Sleep is the normal physiological process of our body which is as important as respiration and digestion. Sleep is vital for maintaining our physical and mental health. Normal adults require 8 hours of sleep every day, whereas it 14 to 15 hours of sleep is recommended for for infants and toddlers.

What are the different stages of Sleep

Every human has a natural circadian clock in their body, which is responsible for maintaining our sleep - wake homeostasis. The different stages of sleep include REM and NREM that is rapid eye movement sleep and non rapid eye movement sleep respectively. REM is the deep sleep stage in which it is very difficult to wake up the person as this stage includes the sensory inhibition and all voluntary muscles along with almost all interactions with the surroundings are inhibited. Therefore, a person s physical stress and tiredness also gets relieved during this stage of sleep. NREM sleep is the stage between REM and awakening and here the person may have sensory connection with his or her surroundings, but may not respond.

Sleep and its benefits
Sleep and stress have a very strong connection with each other. The best way to relieve stress and any other mental disturbance is sleep. It is essential to have knowledge about sleep psychiatry for almost all physicians as they face many sleep deprived patients in their day to day practice.

    Sleep is not only responsible for relieving mental stress and depression, but has other benefits as well
    Sleep is also essential for the normal physiological growth in early infancy and it is vital for development of normal alertness, attention and knowledge
    It also relaxes our voluntary muscles and thereby, relieves us from physical stress
    Sleep disturbance may also aggravate diseases in our body. Sleep is also the state of recovery and healing.

Sleep psychiatry also insist on meditation and ensures that people have normal pattern of sleep, in order to maintain the mental health of the person in a normal state.

Sleep Pyschiatry: Its Stages and Benefits

Sleep apnea is a disorder which is characterized as interruptions in breathing when you are sleeping. These interruptions or pauses in breathing usually last for about 10 to 20 seconds and may be repeated over 100 times alongside the duration of your sleep. This condition leads to poor sleep resulting in drowsiness, fatigue and poor concentration throughout the day.

Sleep apnea can be classified as:
1. Central sleep apnea: Central sleep apnea impairs the central nervous system wherein the brain fails to control muscles which regulate breathing while you sleep.
2. Obstructive sleep apnea: This type of sleep apnea occurs when the soft tissues present in the back of the throat block the airway and thus resulting in loud snoring.

Signs and symptoms
The various signs and symptoms of sleep apnea are
1. Loud and chronic snoring during sleeping
2. Interruptions in breathing
3. Shortness of breath during sleep
4. Fatigue during the day
5. Choking and gasping during sleep
6. Extreme irritability and drowsiness
7. Experiencing headaches in the morning
8. impaired concentration and forgetfulness
9. Chronic sore throat and dry mouth
10. Depression

The various risk factors for sleep apnea are:
1. If you are overweight
2. If you are male
3. If you are over the age of 40
4. If you have a large tongue and tonsils
5. If someone in your family has sleep apnea
6. Nasal obstruction due to sinus problems

There are certain prevention measures to control sleep apnea, they are:
1. Limit smoking: Smoking may cause you to retain fluid in the throat which contributes to sleep apnea.
2. Exercise: You should exercise regularly to keep off weight as being overweight increases the chances of getting affected by sleep apnea.
3. Schedule your sleep: You should get enough sleep every day so that your body is refreshed and revitalized. Getting enough sleep, thus helps in preventing sleep apnea.

Risk Factors Associated with Sleep Apnea

Sleep problems, which can be defined as a sleeping pattern where the parents are unsatisfied, are one of the leading concerns of parents. Children should get a minimum nine hours of sleep so that their health and brain development can occur. Sleep problems can affect not only their health, but also their social and school life. Any interruption or abnormality in a child's sleeping patterns should be examined by a doctor and parents should make necessary efforts for knowing the actual causes of sleep interruption of their kids.

What are the causes of sleep disorders in children?

    Injuries and accidents
    Behavioural troubles
    Overeating
    Slow-reaction times
    Performance problems
    Mood problems
    Learning, concentration and memory troubles

Commonest signs of sleep troubles in kids:

    Difficulty in falling asleep
    Occurrence of unusual events at the time of sleeping like nightmares or sleep-walking
    Snoring and breathing pauses
    Difficulty in staying awake in daylight
    Daytime performances can be adversely affected

Best methods for dealing with sleep disorders in children:

    Regular bed-timing should be sincerely maintained at night.
    Relaxing routine for bedtime needs to be followed,including story-book reading, getting warm bath and others.
    Noise in the house, especially at night, should be minimized so that unwanted disturbances can be eliminated.
    If the room temperature is pretty comfortable, then your kids can sleep peacefully.
    Giving caffeine in excess quantity, especially before sleeping, should be reduced otherwise the kids will not sleep well.
    Meals should not be provided just before bedtime; rather they should be taken a few hours before sleeping.
    If your kids are so very addicted to different electronic gadgets or devices like telephones, televisions, computers and others, then they might face sleeping troubles. Thus, it is your duty to keep your kids away from this kind of addiction.
    If your kids are too very tired, then do not keep them awake forcibly; rather you should make them sleep immediately so that they can get a relaxed sleep at night.

