9 sleep disorders and how to treat them

A sleep disorder, also known as somnipathy, is a medical condition that affects a person’s sleep patterns. In several cases, somnipathy can be related to an issue or issues in a person’s brain.

Sleep disorders can be connected to the brain in several ways.

First, many different neurological conditions can interfere with the brain’s ability to regulate sleep and wakefulness, eventually causing sleep disorders. In fact, recent research shows that 60 to 70 percent of people with cognitive impairment of some kind also experience sleep disorders.

Some of these neurological conditions include Alzheimer’s disease and other dementias, epilepsy, Parkinson’s disease and other movement disorders, and, in some cases, stroke.

Second, head trauma or a traumatic brain injury (TBI) can damage a part of the brain called the “basal forebrain.” This is an area of the brain involved in initiating sleep, and damage to it can lead to insomnia and other issues.

Other potential connections between sleep disorders and the brain could be sleep apnea, circadian rhythm disorders, neurodevelopmental disorders such as autism or schizophrenia, and genetics.

In this story, we’ll highlight nine sleep disorders. Some of them are considered parasomnias, a category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep. All of them are serious.

REM Behavior Disorder, or RBD

This condition is a parasomnia during which a patient acts out their dreams. This happens because the patient is unable to get their muscles into a state of paralysis, or atonia, during REM sleep. According to recent research, the dream enactment can range in severity from benign hand gestures to violent thrashing, punching, and kicking.

At the end of an episode of RBD, a person may awaken and become alert quickly; they might also be able to provide a coherent story about the dream. Treatments for this condition include medications such as melatonin, clonazepam, and pramipexole, as well as lifestyle changes such as tinkering with the sleep environment and tweaking rituals and routines before bed.

Sleep Paralysis

To be clear, sleep paralysis is a normal part of REM sleep, but experts consider it to be a disorder when it occurs outside of REM sleep. Research indicates that this paralysis may be accompanied by hallucinations, which most people will assume are part of their dreams. Put differently, sleep paralysis feels like being awake but unable to move or speak.

This condition can occur in otherwise healthy people, as well as in those presenting symptoms of narcolepsy and other sleep issues. There is no treatment for sleep paralysis during an episode, but treatment at other times includes improving sleep hygiene, cognitive behavioral therapy, and medication to prevent REM sleep or treat an underlying disorder.

Nightmare disorder

Everybody has nightmares from time to time. But people with Nightmare Disorder have nightmares *all* the time—a near-nightly terror. People with this condition often wake in a cold sweat with elaborate memories of horrible dreams. Their waking life suffers tremendously, as they walk around exhausted.

Researchers from the American Sleep Association think this condition is caused by stress and sleep deprivation , as well as some medications. In severe cases, counseling or sedative drugs might be necessary to soothe the anxiety underlying the bad dreams.

Research indicates Image Rehearsal Therapy (IRT) is an efficacious treatment for this condition.

Klein-Levin Syndrome

Also known as “Sleeping Beauty Syndrome”, this disorder causes people to sleep for long periods of time, up to 20 hours per day. Episodes can last for days or weeks and are accompanied by mood swings, confusion, and hypersexuality. The syndrome comes in waves, where at the onset a person will sleep most of the day and night. About 70 percent of those affected by Klein-Levin are teen boys, according to the National Institutes of Health.

Though the cause is unknown, some scientists think a malfunction in the hypothalamus, which helps to regulate sleep and body temperature, may play a role.

Exploding Head Syndrome

This disorder causes people to be startled awake by what they perceive to be loud noises during sleep such as gunshots, explosions, or door slamming. For the person who hears these noises, the explosions seem to originate either from right next to the person’s head or inside the skull itself. Noises occur at the onset of deep sleep or during the transition from sleep to wakefulness.

Thankfully, a recent case study indicated there is generally no pain involved with this disorder. There’s very little danger, too. Just inconvenience. And terror.

Night-eating syndrome

People with this sleep-related eating disorder go on eating binges at night, only to wake up the next day with little to no memory of the event. Some endanger themselves by chopping ingredients or turning on the stove. Others eat raw ingredients, like frozen food or plain butter.

The disorder is poorly understood, but, like sleepwalking, it occurs during non-REM sleep. Research indicates those who experience night-eating syndrome may have pre-existing conditions such as obesity or a propensity for anorexia. Drugs that increase dopamine, a neurotransmitter associated with reward and pleasure, can help stop the unconscious nighttime snacking.

Sleep Sex

Sexsomnia, also known as sleep sex, is a distinct form of parasomnia, or an abnormal activity that occurs while an individual is asleep. According to research, it is characterized by an individual engaging in sexual acts while in non-REM sleep.

First described in a 1996 case study of seven individuals, sleep sex can range from loud sexual moans to self-injurious masturbation. In certain cases, it can be criminal and result in sexual assault or rape—this even became the plot of an episode of old “Law & Order.” Treatments for this disorder vary but at least one study yielded positive results with a device designed to mitigate sleep apnea.

Night terrors

Unlike nightmares, which arise during REM sleep, night or sleep terrors happen during non-REM sleep, usually early in the night. They are most common in children. The person experiencing the terror may suddenly sit upright, eyes open, and stare. The person often yells or screams, and can’t be awakened or comforted.

Research into this disorder started decades ago and is ongoing. In many cases, night terrors mix with sleepwalking. The cause of night terrors is a mystery, but fever, irregular sleep and stress can trigger them.

Fatal Familial Insomnia

In this rare condition, people lose the ability to sleep at all and eventually die. The word “Familial” is in the name of the disorder because it runs in families, suggesting the problem could be congenital. In almost all cases, the disorder is caused by an abnormal variant in the prion-related protein (PRNP) gene.

Most people diagnosed with Fatal Familial Insomnia die within six to 36 months of the onset of symptoms; they usually die from cardiovascular and other symptoms triggered by the sleep disorder. Recent research into this phenomenon focused on the intersection of Fatal Familial Insomnia and COVID-19.

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