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Insufficient sleep syndrome is a type of hypersomnia. Hypersomnia disorders are characterized by excessive daytime sleepiness and the inability to be awake during the day. Those that have a hypersomnia disorder usually sleep more than 9 hours within a 24-hour period. The cause of the sleepiness is not linked to a circadian rhythm problem or disturbed nighttime sleep, but instead, it is a personal choice. The syndrome involves a willing sleep restriction during the night. It is also known as behaviorally induced insufficient sleep syndrome because it happens out of the person’s choice to give up sleep in favor of some other activity. Insufficient sleep syndrome is considered to be a major cause of excessive daytime sleepiness, mood changes, weight gain, and fatigue, as well as a trigger of many other health problems that involve sleep deprivation.
Even though the disorder is voluntary, it is also unintentional. How is that possible? Well, many individuals suffering from this syndrome can’t recognize that sleep deprivation symptoms are the consequences of their actions. The syndrome happens when you regularly fail to get the proper sleep amount at night, which results in sleep deprivation. Because of all this, you are not able to be alert or focused during the day, and your daily life quality severely deteriorates.
People nowadays sleep 25% less than they did a century ago. There is no significant difference between our generation and our ancestors, and no reason why we should need less sleep than they did and no reason why they needed more sleep than us, and yet that is the situation. This is probably because life today is more hectic than it was back then. With school, after-school activities, work, sports, at home commitments, entertainment, and socializing, people are busy at all times and, as disappointing as it is, there is not much time for sleep. Because of this situation, people sacrifice their sleep for other activities and tasks. Sure, a few hours a week does not seem like a big sacrifice or loss, but it can quickly turn into a sleep disorder.
Insufficient sleep is classified as a central disorder of hypersomnolence, along with other sleep disorders like idiopathic hypersomnia, narcolepsy, and Kleine-Levin Syndrome. The symptoms for the insufficient sleep syndrome include regularly sleeping for less than the average 6-8 hours per night, excessive daytime sleepiness, fatigue, lowered energy level, reduced alertness, memory problems, lack of concentration and focus, muscle weakness and pain, distractibility, attention problems, falling asleep during sedentary activities (like watching TV, reading, driving, working), irritability, mood and behavior changes. However, the long-term effects can include metabolic changes, depression and even death.
The insufficient sleep syndrome affects about two percent of people who ask for help in a sleep center. It mostly happens to adults in their mid-to-late 30s, and it is undetected until their 40s when it starts affecting their daily life. The syndrome affects more men than women, and it can be the result of the day-shift work schedule that needs you to be at work very early or work during the night.
There is no specific known cause of the insufficient sleep syndrome or a connection to another sleep disorder. People with long hours of work or night shift workers are at risk of having this sleep syndrome, but anybody who suffers from chronic sleep deprivation is susceptible.
Prior to diagnosing insufficient sleep syndrome, the doctor needs to rule out any other health condition that can cause excessive sleepiness. Among those conditions are idiopathic and any other type of hypersomnia, narcolepsy, shift work disorder, any circadian rhythm disorder, and sleep apnea.
Polysomnography (sleep study)
Having a polysomnogram may be the best way to track your brain, heart and lung activity overnight. The polysomnography is essentially an overnight sleep study and a proven method for diagnosing sleep syndrome. The study is performed in a lab that is explicitly equipped to study your mind and body while you are sleeping. The doctors watch you and all the data about your heart rates, oxygen levels, breathing rates, brain waves, and sleep patterns to determine if you have a sleep disorder. It also records the movements of your arms and legs. Additionally, a sleep study of a daytime nap can also be an excellent way to check for disorders because it tracks your sleep patterns in a short sleep period.
Actigraphy is a non-invasive method used to determine if a person has a sleep disorder or syndrome. The goal of this method is to watch human rest and activity cycles. This is done by wearing a small and portable device called an actigraph, around any joint, but most commonly around your wrist or ankle. Sleep actigraphs are usually worn on the wrist of the non-dominant arm. You wear the device for a week and during that time the device measures the level, the time of day, and how your body reacts to certain activities.
