Sleep disorders

Do you often have difficulty falling asleep? Maybe you suffer from...

insomnia

Symptoms

• Dissatisfaction with the quality orquantityof sleep combined with difficulty falling asleep, difficulty staying asleep and or early morning awakenings with the inability to fall asleep again

• the sleep disorder leads torestrictions in social, educational and professional life or other areas of life

• the sleep disorder occurs at least three times a week for at least three months

Causes

There are various causes of insomnia. It is often caused by work-related or interpersonal stress. In addition, the intake of certain substances is also a cause of insomnia. The consumption of alcohol in particular leads to insomnia.

Type of insomnia

In the course of a study, those affected were divided into five groups, each suffering from a different degree of insomnia.

Category 1: particularly severe

Category 2 + 3: moderate severity

Category 4 + 5: comparatively mild cases

Symptoms, what now?

In order to develop an effective treatment strategy, it is first necessary to accurately diagnose the symptoms. A five-stage diagnosis is helpful for this. This includes the following points:

1. medical history/diagnosis

2. psychiatric/ psychological anamnesis

3. sleep history

4. actometry (= recording of movement activity and thus sleep-wake rhythms)

5. polysomnography (=measurement of physiological functions; most comprehensive sleep examination)

Why is treatment necessary?

Failure to treat insomnia can have far-reaching consequences for your own health. It has been proven that insomnia can be seen as an independent risk factor forheartattacks, heart failure and high blood pressure. It has also been shown that reduced sleep duration caused by insomnia, for example, results in weight gain.

Facts

• Approximately 10% ofadults in industrialized countries suffer from chronic insomnia.
• Approximately 6% of the German population suffers from insomnia.

Are you often overcome by sudden, intense tiredness? Perhaps you suffer from...

Narcolepsy

Symptoms of narcolepsy

The symptoms of narcolepsy are varied and often lead to a misdiagnosis at first.

• Main symptoms: daytime sleepiness and cataplexy

• Associated symptoms:disturbed night sleep, automatic behavior, sleep paralysis, hallucinations during the transition from wakefulness to sleep, weight gain

Types of narcolepsy

Narcolepsy refers to a disorder of sleep and wakefulness. It is also the umbrella term for the two subtypes of narcolepsy type 1 and narcolepsy type 2, which differ from each other in that cataplexy occurs as a concomitant symptom in type 1 disease. Cataplexy describes the sudden (unilateral or bilateral) loss of tension in the postural muscles, which is caused by intense emotions. This is not the case with type 2 disease.

Causes of narcolepsy

In general, the causes of narcolepsy type 1 and narcolepsy type 2 are not yet very well researched. In patients diagnosed with narcolepsy type 1, little to nohypocritin could be detected in the cerebrospinal fluid (CSF). The nerve cells in the brain responsible for the production and release of the neurotransmitter are only present to a very small extent or not at all in these people. Scientists suspect that an autoimmune reaction is the cause of the absence of the special nerve cells.

Very little is known about the causes of narcolepsy type 2.

Symptoms, what now?

If symptoms, such as regular daytime sleepiness, occur every day for three months without any other recognizable cause, it is advisable to consult a doctor . However, it is important to note that although a clinical diagnosis can be made, this can often be flawed. A type 1 disorder in particular can often be confused with epilepsy. Only in a sleep laboratory is it possible to differentiate very precisely between narcolepsy and diseases with similar symptoms and enable patient-oriented treatment.

Why is treatment necessary?

Early detection and correct treatment of narcolepsy are particularly important, as the condition can lead to massive restrictions in quality of life. In addition to an increased risk of accidents, which is caused, among other things, by poor concentration, concomitant illnesses such asobesity anddepression also play an important role. Early detection and correct treatment can alleviate the symptoms and thus improve the patient's quality of life.

The facts

• 26 - 50 out of 100,000 people in Europe suffer from narcolepsy
• 18 - 20% of narcolepsy patients suffer from sleep-related breathing disorders
• 30 - 60% of narcolepsy patients suffer from depression

Do you sometimes wake up in places where you didn't go to sleep? Maybe you suffer from...

Parasomnias

Symptoms ofparasomnias

• Sleepwalking, sleep drunkenness, night terrors/night terrors

• Nightmares, sleep paralysis, enuresis, teeth grinding

• Rhythmic head banging (and other regular movements with one part of the body or the whole body), twitching to fall asleep, hallucinations

Types ofParasomnias

In parasomnias, the sleeping person experiences disturbing events (e.g. sleepwalking, nightmares, ...) in which he/she is actively involved. During sleep, inappropriate nerve impulses occur that control the movement system or involuntary bodily processes. A distinction is made between actions when falling asleep, actions during REM sleep and wake-up disturbances from deep sleep.

Causes ofParasomnias

Parasomnias are usually caused by stress, mental or physical illness or medication abuse. In some families, sleepwalking occurs so frequently that it is assumed that genetic factors are significant. It is also assumed that a not yet fully developed central nervous system plays a role.

Why is treatment necessary?

