What Can Interfere With Sleep?
Insomnia
Insomnia has become an epidemic in America. Two thirds of Americans have significant difficulties sleeping intermittently throughout their life. Half of them consider their problem severe or chronic.
Early Insomnia is a problem getting to sleep. Middle Insomnia includes repeated periods of conscious wakefulness after falling asleep. Late Insomnia is waking before sufficient sleep has occurred, but not being able to get back to sleep. Insomnia can also be the perception of insufficient, non-restful sleep.
Primary Insomnia is often caused by significant stresses, both physical and emotional, occurring in a person's life. This is more likely to be time- or situation-limited.
Chronic Insomnia has a conditioned component that keeps the insomnia going. Individuals with chronic insomnia also have physical predispositions not sleeping well. Research has revealed that the electrical activity of the brain of individuals with chronic insomnia differs significantly from healthy sleepers.
Chronic Pain
Chronic pain is often defined as pain that has lasted 6 months or longer. A more useful definition is pain that persists longer than the time needed for natural healing of a particular type of injury or disease.
The experience of pain occurs in any tissue or organ in which pain signals arise as a result of disease or injury. It can also occur if there is dysfunction or damage to pain nerves themselves.
Under persistent activation, pain transmission may create a “wind up” phenomenon, a reverberating loop that keeps sending the pain message over and over. This induces pathological changes that lower the threshold for pain signals to be transmitted. In addition, it may generate non-pain nerve fibers to also send pain signals.
Restless Leg Syndrome, Periodic Limb Movement Disorder, Myoclonic Twitch
Restless Legs Syndrome (RLS) includes discomfort in the thigh or calf. It is often described as a creepy-crawly feeling. Sleep onset (early) insomnia is common with RLS.
Periodic Limb Movement Disorder is an involuntary movement in one or more of the limbs. It can be a subtle writhing of the foot to distinct rapid jerks. These movements occur, by definition, during sleep, so the person may not be aware of them. It might be thought of as a chronic form of myoclonic twitching.
Myoclonic twitches are brief, involuntary twitchings of a muscle or a group of muscles. It generally is not a diagnosis of a disease. The myoclonic twitches or jerks are usually caused by sudden muscle contractions; they also can result from brief lapses of contraction. The most common time for people to encounter them is while falling asleep (hypnic jerk).
A hypnic jerk is an involuntary muscle twitch which often occurs during the transition from wakefulness to sleep. It is often described as an electric shock or falling sensation, and can cause movement of the body in bed. Hypnic jerks are completely normal, and are experienced by most people, especially when over-tired or sleeping uncomfortably. Myoclonic jerks may occur alone or in sequence, in a pattern or without pattern. They may occur infrequently or many times each minute.
Depression and Anxiety
Clinical depression is a state of intense sadness or despair that has advanced to the point of being disruptive to an individual's social functioning and/or activities of daily living.
Many people identify the feeling of being depressed as "feeling sad for no reason", or "having no motivation to do anything." Those experiencing depression may feel tired, sad, irritable, lazy, unmotivated, and apathetic. Clinical depression is generally acknowledged to be more serious than normal depressed feelings. It often leads to constant negative thinking and sometimes substance abuse.
Anxiety is an unpleasant state that involves a complex combination of uncomfortable/unwanted physical sensations along with negative emotions. These often include fear, apprehension, and worry. The heightened arousal symptoms may be heart palpitations, nausea, chest pain, shortness of breath, or tension headache.
Anxiety includes a cognitive component which entails expectation of a diffuse and uncertain danger. This worry factor may make sleep impossible. The arousal symptoms reflect the body preparing for threat. Emotionally, anxiety causes a sense of dread or panic. Behaviorally, both voluntary and involuntary behaviors may occur in an attempt to escape or avoid the source of anxiety. These behaviors are often maladaptive, being most extreme in anxiety disorders.
Panic, Apnea, and other Breathing Disorders
Respiratory disturbances during sleep may produce fragmented sleep, which can lead to a complaint of insomnia. Daytime sleepiness is a common clue that breathing during sleep may be disordered.
Night-time panics, particularly those that occur during sleep, result from faulty regulation of the CO2 balance in the blood stream. This imbalance sends a message to the brain indicating suffocation, which alarms the body and wakes the person. Repeated episodes can make it difficult to want to sleep, further extending the insomnia problem. (In fact, the person is over-oxygenated.)
Apnea includes hypoxic (low oxygen) episodes during sleep. In apnea, the body really is experiencing a type of suffocation, and the alarm is required to get the body breathing again. Apnea is difficult to self-diagnose. The person with apnea is generally not aware of the gagging/waking episodes that occur as the body tries to restart the breathing system. However, a sleep partner will generally know.
Sleep apnea is a serious, possibly life-threatening condition in which the body seems to forget to breathe when entering into deep sleep. The hypoxic episodes can lead to damaged brain tissue. A person with chronic sleep apnea may look like a person with Attention Deficit/Hyperactivity Disorder (ADHD). Symptoms include poor ability to pay attention, inability to organize complex material, poor memory, feeling foggy and/or disoriented.
Other breathing disorders include chronic and/or congenital respiratory difficulties, such as Chronic Obstructive Pulmonary Disorder (COPD), Cystic Fibrosis, asthma, emphysema, and respiratory allergies.
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