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A normal man spends approximately 1/3rd part of his life span in sleep. Yet, we know so little about sleep. Utility of sleep is not satisfactorily known. Some persons sleep less, some more and yet both of them may be normal. Sleep not only rejuvenates but also other physiological activities takes place like, secretion of Growth Hormone of Pituitary rises (recall that the infants sleep more than the adults).

Before going about disorders of sleep it is important about knowing the major stages of sleep-

Stages of sleep

• Slow wave sleep(SWS) or non-REM
• Rapid eye movement(REM)
   

Slow wave sleep (SWS) : Once a person has fallen asleep, he or she sinks deeper and deeper into SWS, starting from awake to dozing to deep sleep. Breathing slow, pulse rate and body temperature drop and the muscle relax. (SWS) is non-dreaming sleep has characteristically large, regular, slow waves in EEG.

Rapid eye movement (REM) : The eye balls move frequently (thus giving an impression, that sleep is now light), the muscle relaxes more and the intensity of sleep is more. This is the period when the subject dreams. The eyeball movements are probably due to the fact the subject follows the objects in the dream.

REM sleep is important for it is in someway concerned with the consolidation of memory.
 

INSOMNIA

Insomnia is the subjective complaint of insufficient sleep, is used to describe a condition when there is inability to fall asleep or stay in sleep or there is reduction in total time of sleep. Insomnia may be secondary, due to causes like acute hostile environment, or due to severe pain or due to severe pain or due to some mental disease. Insomnia is a specialized subject and can have many causes. However, probably the most common is that of stress.

The theories behind insomnia are certainly varied. A psychoanalyst e.g., might be of the opinion that the condition is to do with repressed fears or wishes. Perhaps the individual associates sleep with death, or may be there is realization of the crude wishes that creep around in one?s dreams, either of which could result in an avoidance of sleeping.

Both types of insomnia can become habits. Under these circumstances, worrying about the insomnia is likely to make matters worse, as a vicious circle results. The less sleep, the more worry, which leads to less sleep.

In these instances, it is important to recognize the effect of this negative thinking and to change mindset.

Sleepwalking (somnambulism)

Occurs in stage 4 SWS. Episodes tend to last about 5-15 minutes, occasionally longer. It is usually impossible to attract the sleepwalker?s attention. Normally they stay in the bedroom and get back into bed themselves, but they can be guided back into bed if necessary.

Sleepwalking seems to have a genetic component. It is especially common in children, peaking during adolescence.Stress appears to increase its frequency.

It is clearly a dangerous condition and some cases of people falling from bedroom windows may well have been due to sleepwalking.

Sleep-talking

Occurs in the earliest stages of SWS. It is not usually seen as a great problem. Most consists of a few words now and then, but some people can hold a conversation while asleep, with no recall of the episodes on waking.

Teeth-grinding(Bruxism)

 

Bruxism ? regular teeth -grinding or clenching of the jaw, most often in SWS but also sometimes unconsciously when the person is awake ? may make a loud, eerie sound. The jaw muscles can exert great power and for some people bruxism can be a severe problem, wearing away or loosening the teeth and possibly causing a stiff jaw and headaches.
This disorder is thought to be stress-related; psychologists assert that it is an expression of frustrated anger.

 

Bedwetting (Enuresis)

Enuresis tends to happen in stage 3 or 4 of SWS. Therapeutically, it is better to praise a child for a dry bed than to express disapproval of a wet bed.

Sleep terrors

In nightmares, the individual wakens from sleep feeling very fearful. They do not have the vivid, action packed qualities of a REM nightmare, and may consist simply of a single thought that horrifies the dreamer ? say, that he or she is the only person in the universe.

The person wakes suddenly in a state of panic, fear and disorientation. Children experiencing a sleep terror may scream and run about the house, clearly agitated. However, in the morning nothing is remembered of the incident.

Snoring

Caused by relaxation of soft palate at the back of throat so that a sonorous vibration occurs with breathing, especially when lying on one?s back. Alcohal can exacerbate the problem as it increases the relaxation.

A nose-clip may help if the air passage is significantly obstructed by the soft palate. in certain cases  an operation may alleviate the condition.

Sleep apnea

People with this condition actually stop breathing when they fall asleep, due to a disruption of the respiratory system or because of an obstruction in the upper tract.

Eventually, after a minute or so, the build-up of carbon dioxide in the blood causes an emergency waking response. The person wakes briefly, perhaps making a big sudden movement, snorts or snores very loudly, then falls asleep again. The whole night consists of awful emergency automatic wakenings, but the person is unaware of what has been happening. The consequence is that the overall sleep of these people is reduced, so that in the daytime they are very sleepy. Parteners usually find sleeping with them intolerable. In severe cases, sleep apnoea may lead to heart problems or stroke.

In some surgery, required cases where there is some form of airway blockage, tracheotomy and partial reshaping of soft palate may be helpful.

Narcolepsy

 

This is an unusual condition, affecting perhaps one in a thousand people, where an irresistible desire to sleep comes over the individual several times a day. It may occur at any time - for example, at a meal, during a business meeting or while talking to someone.

Sufferers are often obese and there seems to be a genetic factor involved. The condition mainly strikes first in the 20s or 30s.

Narcoleptics, when they fall asleep, go straight into REM sleep instead of the various stages of SWS. Duration of these attacks is usually just a minute or two, although they can be as short as a few seconds or as long as an hour. Following an attack, narcoleptics move into SWS.

Unfortunately, because of ignorance by physicians, many narcoleptics are wrongly adjudged psychotic.

REM Nightmares

 

Some 96% of reported nightmares are dreams occurring in REM sleep. They differ from SWS terrors; heart rate and breathing-rate measures increase over a few minutes. The sufferer sweats profusely and eventually busts out of sleep ? perhaps screaming ? feeling extremely shocked and terrified.

Throughout the world, nightmares are a problem on a massive scale. Some unfortunate people experience bad dreams every night. These individuals dread going to sleep and are sometimes even driven to consider suicide.

Some work on dream interpretation shows that many of these powerful dreams are trying to impart some sort of message to the conscious mind. Some nightmares can begin as fairly mild recurring dreams, and then over a period of time grow progressively more disturbing. This indicates that the subconscious - which is on duty 24 hours a day ? set out to alert us to something it has identified in our waking lives that, needs some conscious attention or action. It seems that when these recurring dreams are ignored, they become more frequent and are accompanied by more disturbing content.

Therapeutic techniques for sleep problems

Many of the problems described in this section can be alleviated or cured by a straightforward therapeutic technique that involves giving definite suggestions to the sufferer. The suggestions seem to act like instructions to the unconscious mind so that when the sleep problem starts, it is immediately recognized and an alternative behavior substituted that overrides the problem.

Initial relaxation script

Do this just before going to sleep

Close your eyes and relax each part of your body inturn, starting at your toes. Twist your toes and relax your feet?.. Focus your attention now on your ankles and calf muscle and allow them to relax . . . . . Sense that relaxation spreading to your thigh muscles . . . . . now to your abdomen ?.. and chest. Take a deep breath and now focus on your shoulders ? feel those muscle relax??.Now sense that relaxation spreading down your arms??to your hands and the tips of your fingers??. Now relax the muscles in your neck?.. and face ??and forehead?? and scalp.

The Homeopathy approach to the treatment of sleep disorders patients is more individualistic. This means, homeopathy believes that this is a personality disorder and hence the treatment should be determined only on the basis of in-depth study of the patients' personality. This approach helps treating most cases of sleep disorder successfully.

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