The quality of sleep of those affected does not necessarily have to be impaired, but it can be. Frequent teeth grinding can cause damage to the teeth and jaw, and sleepwalking can even lead to accidents or criminal acts. The lives of those affected are made more difficult: the quality of life decreases and the psyche is impaired.

Symptoms, and now?

The timing of treatment depends on the subjective stress caused by the disorder. Since it can also lead to dangerous actions, treatment is often requested by the patient in the case of sleepwalking, for example. As parasomnias are very complex, a comprehensive examination in a sleep medicine center is often necessary. There, body functions during sleep are recorded and analyzed with the help of monitoring systems. The examination should be carried out by an experienced sleep physician who specializes in parasomnias.

Facts

• Children and adolescents are more frequently affected than adults.
• 10 - 50 % of all children and adolescents suffer from nightmares.
• 17% of children under the age of 10panic at night.

Do your legs often tingle when you try to sleep? Perhaps you suffer from...

Restless legs syndrome (RLS)

Symptoms

RLS:

• Urge to move (usually occurs after going to bed & is accompanied by other symptoms)

• Unpleasant tingling ("formication"), can take on extreme proportions

• Symptoms usually occur when awake & can have a negative effect on falling asleep

Periodic movements of the limb: occur (in contrast to those of RLS) mostly during sleep, usually at intervals of 30 seconds & accumulate in the non-REM sleep phase in the first half of the night

Types ofRestlessLegssyndrome

Restless legs syndrome (RLS for short) describes a phenomenon in which those affected have an urge to move, which is accompanied by discomfort in the legs. These usually occur when awake. Unlike RLS, periodic movements of the limbs occur during sleep and are beyond the control of those affected. If these occur in conjunction with daytime sleepiness and/or sleep disturbance, they can be described as an independent disease. Although RLS often occurs with periodic limb movements, the reverse is not true.

Causes ofrestlessLegssyndrome

In more than half of cases, RLS is caused by genetic factors. If RLS can be diagnosed more frequently within the family, more severe and complicated cases can usually be assumed, which are difficult to treat. In cases where a genetic cause can be ruled out, RLS is usually due to pregnancy, renal insufficiency requiring dialysis or iron deficiency. The causes of periodic limb movements are still largely unknown, but the factors responsible for triggering the symptoms are the same as for RLS. Periodic limb movements are particularly common in patients with narcolepsy or renal insufficiency.

Symptoms, what now?

If symptoms occur, it is advisable to seek help from a doctor. This can be done in the course of a clinical neurological examination and is usually carried out in the case of non-symptomatic RLS. However, as other diseases with similar symptoms cannot be completely ruled out, it is important to carry out further medical examinations and to take the patient's entire medical history into consideration. An examination in a sleep laboratory is only necessary in very unclear cases. In contrast, more complex examinations are required to investigate periodic limb movements. The causes can only be analyzed precisely in the sleep laboratory.

Why is treatment necessary?

If the symptoms of RLS or periodic limb movements are not treated, this can lead to serious consequences for those affected (particularly sleep deprivation and greatly reduced performance). These in turn lead to an impaired quality of life for those affected and an increased risk of accidents (e.g. due to fatigue in road traffic).

Fact

• 5 - 10% of the total population will suffer from RLS in their lifetime.

Do you often feel very unfocused, have a dry mouth and a headache when you wake up? Perhaps you suffer from...

Sleep apnea

Symptoms of sleep apnea

• Breathing stops for at least 10 seconds during sleep

• Severe daytime tiredness à concentration and memory problems, reduced performance

• Reduction in libido and potency

• microsleep

• Morning headaches, dry mouth

Types of sleep apnoea

Sleep apnoea is present if more than five breathing interruptions occur in one hour, eachlastingat least ten seconds. A distinction is made between obstructive and central sleep apnoea. They differ in their causes, but show similar symptoms.

Causes of sleep apnoea

In obstructive sleep apnoea, the airways are obstructed or narrowed. This may be due to anatomical features, obesity, sleeping in a supine position or increased muscle relaxation caused by alcohol, medication or drugs. The breathing pauses occur because the strength of the respiratory muscles is not sufficient to get air through the blocked airways.

In central sleep apnoea, the cause lies in the brain. The respiratory muscles briefly lack the command from the brain to become active. The brain only reacts when the oxygen content in the blood falls below a critical level.

Symptoms, what now?

Various methods are available for treatment. However, sometimes these are only successful if they are combined. In the case of obesity, it is important to reduce weight through diet and exercise programs in consultation with a doctor. If the person concerned smokes, this should be stopped and alcohol should not be consumed four hours before going to bed. In addition, splints can be used to enlarge the breathing space or a breathing mask can be used for nasal positive pressure ventilation. If conventional treatment methods fail, surgical procedures are carried out.

Why is treatment necessary?

Breathing interruptions can endanger health and contribute to the development of high blood pressure, for example. Sleep apnoea can therefore have negative consequences and even shorten life expectancy.

Facts

• 4% - 9% of people in Germany suffer from sleep apnea. However, there is a high proportion of undiagnosed cases.
• Men between the ages of 40 and 65 are most frequently affected by sleep apnoea.
• Those affected often do not even notice their breathing stops themselves, but are often only noticed by their bed partners.