Sleep disorders

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

Insomnia

Symptoms

Dissatisfaction with sleep quality or quantity associated with difficulty falling asleep, difficulty sleeping through the night, and or early morning awakenings with the inability to fall back asleep

The sleep disorder results in limitations in social, educational, occupational, or other areas of life

The sleep disorder occurs at least three times a week for at least three months

Causes

There are several causes of insomnia. It is often caused by work-related or interpersonal stress. In addition, the ingestion of certain substances is also a reason for insomniac disorders. In particular, the ingestion of alcohol leads to insomnia.

Type of insomnia

In the course of a study, the affected persons were divided into five groups, each suffering from a varying degree of insomniac disorders.

Category 1: particularly severe

Category 2 + 3: moderately severe course

Category 4 + 5: comparatively mild cases

Symptoms, now what?

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

1. medical history / diagnosis.

2. psychiatric / psychological anamnesis

3. sleep anamnesis

4. actometry (=recording of movement activity and thus of 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 one's health. For example, it has been proven that insomnia can be seen as an independent risk factor for heart attacks, heart failure and high blood pressure. In addition, it has been shown that reduced sleep duration caused by insomnia, for example, results in weight gain.

Facts

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

Are you often overcome by sudden, severe fatigue? Maybe you suffer from...

Narcolepsy

Symptoms of narcolepsy

Symptoms of narcolepsy are varied and often allow for a misdiagnosis at first.

Main symptoms: daytime sleepiness and cataplexy

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

Types of narcolepsy

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

Causes of narcolepsy

In general, the causes of narcolepsy type 1 and narcolepsy type 2 are not well understood. In patients diagnosed with narcolepsy type 1, little to no hypocritin has been 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 an autoimmune reaction as the origin of the absence of the special nerve cells.

For narcolepsy type 2, there is very little knowledge so far regarding the causes.

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. It is important to note, however, that although a clinical diagnosis can be made, it can often be erroneous. Especially a type 1 disease can often be mistaken for epilepsy. Only in a sleep laboratory is it possible to distinguish narcolepsy very precisely from diseases with similar symptoms and to enable patient-oriented treatment.

Why is treatment necessary?

Early detection and proper treatment of narcolepsy are particularly important, because the disease can lead to massive restrictions in the quality of life. In addition to an increased risk of accidents, which is caused, among other things, by impaired concentration, concomitant diseases such as obesity and depression also play an important role. Early detection and proper treatment can alleviate the symptoms and thus improve the patient's quality of life.

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

Parasomnias

Symptoms of parasomnias

Sleepwalking, sleep drunkenness, night terrors/night terrors.

Nightmares, sleep paralysis, wetting the bed, 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 of parasomnias

In parasomnias, disturbing events (for example, sleepwalking, nightmares, ...) happen to the sleeping person in which he/she is active. During sleep, there are inappropriate impulses of the nerves that control the motor system or involuntary body processes. A distinction is made between actions during falling asleep, actions during REM sleep, and disturbances in waking from deep sleep.

Causes of parasomnias

The cause of parasomnias is usually stress, mental or physical illness, or medication abuse. In some families, sleepwalking occurs so frequently that genetic factors are thought to be significant. It is also thought that a central nervous system that is not yet fully developed plays a role.

Why is treatment necessary?

The quality of sleep of those affected does not have to be impaired, but it can be. Frequent teeth grinding can cause damage to the dentition 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 affected.

Symptoms, and now?

The timing of treatment depends on the subjective burden of the disorder. Since dangerous actions can also occur, treatment is often desired from the patient's side in cases of sleepwalking, for example. Since parasomnias are very complex, a comprehensive examination in a sleep medicine center is often required. There, monitoring systems are used to record and analyze body functions during sleep. The examination should be performed by an experienced sleep physician who specializes in parasomnias.

Facts

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

Do your legs often tingle when you try to sleep? Maybe 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 ("ants walking"), can take on extreme proportions

Symptoms mostly occur while awake & can have a negative effect on falling asleep

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

Types of Restless Legs Syndrome

Restless Legs Syndrome (RLS for short) or restless legs describes a phenomenon in which the affected person has to give in to an urge to move, which is accompanied by paraesthesia in the legs. These usually occur while the patient is awake. Unlike RLS, periodic movements of the limbs occur during sleep and are beyond the control of the affected person. If these occur in conjunction with daytime sleepiness and or sleep disturbance, they may be considered a disease in their own right. Although RLS often occurs with periodic movements of the limbs, this fact does not apply in the opposite case.

Causes of Restless Legs Syndrome

In more than half of the cases, the disease with RLS is genetic. If RLS can be diagnosed more frequently within the family, it is mostly assumed to be more severe and complicated cases, 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. In cases of periodic movements of the limbs, the causes are still largely unclear, but the factors responsible for triggering the symptoms are the same as for RLS. Especially in patients* with narcolepsy or renal insufficiency, periodic limb movement is more often seen.

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 already first findings and is usually carried out if it is a non-symptomatic RLS. However, since other diseases with similar symptoms cannot be completely ruled out, it is important to conduct further medical examinations and to include the patient's entire medical history. An examination in the sleep laboratory is only necessary in very unclear cases. In order to be able to examine periodic movements of the limbs in return, more complex examinations are necessary. Only in the sleep laboratory can the causes be analyzed precisely here.

Why is treatment necessary?

If the symptoms of an RLS disorder or periodic movements of the limbs are not treated, this can lead to serious consequences for the affected person (especially sleep deprivation and severely reduced performance). These, in turn, entail an impairment of the affected person's quality of life as well as an increased risk of accidents (e.g., due to fatigue in road traffic).

Fact

- 5 - 10% of the total population have to deal with RLS in their lifetime.

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

Sleep apnea

Symptoms of sleep apnea

- breathing stops during sleep for at least 10 seconds

- severe daytime sleepiness à concentration and memory problems, lower performance

- Reduction of libido and potency

- microsleep

- morning headache, dry mouth

Types of sleep apnea

Sleep apnea occurs when more than five pauses in breathing occur in one hour, each lasting at least ten seconds. A distinction is made between obstructive and central sleep apnea. They differ in their causes, but show similar symptoms.

Causes of sleep apnea

In obstructive sleep apnea, the airways are obstructed or narrowed. This may be due to anatomical abnormalities, obesity, sleeping in a supine position, or increased muscle relaxation caused by alcohol, medications, or drugs. The pauses in breathing occur because there is not enough strength in the breathing muscles to get air through the blocked airways.

In central sleep apnea, the cause is in the brain. The respiratory muscles lack a short-term command from the brain to become active. The brain does not react until the oxygen level in the blood drops below a critical level.

Symptoms, what now?

Various methods are available for therapy. Sometimes, however, these are only successful if they are combined. If the person is overweight, he or she should reduce the weight through diet or sports programs in consultation with a doctor. If the person concerned smokes, this should be given up. No alcohol should be consumed four hours before going to bed. In addition, splints can be used to increase the breathing space or a breathing mask can be used for nasal positive pressure ventilation. In case of failure of the classical therapy methods, surgical procedures are performed.

Why is treatment necessary?

The breathing stops can endanger health and contribute, for example, to the development of high blood pressure. So sleep apnea can have negative consequences and even shorten life.

Facts

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