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Most of us struggle with not getting enough sleep and constantly wish for more hours in the day, yet there are individuals who spend the majority of their time sleeping, akin to infants who can sleep for as much as 19 hours. While such extensive sleep is beneficial and necessary for infants, in adults, excessively sleeping can be a sign of a sleep condition known as idiopathic hypersomnia.

People with this disorder will feel sleepy during the day even if they slept for the recommended minimum of 8 hours during the previous night, and they are experiencing chronic excessive daytime sleepiness. Idiopathic hypersomnia is a neurological sleep disorder which belongs to the group of hypersomnias, we differ primary hypersomnia which occurs on its own (IH), and secondary hypersomnia which is usually caused by some other disorder, medication or condition. The exact cause is unknown, but there are cases of people with IH whose family members also have either IH or narcolepsy, so it could be that there is a genetic predisposition to it. In some cases, doctors have noticed abnormal production of a molecule that acts like a sleeping pill, but they still do not know what exactly is inside of that molecule and how it affects people.

There is no FDA approved treatment for IH at the moment, but some people use medications recommended for narcolepsy as it can help. Before the use of polysomnographic studies, IH was often misdiagnosed as narcolepsy. Idiopathic hypersomnia is very similar to narcolepsy, and other types of hypersomnia which all can have a negative impact on people’s job performance, school, social life. Some experts suggest IH should be widely recognized as a disability. Many people who have to live with IH sleep more than 12 hours out of 24, and they can only hope that scientists will find a medication that could control their symptoms.

If you want to help doctors solving the puzzle, you can join the international patient registry which supports research and collects data about patients who have been diagnosed with IH.

Idiopathic Hypersomnia Symptoms

The first symptoms of idiopathic hypersomnia occur mostly in adolescence or early twenties, and it can take weeks or months for those symptoms to fully develop. People will notice that they struggle to stay awake and alert during the day and that they fall asleep unintentionally, at inappropriate places and time, which threatens to hinder their daily functioning.

Sleeping longer during the night doesn’t eliminate their sleepiness the next day, and they also struggle with waking up in the morning or after daytime naps. Even after those daytime naps, IH patients don’t feel refreshed or energized. The IH is a chronic disorder, and its symptoms may fluctuate or become more stable over time, but it is hard to predict or control them because it is all very individual.

Here are the main symptoms of idiopathic hypersomnia:

• Chronic excessive sleepiness which disrupts your work and social life, even though you have a healthy sleep routine.
• Sleeping for at least 9 hours out of 24 hours and still wanting to take naps or feeling drowsy and fatigued.
• Sleep inertia or sleep drunkenness after naps and nighttime sleep shows that you have a prolonged process of waking up and an urge to sleep more.
• Having problems with concentration, memory, and attention, so-called brain fog.
• Daytime power naps are not working for you, and you are still drowsy.
• Short sleep latency – people with IH will fall asleep quicker than the average person, and according to multiple sleep latency test, they can fall asleep in less than 8 minutes.
• Other, not so common symptoms, include excessive sweating, struggling with body temperature regulation, faintness, sleep paralysis, Raynaud’s disease, etc.

If you recognize any of these symptoms, you should talk to your doctor, depending on the intensity and frequency of symptoms, your doctor will recommend a sleep specialist or a sleep clinic to visit. Your sleep study should be positive on IH if you have these symptoms for at least six months, and if you are not already diagnosed with narcolepsy or post-traumatic hypersomnia.

Idiopathic Hypersomnia Treatment

Researchers are still testing medications for IH, and currently, none is officially approved by the FDA. That is why most people settle with drugs that promote wakefulness and are FDA approved for narcolepsy and use it off-label to alleviate their symptoms enough to function normally.

One of those medications for narcolepsy is modafinil, which is a wake-promoting drug often used among shift workers, patients with sleep apnea and narcolepsy. Modafinil has been used in placebo-controlled studies which included patients with IH, and it has been proved that it helps with sleepiness, however, it does not work for everyone with IH and it some cases its effects fade over time.

Behavioral therapies and scheduled naps may work for narcolepsy, but not for IH. There are a few emerging therapies which include sodium oxybate, clarithromycin, and flumazenil, for those who do not respond to medications.

Besides stimulant medications, people with IH do not have many other options, they simply have to find more time to sleep. It is recommended for them to talk with their friends, family or coworkers and to inform them about their condition and its symptoms so that they know what to expect. Also, they should avoid alcohol and any other medications that can stimulate drowsiness.

