Introduction

Annually, around 70 countries adjust their clocks one hour ahead in spring and revert an hour in the autumn/fall. This custom was first proposed by George Hudson in 1895 with the intention of allowing people to get more solar time in the summer. This was followed by similar proposals in different countries that wanted to help their populace to make optimal use of day light and save on energy costs. The goal of coming up with such measures in agrarian societies was to align work and personal routines with daylight hours. However, 100 years later, work routines have changed thus rendering this practice archaic. Further, time alterations during daylight saving time have been found to be disruptive to sleep patterns and have been linked to multiple health issues such as strokes and heart attacks. Therefore, from a health point of view, the practice is detrimental though there are some measures that people can use to cope with its effects.

Effects of daylight savings time on sleep

The human body relies on the natural 24-hour cycle to set up its circadian rhythm. Disruptions to this cycle causes the internal clock to become out of sync with the day-night cycle. In spring, when people are expected to set their clocks ahead by an hour, an hour of sleep is lost. Hence, most people experience the jet lag symptoms, just as someone traveling between time zones would feel. The following are some of the ways that daylight savings adjustments interrupt sleep:

1. Circadian rhythm disturbances

The circadian rhythm is a repetitive 24-hour cycle that regulates one’s physical, mental, and behavioral processes. It helps regulate things such as metabolism, stress, body temperature, and sleep. While an adjustment of an hour might not seem like much, the unexpected shift throws the rhythm out of sync.  In the 24-hour cycle, the internal clock will have fixed certain times to induce sleep and wakefulness. However, adjustments due to Daylight Savings Time transitions exert unanticipated external pressure to the rhythm. Notably, the new sleep and wake up times adopted during DST put undue stress on the body and offset the internal clock. Thus, the circadian rhythm becomes unable to correctly regulate sleep-related processes, which can lead to sleep deprivation.

2. Reduced sleep duration

When clocks spring forward to the Daylight Saving Time, an actual hour of sleep is lost. Further, researches show that people lose 40-50 hours of sleep for a period ranging from several days to weeks until the internal clock resets. The consequences of inadequate amounts of sleep might vary but in the long term, they can manifest as sleep disorders.

3. Longer sleep latency

When time is pushed forward in spring, it is expected that people will sleep earlier to compensate for the adjustment. However, sleep onset in the early days or weeks of daylight savings time could be delayed as the body is not accustomed to falling asleep at such times. This is because several internal body processes will not be tuned with immediacy to facilitate sleep onset at the new sleeping times. Therefore, daylight savings time causes increased sleep latency whereby people take more time to fall asleep once they go to bed. Long sleep latency reduces the amount and quality of sleep and can lead to sleep disorders such as excessive daytime sleepiness.
Sleep fragmentation


An immediate consequence of daylight savings is the desynchronization of the internal clock. The internal clock is a vital sleep regulator that ensures that one gets the recommended 7-8 hours of sleep per night. However, when it is out of sync, it is common for people to wake up several times during a sleepful episode. Sleep fragmentation leads to poor sleep quality which can cause fatigue, daytime sleepiness, and sleep deprivation.

Other consequences of daylight savings

1. Increased fatal car accidents

A 2014 study by Austin Smith found a relationship between increased fatal crashes and DST transition. The analyzed data showed that the first week after a spring time change recorded a 6.3% increase in fatal car accidents. The researcher argued that the upsurge of accidents was caused by interrupted sleeping patterns during DST that caused drivers to feel drowsy in the morning and late evenings. In a prior study conducted in 1999 by John Hopkins and Stanford University researchers, the Mondays after switching to DST recorded more fatal crashes than the average Monday. Therefore, researchers have uncovered that Daylight Saving Time transitions lead to severe accidents that would otherwise not occur.

2. Depression

Daylight savings time can to lead to depressive feelings, irritability, and anxiety. Sleep studies have shown that sleep deprivation has negative effects on one’s moods. People who experience sleep deprivation are, therefore, likely to become moody, sad, anxious, disinterested, and depressed.  A Danish research team confirmed that the number of depression cases reported in hospitals peaks after a daylight saving time transition. Depression has been linked to the disturbances of the circadian rhythm when adapting to DST. It can lead to more serious disorders such as insomnia and excessive daytime sleepiness.

3. Cardiovascular conditions

Daylight saving time has been reported to expose people to greater risks of heart attacks and stroke. In 2018, the American Heart Association published an article that indicated that the risk of heart attack rose by 24% on the Monday following the start of daylight saving time and reduced by 21% after the autumn/fall change to standard time. Thus, the change poses a significant risk to patients with high blood pressure as they are more likely to get heart attacks and stroke. Heart function involves several variables, such as heart rate, heart rate variability, and diastolic and systolic blood pressure. The variables are affected by the circadian rhythm. When a daylight saving time transition occurs, the circadian rhythm becomes unsynchronized, and this can cause cardiac arrhythmia where the heart beats too quickly, slowly, or irregularly. Abnormal heart function can lead to stroke and cardiac arrest.

4. Changes in appetite

Appetite is dependent on hormones such as ghrelin and leptin that affect one’s cravings and satiety. The production of these hormones is directly affected by sleep. During daylight time saving transitions, disturbances to the sleep-wake cycle cause the hormone levels to become unbalanced leading to increased cravings and a lack of satiety. Hence, people report feeling insatiable hunger the day after transitioning to DST. Further, the new time schedules that come with daylight savings time affect one’s meal times too. The mismatch between the body’s accustomed eating periods and the actual time that one eats during DST can, therefore, lead to increased cravings.

5. Workplace injuries

Daylight savings time is associated with increased workplace injuries more so in jobs that require high levels of alertness or physical labor. In a study of mining accidents, researchers found that there was an increased number and severity of injuries on the Monday following the transition to DST. In contrary, the recorded injuries plummeted in November after the switch back to standard time. The underlying reason was that daylight saving time shifts affected sleep quality and sleep duration. This highlights that employees are likely to feel drowsy during the daytime after switching to DST. In some occupations, drowsiness can lead to severe bodily harm or fatalities due to reduced cognitive abilities. focus and poor alertness levels.

Coping with sleep and health challenges of Daylight Saving Time

Daylight savings time transition can affect one’s overall well-being. The time alteration practice has pronounced health effects including cardiovascular conditions and fatal accidents. Hence, it is advisable to anticipate and prepare for the transition to minimize the chances of suffering the negative effects. The following are some of the ways that can help one handle the changes in time better:

1. Making gradual shifts

The circadian rhythm is not usually tolerant of sudden changes and once disturbed, it can take days or weeks to reset. Most of the complications that arise from DST transition are tied to disruptions to the circadian rhythm; hence, they can be avoided by making subtle changes during the transition. Therefore, 10 days before transitioning to DST, one can go to bed progressively 10 minutes earlier. The subtle changes avoid interruptions to the circadian rhythm and prevent an onset of the complications associated with the transition.

2. Maintaining a fixed schedule

A consistent routine can either avoid disrupting the body’s internal clock or aid it to recover from the effects of DST. Thus, following a set routine for meal times, exercise, and sleep duration prior to and after switching to DST is highly recommended.

3. Following a bed time routine

The dreaded effect of DST is sleep deprivation since it can aggravate most other negative consequences of the transition. Therefore, getting sufficient night time sleep can help prevent or mitigate the severe effects of DST transition. A bed time routine can help one to naturally prepare for sleep and get restorative sleep for the recommended number of hours (7-8). Before bed time, one should avoid meals, alcohol, and blue light emitters such as phone and computer screens. Further, one should dim lights to allow melatonin production to increase. These practices motivate the natural onset of sleep and allow one to get sufficient rest throughout the night.

4. Avoiding daytime naps

After switching to DST, day time naps become more tempting. However, they can significantly reduce sleep pressure and further affect one’s normal sleep-wake cycle. Sleep pressure is an unconscious biological response that increases the body’s need for sleep. The pressure increases with the amount of time that one is awake. Therefore, taking day time naps relieves the pressure and can make it hard to fall asleep at night. Consequently, after transitioning to DST, day time naps should be avoided. Instead, one should step into direct sunlight regularly for the production of the sleep hormone to be hindered during the day.

5. Melatonin supplements

When the body’s internal clock has been disturbed, the sleep-wake cycle becomes inconsistent. Nonetheless, getting enough night time sleep is vital for normal bodily function. Thus, before the internal clock adjusts to the new sleep schedules, one can use melatonin supplements, which are available over the counter.

Is Daylight Saving Time still beneficial?

Germany, which was among the first countries to adopt daylight savings time, anticipated that the change would allow people to save on energy. People would stay out longer during the day, hence minimizing the use of artificial light sources. The argument was plausible at the time since the commonly used tungsten bulbs alongside other light sources were expensive or uneconomical. However, a century later, the cost of energy is low and highly economical light sources are available. Hence, switching to daylight saving time to save on energy is no longer valid reasoning.

Further, another motivator for switching to daylight saving time was to increase the productivity of workers. At the time, most jobs were done during the day time. Thus, adjusting time would get people working in fields and factories for longer during the day time. Today, researchers have used time tracking software to monitor the productivity of employees after daylight saving time transitions and noted poor productivity in the days following the switch. It is estimated that $480 million is lost annually from decreased productivity arising from DST transition. Therefore, switching to DST to improve employee productivity is no longer viable.


However, it is apparent is that DST has considerable negative health effects. Researchers have discovered direct relationships between daylight savings time transition and many health complications. Most of these health problems are linked to the disruptions that DST transitions have to the body’s vital circadian rhythm.  From a health perspective and stand point there is no benefit to daylight savings time, it causes more harm than good in our modern world.

Conclusion

Daylight saving time (DST) is the practice of adjusting clocks one hour ahead during warmer months. The practice dates back to the late 19th Century and it was intended to allow people to make optimal use of daylight hours. The custom has been held for more than 100 years in at least 70 countries, even though it has outlasted its usefulness. Daylight saving time has a significant effect on sleep and, by extension, causes several other medical complications. DST has been found to cause circadian rhythm disturbances, reduced sleep duration, longer sleep latency, and sleep fragmentation. Further, the transition to DST has been found to have a direct relationship with increased fatal car crashes, depression, cardiovascular conditions, changes in appetite, and workplace injuries. One can cope with the challenges of DST transition by making gradual shifts, maintaining a fixed schedule, following a bedtime routine, avoiding daytime naps and taking melatonin supplements.

 

 

 

NEED HELP WITH IRREGULAR SLEEP-WAKE RHYTHM DISORDER?

Insomnia


Introduction

Insomnia is a condition in which one has difficulty falling asleep and maintaining sleep throughout the night. Insomniacs do not get sufficient sleep and, therefore, do not feel refreshed during the day. They have difficulty carrying out daily activities because they are not well-rested. The body requires sufficient sleep for physical restoration. When one does not get enough sleep for prolonged periods, their productivity is significantly reduced. Insomnia is characterized by lack of energy, reduced concentration, poor memory, irritability, fatigue, and daytime sleepiness. An individual is considered to have insomnia when the symptoms of the condition last for over three months. Insomnia is mainly caused by sleep disturbances due to poor sleep hygiene, such as sleeping in noisy environments, working in bed, and taking stimulants before bed. It can also be caused by underlying health problems including depression, anxiety, obesity, and other sleep disorders. The condition is treatable through medication, supplements or lifestyle changes.