If you think that sleep disorder has become a serious issue with your kids as well, then nothing can be a better option than consulting any health physician. They can best analyse the underlying cause of this issue with your kids.

How to Deal With Abnormal Sleep Behaviour in Children?

Snoring is something that not only spoils the sleep of your partner but leaves you embarrassed while travelling or any family gatherings. It is more popular among males but these days, women are also facing this issue. The problem only worsens with age and weight. On the other hand, the person suffering from Sleep Apnoea not only affects his and his partner's sleep but puts his life at risk.

Difference Between Sleep Apnoea And Snoring:

There is a huge difference between just Snorers and those suffering from Sleep Apnoea. Sleep Apnoea almost always results in frequent and loud snoring, while disturbing the breathing pattern. This leads the person suffering from Sleep Apnoea to feel tired even after long sleeping hours.

While Sleep Apnoea will almost always lead to loud snoring, snoring alone does not mean that one is suffering from Sleep Apnoea.



Causes And Symptoms

Snoring

  When a person sleeps, the throat muscles relax and the tongue bends backwards. This narrows down the throat to some extent.
  As the person keeps inhaling and exhaling, the throat muscles vibrate. These vibrations lead to snoring. The narrower the throat becomes, the more are the vibrations and the sound.
  The throat muscles tend to relax more with age. This is why snoring usually increases with age.
  If a person has obstructions in the form of Tonsils, Nasal polyps or Deviated nasal septum, the narrowing gets worse and leads to extensive snoring.
  If there is an inflammation in the throat or nose due to some infection or allergy, the throat may become narrower and result in loud snoring.
  In some people, sleeping positions like sleeping on the back or otherwise may abate snoring.
  Alcohol consumption during evening time may abate throat muscle relaxation and give rise to snoring.

Sleep Apnoea

  It is better described as episodes of pauses in breathing for more than 10 seconds at a time.
  The immediate cause of Sleep Apnoea is extensive narrowing or complete collapse of the upper airway.
  As breathing is paused temporarily, it causes a shortfall of Oxygen in blood. As it happens, the heart works harder to make up for it, even when the person is sleeping. This increases the risk of heart attack and stroke.
  It causes disturbance in the natural sleep cycle.

Treatment

Snoring

  Avoidance of risk factors like various allergies
  Correction of sleeping position with training

Sleep Apnoea

  The most common treatment is CPAP (Continuous Positive Airway Pressure). This is a mask like device worn on the nose before sleep. It keeps the upper airway open with a small positive pressure delivered.
  There is also the option of Uvulopalatopharyngoplasty. This is a surgical intervention to remove excess of soft palate tissue and open up the airway. The remaining tissue becomes stiff and thus minimize vibration.
  If there is a Tonsil or Deviated Nasal Septum or Nasal Polyp, it needs to be resected out in order to minimize obstruction to the airway.

Snoring and Sleep Apnoea are very common issues and can be treated by experienced doctors very easily.

Ways to diagnose snoring and sleep apnoea:

The doctors ask about the allergies you are suffering from, as well as your eating patterns, medicines and drinking and smoking habits. The doctor also examines your throat and nasal passages to ascertain if there are any kind of nasal, dental, mouth jaw, or throat deformities that are triggering your snoring. If your doctor will feel that you may be suffering from sleep apnoea, then your partner may be asked to keep a diary noting your sleeping and snoring patterns.

Polysomnography and CPAP Titration are some other ways through which the doctors diagnose sleep apnoea.

Polysomnography: Polysomnography, also called a sleep study, is a type of test that is conducted to diagnose sleep disorders. In this test, the doctors record the brain waves, the oxygen level in the blood, heart rate and breathing, as well as eye and leg movements of the patient.

CPAP Titration: A CPAP titration study is a type of in-lab sleep study that is carried out to calibrate continuous positive airway pressure (CPAP) therapy. It is a common treatment that is used to manage sleep-related breathing disorders including obstructive sleep apnea, central sleep apnea and hypoventilation and hypoxemia.

In case you find out that you are suffering from snoring or sleep apnoea, you should immediately visit a pulmonologist to get the proper treatment. 