Narcolepsy and Idiopathic Hypersomnia

Since these two conditions are often mixed, in the chart below, we are going to summarize and compare their main symptoms.

According to the doctors, both, IH and narcolepsy are central disorders of hypersomnolence, so they share a few similarities, among which the most important one is excessive daytime sleepiness. When it comes to diagnosis, doctors use overnight sleep studies such as PSG and MSL test to identify these disorders. The number of sleep onset REM periods is the key thing that helps doctors determine which disorder a patient has. SOREMPs are REM periods of sleep which occur within 15 minutes of sleep onset. PSG and MSL tests show that patients who have narcolepsy usually have 2 or more SOREMPs, while patients with IH do not have it at all.

Among other differences is the fact that patients with narcolepsy find brief naps highly refreshing and restorative, while IH patients cannot have a prolonged nap time and they are not feeling much rested after napping.

Cataplexy is a temporary and sudden weakness in muscles, triggered by strong emotions such as laughing or crying, and it is rarely seen outside of narcolepsy, so it is a typical symptom that leaves little to no space for misdiagnosing narcolepsy.

Idiopathic Hypersomnia Disability

There are many definitions of disability, whether they are financial or physical. All illnesses that are not visible with bare eye face a lot of stigmas, and sometimes it is easier to explain IH as a form of narcolepsy, without going in-depth too much. Another issue is that people with IH are often perceived or labeled as merely lazy, and those prejudices can be harsh because people do not have IH written on their forehead, and even if they did, many would still write it off as something that is not even a real disorder. Many people do not consider it a problem or disability, because who would not love to sleep that much and have a valid excuse for it. But, when you are an adult who needs to work, provide and function you cannot afford yourself a luxury to sleep that much.

Memory issues are common among people with IH, concentration and decision making also suffer, and every basic task requires an extra effort. Everyone can feel cranky and moody when being sleep deprived, but imagine how it is to live in a constant blur and mood swings. Medications and stimulants only work until a certain extent, healthy people sleep at night because there is no such thing as a pill that could replicate the effects of restorative sleep, and the same thing is with IH.

Medications that are currently used for IH cannot repeal the symptoms entirely, so these people have less time during which they can be productive; hence we cannot expect from them to work from 9 to 5. But, there are still options for people with IH who want to work; they can apply for short-term or long-term disability.

• Short-term disability policies will provide benefits after a brief waiting period which can last up to a month. This program is available for at least three months, but it can also last for years, and it usually pays around 60% of the salary. The employee has to gather all documentation and medical history so that the insurance company can confirm it. Once your short-term disability benefits are exhausted, you can apply for long-term.
• Long-term disability benefits can be available to private police or employer. The waiting period for approval is a bit longer, 180 days, but they can be available even through the entire retirement age.

If you are dealing with IH, and you are afraid that you might lose your job because of it, do not wait until they write you off completely, but secure your eligibility for disability programs through your employer.

Life With IH

People living with idiopathic hypersomnia feel like all they can do is sleep, all the time, every day. Patients with IH cannot control their condition because although their body got enough restorative sleep time, their brain did not. Their brain is in a state of chronic sleep deprivation, and those people feel like they are always sleep deprived even though they get more sleep than the average person.

Sleep-deprived people would say that those with IH are “blessed” because they do not struggle with falling or staying asleep, but that is just because those two conditions are complete opposites. An even better example of a contrary sleep disorder is insomnia.

One woman living with IH for years described that her symptoms became fully apparent when she was a teen, but she reported that even when she was a baby, her mom could not breastfeed her because she would fall asleep before getting a chance. During her childhood, she was often characterized as lazy, but the truth is that she was always tired, although no one took that seriously. She also highlighted that people with IH are everything except lazy since they have so little time to be productive, they put so much effort into anything because they desperately want to be able to do what everyone else usually does. She reported that getting a diagnose after a sleep study was the best day ever because she finally knew the answer to her problems, and even though it did not actually solve her condition, it was a long-awaited solution.

Certain sleep disorders can be more challenging to identify. You might only feel somewhat sleepy during the day and experience slight tiredness, leading you to think there’s nothing amiss with your sleep patterns. Nonetheless, should these symptoms continue over a longer stretch, your sleep quality could degrade significantly, possibly leading to insomnia. Inadequate rest raises the likelihood of several health issues; it also impairs your cognitive abilities, productivity, and overall life satisfaction. Therefore, if you or your partner exhibits any unusual sleep-related symptoms, it’s crucial to seek advice from a healthcare professional.