Symptoms

Insomnia is characterized by difficulties in falling asleep and maintaining sleep throughout the night. A person with the disorder does not get adequate night time sleep and this leads to:

1. Impaired cognitive performance

Insomnia significantly affects cognitive function because sleep is needed in restoring mental processes. A person who gets sufficient sleep wakes up feeling refreshed and stays alert throughout the day. Their mental function is usually at full capacity throughout the day. On the other hand, individuals who have insomnia have impaired mental function and show characteristics such as:

  • Decreased alertness
  • Lack of vigilance
  • Slow response speed
  • Poor memory
  • Difficulty in concentrating

The lack of sleep destabilizes neurobehavioral functions when a person is awake, and their daily activities are significantly affected.

2. Sleep deprivation

Insomnia causes difficulty in falling asleep and, therefore, a person does not get sufficient sleep. They are sleep deprived and show characteristics such as exhaustion, daytime sleepiness, and impaired mental function. The condition affects a person’s daily activities as they can easily fall asleep when carrying out various tasks. Their energy levels are also low because they feel unrefreshed and find it difficult to engage in normal activities.

3. Excessive daytime sleepiness

Excessive daytime sleepiness is a major symptom used in the diagnosis of insomnia. The lack of sleep caused by insomnia leads to a person feeling drowsy during the day. The individual stays awake throughout the night and, therefore, is unrefreshed in the morning. They require frequent naps during the day to offset their sleepiness feeling. Due to exhaustion and drowsiness during the day, insomniacs can fall asleep when carrying out tasks that require a high level of alertness, such as driving, leading to accidents.

4. Fatigue

Insomnia causes insufficient sleep at night and, therefore, a person does not get enough rest. Normally, up to eight hours of uninterrupted sleep are required to feel refreshed and stay alert throughout the day. When an individual does not get enough sleep, they feel exhausted and have difficulty carrying normal tasks. The body is also not restored due to the lack of night time sleep, and the individual is, therefore, excessively tired.

Causes

Insomnia is caused by disturbances and disruptions that make it difficult to fall asleep and maintain sleep throughout the night. These disruptions can be due to:

1. Poor sleep hygiene

Sleep hygiene refers to the habits that a person carries out to prepare for sleep and the state of the environment in which one sleeps. Poor sleep hygiene involves the different factors that lead to sleep interruptions, including:

  • Taking stimulants, such as caffeine, before bed
  • Consuming alcohol
  • Sleeping in a noisy environment
  • Having too much light in the bedroom
  • Irregular sleep schedules
  • Napping during the day

These factors make it difficult for a person to fall asleep at night. When one tries getting some sleep, they are constantly interrupted, and they have to wake up several times during the night. Individuals who have poor sleep hygiene do not get sufficient sleep and end up being sleep deprived.

2. Underlying health conditions

Some health conditions make it difficult for a person to fall asleep, thus causing insomnia. They include:

a.  Depression

Depression is a mental condition in which one remains in a constant state of despair. The condition makes it difficult for a person to fall asleep and maintain uninterrupted sleep throughout the night. It increases the sleep onset time, therefore, a person sleeps for only a few hours. The person also wakes up constantly at night and awakens early in the morning. The sleep efficiency and quality are reduced significantly and one ends up feeling unrefreshed during the day.

b. Anxiety disorder

The anxiety disorder is a condition in which a person remains in a constant state of fear and worry. They have excessive feelings of fear that affect sleep. It is commonly associated with insomnia. The person experiences restlessness when asleep, thus their sleep quality is reduced. The person also stays awake for long at night stressing or thinking too much and does not get sufficient sleep.

c.  Obesity

Obesity is a condition in which an individual has excess body fat that affects their daily function. It is associated with many sleep disorders because it significantly reduces sleep efficiency. An obese person is frequently fatigued and requires naps during the day. They end up having difficulties falling asleep at night. Obesity also causes breathing difficulties due to excess fat around the neck area and the diaphragm. The fat compresses the air passages obstructing the flow of air. The breathing difficulties constantly interrupt one’s sleep throughout the night.

3. Other sleep disorders

Insomnia is commonly symptomatic of other sleep disorders, such as:

a. Obstructive sleep apnea (OSA)

Obstructive sleep apnea is a common sleep disorder that affects breathing. The airways are obstructed when asleep by tissues and abnormalities around the air passages. The individual has frequent breathing disruptions that can last for up to ten seconds. The person stops breathing several times during the night, and this disrupts their sleep. They awaken frequently and their sleep quality is significantly reduced.

b. Restless legs syndrome (RLS)

The restless legs syndrome is a disorder that causes unusual sensations in the legs, such as itching, burning, aching, and pulling. This condition is caused by nerve damage and its symptoms appear in the evening and night hours when sitting or lying down. The person experiences an intense urge to move their legs to get rid of these sensations. This condition makes it difficult to maintain sleep because the symptoms worsen when lying down.

c.  Irregular sleep-wake rhythm

The irregular sleep-wake rhythm is a rare sleep disorder in which a person has unusual sleep-wake patterns. It is caused by alterations in the circadian rhythm, which controls sleep and wake times. A person normally sleeps in the nighttime, when there is darkness, and stays awake during the day, when there is sunlight. When a person has this condition, however, the body’s sleep-wake rhythm and the light-darkness cycles are not aligned. They sleep at irregular times and do not get enough hours of sleep at night.

4. Low melatonin levels

Melatonin is a hormone that regulates sleep by controlling the natural sleep-wake cycle. The hormone causes the body to prepare for sleep when it is dark and its absence causes one to stay alert during the day or when there is light. Low melatonin levels lead to difficulties in falling asleep and maintaining sleep throughout the night.

Diagnosis

The diagnosis of insomnia is mainly based on the information provided by the individual concerning the condition. The doctor also uses other methods during the diagnosis, including:

1. Reviewing medical history

A person’s medical history can be used to identify any underlying health conditions that may be affecting sleep and causing insomnia. This condition commonly occurs as a symptom of other health problems, especially sleep disorders. Doctors, therefore, assess the patient’s past and present health conditions to determine the health problems that may be causing difficulties in maintaining sleep.

2. Overnight sleep study

An overnight sleep study is an analysis of the body’s activity when asleep. A device is attached to the patient’s body to measure and record different elements related to sleep, including brain waves, muscle activity, breathing rate, and heartbeat. The study is usually carried out in a sleep center where the patient is watched throughout the night. The doctor obtains useful information on the sleep habits of the patient that help in the diagnosis.

3. Sleep diary

The doctor can ask a patient to keep a sleep diary for up to two weeks to provide more information for use in diagnosis. The diary contains a record of the individual’s sleep and wake times, naps taken during the day, and wake times at night. The patient records this information to help the doctor to ascertain their sleep habits.

4. The multiple sleep latency test (MSLT)

The MSLT is a group of tests that are carried out to measure a person’s sleep latency, which is the time taken to fall asleep. Individuals who have insomnia have difficulty falling asleep and, therefore, have a long sleep latency. These tests are used to determine the length of sleep that a person gets at night, with people who have insomnia showing very few sleep hours.

5. Epworth Sleepiness Scale (ESS)

A patient who reports excessive daytime sleepiness as a symptom is tested using the ESS. The ESS is a questionnaire that is given to a patient for use in diagnosis. It contains questions about the individual’s likelihood to fall asleep during different times of the day. The scale ranges from 0 to 24. A person who experiences excessive daytime sleepiness gets high scores, often over 16, in the scale.

Treatment

Insomnia is mainly treated by addressing the underlying health condition that may be causing it. It can also be treated through:

1. Medication for aiding sleep

Medications can be used to help a person stay asleep throughout the night. These medications are known as hypnotics and they work by reducing the activity of the brain when asleep, thus improving sleep quality. The common types of hypnotics used in treatment include:

a.  Benzodiazepines

Benzodiazepines are medications that suppress the activity of the central nervous system. They reduce the activity of the brain and enable a person to have uninterrupted sleep throughout the night. Common benzodiazepines used in the treatment are:

  • Xanax
  • Valium
  • Ativan
  • Librium
  • Klonopin

b. Antidepressants

Antidepressants are medications used in treating depression. They have a sedative effect and are, therefore, used in low amounts to treat insomnia. When taken, they reduce the activity of the central nervous system and enable a person to fall asleep. Serotonin reuptake inhibitors (SSRIs), which are common antidepressants, are frequently used to improve sleep quality. They reduce sleep onset and help a person maintain sleep.

c.  Melatonin receptor agonists and supplements

Melatonin receptor agonists activate melatonin receptors and increase the production of melatonin. Melatonin is an important hormone that regulates sleep and wake times. People who have low melatonin levels have difficulties in falling or maintaining sleep. When these medications are taken, the person can fall asleep at night and get sufficient sleep. The commonly prescribed melatonin receptor agonists include:

  • Agomelatine
  • Ramelteon
  • Tasimelteon

Melatonin supplements, available over the counter, can also be taken by individuals who have insomnia. They increase the amount of melatonin in the body, thus enabling a person to sleep throughout the night.

2. Lifestyle changes

Some changes in one’s lifestyle can help improve sleep by eliminating habits that affect sleep quality and efficiency. These changes are based on proper sleep hygiene, and they help a person to get sufficient sleep. A doctor can recommend changes such as:

  • Sleeping in a dark and quiet environment
  • Having a regular sleep schedule
  • Avoiding naps during the day
  • Having fixed work schedules that do not extend into sleep time
  • Avoiding alcohol
  • Avoiding stimulants, such as nicotine and caffeine, before bed
  • Consuming a healthy diet
  • Exercising regularly during the day

Conclusion

Insomnia is a serious sleep disorder in which a person has difficulty falling asleep at night. Sleep is needed by the body for restoration and to help one stay alert throughout the day.  A person who has difficulty sleeping lacks restorative sleep and does not feel refreshed. They show symptoms such as fatigue, sleep deprivation, excessive daytime sleepiness, and impaired mental function. Insomnia is caused by different factors, including poor sleep hygiene, underlying health conditions, low melatonin levels, and other sleep disorders. It is diagnosed based on the information provided by the individual concerning their sleep habits, as well as analysis of their medical history. Tools such as a sleep diary, polysomnography, MSLT, and ESS can be used to aid in making a proper diagnosis. The condition is mainly treated by addressing the underlying health condition. It can also be treated using hypnotics, natural supplements and lifestyle changes.

 

 

Looking For Help With Sleep Hallucinations?

Restless Legs Syndrome


Introduction

The restless legs syndrome (RLS) is a disorder characterized by abnormal and uncomfortable sensations in the legs. One gets an irresistible urge to move their legs constantly to rid the sensation. This condition occurs in the evening and night time when a person is sitting or lying down. It can disrupt sleep since the patients experience unpleasant sensations causing them to wake up. The syndrome is caused by a malfunction in the nervous system that leads to unusual sensations in the limbs. The condition is chronic and cannot be cured. There are, however, different methods of managing it including using dopamine agonists, taking iron supplements, and making some lifestyle changes.

Symptoms

The main symptom of the restless legs syndrome is the unusual sensation and irresistible urge to move one’s legs. The sensations reported by people with the disorder include:

  • Itching
  • Pulling
  • Aching
  • Throbbing
  • Pins and needles

One feels the need to move their legs frequently to get rid of these sensations. Other than the legs, the condition can also affect other areas including the arms, chest, or head. The sensations normally occur on only one side of the body but they can also affect both sides in rare occurrences. Restless Legs Syndrome worsens in the evening or night time and affects a person’s daily life by causing symptoms such as:

1. Sleep deprivation

The condition poses a difficulty in falling asleep, thus a person does not get adequate restorative sleep. The uncomfortable sensations and the overwhelming urge to move the limbs will usually wake one up at night. Thus, the individual faces frequent disturbances throughout the night and, therefore, does not get sufficient sleep, which in the long term leads to sleep deprivation.

