Sleep Disorders

 Types

 Symptoms

 Causes

 Diagnosis

 Treatment

 Outlook

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You may have a sleep disorder if you regularly have sleeping problems. They can also result from underlying conditions such as

insomnia and sleep apnea, among others.

Sleep disorders are a group of conditions that affect the ability to sleep well on a regular basis. Whether they are caused by a health

problem or by too much stress, sleep disorders are becoming increasingly common in the United States.

In fact, more than one-third of adultsTrusted Source in the United States report getting fewer than 7 hours of sleep in a 24-hour

period. More than 70 percentTrusted Source of high school students report getting fewer than 8 hours of sleep on weeknights.

Most people occasionally experience sleeping problems due to stress, hectic schedules, and other outside influences. However,

when these issues begin to occur on a regular basis and interfere with daily life, they may indicate a sleeping disorder.

Depending on the type of sleep disorder, people may have a difficult time falling asleep and may feel extremely tired throughout the

day. The lack of sleep can have a negative impact on energy, mood, concentration, and overall health.

In some cases, sleep disorders can be a symptom of another medical or mental health condition. These sleeping problems may

eventually go away once treatment is obtained for the underlying cause.

When sleep disorders aren’t caused by another condition, treatment normally involves a combination of medical treatments and

lifestyle changes.

It’s important to receive a diagnosis and treatment right away if you suspect you might have a sleep disorder. When left untreated,

the negative effects of sleep disorders can lead to further health consequences.

They can also affect your performance at work, cause strain in relationships, and impair your ability to perform daily activities.

What are the different types of sleep disorders?

There are many different types of sleep disorders. Some may be caused by other underlying health conditions.

Insomnia

Insomnia refers to the inability to fall asleep or to remain asleep. It can be caused by jet lag, stress and anxiety, hormones, or

digestive problems. It may also be a symptom of another condition.

Insomnia can be problematic for your overall health and quality of life, potentially causing:

 depression

 difficulty concentrating

 irritability

 weight gain

 impaired work or school performance

Unfortunately, insomnia is extremely common. Up to 50 percent of American adults experience it at some point in their lives.

The disorder is most prevalent among older adults and women.

Insomnia is usually classified as one of three types:

 chronic, when insomnia happens on a regular basis for at least 1 month

 intermittent, when insomnia occurs periodically

 transient, when insomnia lasts for just a few nights at a time

Sleep apnea

Sleep apnea is characterized by pauses in breathing during sleep. This is a serious medical condition that causes the body to take

in less oxygen. It can also cause you to wake up during the night.

There are two types:

 obstructive sleep apnea, where the flow of air stops because airway space is obstructed or too narrow, and

 central sleep apnea, where there is a problem in the connection between the brain and the muscles that control your

breath.

Parasomnias
Parasomnias are a class of sleep disorders that cause abnormal movements and behaviors during sleep. They include:

 sleepwalking

 sleep talking

 groaning

 nightmares

 bedwetting

 teeth grinding or jaw clenching

Restless leg syndrome

Restless leg syndrome (RLS) is an overwhelming need to move the legs. This urge is sometimes accompanied by a tingling

sensation in the legs. While these symptoms can occur during the day, they are most prevalent at night.

RLS is often associated with certain health conditions, including attention deficit hyperactivity disorder (ADHD) and Parkinson’s

disease, but the exact cause isn’t always known.

Narcolepsy

Narcolepsy is characterized by “sleep attacks” that occur while awake. This means that you will suddenly feel extremely tired and

fall asleep without warning.

The disorder can also cause sleep paralysis, which may make you physically unable to move right after waking up. Although

narcolepsy may occur on its own, it is also associated with certain neurological disorders, such as multiple sclerosis.

What are the symptoms of sleep disorders?

Symptoms differ depending on the severity and type of sleeping disorder. They may also vary when sleep disorders are a result of

another condition.
However, general symptoms of sleep disorders include:

 difficulty falling or staying asleep

 daytime fatigue

 strong urge to take naps during the day

 unusual breathing patterns

 unusual or unpleasant urges to move while falling asleep

 unusual movement or other experiences while asleep

 unintentional changes to your sleep/wake schedule

 irritability or anxiety

 impaired performance at work or school

 lack of concentration

 depression

 weight gain

What causes sleep disorders?

There are many conditions, diseases, and disorders that can cause sleep disturbances. In many cases, sleep disorders develop as

a result of an underlying health problem.

Allergies and respiratory problems

Allergies, colds, and upper respiratory infections can make it challenging to breathe at night. The inability to breathe through your

nose can also cause sleeping difficulties.

Frequent urination
Nocturia, or frequent urination, may disrupt your sleep by causing you to wake up during the night. Hormonal imbalances and

diseases of the urinary tract may contribute to the development of this condition.

Be sure to call your doctor right away if frequent urination is accompanied by bleeding or pain.

Chronic pain

Constant pain can make it difficult to fall asleep. It might even wake you up after you fall asleep. Some of the most common causes

of chronic pain include:

 arthritis

 chronic fatigue syndrome

 fibromyalgia

 inflammatory bowel disease

 persistent headaches

 continuous lower back pain

In some cases, chronic pain may even be exacerbated by sleep disorders. For instance, doctors believe the development of

fibromyalgia might be linked to sleeping problems.

