Sleep disorders (inability to fall asleep or maintain sleep) are an epidemic problem in the United States.

According to the National Sleep Foundation, 30% of Americans experience disrupted sleep, and another 10% struggle with sleep disorders. The Centers for Disease Control and Prevention (CDC) estimates that more than a third of American adults don't get the recommended seven hours of sleep a night. Older people and those with chronic illnesses are especially prone to sleep disorders. Adults should get about seven to eight hours of sleep per night for optimal health.

Sleep is essential for learning and memory formation, emotional wellbeing, physical growth and development, immune function, and cardiovascular health. Sleep is also an integral part of the cellular repair process that helps regulate insulin and other hormones that control appetite. Lack of sleep can greatly reduce a person's quality of life. Sleep deprivation also increases the risk of a variety of health problems, including cardiovascular disease, depression and obesity. Sleep disorders can cause a variety of symptoms, such as feeling unwell after waking up, daytime fatigue, irritability, frustration or anxiety, excessive restlessness in sleep, difficulty completing school or work tasks and an increased risk of accidents, especially traffic accidents.

Despite the large number of people with sleep disorders, traditional treatments are still far from ideal. For example, popular hypnotic sleep AIDS such as zolpitam (Ambien), Esopicron (Lunesta), and temazepam (Restoril) have been significantly associated with the risk of death and other serious adverse effects. However, people who used the medical sleep aid generally had poorer sleep quality overall, which could explain some of the association. These shocking findings highlight the need for safe and effective strategies to improve sleep quality, especially when as many as 10% of U.S. adults use hypnotic sleep AIDS.

Hypnotic sleep AIDS by no means cure chronic sleep disorders. In this article, you'll learn what causes sleep problems and simple lifestyle changes to improve your sleep quality. You'll also discover emerging therapies that can improve sleep quality over the long term with fewer side effects than some popular sleep AIDS. In addition, you'll learn about some natural compounds that regulate sleep rhythms, which may be safer than some drug treatment options. Generally speaking, there are two types of sleep disorders: narcosleep disorder - difficulty falling asleep maintenance sleep disorder - difficulty maintaining sleep. Both narcolepsy and maintenance sleep disorders can be acute or chronic.

Acute sleep disorders are often associated with disruptive or stressful life events and usually resolve without treatment within a few weeks. Approximately 30 to 50 percent of people in industrialized countries experience periodic acute sleep disturbances. Some conditions last only a few days and can be described as transient sleep disorders. Chronic sleep disorders are longterm difficulty sleeping at least three nights a week for at least three months. Chronic sleep disorders are the type associated with longterm health problems and account for about 510% of the population. Finally, sleep disorders can be described as primary or secondary. Primary sleep disorders occur without any obvious underlying cause.

Secondary sleep disorders, which can be described as comorbid sleep disorders, are due to another condition or disease. For example, people with chronic back pain may be unable to sleep due to the constant discomfort. To diagnose a sleep disorder, your doctor will perform a physical examination to determine any underlying medical cause of the sleep problem, including blood tests to rule out thyroid disease. In addition, a detailed sleep questionnaire or sleep diary can shed light on the patient's sleepwake pattern and degree of sleepiness during the day and night. For other signs of sleep disorders, such as sleep apnea, patients may need a sleep study, a test that monitors and records physical activity (including brain waves, breathing, heartbeat, and eye and body movements) during sleep. Risk factors for sleep disorders include being female, having a previously diagnosed mental or physical health condition, being older than 60 years, being stressed, using certain medications (such as stimulants), and having irregular sleep schedules.

1. Sex and Hormones Due to the hormonal changes of menstruation, pregnancy and menopause, women are more likely to suffer from sleep disorders than men. Sex hormones (e.g., estrogen, progesterone, and testosterone) can seriously affect sleep, especially in women. As many as 61% of postmenopausal women report symptoms of sleep disorders. Studies have shown that hormone replacement therapy for menopausal women significantly improves sleep. Sleep disturbances are associated with reduced testosterone levels in both men and women. In a cohort study of more than 1,300 men over age 65, subjects with lower testosterone levels had increased sleep inefficiency (time spent in bed as a percentage of sleep) and nighttime awakenings, although this association was largely driven by being overweight.