2. Excessive daytime sleepiness

The direct consequence of the sleep disturbances caused by restless legs syndrome is insufficient night time restorative sleep. Since one is frequently awakened by the unusual feelings in the legs, they, do not sleep soundly at night and end up feeling tired during the day. The person might require frequent naps during the day to offset the sleepiness.

3. Insomnia

An individual who has restless legs syndrome has difficulty falling asleep. The feelings in the legs, such as itching, aching, and pulling, can keep one awake through the night. The person is, therefore, unable to fall asleep or maintain sleep throughout the night due to the irritating sensations.

4. Fatigue

Due to the lack of sufficient sleep caused by restless legs syndrome, one does not get enough rest. The body requires restorative night time sleep for an individual to feel refreshed and energized. When a person has insufficient sleep due to the unpleasant sensations, they are constantly fatigued. They feel exhausted and have trouble carrying out their daily tasks.

5. Charley horse (Muscle spasm)

Charley horse, also known as a muscle spasm, is an unpleasant muscle contraction that commonly occurs in the legs. It usually lasts for a few seconds and resolves on its own. The contractions can also last for longer causing severe pain to the person. Restless legs syndrome triggers Charley horses and the two conditions commonly occur together.

6. Dysesthesia

Dysesthesia is a condition involving abnormal sensations affecting the sense of touch. One gets sensations such as itching, burning, and prickling. The condition is commonly caused by damages to the nervous system. It occurs as the main symptom of restless legs syndrome and it causes a significant urge to move one’s legs to get rid of the unusual sensations. Movement of the limbs usually eliminates the sensations but only partially.

Causes

The restless legs syndrome is caused by different factors, including:

1. Low levels of dopamine

The disorder is associated with the hormone dopamine, which functions as a neurotransmitter. It transmits information through the nerve cells to the basal ganglia, a part of the brain that controls muscle activity. When there is a low level of dopamine production, signalling in the brain reduces. Normal movement is affected and the individual experiences muscle spasms and compulsive movements. The main cause of a reduction in dopamine levels is nerve damage that affects neurotransmission.  Dopamine levels also tend to fall naturally in the evening hours and this causes an increase in the symptoms of the restless legs syndrome.

2. Genetic factors

The restless legs syndrome is a hereditary disorder because it is common in people who have a family history of the condition. Genetic influences play a significant role in the condition especially when it begins at a young age. The condition is considered to be a dopamine-dependent disorder. Therefore, genes that are associated with the dopaminergic system cause the condition. Damages in these genes, which are carried on to offspring, cause problems in muscle control leading to unusual sensations and involuntary movements.

3. Underlying health conditions

In many cases, the restless legs syndrome is secondary to other underlying health conditions. Most of these conditions are long-term and have the restless legs syndrome as a symptom. Some common health conditions that are associated with RLS include:

  • Parkinson’s disease
  • Kidney failure
  • Diabetes
  • Peripheral neuropathy

4. Iron deficiency

Low levels of iron in the body lead to a reduction in dopamine production. Reduced dopamine levels affect neurotransmission to the brain, thus muscle control is impaired and RLS is triggered.

5. Pregnancy

Pregnancy triggers the restless legs syndrome, whereby expectant women suddenly get abnormal sensations in their legs especially in the last trimester. The condition can occur in women who did not previously have the disorder. The symptoms, however, resolve on their own a few weeks after birth.

6. Lifestyle

An individual’s habits can trigger the symptoms of the restless legs syndrome. Insufficient sleep due to irregular sleep schedules and active nightlife can trigger the condition. Taking alcohol, nicotine, and caffeine is known to aggravate the symptoms of the syndrome. These substances stimulate the nigrostriatal dopaminergic pathway and increase the level of dopamine in the striatum. Withdrawal from these substances also causes symptoms similar to the restless legs syndrome.

Diagnosis

There is no specific test for RSL and most of the diagnosis is based on the information provided by a patient. The condition can be diagnosed by a general physician but in some cases, a neurologist is involved to eliminate any uncertainties. Some of the tools that are used in diagnosing the condition include:

1. Interviews

The doctor can interview the patient to learn more about their symptoms. The interviews have questions based on the main symptoms that are associated with restless legs syndrome cases, which are:

  • Unpleasant sensations in the legs
  • An overwhelming urge to move one’s legs
  • The exacerbated of symptoms when one sits or lays down
  • Temporal relief of the symptoms by movement
  • Symptoms worsening in the evening

2. Severity scale

The clinical severity of the condition is commonly graded using the Johns Hopkins RLS Severity Scale. The scale is easy to use and reliable in determining the severity of a restless legs syndrome case. It is based on an analysis of the time of day that the symptoms begin to appear. The symptoms occur in the evening hours but at different times depending on the severity. Based on the symptom onset, the scale gives three scores:

  • Mild – The symptoms begin to appear when in bed
  • Moderate – The symptoms begin after 6 pm but before one is in bed
  • Severe – The symptoms appear before 6 pm

This scale is subjective and is used as a quick screening device for the disorder. It is also useful in monitoring progress during the treatment of the condition.

3. Family history

The restless legs syndrome is a hereditary disorder and, therefore, a person’s family history can be used in diagnosis. It is helpful to evaluate family members, both with or without the condition, to identify whether genes may have played a role in the manifestation of the condition. The restless legs syndrome is considered a dopaminergic-dependent disorder, and therefore, the genes that are involved in the dopaminergic system play a major role in its expression. When faults in these genes are inherited, they can be expressed in the form of the restless legs syndrome. Doctors, therefore, ask about a person’s family history to know whether the condition is hereditary.

4. Reviewing medical history

The restless legs syndrome is commonly a symptom of an underlying health condition, therefore, doctors use a person’s medical history in diagnosis. Different medical conditions, including Parkinson’s disease, diabetes, peripheral neuropathy, and kidney failure, can cause the symptoms of the restless legs syndrome to occur. It is usually a symptom of other health conditions, thus secondary in many cases. Doctors analyze the patient’s past and present health conditions to identify any medical problems that may cause or trigger the syndrome.

5. Blood tests

Blood tests are used to identify the presence of other medical conditions. Through these tests, other health complications that may be contributing to the condition’s symptoms are identified. Some of the medical conditions that are identified through blood tests are diabetes, kidney failure, and iron deficiency anemia.

6. Sleep tests

When the disorder causes significant disruptions to a person’s sleep, sleep tests are recommended by the doctor. The immobilization test is the most commonly carried out for restless legs syndrome cases. It involves lying and remaining still in bed. Involuntary movements are then monitored. Polysomnography, which is an overnight sleep study, is also recommended in some situations. It involves measuring and recording the different elements that are involved in sleep, including breathing rates, heartbeat, brain waves, and muscle activity.

Treatment

There is no specific treatment for the restless legs syndrome, especially when there is no underlying health condition involved. The condition can, however, be managed in different ways, including:

1. Dopamine agonists

The condition is a dopamine-dependent disorder and its symptoms occur due to low levels of dopamine in the body. Dopamine agonists are, therefore, used in treatment to increase the levels of dopamine. The transmission of signals to the brain is improved using these medications thus enabling better muscle control. Some of the dopamine agonists used in treatment include:

  • Ropinirole
  • Pramipexole
  • Rotigotine skin patch

2. Painkillers

The symptoms of the restless legs syndrome can be painful, thus painkillers are prescribed to relieve the pain. A person experiences painful sensations such as burning, aching, and itching. Some of the painkillers used in treating these symptoms include:

  • Opiate-based painkillers such as codeine
  • Gabapentin
  • Pregabalin

3. Iron supplements

The lack of iron is a major cause of the disorder, and extreme deficiency significantly aggravates the symptoms. Iron supplements are, therefore, useful in treating the restless legs syndrome. Studies show that oral iron supplements improve the symptoms of RLS significantly. Oral iron supplements are available over the counter and they are recommended for mild and moderate RLS cases. In severe cases, iron can be delivered into the body intravenously. Individuals who have normal levels of iron respond well to iron supplements as a form of treatment for the syndrome in some cases.

4. Increasing sleep efficiency

The condition commonly disrupts sleep because its symptoms worsen when a person is lying down. Medications can, therefore, be used to help a person sleep throughout the night without interruptions. These sleep medications, commonly known as hypnotics, improve sleep quality and reduce wakefulness. There are many types of hypnotics, including:

  • Benzodiazepines
  • Antidepressants
  • Antipsychotics
  • Antihistamines
  • Melatonin receptor agonists
  • Orexin antagonists
  • Supplements
  • OTC drugs

5. Lifestyle changes

Mild restless legs syndrome cases can be managed with some lifestyle changes, including:

  • Consuming a healthy diet that is rich in iron
  • Exercising regularly but not close to bedtime
  • Getting sufficient sleep by having proper sleep hygiene
  • Avoiding stimulants, such as nicotine and caffeine, that aggravate the symptoms of RLS
  • Avoiding alcohol

6. Natural remedies

When experiencing restless legs syndrome symptoms, some home remedies can be used to alleviate the symptoms, including:

  • Massaging the legs
  • Bathing with warm water
  • Applying a hot or cold compress on the affected areas
  • Carrying out other activities to keep the mind busy, such as reading
  • Relaxation exercises, such as yoga
  • Moving around

Conclusion

The restless legs syndrome is characterized by unpleasant sensations and an overwhelming urge to move one’s legs. The condition normally worsens in the evening and can adversely affect one’s sleep. It leads to fatigue, daytime sleepiness, and insomnia because they disrupt sleep. The restless legs syndrome is a dopaminergic disorder caused by low levels of dopamine in the body. Dopamine is required in the neurotransmission of signals between muscles and the brain. Low levels of dopamine affect muscle control causing involuntary movements and unusual sensations. It is, therefore, treated using dopamine agonists that improve muscle control. The condition can also be managed by using painkillers, iron and other supplements, and hypnotics. Some lifestyle changes can also help in managing the syndrome, including avoiding alcohol, avoiding stimulants, eating healthy foods, and having proper sleep hygiene.

 

Looking For Help With Sleepwalking?

Parasomnia


Introduction

Parasomnia is a group of sleep disorders that are caused by malfunctions in the central nervous system when asleep. They occur when a person is partially awake. The common parasomnias are sleepwalking, night terrors, sleep paralysis, and sleep hallucinations. Normally, one is not usually aware of most of these events and might have little to no memory of their occurrences after waking up.  Parasomnias are disruptive and make it difficult to maintain sleep throughout the night, thus causing insufficient sleep. The conditions mainly occur in children who gradually stop experiencing them as they grow up.