Stress and anxiety

Stress and anxiety often have a negative impact on sleep quality. It can be difficult for you to fall asleep or to stay

asleep. Nightmares, sleep talking, or sleepwalking may also disrupt your sleep.

How are sleep disorders diagnosed?

Your doctor will first perform a physical exam and gather information about your symptoms and medical history. They may also

order various tests, including:

  Polysomnography (PSG): This is a lab sleep study that evaluates oxygen levels, body movements, and brain waves to

determine how they disrupt sleep vs. home sleep study (HST) that is performed in your own and is used to diagnose sleep

apnea.

 Electroencephalogram (EEG): This is a test that assesses electrical activity in the brain and detects any potential

problems associated with this activity. It’s part of a polysomnography.

 Multiple sleep latency test (MSLT): This daytime napping study is used in conjunction with a PSG at night to help

diagnose narcolepsy.

These tests can be crucial in determining the right course of treatment for sleep disorders.

How are sleep disorders treated?

Treatment for sleep disorders can vary depending on the type and underlying cause. However, it generally includes a combination

of medical treatments and lifestyle changes.

Medical treatments

Medical treatment for sleep disturbances might include any of the following:

 sleeping pills

 melatonin supplements

 allergy or cold medication

 medications for any underlying health issues

 breathing device or surgery (usually for sleep apnea)

 a dental guard (usually for teeth grinding)

Lifestyle changes
Lifestyle adjustments can greatly improve your quality of sleep, especially when they’re done along with medical treatments. You

may want to consider:

 incorporating more vegetables and fish into your diet, and reducing sugar intake

 reducing stress and anxiety by exercising and stretching

 creating and sticking to a regular sleeping schedule

 drinking less water before bedtime

 limiting your caffeine intake, especially in the late afternoon or evening

 decreasing tobacco and alcohol use

 eating smaller low carbohydrate meals before bedtime

 maintaining a healthy weight based on your doctor’s recommendations

Going to bed and waking up at the same time every day can also significantly improve your sleep quality. While you might be

tempted to sleep in on the weekends, this can make it more difficult to wake up and fall asleep during the workweek.

What is the outlook for someone with a sleep disorder?

The effects of sleep disorders can be so disruptive that you will likely want immediate relief. Unfortunately, long-term cases can take

a bit more time to resolve.

However, if you stick with your treatment plan and regularly communicate with your doctor, you can find your way to better sleep.

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Last medically reviewed on July 28, 2020

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Jul 28, 2020

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Sleep and Wakefulness

 Benefits of sleep

 Stages of sleep
  Sleep disorders

 Tips for good sleep

Share on PinterestBoris Jovanovic/Getty Images

Sleep is an important part of your overall health and quality of life. How well you sleep affects how well you feel when you’re awake.

Both the length and quality of your sleep are important. Most people spend nearly a third of their lives sleeping, and this is

necessary for good productivity and health.

Too little or too much sleep can have adverse health effects and impact your quality of life. Plus, some chronic conditions that cause

altered sleep patterns may get worse from lack of sleep, which could result in a shortened life expectancy.

But it is possible to get your sleep back on track or improve the quality of sleep you get each night. Read on for more about the

benefits of sleep, sleep disorders, and ways to get a better sleep.

What are the benefits of sleep?

Sleep is important. When you’re asleep, your body replenishes and repairs itself, both mentally and physically. It needs this time to:
  repair muscles

 consolidate memories

 release hormones that maintain growth and digestion

Good-quality sleep helps:

 control your appetite

 support your immune system

 promote good overall health

Many adults are chronically sleep-deprived from going to bed too late or waking up too early.

Getting too little high-quality sleep can leave you feeling fatigued, unable to concentrate, and mentally foggy. It can also raise your

risk of accidental injury and certain health conditions.

The amount of sleep you need depends on your age. Children and teens generally need more sleep than adults.

For most adults, the National Heart, Lung, and Blood Institute recommends getting 7 to 8 hours of sleep per night. Getting too little

or too much (typically defined as more than 10 hours per night on most nights) can lead to health concerns.

Stages of sleep

Your sleep cycle can be broken into two main types of sleep: nonrapid eye movement (NREM) and rapid eye movement (REM)

stages.

NREM stages typically make up 75 to 80 percentTrusted Source of your time asleep. Most adults will enter sleep from a drowsy

state via NREM sleep.

NREM sleep is divided into three substages:

 stage N1
  stage N2

 stage N3

Older research had identified four stages of NREM sleep; however, experts currently combine the third NREM stage and the former

fourth stage as stage N3.

Here’s more about the three NREM stages:

 Stage N1. This is the typical transition from wakefulness to sleep. Is the lightest stage of sleep; people awakened from it

usually don’t realize they were actually asleep. Stage N1 sleep typically accounts for 5 to 10 percent or less of the total

sleep time in young adults

 Stage N2. This generally comprises the largest percentage of total sleep time in middle-age adults, typically 45 to 55

percent of the night

 Stage N3. This is frequently referred to as “deep sleep” or “slow wave sleep.” During N3 sleep, blood flow to your muscles

increases, growth hormones are released, and tissues can repair themselves. Stage N3 typically accounts for 10 to 20

percent of the total sleep time in young to middle-age adults and decreases with age. It tends to occur more in the first

half of the night, particularly at the beginning of the night, and it’s often more difficult to arouse sleepers from, compared

with stages N1 and N2.