Obesity and abdominal obesity are associated with low testosterone levels in men and, in turn, low testosterone may also promote obesity. Low testosterone levels may also contribute to poor overall sleep quality, which may be improved with moderate testosterone replacement therapy. Lower serum testosterone levels are associated with more severe OSA. Osa is most common in middleaged men, especially those who are overweight. People with obstructive sleep apnea have increased nighttime awakeners, fragmented sleep, reduced sleep efficiency, and reduced rapid eye movement (REM) sleep, which in turn may reduce testosterone levels. More research is needed to understand the causal link between sleep quality and testosterone levels, especially in people who are older or obese and in people with chronic medical conditions.

2. Obstructive Sleep ApneaA hidden epidemic with Deadly consequences Obstructive sleep apnea is a common but often overlooked sleep disorder that can cause breathing to stop and restart during sleep. Soft tissue near the throat relaxes and blocks the airways, reducing oxygen flow. The resulting low oxygen levels in the blood can wake individuals up, leading to disrupted sleep (even if they don't fully remember waking up).

This pattern can be repeated between 5 and 30 times per hour throughout the night. More than 18 million Americans suffer from obstructive sleep apnea, which causes poor quality sleep, snoring, mood instability and fatigue. Sleep apnea is a leading risk factor for cardiovascular disease, the leading cause of death among adults in the United States. Sleep apnea has also been linked to obesity. Obstructive sleep apnea is associated with a 68% increase in coronary heart disease in men and may also be associated with elevated cholesterol levels, high blood pressure, type 2 diabetes, cancer death, stroke and death.

3. Mental Health Sleep disorders can be a symptom of and a cause of many mental health problems, including anxiety, depression, schizophrenia, ADHD and bipolar disorder. People with untreated sleep disorders are two to 10 times more likely to develop a new or recurrent depression. A longitudinal study of people aged 65 years and older in Japan found a statistically significant bidirectional relationship between sleep disorders and the occurrence of depression. Studies have shown that sleep disorders are also a risk factor for anxiety disorders and substance abuse. In a longitudinal study of adolescents, sleep disorder symptoms were associated with alcohol use, cannabis, illicit drugs, and suicidal ideation and attempts. Sleep disorders have also been linked to certain personality traits, such as social introversion and depression.

A randomized controlled study found that those who were sleep deprived showed more affective responses to unpleasant images than those who were not sleep deprived, suggesting that sleep plays an important role in affective responses. In another controlled study of 14 people with chronic primary sleep disorders, participants underwent MRI scans during an emotion regulation task that showed negative or neutral images. They were asked to either view the image or use cognitive reappraisal techniques (in which you work to interpret the image as less negative in order to make you feel better about the image you are viewing) to reduce their emotional reactions. People with sleep disorders show higher levels of activity in the emotionprocessing regions of the brain, suggesting that they suffer from dysfunction in neural circuits that affect their ability to regulate emotions.

Psychophysiological sleep disorders are a common type of chronic sleep disorders that can be difficult to treat. It seems to be associated with high cortical arousal during sleep. Psychophysiological sleep disorders are associated with excessive anxiety at bedtime, especially excessive worry about not being able to fall asleep. People with the disease have trouble relaxing when they fall asleep, leading to thoughts of racing. They often focus on the difficulty of falling asleep, which can lead to more anxious feelings and further disturb sleep.

Over time, poor sleep and worries about sleep can be associated with sleep disorders, leading to a longterm poor sleep pattern that affects daytime activities. Some believe that in addition to emotional arousal, people with psychophysiological sleep disorders may also have dysfunctional neural inhibitory mechanisms that normally help the brain "disconnect" from daytime thought patterns. Treatments for psychophysiological sleep disorders include good sleep hygiene, no napping during the day, limiting caffeine intake, cognitive behavioral therapy, and methods to address worries (such as keeping a diary or making a list of problems). A recent longitudinal case series of 60 subjects found that psychiatric comorbidities were strongly associated with negative treatment outcomes for people with psychophysiological sleep disorders, with those with stronger social support and cognitive coping skills most successful at treatment.

4. Health Conditions Certain health conditions may disrupt sleep and increase the risk of sleep disorders. These include chronic pain, asthma, heart failure, stroke, gastrointestinal disorders and an overactive thyroid.

5. Age Most adults over the age of 65 need about seven to nine hours of sleep a night. However, people in this age group often struggle with sleep disorders. A poll by the National Sleep Foundation found that one in five adults between the ages of 55 and 84 have trouble falling asleep, and one in four of those have woked up a few days earlier each week over the past year.