Types of parasomnias

The common types of parasomnias include:

1. Sleepwalking

Sleepwalking is a disorder in which an individual has unusual body movements when asleep. One can walk and engage in other activities while in their sleep without being aware. The condition occurs when the central nervous system (CNS) is over-excited during sleep. This fault leads to the person carrying out routine activities while still asleep. Some of the activities that can be carried out in sleepwalking include:

  • Walking
  • Sitting up in bed
  • Eating
  • Dressing
  • Driving

Some of the characteristics that indicate that a person is sleepwalking are:

  • A glazed expression
  • Strange and clumsy behavior
  • Unresponsiveness
  • Confusion after waking up
  • No memory of the event after waking up

2. Night terrors

Night terrors are terrifying experiences that occur when a person is asleep. These experiences are imagined but they appear real to the individual, thus causing significant panic reactions. They are characterized by:

  • Screaming
  • Increased body movement
  • Kicking
  • Restlessness
  • Increased heartbeat
  • Increased breathing
  • Sweating

3. Sleep paralysis

Sleep paralysis is an unpleasant experience that causes a person to feel immobilized when asleep. The individual is unable to move their limbs for a short time, and the paralysis causes significant distress. The condition occurs while one wakes up, thus the victim will be fully aware of the event and remembers it clearly after waking up. During the event, the person experiences:

  • Immobility
  • Difficulty in breathing
  • Panic reactions
  • Distress

4. Sleep-related hallucinations

These are hallucinations that occur during sleep causing one to experience imaginary sensations. The sensations appear real to the individual and are usually distressing. They occur when one is about to fall asleep or wake up and have a surreal appearance. The person is terrified and confused during the occurrence. The common sleep hallucinations are visual and consist of vivid images and light changes. During sleep hallucinations, the patient experiences:

  • Terror
  • Anxiety
  • Rapid breathing
  • Increased heart rate
  • Confusion after waking up
  • Mumbling during sleep
  • Restlessness

Symptoms

The symptoms of parasomnias are different depending on the type of condition that one experiences. However, the general symptoms that indicate that a person is experiencing parasomnias include:

1. Excessive daytime sleepiness

People that commonly experience parasomnia do not get sufficient sleep. The condition(s) disrupts night time sleep, thus causing one to feel sleepy during the day. One can doze off easily and might feel the urge to take frequent day time naps to make up for the lack of sleep. Excessive daytime sleepiness affects a person’s daily function by making it difficult to stay alert. Hence, it can be dangerous to people that perform activities that require high levels of concentration, such as operating heavy machinery.

2. Fatigue

Fatigue is a general feeling of tiredness. A fatigued person lacks the energy and motivation to carry out daily activities. Parasomnia disturbs sleep causing the individual to not get well-rested. The sleep quality and efficiency are lowered, thus one is not refreshed in the morning. People experiencing fatigue are easily irritated, weak, run out of breath easily, and have difficulty in making decisions.

Causes

Parasomnias occur due to alterations in the sleep states leading to faults in the transitions between wakefulness and sleepiness. The main causes of parasomnias are:

1. Complications in non-rapid eye movement sleep (NREM)

NREM is a stage of sleep that is regulated by higher brain centers and in which dreams are not experienced. During this stage, one transitions from sleep to wakefulness or from wakefulness into sleep. The sleep during this stage is light and the period lasts for a few minutes. The individual is not fully aware of their surroundings but is partially awake. If observed, the person will show both sleep and wake features. They might exhibit unusual behavior in sleep, such as increased body movement and restlessness, which is usually noticed by a sleep partner. Many parasomnias occur during NREM sleep, including sleep paralysis, sleepwalking and, night terrors.

2. Complications in rapid eye movement sleep (REM)

REM sleep is a normal sleep stage in which one experiences dreams.  Alterations in REM sleep cause a person to experience vivid dreams that appear real. When the central nervous system becomes over-excited during REM sleep, the individual can react to objects in their dreams. The person’s body movement increases and they engage in abnormal behavior, such as walking and talking during sleep.

3. Drug or substance abuse

Drug and substance abuse can alter one’s sleep states causing mental instability. The person, therefore, exhibits unusual and often undesirable behavior.  Intoxication impairs brain function and causes sleep fragmentation. This fragmentation affects the transition between wakefulness and sleepiness, thus triggering parasomnia. Illicit drugs are commonly associated with sleepwalking and sleep hallucinations. Withdrawal from illicit drugs also provokes unusual sleep behaviors.

4. Underlying medical condition

Parasomnia is commonly a sign of an underlying medical condition. Many people who exhibit unusual behavior when asleep have neurological or psychiatric conditions. These conditions affect the function of the brain and can lead to sleep fragmentation. Some of the health conditions that trigger parasomnia include:

  • Febrile illnesses
  • Schizophrenia
  • Parkinson’s disease
  • Stress
  • Melatonin deficiency
  • Anxiety
  • Depression
  • Post-traumatic sleep disorder

5. Under-development of the central nervous system (CNS)

CNS plays a significant role in controlling bodily functions. When the CNS is not fully developed, it can function erratically leading to unusual body activity. Parasomnia occurs when the CNS is excited during sleep causing movements when the body should be immobile. The condition is commonly seen in children and young adolescents and resolves with time when the CNS matures.

6. Some medications

Some medications are known to trigger parasomnias. They include:

  • Selective serotonin reuptake inhibitors
  • Tricyclic antidepressants
  • Beta-adrenergic blocking agents
  • Alzheimer’s disease medications

Many of these medications impact the brain and affect its ability to control muscle function. When this alteration occurs during REM sleep, the person reacts to non-existent objects that are only present in a dream. The victim will portray unusual behaviors, such as kicking, talking, walking, and screaming, when asleep.

Diagnosis

Parasomnia is diagnosed based on the information available about the occurrence of the disorder. In many cases, the individual experiencing parasomnia has little to no memory of the condition, and therefore the information is provided by family, friends, or a sleep partner. Doctors can further probe one’s sleep habits to help confirm a case. Other than the information provided, there are several tools and techniques that doctors use in diagnosing parasomnia, including:

1. Medical history

An individual’s medical history can help the doctor to diagnose parasomnia. Neurological and psychiatric medical conditions commonly trigger parasomnia by affecting the function of the brain. A doctor will reviews the patient’s medical history to identify any conditions that affect sleep, such as PTSD, depression, schizophrenia, anxiety disorders, Parkinson’s disease, and febrile illnesses. In the case of children, the parents or guardians provide the information on the other underlying health conditions the young patient may have.

2. Electroencephalography (EEG)

An EEG test involves measuring a person’s brain waves when asleep and identifying any abnormalities. The EEG machine is used to record the brain activity through electrodes that are attached to one’s scalp when asleep. An individual who experiences parasomnia shows both sleep-like and wake-like features during sleep. This overlapping of the sleep states leads to the unusual behaviors that are exhibited when asleep, such as walking, mumbling, and kicking.

3. Sleep study

An overnight sleep study, commonly known as a polysomnography, is often carried out when diagnosing sleep disorders. The study involves examining one’s activity when asleep. Different elements of sleep are analyzed including breathing rates, heartbeat, muscle activity, and eye movements. This study is normally carried out in a sleep center where the individual is observed throughout the night by a doctor.

4. Physical and neurological exam

Doctors usually examine the individual’s present physical and neurological condition to identify sleep disorders. The test is done to rule out any other health conditions and neurologic disorders that can disrupt one’s sleep. A thorough physical examination is carried out by observing the different areas that are involved in sleep. If a complication is identified, further tests are carried out using computerized tomography (CT) and magnetic resonance imaging (MRI) scans.

Treatment

There is no specific treatment for parasomnia because it is a large group of conditions each with different causes and triggers. It is, however, managed using different methods, including:

1. Medications

Medications can be used to manage parasomnia when the symptoms occur frequently. Some of the medications used in treatment include:

a. Benzodiazepines

Benzodiazepines are the most commonly used medications in the treatment of parasomnia. They are primarily used to prevent awakening in the middle of the night. When taken, they suppress the CNS and prevent its excitement when a person is asleep. Thus, they are highly effective in treating parasomnias caused by complications in REM sleep. There are many types of benzodiazepines available, including:

  • Clonazepam (Klonopin)
  • Alprazolam (Xanax)
  • Diazepam (Valium)
  • Clobazam (Onfi)
  • Lorazepam (Ativan)

b. Antidepressants

Antidepressants have a sedative effect and, therefore, suppress the CNS when they are taken. They prevent awakening during the night due to a faulty excitement of the CNS. Hence, one can sleep throughout the night without disturbances after taking them. Antidepressants improve sleep quality and efficiency, thus prevent the occurrence of parasomnia symptoms.

c.  Melatonin supplements

Melatonin is a hormone that regulates sleep and wake times. In absence of light, a large amount of melatonin is produced, thus enabling the person to fall asleep throughout the night. During the day, the production of melatonin reduces and the person stays alert. Melatonin supplements, which can be purchased over the counter, can be used to reduce the symptoms of parasomnia. They help one to get deep sleep without interruptions throughout the night. Also, these supplements come with no side effects for most people or at the least minimal, unlike other prescription drugs that have harsh and long term side effects.

2. Alternative medications

When parasomnia is triggered by the medications that one is taking, doctors usually recommend alternative medications or dosages. The alternative medication will reduce the symptoms of parasomnia while still treating one’s health condition. Some medications that frequently trigger parasomnia are antidepressants and treatments for Alzheimer’s disease.

Doctors can recommend a change from tricyclic antidepressants to selective serotonin reuptake inhibitors (SSRIs), which have fewer side effects. Some common SSRIs are fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro). Individuals who get parasomnias when using SSRIs can also use alternatives such as Bupropion (Wellbutrin), mirtazapine (Remeron), vilazodone (Viibryd), and vortioxetine (trintellix).

Cholinesterase inhibitors are normally used for Alzheimer’s disease and the common ones include Donepezil (Aricept), Galantamine (Razadyne), and rivastigimine (Exelon). A patient’s progress is usually closely monitored thus a doctor can recommend a change from one medication to another, when side effects are noticed. One of the alternative medicines is Memantine (Namenda), which regulates the activity of glutamate in the body.

3.     Cognitive-behavioral therapy

Cognitive-behavioral therapy involves educating the patient about the condition that they are going through. It aims at improving mental health by helping the individual think positively about the condition. Parasomnia leads to stress and anxiety as well as negative thoughts patterns about harming oneself and others. Through cognitive behavioral therapy, the negative thoughts are replaced or mitigated, and one is able to manage the condition better.

4. Physical safeguards

Parasomnia increases a person’s body movements when asleep. This increases the risk of harming oneself and others. The doctor can, therefore, recommend changing the sleeping environment to ensure that it is safe. This can be done by:

  • Removing potentially harmful objects from the room, such as sharp objects
  • Padding the floor around the bed
  • Adding barriers to the edges of the bed
  • Decluttering the bedroom

Conclusion

Parasomnia is a large group of sleep disorders that occur due to the malfunction of the CNS when asleep. They cause unusual and undesirable behaviors, such as walking, talking, kicking, and screaming, when asleep. A delay in the maturation of the CNS during childhood is the main cause of the condition. The under-developed CNS can err in its function, thus causing activities that occur in wakeful episodes to erroneously happen during sleep. Other factors that trigger parasomnia are dissociations in REM and NREM sleep states, drugs or substance abuse, underlying health conditions, and some prescription medications. There is no specific treatment for parasomnia but it can be managed by preventing the activation of the CNS during sleep. Medications, such as benzodiazepines, antidepressants, and melatonin supplements, enable one to maintain uninterrupted sleep throughout the night. Parasomnia can also be managed through cognitive therapy and changes in the sleep environment to keep the person and others safe.

 

Interested in Help with Restless Leg Syndrome?


Introduction

Sleep deprivation is a condition whereby one does not get sufficient sleep at night. It is common in modern society due to the increased workload and night activity. Sleep is vital because it helps the body restore itself, heal, and remove some metabolic wastes. It is an important indicator of overall health and well-being and is used in the diagnosis of many health conditions. An adult requires about seven to eight hours of sleep at night to feel refreshed and well-rested. Getting insufficient sleep repeatedly can lead to complications, such as daytime sleepiness, hypersomnia, an impaired immune system, difficulty concentrating, lack of energy, and poor memory. Sleep deprivation is mainly caused by sleep disturbances that reduce the amount of sleep time that a person gets. These disturbances can be caused by underlying health conditions, including stress, depression, and anxiety. Poor sleep hygiene, such as taking stimulants before bed and sleeping in a noisy environment can also lead to insufficient sleep. The condition is treated using medication, supplements, over the counter products and other natural means.