REM sleep has typically been associated with vivid dreaming, based on early studies in which patients were awoken out of REM

sleep. REM sleep typically accounts for less than a quarter of total sleep time and plays an important role in memory consolidation.

Sleep disorders

Some people have sleep disorders that make it difficult to get good a quantity and quality of sleep. Sleep disorders include:

 insomnia

 sleep apnea

 circadian rhythm disorders

 parasomnias
Insomnia

Insomnia is a common condition characterized by difficulty falling asleep or staying asleep or waking up too early.

You may experience insomnia for several reasons. Common causes include:

 stress

 anxiety

 an inconsistent sleep schedule

 overall poor “sleep hygiene” (discussed below)

Insomnia may also be an underlying component of depression or generalized anxiety, which often requires treatment.

Obstructive sleep apnea (OSA)

OSA, often referred to as sleep apnea, occurs when your airways briefly collapse while you’re sleeping. This interrupts (or obstructs)

your breathing.

OSA can potentially happen multiple times per night. It can wake you up suddenly and cause stress, resulting in poor sleep, though

some people aren’t aware they’re waking up during the night.

Symptoms may include:

 fatigue

 headaches

 snoring

Sleep apnea can have adverse effects on your long-term health, so it’s important to contact a doctor if you think you’re experiencing

OSA.
Circadian rhythm disorders

Circadian rhythm disorders occur when your sleep schedule becomes irregular. The most common type of circadian rhythm sleep

disorder is called “shift work disorder” or “jet lag“

People who work during the night are at risk of this condition. It occurs when you feel tired at night while you’re working, but you

have difficulty sleeping during the day when you’re not working.

Jet lag can also disrupt your sleep rhythms.

Parasomnias

Parasomnia is a catchall term for strange and unusual behaviors that people experience prior to falling asleep, while asleep, or

during the arousal period between sleep and wakefulness. These behaviors vary considerably in terms of characteristics, severity,

and frequency.

Parasomnias include:

 sleepwalking

 talking during sleep

 grinding your teeth during sleep

 having nightmares

Tips for sleeping well

Sleeping well is necessary for good health. But for many people, it’s hard to do. Try these simple strategies to enjoy better quality

sleep.

Get treatment for sleep disorders

If you suspect you have insomnia, sleep apnea, or another sleep disorder, talk with your doctor. Many sleep disorders can be

managed through lifestyle changes or other treatments.

For example, your doctor may advise you to:

 Change your sleep environment or habits.

 Practice meditation or other relaxation strategies.

 Take prescription medications.

 Undergo a sleep study, known as a polysomnogram, to further evaluate the cause of your sleep disturbance.

OSA can be treated with a continuous positive airway pressure (CPAP) machine.

This is a noninvasive ventilator that helps keep your airways open while you sleep. You’ll wear a mask that allows pressured air to

be delivered to your airways.

Practice healthy sleep hygiene

Healthy sleep habits can help you fall asleep, stay asleep, or enjoy better quality sleep.

For example, a consistent sleep schedule is important. Try to go to bed and wake up at the same times each day, even on

weekends and holidays.

Making your bedroom more sleep-appropriate and comfortable can also help. Take steps to keep it dark, cool, comfortable, and

quiet, such as the following:

 Consider limiting indoor sources of light, buying dark curtains, and using earplugs.

 Update your mattress, pillows, and bedding as needed.

 Limit use of screens (TV, phone, tablet, or computer) 30 to 60 minutes before sleep.

 Shop our expert-verified products for achieving deeper sleep.

Developing a pre-sleep routine can also help prepare your body and mind for sleep. This routine should include relaxing activities,

such as:

 taking a warm bath

 drinking herbal tea

 reading a calming book

 listening to calming music

 writing in a journal

 practicing restorative yoga

 meditating

Avoid loud noises, bright lights, glowing computer screens, and other stimulating things before bedtime.

Since stress often causes sleep deprivation, efforts to reduce stress are also important. For example, consider:

 simplifying your lifestyle

 setting priorities

 delegating tasks

 taking regular breaks

Prioritize self-care by eating a well-balanced diet, getting regular exercise, and making time for activities you enjoy.

It may also help to:

 Avoid caffeine, especially late in the day.

 Avoid alcohol, which can disrupt sleep stages.

 Don’t drink too many liquids at night to lessen your need for bathroom trips.

 Avoid exercise late in the day.

 Avoid daytime naps, or limit them to 30 minutes or fewer.

If these lifestyle changes don’t help you get the sleep you need, talk with a healthcare professional.

You may have an underlying health condition that’s keeping you awake at night. A doctor can recommend next steps and strategies

to improve your sleep.

Last medically reviewed on May 26, 2021

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Written By

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ADHD and Sleep Disorders

 Symptoms of ADHD

 Research

 Common sleep disorders

 Diagnosis of sleep disorders

 Treatment for sleep disorders

 Lifestyle changes and home remedies

 Takeaway

Understanding ADHD

Attention deficit hyperactivity disorder (ADHD) is a chronic condition that causes various hyperactive and disruptive behaviors.

