Why am I so tired?
If you’re one of the millions of people that feel tired all the time, you may have a sleep disorder – and you’re not alone. It’s estimated that approximately 90 million people in the United States struggle with sleep disorders which can lead to serious health conditions that may impact more than just the length of your sleep. There are many different treatment methods for the various sleep disorders. Let’s review the more common ones, and what can be done to treat them.
What is a sleep disorder?
Simply put, a sleep disorder is a negative change or problem with the way you sleep. This can range from unwanted activities and occurrences during sleep, like snoring and sleep apnea, to disorders that affect your entire sleep experience, like insomnia.
Sleep disorders don’t just begin and end when your head hits the pillow. In fact, their presence often carries over into your waking life as well. Do you ask yourself “why am I so tired?” on a regular basis, or have you ever been told you gasp for breath while sleeping? Have you ever fallen asleep in the middle of the day when you didn’t mean to, such as at work or while driving? These are all potential symptoms of sleep disorders.
Of the approximate 90 million people in the United States who are living with a sleep disorder, it is estimated that more than half suffer from sleep apnea. Sleep apnea occurs when there are brief pauses in breathing during sleep, often associated with a partial or complete blockage within the throat. This happens when you lie down to sleep and the muscles in your throat relax. This may lead to a shift in the tongue or soft palate, causing your airway to narrow so much that it briefly closes off completely. This disrupts breathing and may reduce the level of oxygen in the blood.
Drops in oxygen levels alert the brain that something isn’t working as it should. As a result, the brain wakes up the sleeping person so the airway can be reopened. This becomes a problem when the sleeping person is woken up over and over again, sometimes dozens of times an hour. Repeated awakenings lead to a deficit in deep, restorative sleep.
Sleep apnea has been linked to many health issues, including: irregular heartbeat, high blood pressure, type 2 diabetes, depression, heart attack, and stroke. A lack of deep, restorative sleep can also impair attention and short-term memory.
Whether you’ve been formally diagnosed with sleep apnea or are just looking for more information, there are a wealth of treatment options available. Treatments vary from changes in lifestyle to special devices that keep you sleeping in a specific position to a breathing machine called CPAP that helps keep your airway open.
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Insomnia is also a common sleep disorder, with about 30 percent of adults reporting acute insomnia at some point in their life and 10 percent reporting chronic insomnia. Insomnia is characterized by having trouble falling asleep, staying asleep, or a combination of both.
Acute insomnia is common and often is brought on by stressful situations that are impermanent, like stress in the workplace, a traumatic incident, or temporary family stressors (job loss, illness, divorce, death, etc.). Acute insomnia lasts for a couple of days or a few weeks at most.
Chronic insomnia lasts for three months or longer, and the causes may differ. It may be worsened by untreated sleep disorders, certain prescriptions medicines, other medical conditions like chronic pain, or mood disorders like anxiety or depression.
Whether insomnia is acute or chronic, the effects are just as troublesome. A lack of sleep can impair cognitive functioning during the day, not to mention the commonly reported problem of being tired all the time.
Insomnia also causes problems beyond the immediate person who suffers from it. For example, you may feel drowsy while driving, which could lead to an accident that may injure others. Driving while feeling drowsy, or even briefly falling asleep at the wheel, is responsible for 1,550 fatalities and 40,000 nonfatal injuries in the United States every year.
Acute insomnia may be treated with the short-term use of prescription sleeping pills. Chronic insomnia responds best to cognitive behavioral therapy for insomnia (CBTI), a treatment available from a board-certified sleep specialist.
Restless legs syndrome (RLS)
Also known as Willis-Ekbom disease, RLS is a disorder that causes an uncomfortable sensation and an urge to move the legs while lying down.
Many people dealing with RLS find it difficult to fall and stay asleep, and instances of RLS are often more severe at night. Although RLS affects males and females of all ages, it’s slightly more common for women, and grows increasingly more intense with age.
At this time, there isn’t a known, concrete cause for RLS. Some sleep professionals believe it’s caused by an imbalance of dopamine, the chemical in the brain that helps control muscle movement.
Treatments include iron replacement among those who are deficient, and prescription medications that may enhance dopamine levels.
Narcolepsy is a condition characterized by extreme sleepiness, sleep paralysis, hallucinations, and unintentionally falling asleep in the middle of the day. It’s estimated that narcolepsy affects one in every 2,000 to 3,000 people.
Treatment for narcolepsy depends on the individual, but often a treatment program consists of a combination of medication and lifestyle changes. Stimulant medications are often used to reduce sleepiness, and other prescription drugs may decrease associated symptoms. The behavioral adjustments can include eliminating alcohol use, staying active, taking strategic, short naps during the day, and seeking counseling. There is no known cure for narcolepsy, but adherence to a treatment plan can help alleviate symptoms.
How do you know if you have a sleep disorder?
This is not an exhaustive list of every sleep disorder, but an overview of the more common ones.
A good marker that something isn’t quite right with your sleep is that you often feel tired all the time. Sometimes, bed partners can be valuable in providing their own perspective. If they report that you snore exceptionally loudly and sometimes stop breathing or gasp for breath, you could have sleep apnea. Looking further into that can be one of the best ways to improve your quality of life.
You can also track your sleep experience each night. Take note of how many times you wake up at night—and for how long. Be mindful of how long it takes you to fall asleep at the beginning of the night, and how rested you feel when you wake up the next morning. You can write this in a sleep journal, or use an app that tracks the information. Also, take note of your diet, medications, and what alcoholic and caffeinated beverages you consume and how these may impact your sleep.
There are several helpful devices on the market right now that can give a report filled with helpful data about your sleep health. A visit to a doctor who specializes in sleep medicine is also an option to help interpret these data and use the insights to decide on next steps.
Ed Pienkosz is an experienced healthcare and behavior change professional with a focus on improving the quality of life through awareness, education and empowerment. He has more than 30 years of professional experience in healthcare and wellness including Population Health, Chronic Disease management and prevention, and quality of life improvement. Ed holds a Master’s of Science in Exercise Physiology and is a member of the International Consortium for Health & Wellness Coaching.