Symptoms

Sleep deprivation is commonly characterized by sleepiness, irritability, anxiety, and depression. The major symptoms of the condition are:

1. Impaired cognitive performance

Sleep deprivation is commonly associated with decreased alertness, vigilance, and response speed. It leads to impaired cognitive performance due to the destabilization of neurobehavioral functions in wakefulness. The cognitive functions that are mainly affected by sleep deprivation include:

  • Working memory
  • Psychomotor speed
  • Attention
  • Concentration

Prolonged sleep deprivation leads to persistent cognitive deficits leading to changes in different parts of the brain, including:

  • The frontal control region
  • Parietal control region
  • Secondary sensory processing areas
  • Thalamic region

The individual with the condition is not usually aware of the accumulating cognitive deficits. However, with time, the changes become severe and noticeable by affecting one’s performance in routine tasks.

2. Daytime sleepiness

Daytime sleepiness is the most commonly used symptom in the diagnosis of sleep deprivation. Insufficient sleep causes a person to feel drowsy during the day. Adults require about eight hours of uninterrupted sleep at night for the body to be refreshed and alert throughout the day. A prolonged lack of sufficient sleep leads to excessive sleepiness and general lack of alertness during the day. Daytime sleepiness increases the risk of hurting oneself or others when one falls asleep during activities such as driving and operating heavy machinery. An individual with daytime sleepiness can fall asleep abruptly and cause serious accidents, with the most common reported cases being sleep-related car crashes.

3. Obesity

Sleep deprivation can increase the risk of obesity. Studies have shown that sleep deprivation is associated with weight gain because it alters the metabolism of glucose, increases one’s appetite, and reduces the use of energy. The person with the condition is, therefore, likely to gain a lot of weight leading to obesity.

Causes of sleep deprivation

Sleep deprivation is caused by a lack of sufficient sleep, which causes the person to feel unrefreshed. Some complications that affect one’s sleep, which can lead to the condition, include:

1. Depression

Depression affects a person’s sleep by causing difficulty in falling asleep and maintaining uninterrupted sleep throughout the night. It increases the time taken to fall asleep (prolonged sleep latency), which reduces the amount of time that a person stays asleep. Depression also causes frequent awakening during the night and early awakening in the morning. Hence, one’s sleep quality is significantly reduced and they do not feel refreshed in the morning. A consistent lack of sufficient sleep becomes sleep deprivation.

2. Alterations in the circadian rhythm

The body’s sleep and wake times are controlled by a biological clock in the hypothalamus region of the brain. The internal clock regulates the time that a person falls asleep and wakes up. This regulation creates a rhythm known as the circadian rhythm. When this rhythm is altered, the person has difficulty falling asleep and wakes up during abnormal times. These alterations can be caused by poor sleep hygiene, irregular sleep schedules, and the use of medications that affect sleep. Frequent changes in a person’s sleep patterns cause significant alterations to the circadian rhythm that lead to sleep deprivation.

3. Low melatonin levels

Melatonin, a hormone synthesized by the pineal gland, plays a significant role in sleep regulation. It is part of the natural sleep-wake cycle that enables a person to fall asleep and wake up at the appropriate times. Melatonin is produced when the retina detects darkness, and in large amounts in absence of light. When there is light, the melatonin production decreases to ensure wakefulness. If the body produces low amounts of melatonin, it becomes difficult for a person to fall asleep or to have uninterrupted night time sleep. Therefore, low melatonin levels are said to cause sleep deprivation.

4. Reduced sleep duration

Sleep deprivation occurs when a person does not get the recommended sleep duration of eight hours in each sleep-wake cycle. Sleep duration is commonly affected by disturbances that occur when one is asleep, which can be caused by health conditions, noise, light, alcohol intoxication, drug abuse, and use of some prescribed medications. Further, irregular sleep schedules significantly affect a person’s sleep time. These irregularities can be caused by factors such as changes in work schedules and traveling across time-zones. When one’s sleep time is not sufficient  enough for each night for a prolonged period, they eventually experience sleep deprivation.

5. Insomnia

Insomnia is a sleep disorder that causes difficulty in falling asleep and maintaining sleep throughout the night. The condition can be short-term or chronic, and it causes one to get nonrestorative sleep. Insomnia is commonly caused by factors including poor sleep hygiene, depression, anxiety, some types of medications, and underlying medical conditions. People with insomnia do not get good quality sleep and end up being sleep deprived.

Diagnosis

In hospitals, sleep deprivation and its possible causes can be identified using different tests, including:

1. Polysomnography

A Polysomnography (PSG) is a sleep study that is used to analyze a person’s brain and body activity when asleep. A sleep deprived person has a high sleep propensity and is likely to fall asleep within a short period during the test. The individual will also fall asleep abruptly, even when carrying out activities that require high levels of alertness. Doctors may review a patient’s lifestyle and sleep habits before carrying out a sleep study to help get the background of one’s sleep deprivation.

2. Epworth Sleepiness Scale (ESS)

An ESS is used to measure and analyze a person’s daytime sleepiness. Individuals who are sleep deprived commonly feel sleepy during the day, and the sleepiness can affect their daily activities. The ESS is used as a screening tool to examine and determine the level of sleepiness. The test involves a questionnaire probing one’s sleep habits in different situations during the day. The patient fills it out by indicating their probability of falling asleep in different situations. The test has a scale of 0 to 24, and a person who scores over 16 requires further assessment. ESS and PSG results are commonly used together in diagnosing sleep deprivation.

3. The Multiple Sleep Latency Test (MSLT)

MSLT is a test used to measure the time that a person takes to fall asleep. A sleep deprived person is likely to fall asleep within a short period. They, therefore, have a short sleep latency and tend to fall asleep within less than two minutes. The results of this test can vary depending on the person’s sleep efficiency, sleep duration, drug use, and physical exercise. As an individual continues to lack sufficient sleep, the sleep latency continues to decrease.

4. The Maintenance of Wakefulness Test (MWT)

MWT is a test quite similar to MSLT because it is also used to measure sleep latency. It, however, requires the person to stay awake and resist falling asleep. A sleep-deprived person shows low sleep latency.  They easily fall asleep and struggle to stay awake.

5.     Cognitive assessments

Cognitive assessments are necessary to assess sleep deprivation and its effects on the brain. The lack of sleep has been found to affect different cognitive functions. It has significant effects on activities that require alertness, vigilance, and attentiveness. The cognitive assessments show valid reflections of the effects of lack of sleep on the activity of the brain during wakefulness. Most cognitive assessments involve studying the dorsolateral prefrontal cortex, which plays a major role in controlling alertness.

Functional neuroimaging is a common technique used in cognitive assessment. It shows the effects that sleep deprivation has on the brain. Functional neuroimaging identifies the changes in the brain that are a result of sleep deprivation. These changes take place in the frontal and parietal control regions, secondary sensory processing regions, and the thalamic areas. Neuroimaging shows the prefrontal cortex as the main region that is affected by sleep deprivation.

There are different methods of Functional neuroimaging that are used in cognitive assessment, including:

  • Positron emission tomography (PET)
  • Functional magnetic resonance imaging (FMRI)

These methods examine brain metabolism and changes in neural activity that are related to sleep deprivation.

6. Assessment of underlying health conditions

Sleep deprivation can be as a result of health conditions, such as depression, anxiety, gastrointestinal disturbances, musculoskeletal pain, and the Restless Leg syndrome. This condition occurs as a symptom of other underlying health conditions in many cases. Doctors usually review the patient’s medical history and test them for potential causal health problems. The medications that a patient takes can also lead to sleep deprivation, including oxycodone, codeine, methylphenidate, and ephedrine. Thus, doctors also review one’s active medication use to determine whether they may be contributing to sleep deprivation.

Treatment

Sleep deprivation is mainly treated by addressing the problem that may be causing it, especially lack of sufficient sleep. The condition can be treated using different medications, supplements and lifestyle changes that improve one’s sleep quality. The following are the common treatment options:

1.  Use of hypnotic medications

Hypnotic medications, commonly known as sleeping pills, are used to induce sleep in people who have trouble falling asleep and maintaining sleep throughout the night. These medications are used to treat insomnia, a sleep disorder that causes sleep deprivation.  The common types of hypnotic medications that can be used to treat sleep deprivation include:

a.  Benzodiazepines

Benzodiazepines are drugs that slow down the activity of the brain and induce sleepiness. The commonly used benzodiazepines are Xanax, Ativan, Librium, Valium, and Halcion

b.  Nonbenzodiazepine receptor agonists

These medications are used to treat insomnia and are effective because they do not have adverse effects on the body. The basic forms of Nonbenzodiazepine receptor agonists include:

  • Zolpidem
  • Zaleplon
  • Eszopiclone

c.   Melatonin receptor agonists

These medications bind to melatonin receptors and activate them, enabling the production of melatonin. The hormone induces sleep and improves sleep quality. The common melatonin receptor agonists are:

  • Ramelteon
  • Agomelatine
  • Tasimelteon

d.  Antidepressants

Antidepressants, when used in low doses, can be used to induce sleep. They have a sedating effect that improves sleep quality. The common antidepressants are:

  • Trazodone
  • Amitriptyline
  • Doxepin

2.  Melatonin supplements

The lack of melatonin is a major cause of sleep deprivation, thus OTC melatonin supplements can help alleviate the condition. The supplements are sold in the form of tablets and liquids. When taken they help a person fall asleep and stay asleep throughout the night. Avoiding stimulants when taking melatonin supplements can increase their effectiveness in improving sleep quality.

3.  Proper sleep hygiene

Different practices can help a person get sufficient night time sleep. They include:

  • Avoiding meals too close before bedtime
  • Avoiding caffeine, nicotine, and alcohol before bedtime
  • Sleeping in a dark and quiet environment
  • Following a regular sleep schedule
  • Avoiding naps during the day
  • Having fixed work schedules

4. Self-care

Sleep deprivation increases the risk of sleep-related accidents. It induces psychomotor impairments, same as alcohol. Car crashes are common among the sleep deprived since they can fall asleep abruptly. The condition, therefore, poses a risk to oneself and public safety. A sleep-deprived person can practice self-care by avoiding sensitive tasks that require high levels of alertness, including driving motor vehicles and operating other machinery.

Conclusion

Sleep deprivation is a major sleep disorder throughout the world that affects people’s normal activity and health. It is caused by a lack of sufficient sleep that can be caused by various factors such as underlying health conditions and  poor sleep hygiene. The condition can lead to harm if left untreated because it can cause one to fall asleep when undertaking tasks that require high levels of alertness and concentration, such as driving. It is treated using medications that help a person get sufficient sleep, known as hypnotic medications, which include benzodiazepines, non-benzodiazepine receptor agonists, melatonin receptor agonists, and antidepressants. Melatonin supplements can also help improve a person’s sleep quality without the nasty side effects prescriptions meds bring. Doctors also recommend having proper sleep hygiene to ensure that one gets uninterrupted sleep to feel refreshed in the morning.

 

Looking For Help With Snoring?


Introduction

Periodic Limb Movement Disorder (PLMD) is a sleeping disorder that causes unconscious movements, primarily in the legs, when one is asleep. A person with the disorder experiences restlessness at night and their sleep quality is significantly reduced. PLMD is commonly associated with other sleep disorders, including, daytime sleepiness, insomnia, restless legs syndrome (RLS), narcolepsy, and sleep apnea. It is caused by an over-excitement of the central nervous system when a person is asleep, thus causing unusual body movements. The disorder only manifests during Non-REM sleep since skeletal muscles are temporarily paralysed during REM sleep. Many health conditions are linked to PLMD, including uremia, diabetes, spinal cord injury, dopaminergic deficiency, and iron deficiency. PLMD has no specific treatments but it can be managed using medications, supplements, and lifestyle changes.

