Healthy sleep is crucial for physical and mental health and for the ability to function properly in daily life. Still, the ability to achieve adequate restful sleep is a challenge for many. There are those who have trouble falling asleep, those who have recurrent bouts of awakenings throughout the night, and those who feel tired and exhausted despite having spent a sufficient time in bed.
These circumstances and experiences have many causes and explanations. There is a good chance you have heard of or are familiar with the term ‘insomnia’, but it is important to note that there are other sleep disorders that may cause disturbance in one’s ability to sleep.
Sleep disorders are conditions that affect the quality, duration, timing and patterns of sleep. They may lead to an inability to sleep, excessive sleepiness during the day, undesirable behaviors during sleep, and/or an inability to maintain regular sleep-wake patterns.
Recognizing the types of sleep disorders may aid in identifying when professional help should be sought for a sleep disturbance.
This article will explore the types of common sleep disorders, their symptoms, potential causes, how they are diagnosed, and the types of treatment that are available.
Medical Disclaimer: This article is for educational purposes only. It does not diagnose, treat or cure any sleep disorders. Persisting sleep difficulties may affect one’s quality of life and health. A medical professional should be consulted if so needed.
As described by MedlinePlus, a service of the U.S. National Library of Medicine, sleep disorders consist of, but are not limited to, the following: insomnia, sleep apnea, restless legs syndrome, narcolepsy, parasomnias and circadian rhythm disorders.
Certain conditions can affect nighttime sleep, while others can cause excess sleepiness during the day or abnormal activities during sleep.
Indicators of possible sleep disorders can include (but are not limited to) the following:
- Difficulty falling asleep
- Frequent nighttime awakenings
- Snoring or gasping during sleep
- Extreme sleepiness during the day
- Irregular sleep schedule
- Unpleasant sensations in the legs while at rest
- Unusual movements or behaviors during sleep
- Feeling unrefreshed after a full night's sleep
Not all of the above symptoms indicate a specific sleep disorder. A healthcare professional can evaluate the duration, frequency and severity of the symptoms to make an appropriate diagnosis.
What Are the Main Types of Sleep Disorders?
There are several ways to group sleep disorders based on how they affect sleep.
The most important, and most prevalent, groups are the following:
- Insomnia
- Sleep apnea
- Restless legs syndrome
- Narcolepsy
- Circadian rhythm sleep-wake disorders
- Parasomnias
- Hypersomnias and excessive daytime sleepiness
Let's examine each one.
1. Insomnia
Insomnia is a condition characterized by the inability to fall asleep, stay asleep or get the quality and quantity of sleep needed to feel refreshed and restored during the day.
Insomnia can be short term or chronic.
Symptoms of Insomnia
- Falling asleep takes longer than normal
- Waking up repeatedly during the night
- Waking up too early
- Feeling tired, unrefreshed and not rested in the morning
- Difficulty in focusing
- Irritability and changes in mood
- Anxiety and stress about not being able to sleep
Other possible causes may include, changes in your routine, stressful events, lack of routine, certain medicines, alcohol, caffeine and some medical conditions.
Chronic Insomnia is diagnosed when a person is unable to sleep well at least 3 times a week for at least 3 months.
Various treatments are available and the right treatment will depend on the cause, how long the symptoms last.
Treatments may include Cognitive behavior therapy for insomnia (CBT-I) or sometimes, if recommended by a doctor, medications may be prescribed.
For detailed information on Insomnia and the symptoms, causes and available treatments, visit: Insomnia: Meaning, Symptoms, Causes, Types and Treatment
For more information and resources visit: the National Heart, Lung and Blood Institute's Insomnia Webpage.
2. Sleep Apnea
Sleep Apnea is when a person stops breathing for short periods while asleep and is often associated with loud snoring. This can happen hundreds of times in a single night and be the reason for not feeling rested in the morning. Interruptions in breathing can change oxygen levels and affect the quality of sleep.
Symptoms of Sleep Apnea
- Extremely loud snoring
- Frequent pauses in breathing while asleep, noticeable to others
- Waking up repeatedly during the night
- Headaches in the morning
- Sleeping excessively during the day
- Difficulty in focusing and concentrating
What causes sleep apnea?