People with ADHD often have trouble focusing, sitting still, and controlling their impulses.

ADHD affects millions of children every year, and in many cases the condition continues into adulthood.

The disorder is much more commonly diagnosed in boys than girls, according to the Centers for Disease Control and Prevention

(CDC)Trusted Source.
On the other hand, prevalence in adult men is only slightly higherTrusted Source than prevalence in adult women.

The exact cause of ADHD is unknown.

However, researchers believe genetics and certain environmental factors may contribute to its development. There’s no cure for

ADHD, but several treatments can help to reduce the severity of symptoms.

Symptoms of ADHD

Symptoms of ADHD can appear in children as young as 2 years old, and they usually decrease with age.

Common symptoms of ADHD include:

 having trouble focusing or staying on task

 daydreaming often

 appearing not to listen

 having difficulty following directions or finishing tasks

 losing or forgetting things easily

 having problems organizing tasks and activities

 frequently fidgeting or squirming

 talking excessively

 regularly interrupting other peoples’ conversations or activities

 being impatient and easily irritated

ADHD symptoms can affect many areas of life.

People with the condition often have difficulties with school, work, and relationships. They’re also more likely to have coexisting

conditions, such as anxiety, depression, and sleep disorders.

What the research says about sleep disorders

Sleep disorders are believed to be one of the most common types of coexisting conditions among adults and children with ADHD.

Estimates vary, but they may affect anywhere from 25 percentTrusted Source to over 70 percent of childrenTrusted

Source and adults with ADHD.

Researchers aren’t exactly sure why ADHD and sleep disorders often occur together.

However, it’s believed that the symptoms of ADHD can make it challenging to settle down enough to fall or stay asleep. This can

cause a variety of sleep problems that make it difficult to get a good night’s rest.

Recent research also suggests that genetics and structural brain abnormalities may play a role.

Many ADHD medications are also stimulants. This can cause sleep issues, especially if they’re taken later in the day.

A lack of sleep can aggravate some ADHD and ADHD-related symptoms. However, poor sleep quality usually affects children and

adults differently.

When children don’t get enough sleep, they usually become more hyperactive. Adults, on the other hand, typically feel more

fatigued and have a lack of energy.

DID YOU KNOW?

The term sleep architecture refers to the way you cycle through the stages of sleep each night.

ResearchersTrusted Source haven’t been able to identify consistent differences in the sleep architectures of people with ADHD and

people without ADHD.

Common sleep disorders

Sleep disorders are defined as conditions that interfere with the ability to sleep well on a regular basis.

Most adults require 7 to 9 hours of sleep each night, according to the National Sleep Foundation (NSF). Toddlers and older children

may need 8 to 14 hours, depending on their age group.

Common sleep disorders among people with ADHD include:

 insomnia

 restless legs syndrome (RLS)

 sleep apnea

Insomnia

Insomnia is a sleep disorder that makes it difficult to fall asleep, stay asleep, or both. People with insomnia usually don’t wake up

feeling rested. This can make it hard for them to function normally throughout the day.

Insomnia can affect your:

 mood

 energy levels

 overall quality of life

It tends to become more common with age, as changes in sleep patterns and general health occur.

Symptoms of insomnia often include:

 having trouble falling asleep

 waking up from sleep during the night

 waking up too early

 not feeling refreshed after sleeping

  feeling tired or sleepy during the day

 feeling anxious, depressed, or irritable

 having trouble focusing or remembering things

 making more errors than usual

 having tension headaches

 having digestive issues

Restless legs syndrome (RLS)

Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is characterized by an overwhelming need to move one’s legs.

This desire is usually triggered by leg discomfort, such as throbbing, aching, or itching.

These uncomfortable sensations often occur at night, especially when a person is lying down. Moving can make the discomfort go

away temporarily.

RLS can affect people of any age, but it typically becomes more intense as time goes on. It may make sleeping difficult, which can

result in daytime sleepiness and fatigue. The symptoms of RLS include:

 an uncomfortable sensation in the legs that begins after lying down or sitting for a long period of time

 having an irresistible urge to move the legs

 leg discomfort that temporarily subsides when the legs are moved

 twitching or kicking the legs during sleep

 waking up from sleep due to leg movements

Sleep apnea

Sleep apnea is a serious sleep disorder in which breathing temporarily stops during sleep. People with sleep apnea often snore

loudly and feel tired even after a full night’s rest.

There are three main types of sleep apnea:

 Obstructive sleep apnea. This type which occurs when the muscles in the throat relax abnormally.

 Central sleep apnea. This type occurs when the brain doesn’t send the right signals to the muscles that control

breathing.

 Complex sleep apnea syndrome. This type occurs when someone has both obstructive and central sleep apnea at the

same time.

While there are different types of sleep apnea, they all share the same common symptoms.

These symptoms include:

 snoring loudly (this occurs mostly in people with obstructive sleep apnea)

 breathing that starts and stops during sleep, which is observed by another person

 waking up during sleep and feeling short of breath (this occurs mostly in people with central sleep apnea)

 waking up with a dry mouth or sore throat

 having a headache in the morning

 having trouble staying asleep

 being very sleepy during the day

 having trouble focusing

 feeling irritable

ADHD AND NARCOLEPSY

ADHD is also closely associated with narcolepsy, a rare disorder that’s characterized by nodding off and excessive daytime

sleepiness.

