A sufficient duration of normal sleep during each 24-hour cycle promotes alertness and prepares the body for the challenges of the day.
Abnormal sleep is nonrestorative, providing insufficient rest for the body. It’s usually caused by disturbances, called dysomnias, and the result is excessive sleepiness and fatigue during the day. Sometimes sleep behaviors or physiological changes arise during sleep. These can cause partial or complete awakening, called parasomnia.
The loss of alertness as a result of abnormal or insufficient sleep can result in further problems for the one suffering lack of sleep, as well as for others. As one example, the risk of automobile accidents increases among drivers with insufficient normal sleep.
Difficulty falling asleep, frequent awakenings during sleep, and being unable to return to sleep, are all manifestations of insomnia. Mood disorder such as depression is a common cause.
Normal sleep can also be disrupted by any of the following:
- Medical conditions such as heart disease, lung disease, acid reflux, and arthritis
- Self-administered drugs such as caffeine, alcohol, and nicotine
- Medications, including corticosteroids, beta-blockers, and many antidepressants
Circadian Sleep Disorders
Circadian sleep disorders develop whenever sleep behavior is poorly coordinated with the body's internal cycle. This is a common problem for shift workers, including police, firefighters, medical personnel, and military personnel. One very common circadian sleep disorder is well-known to those traveling cross country or internationally; it’s referred to as jet lag.
Night owls - those who function best during the evening and go to bed late – tend to develop two types of sleep problems:
Difficulty falling asleep
The need to sleep later
Night owls may try to compensate by attempting to sleep earlier than their usual bedtime, but are often defeated because their “biological alerting mechanism” is still very active.
Parasomnias - Abnormal behavior during sleep
The transition between sleep and being fully awakened is notably unstable. For most, this transition is uneventful. But some experience bizarre behaviors or unpleasant experiences, called parasomnias, during this transition.
Parasomnias may include:
- Sleep talking
- Night terrors
- Confusional arousals
Those manifesting a parasomnia may seem possessed, or indifferent to those trying to interact with them. Parasomnia behaviors can be quite complex, such as opening a door or eating a snack. They’re usually followed by a return to sleep with no later memory of the event.
Sometimes parasomnias persist from childhood into adulthood. Parasomnias may also develop in adulthood as a result of sleep deprivation, medication, substance abuse, or neurological disorders.
One parasomnia that usually develops in older adults is REM behavior disorder (RBD). This parasomnia is characterized by the physical acting out of dreams. Those manifesting RBD may lunge out of bed, or strike their bed partner. A small percentage of those with RBD later develop a chronic neurological condition. RBD episodes can be controlled with medication.
Care for Parasomnia
Alert as they may seem, it’s a good idea to reduce the risk of injury to sleepwalkers by protecting them from dangerous obstacles and stairways. Those forcibly awakened from a parasomnia event may be initially disoriented, and may struggle violently until fully awake.
Parasomnias can usually be minimized by returning to a regular bedtime routine and a sufficient duration of normal sleep. In some cases, medication may be needed to stabilize sleep.