Sleep apnea occurs when the upper airway becomes obstructed or collapsed while sleeping. This causes a decrease in the supply of oxygen to the body and sometimes a complete blockage.
Central sleep apnea occurs when the brain doesn’t send the correct signals to control breathing.
A healthcare worker can decide on the symptoms to see if a test is warranted.
How is sleep apnea treated?
There are various ways to treat sleep apnea, from positive airway pressure machines to alterations in one’s lifestyle and other surgeries and procedures.
The NHLBI offers a treatment guide for sleep apnea.
Important: Loud snoring, or snoring with pauses in breathing, or snoring accompanied by daytime sleepiness should not be ignored.
3. Restless Legs Syndrome
Also known as Willis-Ekbom Disease, restless legs syndrome (RLS) is the urge to move the legs due to uncomfortable feelings.
Sensations are typically in the legs, but may be in the arms as well.
Sensations may be described as crawling, creeping, tingling, or aching.
Symptoms may be relieved by movement or relaxation. The symptoms occur when at rest, and may be worse in the evenings and at night.
RLS may be inherited. Other causes may include iron deficiency or certain health conditions and medications.
A healthcare worker may examine your symptoms and determine if tests are necessary.
How is restless legs syndrome treated?
Treatment depends on the cause and severity. It may include managing an iron deficiency, reviewing medications that may worsen symptoms, and/or using prescribed treatments.
Iron deficiency can be worsened by taking iron supplements, and thus, they should not be taken without first talking to a doctor.
For more information, see MedlinePlus's sleep disorders website.
4. Narcolepsy
Narcolepsy is a chronic neurological sleep disorder in which the region of the brain that is responsible for regulating sleep and wakefulness is impaired.
Individuals with narcolepsy may experience excessive sleepiness during the day, and may be at risk of falling asleep during normal activities.
Some individuals may experience cataplexy, where there is a sudden loss of muscle tone caused by strong emotions. Other symptoms may include paralysis during sleep and waking, and vivid hallucinations.
Common symptoms of narcolepsy
- Excessive daytime sleepiness
- Falling asleep during normal activities
- Inability to remain alert
- Cataplexy (in some individuals)
- Sleep paralysis (in some individuals)
- Hallucinations
Narcolepsy is not simply feeling tired after not getting a good night’s sleep. If individuals experience excessive and unexplained sleepiness during the day, medical evaluation is warranted.
How is narcolepsy treated?
Diagnosis may require a visit to a sleep specialist and involve an overnight stay at a sleep clinic.
The treatment may include prescribed medications and management of sleep routines, and scheduled naps.
Other treatment options may include continuous positive airway pressure (CPAP) machines.
For more information, see the NHLBI's narcolepsy website.
5. Circadian Rhythm Sleep-Wake Disorders
Your circadian rhythm is your body's internal system that tells you when to be awake and when to be asleep. It uses environmental cues like light and dark to help time this cycle.
Circadian rhythm sleep-wake disorders occur when there is a misalignment of your internal sleep-wake cycle with your daily schedule and the environment around you.
Examples of this include falling asleep and waking up at times that are inconvenient or difficult and make it hard to meet school, work and social obligations.
Symptoms of these disorders include irregular sleep, fatigue and a lack of alertness and concentration during the day.
Treatment for these disorders vary from case to case.
The most important and first step to treatment is to be consistent with your daily schedule.
Additionally, light exposure may be helpful to reset the internal clock. Timing is crucial however with light exposure and/or the use of melatonin as it may help or get you on the right track to sleeping and waking at the right times.
Learn more about circadian rhythm disorders from the NHLBI.
6. Parasomnias
Parasomnias are undesirable and strange behaviors, movements, feelings, and experiences that happen during sleep, while waking up, and while falling asleep.
Some happen during deep sleep, while others happen during the transition between sleep and wakefulness.
Types of Parasomnias
Sleepwalking: Walking or performing other activities while not fully awake.
Sleep terrors: Episodes of intense fear or distress during sleep, for which the person has little to no recollection.