Symptoms

PLMD is characterized by unusual repetitive leg movements that occur when a person is asleep. The movements involve flexing, jerking, and cramping of the feet, and they take place every 20 to 40 seconds. They occur periodically and can last from several minutes to a few hours. These movements occur in the lower limbs, including the hips, knees, and ankles, and can occur on one or both legs. The individual with the disorder is not usually aware of these leg movements because they take place during sleep. They can, however, wake up several times during the night because of the sleep interruptions caused by the repetitive movements. PLMD, therefore, reduces one’s sleep quality due to frequent awakening and general restlessness. The condition also affects the daily activities of the individual by leading to the following observable signs:

  • Non-restorative sleep that causes the person to feel unrefreshed in the morning even after a long night’s sleep
  • Fatigue during the day
  • Daytime sleepiness
  • Insomnia
  • Poor concentration during the day

Causes

PLMD is categorized into two types, primary and secondary, based on its causes.

Primary PLMD

This is PLMD whose exact cause is not known. It is suggested that the condition may be caused by flaws in the nerve regulation between the brain and the limbs. Primary PLMD is not a serious condition but it can cause sleep disturbance.

Secondary PLMD

Secondary PLMD is caused by other underlying health conditions or medications used. Some of the medical conditions that are associated with secondary PLMD include:

1. Uremia

Uremia is a medical condition in which waste products build up in the blood. This build-up occurs because of impaired kidney function. A large number of individuals with PLMD most commonly have kidney problems. Uremia, on its own, is known to cause the classical symptoms of sleep disorders, such as daytime sleepiness, insomnia, and poor concentration, even when one does not have a confirmed sleeping disorder.

2. Cardiovascular disease

Cardiovascular disease is a general term for the illnesses that affect the different elements of the heart, including the blood vessels, heart muscles, and the heart rhythm. Studies show that individuals who experience severe PLMD have detrimental alterations in their cardiac structure. The left ventricular diameter is significantly increased making it abnormally massive. The increased size of the left ventricle causes an increase in nocturnal systolic blood pressure.

3. Spinal cord injury

Spinal Cord Injury (SCI) has been shown to trigger periodic leg movements in sleep. The injury causes the spinal cord to malfunction leading to increased spinal reflexes. One, therefore, becomes restless and experiences unconscious body movements in their sleep.

4. Iron deficiency anemia

Iron deficiency anemia is a medical condition in which the iron levels in the body are significantly reduced. The central nervous system is affected by the inadequacy leading to difficulties in normal cognitive function. Iron deficiency anemia is associated with many sleep disorders. It leads to poor neurological development and altered motor functions. One, therefore, experiences abnormal movements in the limbs when asleep due to the malfunction in the central nervous system. Iron deficiency anemia is usually commonly reported in pregnant women.

  1. Diabetes mellitus

The Periodic Limb Movement Disorder is prevalent in individuals who have diabetes mellitus, which is a group of metabolic disorders that cause high blood sugar levels over a long period. Diabetes increases the activity of the sympathetic nervous system, thus causing abnormal movements of the limbs when asleep. An individual who has diabetes is, therefore, at higher risk of the periodic limb movement disorder.

  1. Restless legs syndrome (RLS)

The Restless Leg Syndrome is a condition that causes an irresistible urge to move one’s legs. This condition is different from the periodic limb movement disorder in that it occurs during both wakeful and sleeping episodes. The Periodic Limb Movement Disorder and Restless Leg Syndrome, however, have many similarities in their symptoms.  Many individuals with the Periodic Limb Movement Disorder also have symptoms of the Restless Leg Syndrome.

7. Dopaminergic deficit

Dopamine is a neurotransmitter that sends signals to the brain. It helps in controlling body movements and vital brain functions, including sleep, memory, and mood. When a person has a dopamine deficiency, their body movements are not well regulated and this can lead to abnormal limb movements. A dopamine deficiency occurs when the amount synthesized in the body is insufficient or when there is a fault in the brain receptors.

Other than health conditions, the Periodic Limb Movement Disorder can also be caused by some medications including:

  • Neuroleptics
  • Antidopaminergic agents
  • Tricyclic antidepressants
  • Antihistamines
  • Antinausea medications
  • Antipsychotics
  • Sedatives

Risk factors

Several factors increase the risk of the Periodic Limb Movement Disorder including:

  • Older age
  • Feminine gender
  • Cardiovascular disease
  • Obstructive sleep apnea
  • Mental disorders
  • Taking stimulants, such as coffee before sleep
  • Use of sleep aids (drugs)
  • Stress

Diagnosis

The Periodic Limb Movement Disorder is commonly diagnosed based on the information provided by people around a patient because its symptoms occur when one is asleep. Therefore, friends and family can observe the unusual movements, which the person is not aware of, as they happen.  The patient can also inform the doctor of symptoms that may be related to the Periodic Limb Movement Disorder that occur during the day, such as daytime sleepiness, fatigue, and not feeling refreshed even after a long night’s sleep. When making a diagnosis of the Periodic Limb Movement Disorder, the doctor first eliminates all the other related sleep disorders before confirming the condition. Some of the tools that doctors use in diagnosis include:

1. Polysomnography

Polysomnography is an overnight sleep study that is commonly used to determine the underlying cause of a sleep disorder. It is used in the diagnosis of the Periodic Limb Movement Disorder to record and quantify the periodic limb movements experienced in sleep. An electromyogram (EMG) records the electrical activity in legs since muscles produce electrical current when active. EMG electrodes are connected on the patient’s limbs to record muscle activity that doctors can use to distinguish the disorder from normal involuntary movements during sleep. People around the patient can give false-negative and false-positive information on a person’s body movements that can affect the diagnosis. Hence, polysomnography is carried out to validate the information provided by friends and family to make a proper conclusion.

2. Sleep logs

The doctor can ask a patient to keep a sleep diary for about two weeks for use in diagnosis. The diary contains logs of the person’s sleeping habits, including:

  • Sleep and wake times
  • Activities carried out before bed
  • Food and drinks taken before bed
  • The condition of the sleeping environment

Other people can play a supportive role in keeping the diary by indicating in the sleep log any unusual activities that occur when the person is asleep. The information contained in a sleep diary is quite resourceful to doctors when confirming a case of a Periodic Limb Movement Disorder.

3. Auditory brainstem response (ABR) test

An ABR test is used to examine the hearing nerve’s response to sounds by measuring the electrical activity in the brain. Electrodes are placed on the scalp and used to record brain activity. This method is useful in studying the activity of the central nervous system and can be useful in identifying flaws in its function that can lead to the Periodic Limb Movement Disorder. People who have iron deficiency show a malfunction in the central nervous system that causes unusual body movements.

Treatment

There is no specific medical treatment for the Periodic Limb Movement Disorder because it is chronic. Thus, medications are mainly aimed at reducing or eliminating the symptoms of the condition. The medications are used frequently to provide continued relief and to enable patients to lead normal lives.  The common medications used for the Periodic Limb Movement Disorder are:

1. Dopaminergic agents

Dopamine deficiency is a major cause of the disorder because the hormone is required in controlling body movements. Dopaminergic agents are currently the most successful treatments for condition.  They work by increasing the dopamine levels in the body. The common dopaminergic agents used include:

  • Pergolide
  • Pramipexole
  • Ropinerole
  • Talipexole
  • Cabergoline,
  • Piribedil
  • alpha-dihydroergocryptine (DHEC)
  • Levodopa

2. Benzodiazepines

These are medications that work on the central nervous system to bring about different effects in the body, including sedation and muscle relaxation. In Periodic Limb Movement Disorders, they work by suppressing the muscle contractions and reducing the occurrence of limb movements. The patient can, therefore, sleep without interruptions throughout the night. The common benzodiazepine used for the disorder is clonazepam.

3. Anticonvulsant agents

Anticonvulsants are medications that normalize the transmission of nerve impulses in the nerve cells. They help regulate the function of the central nervous system. They tend to reduce muscle activity thus preventing unusual body movements when asleep. The common anticonvulsant used in treating the Periodic Limb Movement Disorder is gabapentin.

4. Gamma-aminobutyric acid-A (GABA) agonists

GABA agonists work by preventing the release of neurotransmitters that stimulate muscle contractions. They cause the muscles to relax when one is asleep thus helping people with the disorder to get undisturbed sleep throughout the night. The most widely used GABA agonist in treating the Periodic Limb Movement Disorder is baclofen.

 

Doctors will closely monitor people who are under medication to see the effectiveness of drugs and identify any adverse effects. Children, pregnant women, and the elderly are treated as special groups and evaluated regularly for early identification of side effects.

5. Treating the underlying health conditions

Secondary Periodic Limb Movement Disorder can be treated by identifying and eliminating the underlying health problems. The disorder is associated with many health conditions and treating them can reduce abnormal limb movements. For example, uremia is treated using hemodialysis and renal transplantation.

6. Iron supplements

Iron deficiency is a major cause of the Periodic Limb Movement Disorder. It causes the central nervous system to malfunction leading to abnormal body movements when a person is asleep. Iron supplements, which can be bought over the counter, have been found to significantly reduce the condition’s symptoms.

Natural treatment options

The Periodic Limb Movement Disorder can be managed using some natural methods and lifestyle changes, such as:

  • Regular physical activity, with high impact exercise during the day and simpler exercise in the evening.
  • Regular sleep-wake times
  • Adequate sleep
  • Avoiding caffeine, alcohol, and nicotine
  • Avoiding medications that can trigger the disorder, such as antihistamines and antipsychotics

Conclusion

The Periodic Limb Movement Disorder is a sleeping disorder whereby a person experiences movements in the lower limbs when asleep. The individual is not aware of the condition because the movements are experienced in sleep. The condition occurs during N-REM sleep in episodes lasting between minutes and hours. The movements disrupt one’s sleep causing one to wake up frequently during the night. The condition, therefore, leads to insomnia, non-restorative sleep, fatigue, and daytime sleepiness. When the cause of the disorder is unknown, the condition is referred to as primary PLMD, whereas when there is an underlying cause, the condition is called secondary PLMD. Secondary Periodic Limb Movement Disorder is caused by health conditions, such as dopaminergic deficiency, uremia, spinal cord injury, cardiovascular disease, iron deficiency anemia, and diabetes mellitus. It can also be caused by medications that affect the function of the central nervous system, including antihistamines, antidepressants, antipsychotics, and sedatives.

The risk of experiencing the disorder increases with old age, cardiovascular disease, mental disorders, and poor sleep hygiene. Women are at a higher risk of experiencing the condition than men. The disorder is diagnosed using different methods including sleep logs, polysomnography, and auditory brainstem response (ABR) tests. The information from people around patients plays a significant role in the diagnosis because the symptoms of the condition occur when a person is asleep. The disorder cannot be treated fully because it is a chronic condition, but some methods are used to manage it. Some common medications used to treat the Periodic Limb Movement Disorder include dopaminergic agents, benzodiazepines, anticonvulsants, GABA agonists, and iron, and other supplements. Treating the underlying health condition can help eliminate the symptoms of the disorder. The condition can also be managed using natural treatment options, such as changing one’s lifestyle habits, getting sufficient sleep, having a proper sleep hygiene, as well as, avoiding alcohol and other substances that affect one’s sleep patterns.

 

Looking For Help and Treatments for Parasomnia


Fatigue generally refers to the feeling of tiredness and low energy. A fatigued person lacks the motivation to carry out daily activities, feels excessively sleepy and has a persistent, unexplained exhaustion. Even when one has had sufficient sleep, they still wake up not feeling refreshed. Fatigue is often a symptom of other health conditions, especially sleep disorders such as narcolepsy, hypersomnia, insomnia, and excessive daytime sleepiness. It can also be caused by medical conditions such as depression, allergic rhinitis, anemia, and obesity. The condition is treated by addressing the underlying health factors that may be causing it.

