In this blog, we will see insomnia and associated sleep disorders of sleep apnea.
Insomnia is a condition when a person has difficulty falling asleep or maintaining sleep or has early awakening in the morning and does not feel fully rested during the daytime. Usually, they have nonrestorative sleep with persistent chronic fatigue symptoms with some impairment of memory. Generally, if the symptoms persist for more than a month, they are considered significant and may need to be evaluated and treated.
In this section, we will look into associated symptoms; specifically sleep disorder breathing or sleep apnea. Snoring is generally present in many and with superficial sleep going into deeper sleep and/or the dream sleep or REM (rapid eye movement sleep) there is collapsing of the upper airway thereby increasing snoring with apneic event thereby waking the person up and inability to fall asleep from choking or waking. It may happen periodically at night and may feel unable to sleep deeply with sleep interruption. Generally, they may sleep 6 to 8 hours but feel un-restful sleep. Usually associated obesity may be present or it may be recent weight gain. Use of alcohol, smoking and nasal congestion can make things worse.
They may have associated daytime sleepiness to some extent with chronic fatigue symptoms and at times may feel extreme fatigue with some bodily pain, muscle pain, or low-grade muscle pain. A diagnostic sleep study may be considered in situations like this. Sleep apnea may be present and it may need to be treated thereby improving insomnia sleep disorder symptoms. This in turn may improve daytime sleepiness, decrease fatigue and bodily pains.
What has been described above is not a common presentation of sleep apnea but a subset of patients may present like this that needs further medical evaluation. Typically the Obstructive sleep apnea may present with moderate to heavy snoring, daytime sleepiness, witness apnea and fatigue with getting difficult to stay awake during the daytime. Insomnia and sleep apnea patients may have some different presentation.
If underlying sleep apnea is not present but the patient still has insomnia then the treatment management would be based on sleep restriction therapy, cognitive behavioral therapy, relaxation, regular low-grade exercise, breathing exercise, and dietary modifications such as avoiding caffeinated products.