Periodic limb movement disorder (PLMD) is one of those sleep disorders that you might not notice at first. It is characterized by repetitive limb movements during sleep. PLMD usually involves the movement of hip, knees, ankles, and toes, but in some rare cases, arm movements can be present. While PLMD doesn’t have any dramatic consequences, it can lead to daytime sleepiness and fatigue, fragmented sleep, and insomnia if symptoms get worse. It might do more harm to your partner’s rest since the person affected often doesn’t realize that they are making these repetitive movements during sleep. The diagnosis requires an overnight sleep study, and the treatment might include the use of medications and lifestyle adjustments.

Symptoms

When PLMD was first discovered in the 1950s, it was named nocturnal myoclonus. We now use term nocturnal myoclonus for a wider variety of muscle jerking and twitching during the night, and PLDM is now characterized by repetitive movements of limbs during sleep. Periodic refers to rhythmic movements that occur every 20-40 seconds, and these events can last up to an hour. It usually involves big toe, ankles, or knees, but it can affect arms as well.

PLDM is the only sleep-related moving disorder that occurs exclusively during sleep. Hypnic jerks or sleep starts are other types of involuntary movements, but they mostly happen during the transition between wakefulness and sleep. You know that feeling, when you suddenly twitch your body, wake up, and it seems like you were dreaming of falling or tripping over. They are entirely normal and occur frequently, but they are not the same as PLDM. Restless legs syndrome (RLS) is another sleep-related disorder that affects limbs, but unlike PLDM, it only affects legs. RLS is described by the extremely unpleasant feeling and pain in lower extremities, and the sufferer feels like they should move to ease the pain. We should make the distinction between those two disorders, even though some researchers are suggesting that they are a part of the same condition. Individuals who have RLS also have PLDM in 80% of the cases, but the reverse can not be said. Unfortunately, the cause for both of these disorders is yet to be found, so there is still plenty of research to be done ahead of us.

Periodic limb movements happen during the non-REM sleep, mostly during light stages of sleep. The people experiencing them often don’t have a clue what’s happening until their partner points it out. Their partners can be awakened multiple times each night, as these movements can vary from mild to kicking, and can make sleeping impossible. Also, people with PLMD might experience one of the following consequences:

• Daytime sleepiness
• Fatigue
• Fragmented sleep
• Insomnia
• Depression
• Poor memory
• Shorter attention span

When more intense movements occur, the people experiencing them is most likely to wake up, and that can lead to sleep fragmentation. Falling back asleep after a few of these events might be hard for some people, and it can further lead to sleep deprivation and insomnia. Memory, learning, and other cognitive abilities such as problem-solving all suffer when you are not getting enough sleep. Your brain and body don’t have enough time to repair and restore, and your daytime functioning becomes worse and worse with every night of insufficient sleep. That is why it is important to talk to a medical professional if you notice that something is impairing your regular rest.

Causes and Risk Factors

PLDM can be primary or secondary. The cause for primary PLDM is still unknown, while secondary PLDM is caused by some underlying medical problem or medication abuse. Some abnormalities in nerves regulating limbs have been observed in the individuals with primary PLDM, but the nature of these abnormalities is still unknown, and it should be a subject of further research. Secondary PLDM has many different causes including:

• Diabetes mellitus
• Iron deficiency
• Spinal cord injury
• Spinal cord tumors
• Anemia – low levels of hemoglobin, a molecule that carries oxygen and carbon dioxide through the bloodstream
• Sleep apnea – breathing difficulties during sleep that causes oxygen deficiency and carbon dioxide build up
• Narcolepsy – a sleep disorder characterized by excessive daytime sleepiness and an overwhelming urge to fall asleep during waking hours
• Uremia – a build-up of waste products in blood due to the poor kidney functioning
• Multiple system atrophy – a rare neurological disorder
• REM behavior disorder – muscles are typically paralyzed during REM sleep, but with this disorder, they are not, so people act out during their vivid dreams
• Restless legs syndrome
• Sleep-related eating disorder – a condition characterized by people eating in their sleep
• Medication use such as antidepressants, antipsychotics, anti-nausea medication, and antihistamines.
• Withdrawal from sedative medications

The prevalence of PLMD is not known, but it is estimated to be about four percent in the adult population. Unlike RLS that is twice as likely to affect women than men, sex doesn’t play a significant factor when it comes to PLDM. It can also affect people of all ages, but it is much more common as you get older. Prevalence is at around 30% for people who are over 60 years old. Listed conditions and disorders increase the chances of developing PLDM, while scientists also argue that we could look for a cause among genetic factors and disrupted dopamine regulation.

