Sleep disturbances

In the long term, regular sleep deprivation can damage your health and increase the risk of numerous illnesses. It is therefore important to take action in good time before the problem worsens. There are various treatment options depending on the cause. You can also do a lot for healthy sleep yourself.

What are sleep disorders?

Sleep disorders do not only affect the duration of sleep. Sleep can also be disturbed if the sleep cycles or sleep stages deviate from normal sleep or affect the daily well-being of those affected. This means that sleep is either too short or too long, is interrupted too often or is not restful.

Everyone sleeps badly sometimes. However, a chronic sleep disorder is only diagnosed if the person concerned sleeps badly at least three nights a week for a period of at least one month.

The ICSD-2 (International Classification of Sleep Disorders) divides sleep disorders into the following groups:

• Insomnia: This refers to problems falling asleep and sleeping through the night. You have difficulty falling asleep if it takes you longer than half an hour to fall asleep. If you have difficulty sleeping through the night, you wake up frequently and cannot fall asleep again for a long time. Waking up too early in the morning also belongs in this group. This means that you wake up several hours before your actual wake-up time without being able to fall asleep again. Insomnia is the most common form of sleep disorder.
• Hypersomnia: In the case of excessive daytime sleepiness, those affected suffer from an increased urge to sleep and extreme tiredness during the day or feel the need to sleep for longer than ten hours, despite sleeping for a sufficiently long time.
• sleep-related breathing disorders: During sleep, breathing is unconsciously controlled by the autonomic nervous system. In the case of a sleep-related breathing disorder, sleep disrupts breathing and short breathing stops occur, for example, as is the case with obstructive sleep apnea syndrome.
• sleep-related movement disorders: Movement disorders can also disturb sleep. Common sleep-related movement disorders include restless legs syndrome (RLS) and periodic limb movement disorder (PLMD).
• Parasomnias: This refers to behavioral abnormalities during sleep. Sleep is interrupted by sudden processes or events such as sleepwalking, nightmares or teeth grinding.
• Circadian rhythm disorders: The circadian rhythm covers approximately 24 hours. The natural sleep-wake rhythm is influenced by the alternation of light and dark during the day and night. In the case of a circadian rhythm disorder, the daily cycle and thus the sleep phase shifts forward or backward. As a result, individual sleeping and waking times get mixed up, for example due to a time difference (jet lag) or shift work.

Sleep disorders – frequency and age

Many people are familiar with sleep disorders. Surveys show that around 25 percent of adults suffer from sleep disorders. More than one in ten people experience their sleep as frequently or permanently unrestful. This makes sleep disorders one of the most common health complaints.

Sleep disorders: Causes and risk factors

The causes of sleep disorders can vary greatly depending on the form they take. Sometimes there are several causes at the same time. In general, these can be divided into two groups:

External influences: These include, for example, noise, bright light, heat and cold, but also stimulants such as coffee, alcohol, nicotine, medication or drugs. Poor sleep hygiene or irregular sleeping times due to shift work or jet lag as a result of long-haul flights with time differences can also play a role.

Internal influences: Stress often makes it difficult for people to fall asleep or sleep through the night. Fears, worries, anger or mental illnesses such as depression as well as pain caused by organic illnesses such as hormonal disorders, cardiovascular diseases or cancer can also disrupt sleep. As already mentioned, restless legs syndrome (RLS), sleep apnea syndrome or narcolepsy can be further causes.

It is not always possible to identify the actual cause of the sleep disorder. This is the case with idiopathic insomnia, for example. This has often existed since childhood without any recognizable cause.

Important to know: Even if the original cause of the sleep disorder has been eliminated, a sleep disorder can still persist. The fear of the next sleepless night is often enough to maintain the sleep disorder.

Symptoms: Sleep disorders

Sleep disorders can – depending on the type and form of the disorder – lead to various complaints. Chronic sleep disorders are characterized by the fact that the affected person sleeps poorly several times a week over a longer period of time. This is noticeable through tiredness and fatigue.

If your body lacks sleep or the quality of your sleep is poor, this can also be reflected in

• Poor concentration and performance,
• Nervousness and irritability,
• Muscle tension,
• Mood swings,
• depressive mood,
• Headaches, neck pain and toothache or a
• Increased sensitivity to pain

become noticeable.

