterns to some extent.
2. Sleep changes with age. While as children we tend to feel like we sleep through the night, from the age of 35-45 we are more likely to stay awake longer at night. This is purely an “ageing” of sleep and not necessarily a sign of problems.
3. Sleep is dynamic. If we sleep badly one night, we tend to sleep better and more deeply the next night. And if we sleep very long and deeply one night, we sleep less well the following night. This in turn means that there is a very effective method for falling asleep faster and sleeping better through the night: not spending too much time in bed and staying awake longer.
4. Our body can also cope with a lack of sleep. This is especially true if there are enough opportunities to sleep and recover later on. The body also recovers while lying awake, so sleep isn't absolutely necessary.
5. Sleep isn't always recognisable. This is probably because it’s difficult to tell whether we're asleep or not. As we can also think while we sleep, we often have the impression that we’re awake even though we’ve been asleep. This is why we often sleep more than we realise.
6. Our sleep and our behaviour during the day are connected. People who never take breaks or time to rest during the day are probably unable to switch off in the evening as well. Regular exercise and activity, good social integration, an activity that is experienced as meaningful, good stress management and a fulfilling life are therefore important contributors to a good night's sleep.
   

Tips for better sleep

Numerous other tips can be followed for better sleep – but it’s always important that these fit in with your everyday routine:

Supplements for sleep disorders

Choline supplements

While choline supplements may have positive effects on memory and attention, a direct link with better sleep isn't to be expected: in fact, for deep restful sleep it's essential that cholinergic activity is low.

Iron

An iron deficiency can lead to tiredness and sleep disorders. For this reason, correcting the deficiency could also improve sleep.

Cannabinoids

Cannabinoids such as CBD oils have pain-relieving effects and can also help patients in pain to fall asleep. The findings on whether cannabinoids directly improve sleep aren't clear.

Melatonin supplements

Melatonin is a hormone produced naturally in the body that's important for our sleep-wake cycle. It can help influence the sleep-wake cycle (e.g. in the case of jet lag) and also has a slight sleep-promoting effect. However, the effect is small compared to other sleep medications.

Home remedies

Some people find relief with home remedies such as lavender oil, lemon balm or valerian.

Rare sleep disorders

There are different treatments for the rarer sleep disorders, which you can discuss with your doctor and sleep specialist.

Greater need for sleep (hypersomnia)

This category includes rare conditions such as narcolepsy or Kleine-Levin syndrome. Narcolepsy is indicated by excessive daytime sleepiness and sudden sleep attacks. Patients with Kleine-Levin syndrome have recurring episodes in which they sleep for 15-21 hours for several nights.

Circadian sleep-wake cycle disorders

This group of sleep disorders covers disturbances to our sleep-wake pattern, e.g. cycles that are pushed forward to extremes, or that lack regularity.

Parasomnia

Parasomnia includes disorders whereby the person’s movements, emotions, perceptions and behaviour don't match the respective sleep phase. These include sleepwalking, nocturnal startling, sleep paralysis (wakefulness in a paralysed, sleeping body) and movement disorders during REM sleep.

Sleep-related movement disorders

Sleep-related movement disorders during sleep include night-time teeth grinding (bruxism), unpleasant tingling or movements in the legs or arms when falling asleep (restless legs syndrome, or RLS for short, or periodic limb movement disorder).

Conclusion: overcoming sleep disorders

Ultimately, success in overcoming sleep disorders is often achieved through a combination of lifestyle changes, therapeutic support and, if necessary, medical intervention. Taking an individualised approach that addresses the specific needs and causes of the person affected is key to this success.

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