Sleep-Wake Disorders

Sleep disorders, or sleep-wake disorders, are chronic conditions involving an abnormal sleep cycle stopping you from getting the right amount of sleep. While adults need an average of 7 or more hours of sleep every night, about one-third of us report insomnia symptoms.

Sleep-wake disorders also affect your quality of sleep. There are two main phases of sleep, called rapid eye movement (REM) and non-REM sleep.

Both work together to keep you sharp and alert for the next day by improving learning, attention, and the processing of new memories. Sleep is also vital in clearing out any waste that built up the brain while you were awake.

But people with sleep-wake disorders are chronically sleep deprived, or oversaturated, and miss out on these benefits of sleep. Seeking help and finding the best treatment plan could help you continue living a healthy life.

The almanac for all things mental health is called the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

According to the DSM-5, people with a sleep disorder have the following symptoms in common:

• excessive daytime sleepiness
• trouble with attention and memory
• potential symptoms of depression
• insomnia or difficulty staying asleep

Sleep-wake disorders fall under an umbrella of sleep conditions, but all are manageable with proper treatment.

Common sleep disorders

Circadian rhythm sleep disorders occur when the body’s internal clock, which is involved in regulating when it’s time to be awake and when it’s time to go to bed, is disrupted.

Common types of circadian rhythm sleep disorder include:

Jet lag disorder. This occurs when your sleep is disrupted when traveling across time zones. Because your body hasn’t had time to adjust to another time zone’s day-night schedule, your body may signal when it’s time to sleep at inappropriate hours.

Shift work disorder. This is a condition that causes you to have difficulty sleeping because of a nontraditional work schedule, such as taking on night shifts for your job.

Delayed sleep phase disorder. This is when your sleep patterns are “delayed” by 2 hours or more in a regular sleep schedule. People who consider themselves “night owls” tend to have this condition, including 7% to 16% of teenagers and young adults.

Advanced sleep-wake phase disorder. This happens when you go to bed and wake up too early or too late compared with traditional sleep schedules. People with this condition can sleep as early as 6 p.m. and have their internal clock geared to start the day at 2 a.m.

Other common sleep disorders that disrupt rest include:

Insomnia. This is a sleep disorder that causes you to have trouble sleeping or getting good quality sleep. People with long-term diagnosed insomnia experience it on at least three or more nights per week or for at least 3 months.

Nightmare disorder. About 50% to 85% of adults report having at least one nightmare in their life, and the likelihood of this happening decreases as you get older. But 2% to 8% of people will continue to experience severe and chronic nightmares, preventing them from getting a good night’s rest.

Substance/medication-induced sleep disorder. This happens when you take drugs such as alcohol or stimulants like cocaine that temporarily disturb REM sleep and keep you alert.

Severe sleep disorders

The following sleep disorders are classified as severe for their effect on people’s well-being:

Obstructive sleep apnea. This is a sleep-related breathing disorder where you can temporarily stop breathing. This can happen at least five times an hour, and each time can last from a few seconds to minutes. People with this condition may have trouble staying awake in the daytime.

Narcolepsy. This is a neurological condition where there are disruptions in brain signals that tell you when to sleep and when to stay alert. About 135,000 to 200,000 people will experience narcolepsy and are at risk of muscle paralysis and suddenly falling asleep while in the middle of an activity like driving a car.

Restless legs syndrome. This affects 7% to 8% of people in the United States. It’s a condition where you have an overwhelming urge to move your legs and other body parts, especially at night.

Because sleep-wake disorders cover a broad range of sleep disorders, you might feel overwhelmed by the labels that clinicians use to describe what you’re feeling.

Here are some terms that may be used to describe sleep disorder terms:

Sleep-wake disorders are complex and driven by many different environmental, psychological, and biological factors, including:

Circadian rhythm disruptions

Your body runs on a 24-hour internal clock called the circadian rhythm. This clock aligns with different environmental cues to know when to send or block sleep signals.

When your internal clock is out of whack — think about when you pulled all-nighters to study for a test or how you felt when traveling to other time zones — your body will send mixed sleep signals at inappropriate times of the day.

Genetics

Clock genes run your circadian rhythm. When these genes are unable to carry out their duties, it can lead to sleep deprivation that comes with its own set of problems, like issues with brain development and keeping your emotions in check.

Clock gene disruptions have also been linked to anxiety disorders, attention deficit hyperactivity disorder, bipolar disorder, and schizophrenia.

Mental health conditions

According to the Anxiety & Depression Association of America, having an anxiety disorder can manifest into sleeping problems and sleep disorders like insomnia.

Blue light

The short-range, high-energy light that our handheld electronics and TVs use to power their screens — which our brains interpret as daylight — interferes with our bodies’ melatonin release and confuses our circadian rhythm.

It’s a direct cause-effect relationship and not something we can just muscle through. Blue light is very disruptive.

In studies like this 2018 one, blocking blue light using glasses with amber lenses was effective in reducing insomnia.

You can learn more about our top recommendations for blue light blockers here.

There are several risk factors for sleep disorders, including:

• a psychiatric condition such as an anxiety disorder or depression
• chronic stress, which has been linked with insomnia and disrupting your body’s sleep-wake cycle
• having a family history of insomnia
• being female

For a doctor to diagnose a sleep disorder, they might ask you to fill out a sleep diary to track when you sleep and how much you get per night.

They may also ask you to wear a motion sensor for 14 days to better understand your rest-activity patterns.

Having a sleep-wake disorder doesn’t have to hamper your life. With the proper therapy and medication, these disorders are manageable.

Melatonin

The American Academy of Sleep Medicine recommends taking melatonin when your circadian rhythm is close to your desired sleep schedule. But they recommend not using this if you’re an older adult with dementia.

Light therapy

Getting exposure to artificial sunlight for 30 to 90 minutes at a time can reset your internal clock and shift your sleeping patterns to a more desired schedule. Over time, you can reduce light therapy to 15 minutes each day or use it only a few times during the week.

Exercise

Working out, even leisurely, is helpful to sleep. But if you’ve already been sweating before hitting the sack to no avail, you might have to tweak your exercise time to no later than 3 hours before bed, so it doesn’t have the opposite effect and keep your heart rate up and recovery time down.

Tweaking your habits to restore sound sleep

The Centers for Disease Control and Prevention (CDC) lists some habits you can fold in to sleep better at night.

Sleep is essential for living a happy and fulfilled life. By getting a better understanding of sleep disorders, you’re taking an important first step toward reclaiming a good night’s rest.

You can also learn more about your recent sleeping habits by answering just a few questions.