According to a 2020 literature review, 33 percent of people with narcolepsy experience symptoms of ADHD.
Diagnosing sleep disorders

Doctors must take extra care when screening for sleeping problems in people with ADHD. Sleep disorders and ADHD have

overlapping symptoms, which can lead to misdiagnosis.

If someone with ADHD complains of sleeping problems, their doctor will request a thorough sleep history.

This involves asking the person about:

 their usual bedtime

 the amount of time it takes them to fall asleep

 awakenings during the night

 problems waking up

 daytime naps

 daytime energy levels

The doctor may also give them a sleep diary. They’ll be asked to use the diary to record their sleeping habits over several weeks.

If the doctor suspects a sleep disorder, they may order different diagnostic tests. There are two main tests used to diagnose sleep

disorders.

Nocturnal polysomnography test

A nocturnal polysomnography test is done in a laboratory while a person sleeps. The person is connected to equipment that

monitors vital signs as well as activity in the heart, lungs, brain, and legs during sleep.

People with sleep disorders:

 usually have a shorter overall sleep time

 move their limbs more during sleep

  may exhibit other irregular behaviors while sleeping

Home sleep test

As the name suggests, this test is done at home. It’s performed in the same manner as a nocturnal polysomnography test.

The person will be given the monitoring equipment to use at home while they sleep. Abnormal vital sign measurements,

movements, and breathing patterns tend to indicate a sleep disorder.

Treatment for sleep disorders

In people with ADHD, it’s important to establish a good treatment plan for sleep disorders. This often involves psychotherapy or

medical treatments that help promote normal sleep.

Some common psychotherapy techniques include:

 cognitive behavioral therapy (CBT), which can show you how to manage or eliminate feelings of anxiety and thoughts

that keep you from falling asleep

 relaxation techniques, such as meditation and deep breathing exercises, which can help reduce stress before bedtime

 stimulus control, which can teach you how to limit the time you spend in bed while not sleeping so you only associate

your bed with sleep

 sleep restriction, where you intentionally limit the time that you spend in bed lying awake or not sleeping

 light therapy, which can help reset your internal clock so that you fall asleep at a later or more appropriate time

Some medical treatments that can help with sleep disorders include:

 prescription sleeping pills, such as zolpidem (Ambien), eszopiclone (Lunesta), or zaleplon (Sonata)

 calcium channel blockers and muscle relaxers, which can help those with RLS

 a continuous positive airway pressure (CPAP) machine, which helps keep airways open and prevents sleep apnea
  oral appliances, which can help to keep the throat open and prevent sleep apnea

Lifestyle changes and home remedies

Making certain lifestyle adjustments is also important.

Some lifestyle changes and home remedies that can help with sleep disorders include:

 going to bed and waking up at the same time every day, even on weekends

 avoiding caffeine in the late afternoon and evenings

 avoiding alcohol and nicotine close to bedtime

 avoiding the use of electronics before bedtime

 using the bed primarily for sleeping and never for activities like working

 keeping the bedroom dark, quiet, and cool

 getting enough exercise during the day

 avoiding heavy meals close to bedtime

 establishing a relaxation routine before bed, such as reading, doing yoga, or taking a warm bath

 use a weighted blanket

Takeaway

Having a sleep disorder in addition to ADHD isn’t easy. However, with the right treatment and lifestyle modifications, you can greatly

reduce your ADHD symptoms and improve your sleep.

Last medically reviewed on December 28, 2020

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Our experts continually monitor the health and wellness space, and we update our articles when new information becomes

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Written By

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Edited By

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Medically Reviewed By

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HEALTH NEWS
Fact Checked

Will Blue Light From Your Phone Disrupt Your Sleep? What We Know
Share on PinterestAntonio Hugo Photo/Getty Images

 A new study suggests that blue light such as from phone screens may not be as disruptive to sleep as previously

thought.

 The study looked at how people reacted to different types of light.

 They found that between the blue, yellow and white light there was no conclusive evidence that blue was worse

than other forms of light.

Light from smartphone screens, tablets, and computers has widely been thought to be disruptive to our natural circadian rhythms.

As a result, an industry has sprung up around “sleep hygiene.”

But a new studyTrusted Source released last month in the journal Nature suggests that so-called blue light — the type of light

emitted from these devices — may not be as disruptive as previously understood.

The study from the University of Basel and the Technical University of Munich, studied “effects of calibrated blue–yellow changes in

light on the human circadian clock.” Researchers exposed 16 subjects to three different types of light for an hour before they went to

sleep for the night. After using blue-dim, yellow, and constant white background/control light, the study authors determined that

there was “no conclusive evidence for an effect of calibrated silent-substitution changes in light colour along the blue–yellow axis on

the human circadian clock or sleep.”

Light itself can be a general disruptor to human sleep patterns, but perhaps not in the way that modern devices may have been

seen in recent years.

How does light affect sleep patterns?

