Sleep disorders are broadly classified into two types:
Primary sleep disorders: These disorders are not caused by any other health conditions. Secondary sleep disorders: These disorders are caused by other health conditions, such as depression, stroke, arthritis, asthma, or thyroid problems.
Primary sleep disorders are further divided into two types of conditions:
Parasomnias: Parasomnias are characterized by abnormal activities during sleep, such as sleepwalking or sleep terrors. Dyssomnias: These disorders are characterized by difficulty falling asleep or staying asleep. Common symptoms include feeling unrested and experiencing extreme sleepiness during the day.
Types of Dyssomnias
Dyssomnias can be broadly categorized into three types:
Intrinsic sleep disorders: These dyssomnias are caused by an internal dysfunction affecting your sleep ability.Extrinsic sleep disorders: These dyssomnias are caused by external factors that affect sleep, such as the environment or your health habits.Circadian rhythm sleep disorders: These dyssomnias are caused by irregular timings or schedules that interfere with the body’s internal clock, or circadian rhythm.
Intrinsic Sleep Disorders
Intrinsic dyssomnias include:
Insomnia: Insomnia can make it difficult for you to fall asleep or stay asleep, causing you to lie awake at night, wake up too early, or feel tired when you wake up. It is often caused by stress or emotional distress. Narcolepsy: Narcolepsy is a neurological condition that can interfere with the brain’s ability to control sleep-wake cycles. You may feel rested when you wake up but then feel very sleepy during the day, which can cause you to fall asleep while talking, eating, or driving. Some people with narcolepsy also wake up frequently at night. Hypersomnia: Hypersomnia is characterized by extreme daytime sleepiness that can make it hard for you to stay awake and alert during the day, despite having gotten adequate sleep at night. Obstructive sleep apnea (OSA): Obstructive sleep apnea is a condition where your breathing temporarily pauses while you’re sleeping, due to blocked or narrowed airways in your throat. This condition is typically characterized by loud snoring, although everyone who snores doesn’t necessarily have sleep apnea. Restless legs syndrome (RLS): Also known as Willis-Ekbom Disease, restless legs syndrome is characterized by uncomfortable sensations in the leg that are accompanied by a powerful urge to move them. The symptoms typically start to occur in the late afternoon or evening and are most severe at night, making it difficult to fall asleep or go back to sleep if you wake up during the night. Periodic limb movement disorder (PLMS): This condition is characterized by frequent, involuntary limb movements during sleep, making it hard to get restful sleep. Your arms and legs may jerk, twitch, or flex a few times per minute for several hours at a time while you’re sleeping.
Extrinsic Sleep Disorders
Extrinsic dyssomnias include:
Poor sleep hygiene: Sleep hygiene involves maintaining healthy habits around sleep, such as going to bed at the same time every day, avoiding electronic screens before bed, and keeping your room dark, quiet, and cool. Research shows that poor sleep hygiene may affect sleep quality. Nocturnal eating syndrome (NES): Nocturnal eating syndrome can occur along with insomnia. It can cause you to wake up several times at night to eat, making you feel like you can’t go back to sleep unless you eat something. This condition is linked to an increased risk of obesity, diabetes, and high pressure.
Circadian Rhythm Sleep Disorders
Circadian rhythm dyssomnias include:
Shift work sleep disorder (SWSD): Shift work sleep disorder typically affects people who work irregular hours, such as night shifts or rotating shifts. Your body’s internal clock has difficulty adjusting to the irregular timings, causing you to have trouble falling asleep, staying asleep, or sleeping at a desired time. Jet lag disorder: Traveling across more than two time zones can disrupt your circadian rhythm, causing you to feel out of sorts, experience headaches, and have difficulty adjusting to the circadian rhythms of the new location you are in. The symptoms can last a few days or weeks until you can regularize your sleep schedule. Delayed sleep phase syndrome (DSWPD): This condition typically affects adolescents and causes them to go to bed a few hours later than usual, making it difficult for them to wake up on time in the morning. Adolescents with this condition often describe themselves as “night owls” and are more alert during the late evening or nighttime hours than in the daytime. Advanced sleep-phase syndrome (ASPS): This condition can cause you to go to bed and wake up earlier than most people. You may have trouble staying awake at night and have difficulty going back to sleep once you’ve woken up early in the morning. Non-24-hour sleep-wake disorder (N24SWD): People with this condition have the same length of sleep time per day, but their internal clock is shorter or longer than 24 hours, so their circadian rhythm varies by one or two hours per day. As light perception plays a major role in regulating circadian rhythms, most people with non-24-hour sleep-wake disorder are totally blind.
Symptoms of Dyssomnias
If you have dyssomnia, the symptoms you experience can vary depending on the type of sleep disorder you have. These are some of the most common symptoms of dyssomnias:
Having difficulty falling asleep when you’re supposed to Regularly taking over 30 minutes to fall asleep at night Having difficulty waking up in the morning Waking up multiple times every night and having difficulty going back to sleep again Waking up too early in the morning and being unable to go back to sleep Waking up feeling tired, as though you’ve not slept at all Feeling extremely sleepy during the day Frequently napping during the day Falling asleep at inappropriate times during the day, sometimes while eating, speaking, or driving Snoring loudly while sleeping, or making other sounds such as snorting, gasping, or choking Pausing breathing for short periods of time while sleeping Experiencing uncomfortable tingling, creeping, or crawling sensations in your limbs in the evening or at night when you’re trying to sleep Jerking or twitching your arms or legs in your sleep Waking up to eat at night, sometimes multiple times per night Having an irregular sleep cycle that doesn’t align with most people’s Feeling stressed and depressed Feeling irritable, anxious, or impatient Experiencing headaches, brain fog, memory issues, and difficulty concentrating during the day Experiencing difficulties with relationships, work or school, and social obligations
Diagnosing Dyssomnias
Healthcare providers such as sleep specialists can diagnose dyssomnias by:
Interviewing you and inquiring about your symptoms Reviewing your personal and family medical history Performing a physical examination Performing a sleep study (polysomnogram) to monitor various biological parameters while you sleep
Treating Dyssomnias
The course of treatment your healthcare provider recommends can vary depending on the type of dyssomnia you have. The treatment options may include:
Cognitive behavioral therapy to reduce your anxiety around falling asleep Relaxation exercises to help you manage your stress levels Bright light therapy, particularly in the mornings, to help reset your internal clock Use of a CPAP (continuous positive airway pressure) machine, if you have sleep apnea Medication, such as sleeping pills, which are generally prescribed for short-term use Supplements, such as melatonin, which help some people, but are also recommended only for short-term use Good sleep hygiene habits A balanced, nutritious diet and an active lifestyle
A Word From Verywell
Dyssomnias are a group of sleeping conditions. If you have one or more of these conditions, you may find yourself feeling tired, irritable, and unable to function during the day. Over time, you might find that your work, school, relationships, and social life are hurting due to chronic sleep deprivation. If you haven’t been sleeping well, it can be helpful to visit a healthcare provider who can diagnose your condition and recommend treatment options. Your primary care doctor can provide a referral to a sleep specialist, if you need one.