Diagnosis

Poor sleep, daytime sleepiness, and fatigue are the most bothersome symptoms for most people affected by PLMD. However, it never occurs to them that their sleep problems are related to nocturnal limb movements since these symptoms are shared with most sleep disorders. Your health care provider might ask you a series of questions to determine the cause of your sleep disturbances. They are likely to ask you about your other medical problems both current and the past ones, your family medical history, your medication use, your travel and work history, as well as your general habits and lifestyle. They might ask you to keep a sleep diary for a week or two prior to your physical exams, with the information about your sleep patterns, associated symptoms, and the way they affected your daily life.

A detailed physical examination takes place to uncover if there is any underlying medical condition causing nocturnal limb movements. Blood tests are carried to determine hemoglobin levels and whether the patient is suffering from anemia, but also to show magnesium and iron levels, basic organ functioning, thyroid hormone levels, and any possible infection that could be causing the disease. A urine sample tells doctors if there is any drug use that could be the cause of the problem. Besides, these tests can show them whether there is some other deficiency and if your body is working properly. Unfortunately, no test can show a positive result and say that you have PLMD, so doctors need to consider various options and also do an overnight sleep study called polysomnography.

Polysomnography is done in a sleep facility where you are closely observed by sleep technicians. They monitor your breathing, heart rate, movements, brain activity, snoring, and other factors to determine the cause of your sleep problems. This helps them gather all the information they need, rule out other sleep disorders, and make sure that PLMD is the right diagnosis.

Treatment

Unfortunately, there is no cure for this disorder, but there are some things that can improve the symptoms. For mild PLMD, doctors often suggest only lifestyle adjustments, while individuals with more severe symptoms are prescribed some medications to help ease them.

Most of the medications used are similar to ones used to treat RLS, and they include:

• Benzodiazepines – drugs that suppress muscle contraction. They are also sedatives, so they will help you sleep through the limb movements. Clonazepam has been shown to produce the best results as it drastically reduces total limb movements per hour. It is the most widely used drug to treat PLMD.

• Dopamine agonists – drugs that increase the levels of dopamine, an important neurotransmitter involved in regulating muscle movement. While these are effective in some people, that is not the case with all PLMD patients.

• Anticonvulsant agents –  medications that reduce muscle contraction.

• GABA agonists – these agents inhibit the release of some neurotransmitters that play a role in muscle contraction. The result is less contraction and relaxation of muscles.

Lifestyle adjustments can help patients with mild symptoms, but people with more severe ones are also recommended to make them besides taking the appropriate medications. Following a regular sleep schedule can improve sleep quality. Creating a relaxing bedtime routine is important, and people with PLMD can try taking a warm bath, a light walk, or a leg massage before sleep to help with the symptoms. Doctors recommend avoiding alcohol and caffeine, especially at a later hour. Be aware that caffeine is also found in chocolate, tea, sodas, and not only coffee and energy drinks.

Proper treatment might lead to cessation of symptoms, but keep in mind that there is no cure for PLMD, and that relapses can occur at any point. Follow good sleep hygiene to minimize the chances of that happening, and regularly check with your medical provider to get a better insight about your condition.

Bruxism is identified as a sleep-related movement disorder that involves involuntary grinding of the teeth during the night. The term bruxism comes from the Greek ‘brychein,’ which translates to teeth gnashing – a fitting description of what occurs with this condition. This disorder can interrupt sleep and result in damage to the teeth. Being involuntary, movements that occur during sleep, such as those experienced with bruxism, are not performed consciously, similar to other sleep-related movement disorders. It’s predominantly associated with rhythmic chewing muscle movements, known as rhythmic masticatory muscle activity (RMMA).

People tend to grind their teeth while they are awake, but this disorder causes a much more significant health issue than occasional daytime teeth grinding. Since it is involuntary, individuals are not aware if they are grinding their teeth or not. People in most cases discover it when the condition is observed and reported by their sleep partners. Self-reports are very rare, and they have a high false-negative rate. If left untreated, the condition can last for years, causing your teeth to wear down, loosen or break, cause jaw pain, headaches, and in some cases temporomandibular joint (TMJ) disorder. The biggest problem with this condition is that it interferes with sleep quality. Teeth grinding tenses the muscle, preventing the body to relax and fall into a deep and restful slumber.