Snoring And Sleep Apnoea - How To Get Rid Of Them?

Insomnia is a disorder where a person has difficulty sleeping. One can have problem falling asleep or staying asleep for long. Some people also have disturbed sleep. This can be a major problem as due to lack of sleep one feels tired and fatigued all day.

Recurring cases of insomnia hamper your daily activities and interfere with the smooth functioning of your life. Therefore, this condition should not be ignored and treated immediately.

Here are the various ways to treat insomnia:
Non-Medical (Cognitive and Behavioral treatment)
Several psychological and behavioral techniques can be used for the treatment of insomnia. Many of these methods can be easily self-taught and others require a therapist to be carried out properly. 

1. Relaxation training, which is also called progressive muscle relaxation involves the patient to tense and relax his muscles systematically in various parts or regions of the body. Relaxation techniques, such as breathing exercises, various forms of meditation, mindfulness and guided imagery are used for treating insomnia people. The use of audio recordings for guidance in these techniques is quite popular.

2. Stimulus control enables building an association between the bedroom and sleep. This is done by limiting several kinds of activities done in a bedroom. This may include going to bed only when very sleepy and leaving bed if you cannot sleep within twenty minutes. A strict bedtime and wake up time schedule has to be maintained.

3. Cognitive behavioral therapy or CBT involves changes in behavior like maintaining a strict sleep time schedule, elimination of afternoon naps and other habits related to sleep. A cognitive component is also added to this method. Unhealthy beliefs and fear regarding sleep are challenged and positive, rational thinking is encouraged. CBT is a very effective procedure for treating insomnia and the track record regarding success is high.

4. Changes in lifestyle are required to treat insomnia and prevent recurrence of insomnia, you should change certain habits and start some new practices. You should limit your intake of caffeine, alcohol and nicotine. Do not consume coffee or tea before going to sleep and avoid smoking. The habits may be stimulating and will keep you awake. Your diet should be balanced. You should avoid having rich and spicy food before going to bed. Avoid late meals and maintain a proper schedule for meals. Regular exercise can improve the symptoms of insomnia and you should try to work out every day.

Medical Treatment
There are many forms of medicines, which can treat insomnia. This includes over-the-counter medicines, as well as prescribed medicines. The type of medicine required completely depends on the severity and symptoms of your insomnia and other factors related to health. Therefore, you must consult a doctor before having any kind of medicine for treating insomnia.

The most common medicines for insomnia, which are usually prescribed by doctors are benzodiazepine hypnotics, non-benzodiazepine hypnotics and melatonin receptor agonists. However, medicines should only be taken after consulting with a specialist. Insomnia not only affects your health but also interferes with all your daily activities. Proper treatment should be taken to treat the same.

Ways to Treat Insomnia

Pain related sleep disruption has affected a large number of people around the globe. Statistics has it that, in India, about 25% of the population suffers from pain-related sleep deprivation. Studies call it  the vicious cycle of pain and sleep  as pain affects your ability to sleep and lack of sleep makes the pain even worse.

Back pain and arthritis are examples of some common pain-related medical disorders. People with these types of chronic pains have reported persistent sleeplessness or have had immense trouble falling asleep.

The following are the primary sleep disorders associated with chronic pain:

Insomnia: It is a medical condition that is characterized by an inability to fall asleep no matter how physically exhausted you are. Insomnia can be acute (lasting for one night to a week) or chronic (that lasts for more than 3 weeks).
Hypersomnia: It is a condition wherein you tend to sleep excessively; in this condition, you will have trouble being awake throughout the day or can fall asleep at any point of time.
Sleep Apnoea: This is a sleep disorder wherein breathing pauses and resumes repeatedly. Risk factors include obesity, age and gender; it is more commonly observed in men. This condition can be chronic with symptoms such as snoring loudly or feeling very tired even after one has had a night s sleep.
Restless leg syndrome: It is a sleep disorder wherein you continuously move your legs while sleeping. However, this condition can also cause you to move your legs even if you aren t sleeping.
Some of the causes of sleep disorders due to chronic pain are:

Pain
Worry and anxiety
Sweating at night
Depression and other mental disorders
Treatment

A pain and sleep disorder should be simultaneous as both the components of it, pain and sleep, are interrelated. Some of the ways people with chronic pain can still have a good night s sleep are:

Limiting caffeine intake
Abstaining from alcohol and smoking, as these disrupt the sleep cycles, thus aggravating the existing pain.
Practicing meditation and other relaxation techniques
Pain killers or sleeping pills can be administered, but only with the doctor s advice.
Hot water fomentation over painful area during night, for better sleep.

Back Pain and Bad Sleep

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