A sleep disorder often goes unnoticed by the person affected. However, relatives or partners notice frequent movements of the person next to them in bed, screams, startling, breathing disturbances or interruptions and sleepwalking.

Sleep disorders: Diagnosis with us

As sleep disorders can have various or several causes, some of which go back a long way, the diagnosis often has to be very comprehensive. In order to obtain as accurate a picture as possible of the symptoms, various diagnostic procedures are generally used for sleep disorders.

In order to make an exact diagnosis, we will ask you about your medical history and rule out possible illnesses as the cause (medical history). It is also important for us to know whether you are taking medication that disrupts your sleep or consume large amounts of caffeine or alcohol.

Sleep diary and sleep questionnaire

A sleep diary or sleep questionnaire provides important information about the diagnosis. In it, you document your sleep behavior, for example in the form of

• Bedtime and sleeping times,
• consciously perceived waking phases,
• Your subjective perception of sleep,
• your life situation and
• certain occurrences and abnormalities such as sleepwalking or teeth grinding.

We can measure the subjective perception of daytime sleepiness using the “Epworth Sleepiness Scale” (ESS). The “Pittsburgh Sleep Quality Index” (PSQI) is used to determine objective sleep quality.

Sleep disorders: Examination in the sleep laboratory

An important diagnostic option is an examination in a sleep laboratory, also known as polysomnography (PSG) in medical jargon. To do this, you or those affected spend one to three nights in the sleep laboratory. This serves to get to the bottom of the sleep disorder. We can also monitor the progress of treatment in the sleep laboratory and adjust it if necessary.

Polysomnography makes it possible to record the exact sleep structure and consists of several examinations:

• Breathing control
• Electroencephalogram (EEG)
• Electrocardiogram (ECG, heart function)
• Electromyogram (EMG, muscle activity on legs and chin)
• Electrooculogram (EOG, eye movements)
• Position of the body
• Oxygen content in the blood

Sleep disorders: additional examinations

A (long-term) ECG of the heart and imaging procedures such as magnetic resonance imaging or computer tomography(MRI or CT) can also help in the diagnosis of sleep disorders.

Sleep-related movement disorders can be detected with the help of actigraphy. This examination uses a sensor on the wrist or ankle to record data over several days, which provides information about your sleep-wake rhythm, leg movements during sleep, sleeping habits or daytime sleep phases. It can also be used to monitor the success of the therapy.

Sleep disorders: Prevention, early detection, prognosis

If sleep disorders are a side effect or consequence of another illness, you should have this treated first. This often improves the sleep disorders or eliminates them completely.

In many cases, you can avoid sleep disorders simply by adopting the right behavior in everyday life. Simple measures such as avoiding caffeine, nicotine and alcohol as well as regular bedtimes are important in this context. These and other important rules on sleep hygiene can be found under the menu item Treatment.

Progression and prognosis of sleep disorders

In the long term, poor sleep can damage your health. In addition to reduced physical and mental performance, a lack of sleep increases the risk of numerous illnesses such as depression, obesity and diabetes. Less growth-promoting hormones are produced, which we need for cell renewal and which keep us fit and healthy. Studies also show that people who regularly sleep less than five hours a night are more likely to suffer from cardiovascular disease and even have a lower life expectancy.

It is therefore important to do something about sleep disorders in good time. The same applies to complaints that make it difficult for you to fall asleep or stay asleep, such as restless legs (restless legs syndrome) or if you snore. You should also pay attention if you suffer from constant tiredness and exhaustion despite getting enough sleep. This can be a sign of sleep apnea syndrome, in which breathing stops at night.

Sleep disorders: Treatment

If you suffer from sleep disorders over a longer period of time, you should consult us because of the possible negative consequences for your health. This also applies if you do not subjectively perceive the disorder as a problem – for example, if you snore or move frequently in bed. We will get to the bottom of the cause and arrange for appropriate treatment.

In the case of acute insomnia, taking a sleeping pill can help. However, medication for sleep disorders is of secondary importance and should not be seen as a permanent solution, especially as it can be addictive and does not eliminate the actual causes of the sleep disorder.

It is therefore important for the therapy to find out the exact causes and – if possible – to eliminate them.