The human eye converts light into electrical impulses via a series of cones, rods, and “so-called intrinsically photosensitive retinal

ganglion cells” (ipRGCs). Blue light, which is emitted from devices like smartphones and tablets, is a short-wavelength form of light,

and it is converted to the color blue by cones, which respond to bright light; rod cells are only operational in low-light conditions and

don’t differentiate between color.

The ipRGCs in the eye receive information about the intensity of light rather than color, and they also keep regular circadian rhythms

in check. The photopigment melanopsin, which is expressed by ipRGCs, helps regulate nighttime melatonin suppression. Cones

send information to ipRGCS, which suggests that the color of light could affect these regular circadian rhythms and a person’s ability

to fall asleep or stay asleep.

A 2019 studyTrusted Source suggested that “mistimed light exposure” — namely, the artificial light from devices we use throughout

the day — could have detrimental effects on sleep and health. But the process that our brains use to modulate internal circadian

rhythms is quite complex, said Dr. Alexander Solomon, surgical neuro-ophthalmologist at Pacific Neuroscience Institute at

Providence Saint John’s Health Center in Santa Monica.

“There is a master ‘clock’ set by these melanopsin cells (which, again, are still most sensitive to blue light) but other activities such

as meal timing and exercise can feed back to that master clock as well,” Solomon told Healthline. “I think if a person is having

difficulty regularly sleeping and waking at a regular time needed for their lifestyle, one change could be to either use blue light

blocking glasses or a similar phone/screen setting, but it’s also to decrease overall exposure to bright light.”

Should you avoid using your smartphone before bed?

Solomon said the study’s findings do not mean that people should expect a good night’s sleep if they’re on their phone before bed.

Solomon pointed out that the study may not reflect the way most people interact with light in general.
“This study had specifically designed the light exposure…to avoid triggering the light-sensitive cell in our eye known to be

responsible for resetting our circadian rhythm, which does not match real-world lighting environments,” Solomon said. “This cell is

sensitive to blue light, so saying blue light doesn’t play as much of a role is untrue. It’s simply saying a bright yellow light can affect

things as much as a dim blue light.”

Keiland Cooper,Ph.D, a neuroscientist at the University of California, Irvine, told Healthline that the recent study just means more

research is needed to fully understand how these devices affect our health.

“While a single study in isolation is rarely conclusive, the main takeaway from present study is that more work needs to be done to

further pin down which aspects of screens at night-time negatively impact our sleep,” Cooper said. “Understanding the precise

mechanisms of screens on our neural functioning is important because it will help inform device designers and manufactures as to

which aspects of their screens may be augmented to aid users sleep and mitigate the side-effects of using our devices.”

How can you get better sleep?

Many devices do have a low-light setting that can reduce the brightness of light, and blue-light blocking glasses can reduce the

amount of short-frequency waves one is exposed to before bed. But Solomon pointed out that sharp contrasts in exposure to light —

and that light’s intensity — may ultimately be a driving factor in how our systems determine sleep schedules and regularity.

“The strongest opportunity for light to set our circadian rhythm comes after prolonged darkness. For example, studies have shown

shift workers who work overnight and see the sun while driving home (again, not a blue light specifically, but instead a bright light)

have much more trouble sleeping on an appropriate schedule than those who manage to get home and sleep before sunrise,”

Solomon said. “I think it’s not something the average person has to consider strongly unless they are having trouble appropriately

adapting to the goal sleep/wake times or experiencing excessive daytime sleepiness. There can be many other factors that play a

role in difficulty sleeping and seeing a sleep specialist/hygienist may be helpful before attributing it to a single factor such as light

exposure.”

“While lowering the intensity of light may help, recommended across countless studies is that the ideal screen-hygiene prior to bed

is to avoid them altogether,” Cooper said.

Takeaway

While “screen time” before bed has recently been thought to disrupt natural circadian rhythms, it’s still a bit murky as to how much

disruption the light from smartphones and tablets can cause. A new study finds that blue light is not clearly worse for sleep than

other forms of light.

Reducing the use of screens before bed is still not a bad idea, given the potential for disruption.

More research needs to be done to fully understand how our systems respond to blue light.

How we reviewed this article:

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Our experts continually monitor the health and wellness space, and we update our articles when new information becomes

available.

Current Version

Jan 5, 2024

Written By

Finn Cohen

Edited By

Gillian Mohney

Fact Checked By

Amanda Ward

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By Finn Maguire Cohen on January 5, 2024 — Fact checked by Amanda Ward

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Are You Tired All the Time? You May Have This Sleep Disorder

Share on PinterestA new study looks at how many people may have the sleep disorder idiopathic hypersomnia. skynesher/Getty
Images

 Extreme daytime tiredness and long hours of sleep are indicators of a rare sleep disorder.

 New research indicates the disorder, known as idiopathic hypersomnia, may be more common than prior

estimates indicated.

 The disorder is still not well understood and is difficult to diagnose.

A rare neurological disorder that is characterized by debilitating daytime tiredness and excessive sleeping could be far more

common than previously thought.

Idiopathic hypersomnia (IH) isn’t just another sleep disorder; in fact, the very name itself, “idiopathic,” means that its cause is

unknownTrusted Source.
Similar to other sleep disorders, like narcolepsy, it results in sleepiness that is so powerful that it can affect your ability to function

normally. It is also hard to diagnose, as people must have significant symptoms for three months before being considered to have

the condition.