Symptoms

Fatigue is unexplained tiredness that is constant and affects a person’s daily activities. Its symptoms are commonly similar to those of a cold or flu. The individual feels drained even after having had enough sleep. The common characteristics of fatigue are:

    • Tiredness
  •          Sleepiness
  •         Low energy
  •          Lack of motivation
  •         Non-restorative sleep
  •         Shortness of breath
  •         Muscle weakness
  •         Irritability
  •          Impaired thinking

Types of fatigue

Fatigue is categorized into three categories, based on the areas of the body that it affects.

1.     Physical Fatigue

Physical fatigue affects the muscles making it difficult for a person to engage in physical activity for a long period of time.

2.     Mental Fatigue

Mental fatigue affects the brain, thus affecting a person’s productivity and cognitive function. This condition is often referred to as burnout.

3.     Metabolic Fatigue

Metabolic fatigue occurs during intense exercise when the substrates needed for the generation of ATP are depleted. The metabolic by-products also accumulate in the muscles causing fatigue.

Causes of fatigue

Fatigue is often associated with medical conditions such as:

1.     Chronic fatigue syndrome (CFS)

The Chronic Fatigue Syndrome is a disorder that causes severe fatigue, weakness, poor memory, low levels of concentration, insomnia, and muscle pain. The condition is persistent and lasts for over six months. People with CFS experience unexplainable tiredness that affects their normal activities. The causes of the condition are usually unknown and it is treated by addressing the symptoms.

2.     Allergies

Allergies are signs of the immune system responding to substances in the environment that may or may not be harmful to the body. They are common in the general population and can be triggered by different agents in the environment, such as pollen, molds, insects, and weather conditions. Allergies can cause fatigue by either affecting a person’s sleep patterns or causing the release of chemicals that lead to tiredness. Avoiding allergens and using medications can help prevent the occurrence of these symptoms.

3.     Depression

Fatigue is commonly associated with depression. A depressed person will feel sad, hopeless, and tired. The person lacks motivation, thus has little or no interest in normal activities. They experience unexplained exhaustion most of the time. The person also finds it difficult to fall asleep at night, thus suffers from insomnia. They are, therefore, exhausted during the day because of a lack of sleep.

4.     Cardiovascular disease

Some heart illnesses may cause this vital organ to fail in its blood pumping actions causing erratic blood supply to some organs. People who suffer from heart disease can get tired very quickly, even when performing easy tasks. They lack the energy to carry out simple activities, such as walking up a flight of stairs. They require to rest frequently and experience labored breathing when carrying out tasks.

5.     Rheumatoid arthritis

Rheumatoid arthritis is an inflammatory disorder that causes joint damage. It is characterized by painful, swollen joints, bone erosion, and deformity. The condition can also affect other parts of the body, including the heart, blood vessels, and lungs. People who have rheumatoid arthritis experience mental and physical exhaustion. The chemicals found in swollen tissues are similar to those produced when one has the flu, and they cause feelings of fatigue.

6.     Sleep apnea

Sleep apnea is a sleep disorder that causes a person’s breathing to temporarily halt for short periods when asleep and begin again. The individual’s breathing is obstructed by abnormalities in the nasal and sinus passages, thus preventing air from getting into the body. The condition causes the person to wake up frequently during the night, thus they do not get restorative sleep, which leads to sleepiness and fatigue during the day.

7.     Obesity

Obesity is excessive body fat accumulation that poses a risk to one’s health. It increases the risk of fatigue because the individual carries more weight. The person’s endurance of physical activity is significantly reduced, thus they get tired quickly. Obesity is also associated with many other complications that cause fatigue, including sleep apnea, cardiovascular disease, and hypothyroidism.

8.     Anemia

Anemia is characterized by a significant decrease in the number of red blood cells and hemoglobin in the body. Red blood cells transport oxygen in the body, thus, if their numbers reduce, the body does not get sufficient oxygen supply. Anaemic people experience fatigue, shortness of breath, and weakness. A reduction in the number of red blood cells is commonly caused by a lack of iron, which is an important component of these cells.

9.     Underactive thyroid

The thyroid gland controls metabolism in the body. It is responsible for the rate of conversion of food into energy for use in the body. A person who has hypothyroidism (an underactive thyroid) lacks energy because their energy conversion process is slow. Thus, they get tired easily and in many cases gain excess weight. 

10.    Urinary tract infections (UTIs)

UTIs are infections in the urinary system that affect different parts, including the kidneys, bladder, ureters, and the urethra. The infections are characterized by pain, irritability and a burning sensation. Individuals with UTIs also feel weak, fatigued, and drained. Fatigue often occurs when the infections spread to the kidneys.

11.  Diabetes

Diabetes, a group of diseases that alter glucose levels in the blood, causes feelings of tiredness in both high and low blood sugars. When the blood sugar levels are high, it indicates that the body has insufficient insulin to transport glucose to cells for energy synthesis. Hence, the glucose remains in the bloodstream as cells are starved of energy causing one to feel fatigued. When the blood sugar levels are low, the body has a glucose deficiency. Hence, organs lack the energy to carry out their different functions causing one to feel fatigued.

Non-medical causes of fatigue

1.     Insufficient sleep

Lack of sufficient sleep at night leads to a person feeling drowsy, unmotivated, and fatigued during the day. Insufficient sleep can be caused by poor sleep hygiene, such as taking caffeine before bed, drinking alcohol, sleeping in a noisy environment, and performing other tasks, such as working, while in bed. Medical conditions, such as sleep apnea, obesity, and depression, can also affect a person’s sleep time leading to fatigue.

2.     Poor nutrition

The foods one consumes affect their health. Poor nutrition can cause the immune system to be weak, leading to an increased risk of other health conditions. Foods with high amounts of sugar cause a spike in the blood sugar levels, which later drops suddenly and leaves the person feeling fatigued. Not eating enough food also causes low energy levels in the body, thus leading to fatigue. 

3.     Excess Caffeine

Caffeine is a stimulant and is, thus taken to increase alertness. Consuming too much caffeine, however, increases a person’s heart rate and blood pressure. It also leads to anxiety and insomnia. When the stimulating effects of caffeine wear off, the individual feels exhausted and lacks motivation.

4.     Dehydration

Lack of water can cause a person to be fatigued. When a person is dehydrated, the volume of the blood reduces, thus making it difficult to get a sufficient supply of blood throughout the body. Blood is needed for the transport of oxygen and, therefore, low volumes of blood cause the body organs to lack oxygen. The person feels tired and runs out of breath easily. A well-hydrated person has clear or pale yellow urine, while when dehydrated, the urine is dark.

Diagnosis

There is no actual test for fatigue and instead, a variety of medical tests are carried out to find the health conditions that may be causing it. The common tests carried out to identify the cause of fatigue are:

1.     Blood tests

These are tests carried out on the blood to identify health conditions such as anemia, diabetes, and hypothyroidism. Blood tests are used by doctors to evaluate how different organs in the body are functioning.

2.     Immunological tests

The body produces antibodies to fight unwanted substances. Immunological tests identify the presence of these antibodies and are used to determine the underlying health condition that an individual may be having.

3.     Overnight sleep study

When a patient complains of non-restorative sleep, studies are carried out to identify any underlying sleep disorder. Sleep disorders, such as sleep apnea, interrupt one’s sleep leading to fatigue. In an overnight sleep study, the different elements that are related to sleep, including brain waves, breathing, and muscle activity are examined to identify any abnormalities.

4.     Exercise stress test

An exercise stress test involves intense exercises during which the response of the heart is recorded and examined. The test shows how the heart is functioning and is used to identify cardiovascular diseases. The common exercise stress test involves running on a treadmill with an electrocardiogram (EKG) machine attached to monitor the heart rate.

Treatment

Fatigue often occurs as a symptom of an underlying health condition and, therefore, the medical treatment options available are dependent on the underlying cause.  There is no specific medication for fatigue, thus doctors prescribe medication for treating the causal illnesses. For example, sleep apnea is treated using positive air pressure machines and surgery, diabetes is treated using medications to control the blood sugar levels, UTIs are treated using antibiotics, and iron supplements are used to treat anemia.

Alternative non-medical options of treatment

1.     Losing weight

People who have excess body fat are more susceptible to fatigue. The excess weight makes it difficult to perform daily activities and the person gets tired easily. One can lose weight by exercising regularly and eating healthy foods.

2.     Quit smoking

Smoking is associated with many health conditions and is known to lower a person’s quality of life. Nicotine is a stimulant, thus can help a person to stay alert and more active. It, however, masks exhaustion. Thus when the stimulant’s effects end, the person feels tired and lacks motivation. Smoking also aggravates sleep disorders, such as sleep apnea, thus causing sleep disturbances. Avoiding smoking, both active and passive (second-hand smoke), can improve a person’s quality of life and reduce fatigue.

3.     Don’t take alcohol

Alcohol has sedative effects, thus relaxes the muscles in the body. Relaxed muscles in the respiratory system can block the movement of air leading to sleep disturbances. Alcohol also increases the bathroom trips taken because it is a diuretic. The frequent trips to the bathroom interrupt one’s sleep, and the loss of liquid through urination causes dehydration. The person gets dehydrated and does not get enough sleep, thus leading to fatigue. Avoiding alcohol can prevent fatigue and help the person to be more active.

4.     Iron supplements

Iron is one of the components in the red blood cells. It, therefore, helps in the transport of oxygen throughout the body. A deficiency in iron reduces the amount of oxygen in the body and causes fatigue. Taking iron supplements can help increase the iron levels in the body, thus prevent a lack of oxygen.

5.     OTC sleep supplements

A good night time sleep is restorative and helps people to feel refreshed at the start of a wakeful episode. Hence, poor night time sleep can cause fatigue and tiredness during the day. One can take OTC sleep supplements to help get adequate sleep at night to feel adequately relaxed through the night and energetic during the day. Melatonin pills are common sleep supplements as they boost the hormone’s levels in the body leading to uninterrupted sleeping episodes.

6.     Proper nutrition

Consuming healthy foods can help one to feel more energetic, thus preventing fatigue. Some food groups that can help with fatigue are:

a.      Starchy carbohydrates

Starchy carbohydrates are a healthy source of energy and essential nutrients. Commonly available starchy carbohydrates are:

  •         Brown rice
  •         Potatoes
  •         Pasta
  •         Bread

b.      Iron-rich foods

The lack of iron leads to iron-deficiency anemia that causes fatigue. Iron can be obtained through foods that are rich in iron, including:

  •         Red meat
  •         Green leafy vegetables
  •          Wholegrains
  •         Nuts
  •          Beans

Conclusion

Fatigue is a condition in which the individual lacks the energy and motivation to carry out daily activities. It is commonly associated with many health problems including obesity, diabetes, chronic fatigue syndrome, allergies, depression, rheumatoid arthritis, anemia, and urinary tract infections. Fatigue commonly occurs as a symptom of other health conditions and is rarely an independent condition. It can occur as either physical, mental, or metabolic fatigue, depending on the part of the body that it affects. The diagnosis of the condition involves identifying the underlying cause of the problem. Blood tests, immunological tests, sleep studies, and exercise stress tests are used to determine the cause of one’s fatigue. The treatment is also aimed at the underlying causes, because there is no specific treatment for fatigue. One can also manage fatigue by avoiding alcohol, quitting smoking, losing weight, getting sufficient sleep, and using supplements that increase energy or enhance sleep quality.

 


 

Looking For Help With Night Terrors?