Once other sleep disorders are excluded, patients will need to make a significant effort to improve their sleep quality. The primary treatment for the insufficient sleep syndrome is to improve sleep hygiene which involves changing sleep habits and adjusting sleep and wake times. Sleep hygiene is a group of habits and practices that can help individuals get quality sleep. It can also include changes to the environmental and behavioral factors that are causing restricted nighttime sleep. Also, eating healthy foods is also a recommended habit that will improve your sleep hygiene and quality. If patients follow treatment recommendations, the insufficient sleep syndrome symptoms quickly improve and resolve.
A chronotherapy is a cognitive behavioral technique that provides an exact sleeping and waking schedule that will train our brains to follow a certain rhythm. When going through this treatment, you are expected to follow a one-month schedule and after that make changes to your sleep. During this schedule, you need to avoid naps and have a three-hour delay for your bedtime. The idea is to gradually make changes so you will be able to retrain your brain before reaching the proper amount of sleep.
Light therapy is a treatment that involves exposure to artificial light that mimics sunlight. Using a lightbox, the person is exposed to full-spectrum light consisting of thousands of lux of white and blue light. These lights act as cues for the brain to regulate the circadian rhythm of the body and maintain a sleep schedule. Because of that, this therapy is extremely helpful to individuals who need to synchronize a specific schedule and rest, among which are those who suffer from night shift work disorder and night owls that experience night as day.
Risk of Untreated Sleep Deprivation
Individuals that are chronically tired have a bigger chance of having accidents while at work or when driving, as well as decreased performance with activities like sport, exercise or work, obesity, disrupted sociability, cognitive troubles, and diabetes.
Practicing Good Sleep Hygiene
Having good sleep hygiene is an excellent way to treat any sleep disorder. Maintaining good sleep hygiene involves following a sleep routine that will provide structure to your sleep and help develop a habit for your body to go to sleep and wake up at the same time each day. The routine needs to be directed at mains period of waking and sleeping, so you will need to reduce the number of naps or any daytime rest periods you previously had, and increase the duration of sleep. The essential thing is to keep sleep logs to track your routine, so you will be sure to follow the routine correctly. For this, you can use phone apps that were made to monitor your sleep or sleep trackers that you can wear.
As time passes, to minimize the risk of relapsing into old sleep patterns, a more strict bedtime will be needed. This strict bedtime means you will have an alarm that will wake you up at the same time in the morning each day. To have the regular sleep-wake rhythm, you need to keep a consistent sleep and wake-up time, even if there are obligations that require you to get up at that time. Sunshine exposure and exercise during the day are recommended but need to be avoided in the evening.
Have a Comfortable Sleep Environment
The best way to fix your sleep problems is to follow a sleep routine properly. When doing so, you need to reserve your bed for rest only. Your bedroom must be a comfortable sleep environment that is reserved just for sleep. The best way to do that is to keep it dark, cool and quiet. Rooms with bright light rooms can upset your circadian rhythm, while noisy environments keep you up during the night. Watching TV or doing work in bed are activities that need to be avoided because your brain will create associations to these things and this can impact your sleep. Generally, electrical devices should not be in bedrooms. If it is necessary for them to be there, then they should be placed at least a few feet away from the bed. Also, the bed must be comfortable, and the mattress cannot have any sagging or lumps that can wake you up. If possible, you should invest in a mattress that will help promote sleep and fit your sleep needs.
Taking stimulants like caffeine or alcohol is not recommended before sleep. Caffeine is an excellent wake-up method for mornings, but after 2 pm it needs to be avoided because it remains in the body for an extended time and it can keep you up at night. Nicotine is also not recommended before bed because it stimulates the production of adrenaline which will wake you up. And of course, eating greasy food or sweets before needs to be avoided.