04 May Sleep Disorders: Causes, Effects and Treatment
During sleep, the functions of the human body slow down, which helps significantly in the recovery of the body’s energy reserve. That is why adequate sleep plays an important role in our health. Many people experience sleep disorders. This is a fairly common phenomenon that can occur either in the form of insomnia or in the form of drowsiness. The symptoms that indicate sleep problems are multiple and can vary from person to person.
It is known that when we have not slept well the night before, we feel tired and lack energy and we have difficulty in concentrating and reduced functionality. But what we do not know so well is that reduced sleep greatly affects the regulation of basic mechanisms of our bodily functions and can cause unpleasant effects on our health.
Another thing we do not know is the fact that sleep disorders can be triggered by a permanent deregulation of the body. This means that a chronic underlying disease that has not been detected or treated may be lurking and sleep disturbance is expressed as a symptom of this pathological condition. Numerous studies have shown that there is a two-way relationship between sleep disorders and the onset of a host of diseases.
The phases of sleep
Sleep is divided into two main phases. The first is defined as non-rapid eye movement sleep (NREM) and the second as rapid eye movement sleep (REM). The NREM, in turn, is divided into four stages. The first is the lightest and then the next stages follow, where the sleep gradually becomes deeper. Each of the sleep stages includes unique brain wave patterns and different eye and muscle movement characteristics. In REM cycles, a seemingly chaotic activity of the brain wave prevails, the muscles are paralyzed and the eyes move rapidly. This is the moment we dream.
When we sleep, we complete the NREM and REM cycles several times during the night. The most time is spent in NREM sleep and almost 25% in REM. If we can not maintain enough time in the deeper stages of sleep, due to interruptions or situations that interfere with the normal sleep, then the phenomenon of sleep disorders occurs, with consequent problems.
Causes of sleep disorders
The neurobiological systems that regulate good sleep quality are complex and extremely sensitive to a variety of factors. Sleep disorders can be the result of intense stress, fatigue, micronutrient deficiencies or the use of certain medications. Furthermore, increased caffeine and alcohol consumption, as well as the reversal of biological rhythms, such as working at night, are factors that contribute to the occurrence of sleep disorders.
Certain diseases and pathological conditions are responsible for causing sleep disorders. For example, chronic obstructive pulmonary disease, digestive disorders, gastrointestinal diseases, heart, kidney and liver diseases, arthritis, endocrine diseases, encephalopathies, certain cancers, restless legs syndrome and frequent urination are just a few of the causes of chronic sleep disorders.
Sleep disorders can also be expressed as a sign of hormonal imbalance. For example, melatonin is a hormone that is produced in the epiphysis and then secreted into the bloodstream. It is a key regulator of circadian rhythms and regulates our biological clock and sleep, but its levels decrease with age. Combined with the hormonal decline that occurs over the years, the declining course of melatonin is one of the leading causes of sleep disorders.
In fact, menopausal or perimenopausal women often experience difficulty in sleeping due to rapid changes in estrogen levels, while a lack of testosterone in men causes sleep apnea.
Sleep disorders and effects on mental and physical health
The most common problems that can occur as a result of disturbed sleep are lethargy, reduced work performance, cognitive impairment and increased sensitivity to pain and discomfort. People who do not get enough sleep become more prone to accidents and mistakes and are at a higher risk of developing anxiety disorders, such as depression.
Due to chronic sleep deprivation, oxidative stress increases rapidly, inflammations begin to form, which gradually intensify. Loss of circadian rhythm control through genetic expression disrupts hormone signaling and interferes with the necessary communication between cells. The hormonal system is completely disorganized and there is an increased predisposition to the occurrence of a number of chronic health disorders, including heart disease, stroke, cancer, arthritis and autoimmunity.
In fact, it has been recognized that sleep is causally related to the regulation of glucose homeostasis and that sleep disorders can lead to an increase in the prevalence of obesity and type 2 diabetes mellitus (T2DM). According to a study published in the journal Diabetes Care, it was found that there is a 27% increased risk of metabolic problems for every hour that the quality and / or quantity of a person’s sleep changes. In this study, the number of participants was 2,003 people, aged 45 to 84 years, who were observed for an average of 6 years.
Lack of sleep disrupts appetite and satiety control hormones (ghrelin and leptin). This condition stimulates the appetite and leads to increased food consumption, in an effort of the body to maintain energy production. In fact, people show a tendency to consume foods rich in fats and carbohydrates. Thus, insufficient sleep has been associated with an 20% increase in daily calories intake.
