Sleep disorder

Sleeping well is a fundamental biological need. Insufficient or poor-quality sleep can affect daytime performance, concentration, memory, mood, and increase the risk of developing other health problems.

More than eighty sleep disorders have been described. The most common are obstructive sleep apnea and insomnia, each affecting approximately 15% of the population.

Types of sleep disorders

Insomnia

Insomnia is characterized by difficulty falling asleep, staying asleep throughout the night, or waking up too early and being unable to return to sleep.

To be considered a disorder, these difficulties must occur at least three times a week and have an impact on daytime functioning. If symptoms persist for more than three months, the condition is considered chronic insomnia.

Obstructive sleep apnea

Obstructive sleep apnea is a disorder in which the upper airway becomes partially or completely blocked during sleep. This causes repeated pauses in breathing, reductions in blood oxygen levels, and brief awakenings that disrupt sleep.

People with sleep apnea often snore heavily and experience excessive daytime sleepiness because their sleep is not restorative.

Other sleep disorders include:

• Parasomnias, such as sleepwalking, night terrors, or talking during sleep.
• Narcolepsy.
• Hypersomnia.
• Circadian rhythm sleep disorders, which are common among shift workers.
• Certain neurological disorders that affect sleep.

Symptoms

Symptoms vary depending on the type of disorder, but the most common include:

• Difficulty falling asleep
• Frequent awakenings during the night
• Waking up earlier than usual
• Loud snoring
• Observed breathing pauses during sleep
• Excessive daytime sleepiness
• Feeling unrefreshed after sleep
• Difficulty concentrating or remembering information
• Irritability or mood changes
• Persistent fatigue

It is important to distinguish between physical fatigue and sleepiness. Fatigue improves with rest, whereas sleepiness can only be relieved by sleeping.

Who is affected?

Sleep disorders can have many different causes. Factors that may contribute to their development include:

• Work-related or family stress
• Irregular schedules
• Night work or shift work
• Screen use before bedtime
• Poor sleep habits
• Consumption of caffeine or other stimulant substances
• Certain neurological conditions
• Specific anatomical characteristics, in the case of obstructive sleep apnea

In recent years, the prevalence of insomnia has increased, likely due to changes in social habits, the widespread use of electronic devices, and rising stress levels.

Diagnosis

Diagnosis begins with a detailed clinical assessment of symptoms, sleep habits, and the patient's medical history.

When necessary, a polysomnography is performed. This test records various bodily functions during sleep, including:

• Brain activity
• Breathing
• Oxygen levels
• Heart rate
• Leg movements
• Respiratory effort

This study allows healthcare professionals to accurately identify the disorder and determine the most appropriate treatment.

Smartwatches and wearable devices can provide general information about sleep patterns, but they do not replace diagnostic tests and cannot establish a medical diagnosis.

Usual treatment

Treatment depends on the type of sleep disorder and the characteristics of each patient. It may include:

• Sleep hygiene measures
• Cognitive behavioral therapy for insomnia
• Medication, when indicated
• Specific devices for the treatment of obstructive sleep apnea
• Individualized treatment plans for shift workers
• Specialized follow-up in Sleep Units

Each treatment plan is tailored to the individual following a comprehensive assessment.

Prevention

Adopting healthy sleep habits can help improve sleep quality and prevent certain sleep disorders. Recommendations include:

• Maintaining regular bedtimes and wake-up times
• Getting the recommended amount of sleep for your age
• Avoiding screen use before bedtime
• Reducing caffeine and other stimulant consumption
• Avoiding heavy meals before bedtime
• Engaging in regular physical activity, preferably in the morning or afternoon
• Ensuring the bedroom is dark, quiet, and comfortable
• For people with insomnia, avoiding daytime naps, as they may make it harder to fall asleep at night

It is advisable to consult a healthcare professional if any of the following occur:

• Difficulty sleeping three or more days per week
• Loud snoring accompanied by breathing pauses
• Excessive daytime sleepiness
• A persistent feeling of not getting adequate rest
• Behavioral changes during sleep
• Fatigue that interferes with daily activities

Early diagnosis makes it possible to identify the cause of the problem and begin the most appropriate treatment.

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