Nightmares: Disturbing dreams that cause the person to be partially or fully awake and remember the dream.
Sleep talking: Speaking while asleep, during which the person has little to no recollection.
REM behavior disorder: Similar to Sleep talking, however, the person acts out their dreams due to the lack of muscle paralysis that occurs during REM sleep.
Not all cases of the aforementioned parsomnias would indicate a disorder. An isolated case of sleep talking or a nightmare, for example, is considered completely normal.
However, frequent cases, becoming aggressive or injuring yourself or others, or changes in your behavior warrant further evaluation.
Parasomnias, in general, are treated with behavioral modification, as well as ensuring the safety of the environment.
For more information on parasomnias and other sleep conditions, see MedlinePlus.
7. Hypersomnia and Excessive Daytime Sleepiness
Rather than the inability to sleep, some people have the inability to stay awake.
Hypersomnia is excessive sleepiness or prolonged sleep in clinical settings. There are numerous possible causes. Hypersomnia should not be used to diagnose a patient based on feeling tired.
Some reasons a person may feel excessively sleepy during the day can include: insufficient sleep the night before, use of medications that cause sleepiness, untreated sleep apnea, narcolepsy, and other medical conditions.
Symptoms that deserve attention
- Falling asleep unintentionally
- Sleeping long but feeling excessively sleepy
- Being unable to stay awake during the day
If you feel excessively sleepy during the day and feel you've allowed yourself enough time to sleep at night, then see a doctor to rule out possible conditions.
It is not safe to drive or operate machinery if you feel excessively sleepy.
What Causes Sleep Disorders?
There is no single cause of all sleep disorders. The contributing factors depend on the specific condition.
There are many contributing factors, including:
- Stress and mental health
- Anxiety and depression can cause insomnia.
- Lifestyle and sleep schedules
- Shift work and travel can disrupt normal sleep schedules.
- Medical conditions
- Pain and other health conditions can affect sleep.
- Medicines and substances
- Prescription and over-the-counter medicines can affect alertness and sleep.
- Genetics and biological factors
Some neurological conditions can lead to sleep disorders. Other disorders may affect how the body moves or changes breathing.
Read our guide on what causes insomnia for more information.
How Are Sleep Disorders Diagnosed?
The first step in diagnosing a sleep disorder is understanding the individual’s symptoms and medical history.
A healthcare worker may inquire:
- What time do you go to bed/get up?
- How long does it take you to go to sleep?
- Do you have trouble sleeping and get up during the night?
- Do you snore and/or get up gasping for breath?
- Do you feel very sleepy and have difficulty staying awake during the day?
- Do you take any medications and/or dietary supplements?
- How much alcohol and caffeine do you consume?
- How long have you had these symptoms?
Sleep diaries
A sleep diary documents when you go to bed and wake up and how long you sleep during the night. It also documents when you take daytime naps. This may help you and your doctor identify when you feel the most sleepy during the day.
Sleep studies
A polysomnogram is a specialized type of sleep study in which many physiologic parameters are monitored during sleep to evaluate a particular medical condition.
Additional daytime testing may be appropriate for particular conditions.
Not all people who have sleep issues need a polysomnogram.
The type of testing that is right for you will depend on the specific concerns and symptoms you have.
What Treatments Exist for Sleep Disorders?
There is no single treatment that works for every sleep disorder. Treatment should match the condition and its underlying cause.
1. Cognitive Behavioural Therapy for Insomnia
CBT-I is an evidence-based treatment for chronic insomnia. It addresses thoughts and behaviours that interfere with sleep and commonly involves sleep education, stimulus control, relaxation and other structured techniques.
2. Treating Sleep Apnea with Positive Airway Pressure
One common treatment for sleep apnea is positive airway pressure (PAP) which works by keeping the airway open while the person is sleeping.
3. Treating Restless Legs Syndrome
Causes of Restless Legs Syndrome may vary. Treatment may include correcting an iron deficiency, adjusting medicines, or using therapies prescribed by a doctor.
4. Adjusting Your Circadian Rhythm
Using light therapy with appropriate timing, and the establishment of consistent routines, may help align a person’s sleep with their desired schedule. In some cases, a healthcare professional may offer medication or other interventions.