Usual treatment for Sleep Disorders
The usual treatment for Sleep Disorders is based on medications, which may include benzodiazepines (sedatives), non-benzodiazepine hypnotics, and melanin receptor agonists. Also, various herbal or other preparations are available, without a prescription. However, the efficacy and safety of these drugs have not been fully tested.
The Modern Therapeutic Approach to Sleep Disorders
As it was mentioned above, sleep disorders can be manifested as symptoms of other major disorders lurking in our body. There are many other factors that contribute to the manifestation of this chronic condition.
The clinical context that is based on the investigation and elimination of the real causes that cause the respective problem is the Modern Medical Reality. Thus, the cellular detection of the underlying causes of sleep disorders, which can be achieved through specialized diagnostic tests, assists the physician, so that he can take all the necessary steps in order to find and then address the causes of the problem.
In order to achieve the ultimate goal, which lies in the treatment of sleep disorders, it is necessary to check through laboratory tests the function of the thyroid and adrenal glands, the levels of iron and nutrients, as well as the indicators of inflammation. In addition, it is necessary to diagnose apnea or periodic movement of the limbs (PLM), a factor which is responsible for causing awakenings from the deeper stages of sleep.
Based on the diagnostic findings, individualized treatment protocols are developed that deal with this chronic condition and are based on the strengthening of the immune system, the reduction of inflammation, the restoration of the balance of the hormonal system and the correction of any nutrient deficiencies. Furthermore, in situations where endogenous melatonin secretion is reduced, exogenous melatonin administration may have a therapeutic effect against sleep disorders. It is, of course, self-evident that taking natural (Biomimetic) melatonin should be supervised by a qualified physician and administered individually, depending on the patient’s endogenous production levels.
With these individualized treatment protocols, the overall health of the patient is promoted, the quality of life is enhanced and then normal sleep is restored. As scientists we enrich our existing knowledge and we are able to understand the complexity of all systems of our body. We know, then, that quality and adequate sleep is of paramount importance to our health and plays a vital role in many aspects of our daily lives. For this reason, any person who notices sleep disorders, which last for a long time and do not subside, is necessary to seek immediate medical guidance in order to improve this precious and necessary part of his life.
Dr. Nikoleta Koini, M.D.
Doctor of Functional, Preventive, Anti-ageing and Restorative Medicine.
Diplomate and Board Certified in Anti-aging, Preventive, Functional and Regenerative Medicine from A4M (American Academy in Antiaging Medicine).
- American Academy of Sleep Medicine (2001). The International Classification of Sleep Disorders, Revised (ICSD-R) (PDF). ISBN 978-0-9657220-1-8. Archived from the original (PDF) on 2011-07-26.
- “REM Sleep Behavior Disorder”. Mayo Clinic. Retrieved 27 July 2016.
- “Sleep Apnea Diagnosis”. SingularSleep. Retrieved 27 April 2018.
- Melinda Smith, M.A., Lawrence Robinson, Robert Segal, M.A. (September 2011). “Sleep Disorders and Sleeping Problems”. Archived from the original on 2011-12-05.
- Voderholzer, Ulrich; Guilleminault, Christian (2012). “Sleep disorders”. Neurobiology of Psychiatric Disorders. Handbook of Clinical Neurology. 106. pp. 527–40. doi:10.1016/B978-0-444-52002-9.00031-0. ISBN 978-0-444-52002-9. PMID 22608642.
- Mathias, J. L.; Alvaro, P. K. (2012-08-01). “Prevalence of sleep disturbances, disorders, and problems following traumatic brain injury: A meta-analysis”. Sleep Medicine. 13 (7): 898–905. doi:10.1016/j.sleep.2012.04.006. ISSN 1389-9457. PMID 22705246.
- Ramar, Kannan; Olson, Eric J. (2013-08-15). “Management of Common Sleep Disorders”. American Family Physician. 88 (4): 231–238. ISSN 0002-838X. PMID 23944726.
- Steardo, Luca; de Filippis, Renato; Carbone, Elvira Anna; Segura-Garcia, Cristina; Verkhratsky, Alexei; De Fazio, Pasquale (2019-07-18). “Sleep Disturbance in Bipolar Disorder: Neuroglia and Circadian Rhythms”. Frontiers in Psychiatry. 10: 501. doi:10.3389/fpsyt.2019.00501. ISSN 1664-0640. PMC 6656854. PMID 31379620.