There are two main types of bruxism – sleep bruxism or nocturnal bruxism that happens during sleep and awake bruxism or diurnal bruxism that happens during wakefulness. Both types cause similar dental damage, but sleep bruxism tends to interfere with sleep, get worse in the morning and aggravates as the day advances, while awake bruxism appears only during the day and doesn’t worsen from morning to night.

The term bruxism was introduced in 1938 to define repetitive teeth grinding that was also known as bruxomania. Back then, there was no differentiation between sleep bruxism and diurnal bruxism. After reviewing both conditions, researchers agreed that bruxism is best defined as a repetitive jaw-muscle activity with grinding or clenching of the teeth and that it should be separated from diurnal bruxism.

Symptoms

Bruxism can display a variety of symptoms like tooth pain, unexplained facial pain, headaches, jaw pain, and earaches. Apart from these, people suffering from this condition can also experience swelling and pain in the jaw, flattened or fractured teeth, changes in teeth shape, increased tooth pain or sensitivity, damage from chewing on the inside of your cheek, and broken or chipped teeth, crowns or fillings.

People with sleep bruxism often have excessive tooth wear, especially attrition that is responsible for the flattening of the occlusal (biting) surface. Apart from that, other types of tooth wear, failure of dental restorations, and tooth fractures are also common. Abfraction is also common, with notches that appear at the gum line of the teeth, and around their neck. Inflammation of the teeth’s periodontal ligament can also happen, making them hurt or sore on the touch or bite.

Hypersensitive teeth are also a common symptom, which occurs when teeth wand their insulating layers dentin and enamel are worn off. Dental pain is in that case experienced when eating or drinking something warm or cold, depending on the level of tooth damage. Cheek biting, pain or fatigue of the muscles, burning sensations of the tongue, restricted mouth opening, lip biting, and hypertrophy of the muscles can also manifest with teeth grinding. Lastly, during sleep, you will produce grinding noise which may get noticed by your sleep partner or roommate, if you have one.

It is estimated that around forty million Americans have problems with teeth grinding at day and night. Approximately ten percent of them experience severe consequences such as teeth, crown, and filings damage.

Young adults with less than thirty years have more issues with teeth grinding than other age groups. Adults over sixty years rarely have this issue. Bruxism is most common during childhood. Almost a third of children grind their teeth, but fortunately, most of them grow out of it when the permanent teeth start showing up. As for genders, bot males and females are equal in the number of sleep bruxism, but awake bruxism is more prevalent in women.

Causes

The cause of bruxism is not yet known and probably involves different factors. What is certain is that awake bruxism and sleep bruxism have different causes, and treatments as well. The condition is often the result of anxiety or stress, with bruxism as a coping mechanism. Adults that are emotional and have hyperactive or aggressive personalities are more prone to teeth grinding. Individuals that have sleep-related breathing disorders have a higher chance of developing bruxism if they do not treat their conditions properly. Disorders like sleep apnea, REM behavior disorder or sleep talking put people at risk of sleep bruxism, as well as nicotine, alcohol, drugs, and caffeine.

One of the causes of sleep bruxism can be sleep arousal – with the rising activity of the cardiac and respiratory systems. The arousals happen up to 15 minutes in one hour of sleep, and they can appear with increased muscle activity. These arousals are more frequent with individuals that have other sleep-related breathing disorders, especially sleep apnea. With sleep apnea, teeth grinding can be an unconscious response where jaw muscles prevent the restrictions of airflow. Many physical conditions can also cause bruxism, such as an abnormal alignment of the upper and lower teeth or acid reflux.

Risk Factors

Many risk factors can increase your chances of having sleep bruxism. The primary risk factor is stress. Increased levels of stress or even anxiety have been known to lead to teeth grinding. The same goes for frustration or anger. Individuals with a competitive, hyperactive or even aggressive personality are more likely to develop this condition. Age is also a significant contributor to teeth grinding. Like we mentioned before, it is most common in young children, but it disappears by adulthood in most cases.

Consuming particular medication or other substances can also lead to sleep bruxism. Psychiatric drugs and certain antidepressants can cause teeth grinding, which can lead to sleep bruxism, both the awake and sleep one. Consummation and abuse of nicotine, tobacco, caffeine, alcohol, or drugs is a significant risk factor for bruxism.