Have you ever fell asleep during a flight only to wake up to neck cramps? Bad habits, poor posture, gritting your teeth, pinched nerves, whiplash, tumors and arthritis can all be contributing factors to why you may be suffering from neck cramps. If its not a underlying health condition then there’s a simple fix, especially if you only suffer from neck pains, aches and cramps during your flights.

 

An innovative and easy solution is to simply invest into the best travel neck pillow for airplanes. But, with so many products available cluttering the marketplace things can get confusing pretty fast, especially when trying to select the best travel neck pillow that’s right for you. But don’t worry we got you covered there too!

We’ve compiled a comprehensive recommendation list for the best travel neck pillows you can find on the market, which has undergone our extensive evaluation process from our panel of experts and quality assurance. Therefore, you can alleviate your neck aches and pains during your travels and sleep comfortably.

 

 

Cloudz Dual Comfort Microbead Travel Neck Pillow
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Some women during pregnancy struggle with restlessness or insomnia. After all, caring for another human being literally inside you can be physically draining. Not all pillows are made equal and you can’t just buy an ordinary pillow to help you sleep, thus, you need to look into a specialized pillow designed for pregnant women. But with so much pillows for pregnant woman on the market how do you know which one is best for you and your little one? The good news is we got you covered there!

We’ve compiled our recommendation list with the best pillows for pregnancy available on the market which have the best manufacturing quality, upgraded features and advanced technology.

We’ve done the hard work for you so you and your baby can sleep comfy. Each product on our recommendation list has gone through our extensive evaluation process, panel of experts, and quality assurance. Therefore, for the sake of both you and your baby’s health you need to look into investing into the best pillow possible, so, that you can alleviate your restlessness, aches, pains and find a good night’s sleep that every mother deserves.

 

 

PharMeDoc Pregnancy Pillow with Jersey Cover

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PharMeDoc Pregnancy Pillow, U-Shape Full Body Maternity Pillow

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Meiz Pregnancy Pillow with Jersey Cover

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INSEN Pregnancy Pillow

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Queen Rose U Shaped Pregnancy Body Pillow

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Full Body Pregnancy Pillow

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COMFYSURE Pregnancy Pillow

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AngQi Pregnancy U shape Pillow

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Restorology Full Body Pregnancy Pillow

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NiDream Bedding Premium U Shape Pregnancy Pillow

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Other Key Points of Consideration

 

Support: Your pillow should be comforting to both you and your baby on board. A pregnancy pillow is not an ordinary pillow, however, specialized for multipurpose maternity use, and should support neck, back, hips, knees and head. They should be fully adjustable and adapt to your belly and back when to read, watch T.V or sleep. These pillow should help alleviate your trimester pains and any other aches that you may be experiencing.

 

Flexibility: Pregnancy pillows are designed to be flexible to meet your needs and activities you may participate in. Whether you’re reading, watching T.V or trying to fall asleep you need a pillow that can contour, support, and provide flexibility. Look for something plush, comfy and supportive, however, it has bee reported pillows that are too firm are rigid and lack flexibility. Thus, keep in mind you want a pillow that’s firm, but not so much that it will hinder flexibility.

 

Materials: The pillows on our recommendation list are made with the highest-grade materials on the market. Therefore, you can rest assure you’re investing into top quality products. As for materials, usually, pregnancy pillows are made from high-density memory foam, natural bamboo and other synthetic materials such as poly-fiber, or bionic polyethylene.

 

Budget: You don’t want to cheap out on a pregnancy pillow and should consider it an investment. Afterall you will be using it at one of the most important stages of your life, pregnancy, when your precious baby is most vulnerable, therefore, you want to invest into a quality pillow than can aid you in your sleep, alleviate trimester pains, and bring both you and your baby comfort. Remember you’re not just buying for yourself, but for your baby too! These are not ordinary pillows and therefore will cost a bit more, and are specifically designed for women who are pregnant.

 

 

Having Trouble Sleeping During Pregnancy? Here Are Some Helpful Sleep Tips…

 

Meditation – Clearing the mind from your daily troubles, stress, and conflicts is what a lot of people don’t do. When going to sleep the average person has a million in one things going on in their mind, from your kids, spouse, bills to pay, chores and of course work. The truth is its not healthy going to bed with such burdens on your mind as this creates stress, and an environment not conducive to sleep.

 

Simply close your eyes, empty your mind, and focus on resting and relaxation. It might be tempting to think about an upcoming event or chore, but you need to practice leaving your burdens and stresses behind when you fall asleep. After all sleep is a sacred time where your body is rejuvenating, healing itself, and self-repairing. Live by the motto “let tomorrow worry about itself” because absolutely nothing should hinder you from a good night’s sleep that everyone deserves!

 

Sleep early – Don’t be a night owl!  Have you taken our sleep quiz to find out what type of sleeper you are? If you have you might have been categorized as a night owl, which means you need to fall asleep earlier instead of worrying, watching Netflix, browsing social media and staying up late.

The average person needs between 7 – 9 hours of sleep! Now the truth is this varies from person to person and there is no cookie-cutter answer for how much hours of sleep you need because everyone’s physiology works a bit differently. But generally speaking, the sweet spot is between 7-8 hours, which will give you an adequate sleep to function optimally.

 

A good rule of thumb is trying your best to sleep before midnight. Most people have to wake up early and may have obligations to take care of in the morning, such as taking your kids to school and of course your job. Therefore, it would be prudent to sleep early, so, you can get an adequate night’s sleep and feel refreshed and energized in the morning.

 

Remove distractions – This is a huge one! If you have electronic devices such as T. Vs, video game consoles, and of course your smart phone, then you may find yourself using them during the nighttime hours when you should be fast asleep! You’ve probably told yourself “only 5 more minutes, than I’ll sleep”, but then end up staying up late for several hours beyond midnight.

 

Did you know the artificial blue lightproduced by most our electronic devices such as smart-phones, laptops and even T.Vs can really mess with our sleep hormones and throw them off balance? That’s why you may find it harder to sleep after using your electronic devices because it disrupts sleep hormones, such as melatonin, increases alertness, and resets our bodies internal clocks.

 

Even LED lights emit blue light which can hamper your sleep. A good idea maybe cover your electronic devices’ LEDs with electric tape or a cloth at night or turn them off if possible. Also, this maybe a little extreme but even moving certain “distractions” like your T.V out of your room or wherever you sleep, so, you don’t get tempted to flick through channels at night. The same goes for your phone, perhaps put it on airplane mode? Or if it proves to be too much of a distraction for you move where it’s not accessible or at the least put it on silent.

 

 

Eat Healthy – Here at Sleepcomfynow.com we are huge advocates on holistic health. Our philosophy supports the healthy mind and body connection, there is a duality between the two, and hence it’s important to watch what you eat!

 

Refrain from eating processed, refined carbs and junk foods. Rather opt into foods that are minimally processed and are as close to natural as possible. A great example of this would be sushi, you can easily break down the ingredients, rice, vegetables, and fish. Eat lean meats (chicken or fish), make sure you grill, or oven bake them slowly at 350 Fahrenheit. Do not fry your meats.

 

Incorporate leafy green salads, both colorful fruits and vegetables, and even add in some nuts if you have no allergies. Additionally, you may want to eat fermented foods or supplement with probiotics. Take care of your gut and it will take care of you! You want to have a good balance health gut flora to have excellent digestion and smooth bowel movements.

 

The truth is eating unhealthy foods can affect your sleep and keep you awake at night. For instance, eating foods that are ranked high in the glycemic index (GI) can drastically spike your blood glucose levels, and give you that “sugar rush” or “high”, which is the last thing you want before going to sleep. The glycemic index is simply a measure of how food affects the elevation of blood sugar levels, from a scale of 0 to 100. The lower the number the better. Foods that are heavily processed, refined carbs and even junk foods rank very high on the GI.

 

Best Pillow for Pregnant Women Details

 

PharMeDoc Pregnancy Pillow with Jersey Cover


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  • Multi-purpose use
  • Alleviates trimester pains
  • Different color options available
  • Lifetime manufacturer warranty
  • Includes travel bag

 

 

PharMeDoc Pregnancy Pillow, U-Shape Full Body Maternity Pillow

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  • U-shaped body pillow
  • Detachable and solid body options available
  • Machine washable cover
  • Lifetime manufacture warranty
  • Removable velvet zipper cover

 

 

 

Meiz Pregnancy Pillow with Jersey Cover


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  • Extra soft
  • Retains fluffiness and integrity
  • Cooling jersey cover (Machine washable)
  • Easy to clean
  • Premium polyester stuffing
  •  No odor

 

 

 

INSEN Pregnancy Pillow


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  • C-shaped
  • Cotton filling
  • Multifunction pillow
  • Full body support pillow

 

 

 

Queen Rose U Shaped Pregnancy Body Pillow


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  • Ergonomic design
  • Versatile
  •  Pain relief
  • U-shaped body pillow
  • Machine washable satin cover

 

 

 

Full Body Pregnancy Pillow


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  • Removable cover
  • Detachable sides
  • Bonus ergonomic pillow
  • Adjustable

 

 

COMFYSURE Pregnancy Pillow


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  • U-shaped full body pillow
  • Hypoallergenic pillow
  • Multifunctional
  • Machine washable
  •  Relieves pressure
  • Supports proper breathing

 

 

 

AngQi Pregnancy U shape Pillow


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  • Full body U shaped cover
  • Premium cotton filling
  • Multifunctional
  • 60-day manufacture warranty
  • Ergonomic design

 

 

Restorology Full Body Pregnancy Pillow


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  • C shaped pillow
  • Washable cover
  • Easy to clean

 

 

 

NiDream Bedding Premium U Shape Pregnancy Pillow


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  • Removable cotton cover
  • U-shape design
  • Multifunctional use
  • Improves blood circulation
  • Relieves aches and pain

 

 

Final Thoughts

You have that precious little one on the way and probably have tons of ideas on how you and your partner going to raise your beautiful baby from naming him/her, toys, and places you will visit. But before you get to that point on your journey, you need to ensure that your baby while in your womb during pregnancy has the best care possible, especially when it comes to sleeping.

Every mother knows when you’re pregnant it’s no longer only about you! You have a baby on board and need to do your best to ensure that baby is comfortable, rested and healthy prior to giving birth. What you eat, your emotional state or mood, and even how you sleep will have an effect on your baby.

 

Looking For The Best Travel Neck Pillows?

Aromatherapy is getting a lot of buzz lately and is a rapidly expanding trend worldwide. Let’s face it scents are powerful they can trigger memories of places, people or things, and also help promote better sleep. This is considered an alternative health practice using essential oils, which through an oil diffuser are dispersed into the air, picked up by our noses and enters our nasal cavity, then relayed to our brain.

Essential oils have calming and relaxation properties which make them ideal for promoting sleep. Usually, lavender, lemongrass, frankincense, peppermint or a blend of different essential oils are used with oil diffusers. Now as potent as essential oils are they  are only as effective as the device used to administer them, oil diffusers, which are responsible for dispersing the oils into the air so that they can be relayed through your nasal cavities to your brain, and promote soothing calmness and relaxation, which aids with sleep.

 

Therefore, if you want to use aromatherapy as an alternative health solution (instead of harsh pharmaceutical drugs) to your sleepless nights or if you wrestle with insomnia, then you will need to invest into a quality oil diffuser.

Don’t worry we got you covered there too! We’ve compiled a list of our top recommendations for the best oil diffusers for sleep you can find on the market. Each product has been proven and tested, evaluated by our panel of experts, and gone through our quality assurance. Below you can take a quick look at our top recommendations on our list.

 

Our Top Recommendations – Best Oil Diffuser Details

 

 

 

Vitruvi Stone Diffuser, Ceramic Ultrasonic Essential Oil Diffuser

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