Once a physician suspects this diagnosis, they must use specialized equipment and a laboratory setting for a sleep study for

confirmation. Because of this, experts have a hard time estimating the number of people dealing with IH.

But that is changing. According to new research from the American Academy of Neurology, the condition could actually be affecting

a far greater number of Americans.

The research, published this week in the journal Neurology, indicates that as much as 1.5% of the population could have IH.

“The estimated prevalence of 1.5% for IH is on par with other common neuropsychiatric conditions such as bipolar disorder,

epilepsy, and schizophrenia,” wrote the study authors. Due to the rigorous requirements of sleep studies, population-based

estimates of IH are difficult to ascertain.

Significant number of people may sleep disorder

“It’s obviously an intriguing study because, as was pointed out in the article, the prevalence of idiopathic hypersomnia has been

lower in some other studies. So at 1.5%, it’s definitely significant in terms of how common this disorder might be,” said Dr. Clete

Kushida MD, PhD, the Division Chief and Medical Director of Stanford Sleep Medicine at Stanford University. He wasn’t affiliated

with the research.

For the study, researchers utilized data from the Wisconsin Sleep Cohort (WSC), an ongoing longitudinal study that has been

running for over 20 years. To develop a picture of how pervasive IH is among the general population, the researchers analyzed the

data from nearly 800 participants in the WSC.

From that cohort, only 12 were identified as likely having IH, which resulted in the finding of a prevalence of 1.5%.

While generally in agreement with the findings, other experts who reviewed the study were hesitant at such a high figure.
“Looking at the paper, I agree that idiopathic hypersomnia is under-recognized. I don’t know that it’s quite that frequent, 1% is really

high,” Dr. Mark Wu, MD, PhD, a Professor of Neurology and Sleep Medicine at Johns Hopkins University, told Healthline.

Wu wasn’t affiliated with the study.

“You really have to do a careful job of teasing apart all kinds of things that could be contributing to this. So I think the way I look at

that paper is, hey, 1% of people out there are really sleepy. And then probably a subset of them have idiopathic hypersomnia,” he

said.

A difficult sleep disorder to diagnose

Participants were identified as likely to have IH based on criteria like sleepiness, amount of sleep, and how long they took to get to

sleep. The study utilized an array of methods, including in-laboratory sleep studies and questionnaires, to assess sleep disorders

and their symptoms.

The Epworth Sleepiness ScaleTrusted Source is a self-reported questionnaire in which people are asked to answer how likely they

are to fall asleep in various situations like watching TV or reading. The highest possible score is 24 points, but anyone scoring 10 or

greater could have a potential sleep disorder”

“Anything over 10 is considered abnormal,” said Wu.

The study found that those with IH had an average score of 14, compared with an average score of 9 for those that did not have the

condition.

Participants in the Wisconsin Sleep Cohort also underwent laboratory sleep studies involving polysoTrusted

Sourcemnography, Trusted Sourcewhich records body functions, including heart rate, eye movement, and brain waves during sleep.

They also participated in “multiple sleep latency” tests, sometimes called nap tests. During nap tests, participants are repeatedly

instructed to try to nap at various points during the day. How quickly they fell asleep was indicative of greater sleep latency.

During the sleep study and nap tests, those who likely had IH took only 4 minutes to fall asleep at night and 6 minutes during naps.

The average for the rest of the cohort was 13 minutes to fall asleep at night and 12 minutes during naps.
How narcolepsy is different

IH is uniquely different from narcolepsy, a more common and well-understood sleep disorder. Narcolepsy is caused by a deficiency

in the brain chemical hypocretin (orexin). The cause of IH is unknown and may be the result of multiple different causes.

And here’s the real kicker: getting more sleep doesn’t appear to help.

Not only does IH cause daytime sleepiness, but it appears to be unaffected by how much sleep you get. In fact, people with IH tend

to sleep more, not less, than healthy people. Lack of sleep isn’t the problem, instead, people with IH don’t feel refreshed or wakeful

after sleeping, even if they’ve gotten more than the recommended eight hours.”

“Patients with idiopathic hypersomnia, when they wake up in the morning, they feel really drunk. They feel like they have this mental

fog, and they cannot clear their head for like an hour or two hours. The other thing that they find in contrast to narcolepsy patients,

they do not find brief naps refreshing. So, if you take a patient with idiopathic hypersomnia and you give them a brief nap, they don’t

feel better. In contrast, a patient with narcolepsy, if they get a brief nap, they do feel better,” said Wu.

How to tell if you have a sleep disorder

“If on a consistent basis [sleepiness] is impairing your ability to do your job or do your activities in your house or at home or for

pleasure, then I think it’s time to consider seeing a sleep medicine physician. You could start by seeing your primary care physician,

and they could make the referral, or you could just directly make an appointment with the sleep medicine physician,” said Wu.

Both Wu and Kushida encourage individuals who believe they are having sleep problems to speak with their healthcare provider.

Sleep disorders like sleep apneaTrusted Source are far more common and much easier to treat than IH.