It is known that sleep efficiency declines after the age of 60. Sleep disorders have been linked to epigenetic aging, which reflects a person's biological age based on DNA methylation. A review of the data by the Women's Health Initiative determined that sleep disorder symptoms were associated with an earlier epigenetic age of blood tissue and an increased number of latedifferentiated T cells, immune cells that trigger inflammatory responses. These results suggest that sleep duration accelerates aging.

6. Drugs and Stimulants A wide variety of prescription drugs can affect sleep patterns, and drowsiness is one of the most common side effects of drug use. Druginduced sleep disorders can be caused by a variety of medications, including hyperemic agents, diuretics, antihistamines, monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), corticosteroids, chemotherapeutic agents, calcium channel blockers, betaagonists, and theophylline. While some medications may cause sleep disorders, others can disrupt sleep patterns or cause daytime sleepiness. In addition, overthecounter medications, such as painkillers, allergy medications, cold medicines and weightloss products, may contain stimulants that cause sleep disturbances. Talk to your doctor if you think medications may be interfering with your sleep.

They may change other medications or modify the dose of your current medication. Caffeine is one of the most widely used stimulants in the world. Caffeine is most commonly found in coffee and other beverages to combat drowsiness and improve performance. Stimulants make it harder for the brain to achieve the relaxed state it needs for sleep. Caffeine's halflife (the time it takes for the body to break down 50% of a dose) ranges from three to seven hours; Large and/or repeated doses of caffeine can cause caffeine clearance to slow down, which can cause the effects to last longer. As a result, caffeine consumption eats up hours of sleep. In a national survey that assessed caffeine consumption and difficulty falling and staying asleep, nonrestorative sleep volume, daytime sleepiness, and the typical amount of sleep obtained per night, caffeine consumption was associated with sleep disorder symptoms, particularly daytime sleepiness. Randomized controlled trials and epidemiological studies have found that caffeine prolongs sleep latency (the time it takes to transition from wakefulness to sleep), reduces total sleep time and sleep efficiency, and worsens perceived sleep quality. Older people may be more sensitive to the effects of caffeine. Most studies show that moderate caffeine intake in the morning does not impair sleep.

8. Nicotine and smoking. The use of nicotine and nicotine replacement therapy and nicotine withdrawal can lead to sleep disorders. One study analyzed 29 years of data from children and adults in a community study classified as heavy/persistent smokers, late smokers, episodic smokers, quitters/reduced smokers, and nonsmokers to assess the prevalence of sleep disorders. The study found that chronic smokers were more likely to have sleep disorder symptoms later in life. Another study of more than 83,000 people from the Behavioral Risk Factor Surveillance System showed that current smokers or smoeless tobacco users were twice as likely to be sleepdeprived as nonsmokers, independent of age, sex, race, alcohol use and body mass index (BMI). Sleep deprivation was also associated with secondhand smoke exposure among people who had never smoked or who had quit.

9. Alcohol Although most people think of alcohol as a depressant, it acts as a stimulant by increasing dopamine release in the brain. Chronic alcohol use is associated with sleep disorders, as is abstinence. More than 60 studies have shown that two to three glasses of wine before bed can promote sleep, but the effect diminishes after three days. Sleep disorders are common in alcoholics and are often associated with the recurrence of sleep disorders. A study of the prevalence of sleep disorders in 302 people with alcohol dependence in a treatment program in Poland found that more than 60% had symptoms of sleep disorders, with delayed onset of sleep as the most common symptom. A history of child abuse, poor health and alcohol abuse severity were predictors of sleep disorders in this group. The longitudinal outcomes study included 267 subjects with alcohol dependence problems and found that 47% of subjects were classified as having a sleep disorder at baseline. Abating alcohol or reducing alcohol intake reduced reported sleep disturbances, although sleep disorders persisted in 60% of cases, particularly in cases of severe sleep disturbances. Alcohol treatment plans should include sleep disorder assessments during treatment to help focus care and prevent relapse.

10. Stress People under stress often struggle with sleep disorders. Worries about financial, work, school, and family issues can lead to emotional hyperactivity and make it difficult to relax into restful sleep. People who are prone to cognitive and emotional hyperactivity may be more prone to stress-related sleep disorders, a study suggests.

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