melatonin

Sleep is a complex biological process. While you are sleeping, you are unconscious, but your brain and body functions are still active. They are doing a number of important jobs that help you stay healthy and function at your best. So when you don't get enough quality sleep, it does more than just make you feel tired. It can affect your physical and mental health, thinking, and daily functioning.

Sleep disorders are conditions that disturb your normal sleep patterns. There are more than 80 different sleep disorders. Some major types include:

• Insomnia - being unable to fall asleep and stay asleep. This is the most common sleep disorder.
• Sleep apnea - a breathing disorder in which you stop breathing for 10 seconds or more during sleep
• Restless leg syndrome (RLS) - a tingling or prickly sensation in your legs, along with a powerful urge to move them
• Hypersomnia - being unable to stay awake during the day. This includes narcolepsy, which causes extreme daytime sleepiness.
• Circadian rhythm disorders - problems with the sleep-wake cycle. They make you unable to sleep and wake at the right times.
• Parasomnia - acting in unusual ways while falling asleep, sleeping, or waking from sleep, such as walking, talking, or eating

Some people who feel tired during the day have a true sleep disorder. But for others, the real problem is not allowing enough time for sleep. It's important to get enough sleep every night. The amount of sleep you need depends on several factors, including your age, lifestyle, health, and whether you have been getting enough sleep recently. Most adults need about 7-8 hours each night.

There are different causes for different sleep disorders, including:

• Other conditions, such as heart disease, lung disease, nerve disorders, and pain
• Mental illnesses, including depression and anxiety
• Medicines
• Genetics

Sometimes the cause is unknown.

There are also some factors that can contribute to sleep problems, including:

• Caffeine and alcohol
• An irregular schedule, such as working the night shift
• Aging. As people age, they often get less sleep or spend less time in the deep, restful stage of sleep. They are also more easily awakened.

The symptoms of sleep disorders depend on the specific disorder. Some signs that you may have a sleep disorder include that:

• You regularly take more than 30 minutes each night to fall asleep
• You regularly wake up several times each night and then have trouble falling back to sleep, or you wake up too early in the morning
• You often feel sleepy during the day, take frequent naps, or fall asleep at the wrong times during the day
• Your bed partner says that when you sleep, you snore loudly, snort, gasp, make choking sounds, or stop breathing for short periods
• You have creeping, tingling, or crawling feelings in your legs or arms that are relieved by moving or massaging them, especially in the evening and when trying to fall asleep
• Your bed partner notices that your legs or arms jerk often during sleep
• You have vivid, dreamlike experiences while falling asleep or dozing
• You have episodes of sudden muscle weakness when you are angry or fearful, or when you laugh
• You feel as though you cannot move when you first wake up

To make a diagnosis, your health care provider will use your medical history, your sleep history, and a physical exam. You may also have a sleep study (polysomnogram). The most common types of sleep studies monitor and record data about your body during a full night of sleep. The data includes:

• Brain wave changes
• Eye movements
• Breathing rate
• Blood pressure
• Heart rate and electrical activity of the heart and other muscles

Other types of sleep studies may check how quickly you fall asleep during daytime naps or whether you are able to stay awake and alert during the day.

Treatments for sleep disorders depend on which disorder you have. They may include:

• Good sleep habits and other lifestyle changes, such as a healthy diet and exercise
• Cognitive behavioral therapy or relaxation techniques to reduce anxiety about getting enough sleep
• CPAP (continuous positive airway pressure) machine for sleep apnea
• Bright light therapy (in the morning)
• Medicines, including sleeping pills. Usually, providers recommend that you use sleeping pills for a short period of time.
• Natural products, such as melatonin. These products may help some people but are generally for short-term use. Make sure to check with your health care provider before you take any of them.

Insomnia is a common sleep disorder. If you have it, you may have trouble falling asleep, staying asleep, or both. As a result, you may get too little sleep or have poor-quality sleep. You may not feel refreshed when you wake up.

Insomnia can be acute (short-term) or chronic (ongoing). Acute insomnia is common. Common causes include stress at work, family pressures, or a traumatic event. It usually lasts for days or weeks.

Chronic insomnia lasts for a month or longer. Most cases of chronic insomnia are secondary. This means they are the symptom or side effect of some other problem, such as certain medical conditions, medicines, and other sleep disorders. Substances such as caffeine, tobacco, and alcohol can also be a cause.

Sometimes chronic insomnia is the primary problem. This means that it is not caused by something else. Its cause is not well understood, but long-lasting stress, emotional upset, travel and shift work can be factors. Primary insomnia usually lasts more than one month.

Insomnia is common. It affects women more often than men. You can get it at any age, but older adults are more likely to have it. You are also at higher risk of insomnia if you:

• Have a lot of stress
• Are depressed or have other emotional distress, such as divorce or death of a spouse
• Have a lower income
• Work at night or have frequent major shifts in your work hours
• Travel long distances with time changes
• Have an inactive lifestyle
• Are African American; research shows that African Americans take longer to fall asleep, don't sleep as well, and have more sleep-related breathing problems than Whites.

Symptoms of insomnia include:

• Lying awake for a long time before you fall asleep
• Sleeping for only short periods
• Being awake for much of the night
• Feeling as if you haven't slept at all
• Waking up too early

Insomnia can cause daytime sleepiness and a lack of energy. It also can make you feel anxious, depressed, or irritable. You may have trouble focusing on tasks, paying attention, learning, and remembering. Insomnia also can cause other serious problems. For example, it could make you feel drowsy while driving. This could cause you get into a car accident.

To diagnose insomnia, your health care provider:

• Takes your medical history
• Asks for your sleep history. Your provider will ask you for details about your sleep habits.
• Does a physical exam, to rule out other medical problems that might cause insomnia
• May recommend a sleep study. A sleep study measures how well you sleep and how your body responds to sleep problems.

Treatments include lifestyle changes, counseling, and medicines:

• Lifestyle changes, including good sleep habits, often help relieve acute (short-term) insomnia. These changes might make it easier for you to fall asleep and stay asleep.
• A type of counseling called cognitive-behavioral therapy (CBT) can help relieve the anxiety linked to chronic (ongoing) insomnia
• Several medicines also can help relieve your insomnia and allow you to re-establish a regular sleep schedule

If your insomnia is the symptom or side effect of another problem, it's important to treat that problem (if possible).

NIH: National Heart, Lung, and Blood Institute

Seasonal affective disorder (SAD) is a type of depression that comes and goes with the seasons. It usually starts in the late fall and early winter and goes away during the spring and summer. Some people do have episodes of depression that start in the spring or summer, but that is a lot less common. Symptoms of SAD may include:

• Sadness
• Gloomy outlook
• Feeling hopeless, worthless, and irritable
• Loss of interest or pleasure in activities you used to enjoy
• Low energy
• Difficulty sleeping or oversleeping
• Carbohydrate cravings and weight gain
• Thoughts of death or suicide

SAD is more common in women, young people, and those who live far from the equator. You are also more likely to have SAD if you or your family members have depression.

The exact causes of SAD are unknown. Researchers have found that people with SAD may have an imbalance of serotonin, a brain chemical that affects your mood. Their bodies also make too much melatonin, a hormone that regulates sleep, and not enough vitamin D.

The main treatment for SAD is light therapy. The idea behind light therapy is to replace the sunshine that you miss during the fall and winter months. You sit in front of a light therapy box every morning to get daily exposure to bright, artificial light. But some people with SAD do not respond to light therapy alone. Antidepressant medicines and talk therapy can reduce SAD symptoms, either alone or combined with light therapy.

NIH: National Institute of Mental Health