32 percent of our lives are spent sleeping. It is a very important behavioural experience we go through. If you want to improve your health, social skills, creativity, mental health or you just want to come up with solutions for the complex problems, neuroscience suggests that all you are required to do is to just sleep and let your brain handle everything subconsciously. Learn more about wonders of sleep in this TED talk by Russel Foster.
Sleep is an important aspect of the human evolution and as we progressed towards the modern age and lifestyle, various factors intruded our natural sleep cycle and disrupted it. These factors influenced our genes which in turn affected those parts of the brain which are responsible for the sleep.
Among the most common sleep problems humans face are the Insomnia and the Parasomnia. The process of curing the disorder begins with awareness. Having awareness and knowledge about a certain disorder sets up the future course of action to cure it. Therefore, in this article, I am going to discuss everything you need to know about Insomnia and Parasomnia.
Insomnia
As per Wikipedia, Insomnia is a sleep disorder in which people have trouble sleeping. They may have difficulty falling asleep or staying asleep as long as desired. 30 percent of the population face Insomnia at some point of their lives. People above the age of 65 are more likely to get affected while females have higher chances of developing insomnia than men.
ÔÇ£Did you know that in 1950s we had 8 hours of sleep and now we have, on an average, 6 and a half hours sleep.ÔÇØ
Insomnia is self-diagnosable and the symptoms include:
- Difficulty falling asleep at night.
- Waking up during the night.
- Waking up too early.
- Difficulty paying attention, focusing on tasks or remembering.
- Depression or anxiety.
- Not feeling fresh when waking up.
- Daytime Sleepiness.
Insomnia can be broadly classified into three types viz; transient, acute and chronic. Transient Insomnia usually lasts for less than a week. It is generally caused by other disorders, changing sleep environments, depression and stress.
Acute Insomnia lasts for a period of less than a month. It causes consistent poor-quality sleep or non-refreshing sleep. It results in problems with daytime functions.
Chronic Insomnia lasts for more than a month. It is either caused by some other disorder or is a primary disorder itself. It is caused by higher levels of stress hormones and can even result in hallucinations and mental fatigue.
Knowing the causes of the Insomnia can help you avoid it. The causes of the Insomnia include:
- Stress and mental disorders like clinical depression, post-traumatic stress disorder, obsessive-compulsive disorder, dementia, bipolar disorder etc.
- Disrupting bodyÔÇÖs circadian rhythms with things like late-night shifts, traveling across multiple zones etc.
- Poor sleep hygiene such as uncomfortable sleep environment, extensive exposure to the mobile screen, irregular bedtime schedule etc.
- Medical conditions such as hyperthyroidism and rheumatoid arthritis.
- Over-consumption of caffeine and alcohol.
- Heart disease etc.
Prevention & Management of Insomnia
Improving health habits and lifestyle can go a long way in preventing Insomnia. Some of those habits are:
- Keep a regular sleeping schedule.
- Be active ÔÇô Fill your day with some activities you would like.
- Limit daytime naps.
- Limit use of caffeine, alcohol etc.
- Create a regular bedtime ritual like reading, listening to soft music etc.
Treatment of Insomnia includes various models and methods. Cognitive Behavioural Therapy (CBT) has been found effective in the treatment of Insomnia that doesnÔÇÖt include any form of medication. In this therapy, patients are taught how to improve sleep habits without setting some unrealistic sleep expectations. CBT is one of the non-medication based strategies that provide long-lasting improvements. Other strategies include relaxation therapy, behavioral interventions, stimulus control etc.
The treatment based on the medications includes sleeping tablets and other sedatives. However, many doctors donÔÇÖt approve of such medication for longer periods of time as their side effects exceed their benefits.
If Insomnia is caused due to another disease, injury or disorder such as restless leg syndrome, pain, heart disease, traumatic brain injury etc,  then curing those can also get you rid of the Insomnia.
Insomnia is perfectly curable. All you are required to do is to adapt yourself to some healthy lifestyle habits.
Parasomnia
Parasomnias are a category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep.
To understand Parasomnia better, we need to understand the sleep cycle. Sleep consists of two different states: Non-Rapid Eye Movement (NREM) sleep and Rapid Eye Movement (REM) sleep. These states alternate in a cyclical fashion. Sleep begins with stage 1 of NREM and then deepens to stages 2,3, and 4 of NREM. This is followed by the first stage of REM. The duration of the one sleep cycle is approximately 90 minutes. Stages 3 and 4 of NREM is also known as deep sleep, delta sleep, or slow wave sleep. REM sleep episodes become longer as the night progresses.
Parasomnias can arise from different sleep states including NREM and REM as well as sleep-wake transitions. Based on this, we can divide parasomnias into the following categories:
- Non-Rapid Eye Movement Parasomnias
- Rapid Eye Movement Parasomnias
NREM parasomnias are arousal disorders that occur during stage 3 or 4 of NREM sleep (Slow Wave Sleep). People with NREM parasomnias experience the arousal disorder because of the abnormal transition between sleep and wakefulness.
NREM parasomnias include:
- Confusional Arousals where a person experiences confusion, disorientation, and bizarre behaviour immediately after awakening from sleep. This behaviour can include things like thrashing and kicking in the bed.
- It includes behaviour such as walking from room to room, talking with open eyes, leaving home etc. Sleepwalkers are difficult to wake and generally donÔÇÖt remember the things they did while sleepwalking.
ÔÇ£Upto 40% children experience at least one sleepwalking incident in their livesÔÇØ
- Night Terrors. This includes behaviours such as screaming and panicking. It lasts for up to 3 minutes and usually ends with a person returning to sleep. 7% of the children experience night terrors.
- Sleep-related Eating Disorder (SRED). It is characterized by episodes of consuming junk food during sleep.
REM is that stage of sleep where a person mostly dreams. Therefore, REM parasomnias are a result of the dreams to some extent. REM parasomnias include:
- REM sleep behaviour disorder (RBD). It involves a person acting out his dreams. It may result in injury, fractures etc. 90% of the RBD patients are males. It is also characterized by vocalization and screaming that may be associated with the dream.
- Recurrent Isolated Sleep Paralysis. In this, a person is usually unable to perform voluntary movements at the onset of sleep or upon waking up from the sleep.
- It includes breath holding and expiratory groaning during sleep. The sound, however, is produced during exhalation as opposed to snoring.
What causes Parasomnia?
Parasomnia is believed to generally run in families. ThereÔÇÖs probably a genetic factor involved in this. Some parasomnias such as RBD is caused by brain disorders.
Possible Treatments of Parasomnia
It has been seen that simply improving sleep habits prove to be effective in the treatment of parasomnia. Good sleep habits include keeping a good sleep schedule, managing stress, relaxing bedtime routine, and having enough sleep.
A person should seek treatment whenever there is a risk of injury. This must be kept in mind that parasomnia is not associated with any psychiatric disorder.
Winding this up, one thing is very clear. Improving and maintaining healthy sleeping habits is very essential. And the people facing insomnia and parasomnia need genuine care and support.
LetÔÇÖs end this discussion with a quote from Thomas Dekker ÔÇô ÔÇ£Sleep is the golden chain that ties health and our bodies togetherÔÇØ