“If you’re sleeping a really long time, and by long I mean in the range of like 10 to 12 hours per day, and you’re very sleepy still

during the daytime, you should definitely have it checked out,” said Kushida.

Wu emphasized that your quality of life is a good barometer for whether you are getting healthy sleep.
The bottom line

Idiopathic hypersomnia is a rare sleep disorder that could actually be much more common.

New research indicates that up to 1.5% of people could have the disorder.

Idiopathic hypersomnia is hard to diagnose, but people who sleep excessively and are also very sleepy during the day should

consider speaking to their healthcare provider.

How we reviewed this article:

HISTORY

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes

available.

Current Version

Dec 14, 2023

Written By

Gigen Mammoser

Edited By

Gillian Mohney

Fact Checked By

Kelsey Costa, MS, RDN

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By Gigen Mammoser on December 14, 2023 — Fact checked by Kelsey Costa, MS, RDN

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Irregular Sleep Patterns May Increase Risk for Dementia

Share on PinterestA new study looks at how sleep patterns impact cognition. Westend61/Getty Images

 A new study shows that people who have irregular sleep patterns may have a greater chance of developing

dementia than those who have more regular sleep patterns.

 When sleep becomes irregular, the circadian rhythm is negatively affected, which can result in issues with

cognitive functioning.

 Experts say maintaining a consistent sleep schedule can help you sleep better.

Along with getting enough sleep, sticking to a consistent sleep schedule is essential to your overall health.

Now, a new study published in Neurology finds people who have very irregular sleep patterns may be at an increased risk

of dementia compared to those who have more regular sleep patterns.

What to know about sleep and dementia risk

For approximately 7 years, researchers observed 88,094 people who were an average of 62 years old. Participants wore a wrist

device for one week to analyze their sleep cycle and regularity of sleep.

Based on this data, the team developed a score for sleep irregularity.

Next, researchers examined the participants’ medical information to see who developed dementia.

They found that people who had the most irregular sleep were 53% more likely to develop dementia than people with moderate

sleep irregularity.

“The association between irregular sleep and the risk of dementia was compelling, especially given that it was observed in such a

large sample,” Matthew Pase, PhD of Monash University in Melbourne, Australia, told Healthline. “The findings were also

independent of sleep duration and disruption, suggesting that sleep regularity is important in itself. This data suggests that when

thinking about what constitutes good sleep, we (researchers and the public) should consider sleep regularity as well as overall sleep

duration and quality.”

Pase, a co-author of the study, said that in future studies, they can investigate if sleeping regularly improves memory.

“Studies could also investigate the mechanisms linking sleep regularity to dementia. For example, are there links between sleep

regularity and Alzheimer’s disease in the brain?” Pase said.

How to avoid irregular sleep

The human body has natural sleep-wake cycles or circadian rhythms that coincide with the time of day, according to sleep experts.

The circadian systemTrusted Source refers to a pattern of day-night oscillation of neural, hormonal, and other regulatory system

patterns that respond best to environmental light. This is particularly true of sunlight.

Experts say that having an irregular sleep pattern affects this system and may be a riskTrusted Source factor for cognitive decline.

“Irregular sleep patterns are a challenge to the circadian timing system, which operates in parallel to our sleeping and waking,”

said Mary A Carskadon, PhD, Professor of Psychiatry and Human Behavior at the Warren Alpert Medical School of Brown
University. “Sleeping provides a profound ‘darkness’ signal to the circadian system and this signal helps to set and stabilize

circadian timing.”

Carskadon did not work on the study.

“Sleep as a human phenomenon, is meant to be synchronized with day-night rhythms,” said Dr. Sudha Tallavajhula, sleep

neurologist with UTHealth Houston and medical director of the Neurological Sleep Medicine Center at TIRR Memorial Hermann.

“Starting from specialized cells in our eyes, multiple networks work in tandem to orchestrate hormonal activity, immune function, and

other critical organ system functions, all targeting the human rest-activity cycle.”

Tallavajhula did not work on the study.

Recent studies have found that cerebrospinal fluid can help remove “waste” from the brain during sleep.

“One newly discovered function of sleeping involves the brain’s glymphatic system, which is involved in clearing waste products

from the brain,” Carskadon. “It’s not hard to see how a cascade of these processes might result in vulnerable accumulation of

material that can compromise cognitive function, particularly over time.”

How to get better sleep

In terms of sleep regularity, going to sleep and waking up as close as possible to a routine schedule is important.

The U.S. Centers for Disease Control and PreventionTrusted Source recommends the following tips for getting better sleep:

 Go to bed at the same time every night and get up at the same time every morning.

 Keep your bedroom dark, comfortable, and relaxing.

 Avoid keeping electronics like your phone, tablet, or laptop in your bedroom.

 Avoid large meals, caffeine, and alcohol shortly before sleep.

 Get regular exercise.

Tallavajhula agrees a regular sleep schedule is key.

“The most common step that sleep medicine experts advise to improve sleep is institution of a regular schedule,” said Tallavajhula.

“This trains the mind, similar to training the body in a gym.”

For some people, especially shift workers, it may not be possible to maintain a regular sleep time and wake-up time.

In that case, avoiding rotating shifts and sticking to an alternative sleep schedule may be beneficial, Tallavajhula advised.