5. Medication and Specialist Care
Some sleep disorders may require a combination of prescription medicines, specialist care, and other interventions.
Medication may be prescribed based on your diagnosis, health status, potential side effects and other risks. Do not take medicines that are not prescribed to you.
For more information about treatments for sleep disorders, visit the NHLBI.
Can Lifestyle Changes Improve Sleep?
Changes in sleep habits may help bring about better sleep, but they will not replace treatment for a sleep disorder.
These habits may include:
- Aim for consistent bed and wake times.
- Get enough sleep.
- Limit use of stimulants like caffeine.
- Avoid alcohol to help you fall asleep.
- Make your bedroom quiet, comfortable, and dark.
- Establish a routine that you find relaxing.
- Do regular exercise.
- Talk to your doctor if you are having persistent problems with sleep.
If you are unsure if your symptoms are caused by a sleep disorder, you should not assume that changes in lifestyle will alleviate the problem on their own.
When to See a Doctor for Sleep Problems?
Generally speaking, you should see a doctor for the following:
- You have continuous difficulty in falling and/or staying asleep.
- You are abnormally sleepy during the day.
- You have loud snoring with periods of not being able to breathe (i.e. gasping for air).
- You often feel unrefreshed when you wake up in the morning.
- You display abnormal and possibly dangerous behavior while you are sleeping.
- Your sleep problems negatively affect your daily activities.
- You’ve made changes to your regular activities to deal with your sleep problems, but symptoms still persist.
- If you’ve fallen asleep while driving or are feeling very sleepy to the point it’s dangerous to drive, please stop driving, and see a doctor as soon as possible.
Early diagnosis can lead to identification of the root cause of the problem and appropriate treatment.
Most Frequent Asked Questions
What are the most common sleep disorders?
Some of the most common sleep disorders are insomnia, obstructive sleep apnea, restless legs syndrome, narcolepsy, circadian rhythm sleep-wake disorders and parasomnias. Excessive daytime sleepiness may occur with a variety of sleep disorders.
What is the difference between insomnia and other sleep disorders?
Insomnia is defined as the inability to fall asleep, and/or staying asleep. Sleep disorders, on the other hand, may be characterized by abnormal movement during the night, breathing interruption during the night, excessive daytime sleepiness, or simply an internal body clock that is not in-sync with the external environment’s time.
Is stress a cause of sleep disorders?
Yes. Stress can be a cause of sleep disorders, including insomnia.
How do I know if I have a sleep disorder?
Sleep disorders are conditions that affect the quality and quantity of a person's sleep. Signs of a sleep disorder may include difficulty initiating or maintaining sleep, or a tendency to fall asleep at inappropriate times. Snoring and breathing cessations during the night, may also signal a sleep disorder.
Can sleep disorders be treated?
Management may include behavior therapy, oral or nasal devices, medications, changes in lifestyle or practices, or the assistance of a healthcare professional.
Can CBD or THC gummies treat sleep disorders?
More research is needed to identify the therapeutic and clinical potential of cannabinoids in the field of sleep. CBD and THC gummies should not be considered a primary means of treatment for sleep disorders.
How much sleep do adults need?
It is generally understood that the average adult requires between 7 to 9 hours of sleep per day; however, requirements can vary. Additional factors, like quality of sleep, how alert you are during the day, your age, and your health can also be considered. Overwhelming daytime sleepiness, in combination with other symptoms, can also suggest the need for further evaluation.
Final Thoughts
There are many different ways that sleep disorders can present in individuals. Some can make it difficult to fall or stay asleep, while others can affect a person’s breathing and still others can cause a person to be excessively sleepy during the day.
Recognizing the pattern is the first step to identifying a problem, but symptoms cannot be used to make a diagnosis.
You should seek help from a medical professional if you experience symptoms of dangerous daytime sleepiness or if you experience breather-related pauses while sleeping, as sleep aids and lifestyle changes are not always sufficient in treating these types of problems.
Identifying the type of sleep issue you may have is the first step to moving forward and seeking the appropriate care.
This article is not intended to serve as medical advice, diagnosis or treatment.