Genetics are also a risk factor for teeth grinding. Because it tends to happen in families, if anyone from your family has bruxism or has a history of it, chances are you might also have it. And some medical and mental health disorders like dementia, epilepsy, Parkinson’s disease, gastroesophageal reflux disorder (GERD), night terrors, Attention Deficit Hyperactivity Disorder (ADHD) and other sleep-related disorders also increase your risks.

Sleep Bruxism in Children

Around thirty percent of five-year-olds have shown signs of bruxism. It can develop as a coping strategy for their teething or earaches, but fortunately, in most cases, it goes away just like sleepwalking, night terrors, and bedwetting. By the age of 13 more than half get rid of their sleep bruxism.

Diagnosis

Diagnosing sleep bruxism is done by checking your oral healthcare. Having a dental checkup every six months is a good way to find early signs of bruxism. Diagnosing sleep bruxism early is difficult, but also advantageous because it can prevent further teeth damage and the detrimental effect on the quality of your sleep.

When diagnosing sleep bruxism, it is vital to exclude any temporomandibular disorders, dental diseases, seizure disorders, and rhythmic jaw movements. This exclusion is done with a dental examination and electroencephalography for seizure disorders. The diagnosis is made clinically. The clinical study is based on the person’s history with reports of grinding noises, sleep disruptions and any other indicators and symptoms. For those who live with other people, the diagnosis is very easy – just by the sound. Individuals that live alone can try using a sound-activated tape recorder, Bruxcore, or Brux Checker.

After all other disorders have been excluded, a sleep study should be done. The study monitors any increased activity in the body during sleep with electrocardiography, airflow monitoring, electromyography, audio-video recording, and electroencephalography.

Treatment

There is no cure for bruxism. You can only reduce its symptoms and prevent further damage it can cause. With a combination of therapies, you can also improve your sleep quality.

The first thing you need to do is to improve your sleep hygiene and reduce stress. You need to maintain a regular sleep/wake schedule and incorporate stress management and relaxation techniques into your bedtime routine. Reducing stress can be done through yoga, meditation, and deep breathing exercises. Warm baths, facial massages, along with avoiding chewing gum and hard foods, as well as eliminating or just reducing alcohol, caffeine, and nicotine are great ways to relieve both the symptoms of stress and sleep bruxism. Going through CBT to practice proper jaw and mouth positions can also contribute to stopping your teeth grinding. Combining cognitive behavioral therapy with occlusal splints (nighttime teeth grinding mouthguards) can also be an effective treatment for sleep bruxism. There are also some medications – muscle relaxants, which can reduce jaw muscle tension when taken before sleep.

It’s important to know that mouthguards and splints are recommended for controlling bruxism, but they do not cure it. Your dentist can either make a mandibular advancement device (MADs) or you can get a tongue retaining device. The devices do not stop the grinding, but they protect your teeth and prevent future damage. MADs and TRDs, apart from alleviating bruxism, can also be used to treat sleep apnea. However, for sleep apnea, using a continuous positive airway pressure (CPAP) device is the best therapy.

Eating disorders are psychological disorders defined by abnormal eating habits that result in negative, sometimes deadly, consequences for an individual’s physical and mental health. Contrary to what many believe, these conditions are severe and often necessitate medical intervention, which can last for up to five years or more, depending on the severity of the condition and the timing of the treatment initiation. Among the disorders classified in this group are anorexia nervosa, bulimia nervosa, binge eating disorder, rumination disorder, pica, avoidant/restrictive food intake disorder, and other specified feeding or eating disorders.

The cause of eating disorders isn’t clear in most cases, but it has been determined that both environmental and biological factors contribute to their development. While eating disorders aren’t lifestyle choices, specific ways of living may put one at a heightened risk of developing such an illness. Strict and persistent dieting, vigorous physical activity and the cultural idealization of the slim figure make eating disorders prevalent in certain pressured population groups like models or dancers, with the incidence rate of over 12% in the latter group alone. People who have a history of sexual abuse have an increased risk of eating disorders, and certain disorders like pica are more prevalent in people who also have intellectual disabilities. Other mental conditions like depression and anxiety regularly comorbid many of these disorders and sleep disturbances are not rare, either, bringing their own sets of complications into the already unstable situation.

Mental health awareness is just gaining momentum. Even with the frequent misconceptions about them, eating disorders, too, are finally starting to get more recognition in the public eye – at least the more prevalent types. But one specific type of eating disorder, while quite intriguing, remains largely unknown and unexplored. A case in point is the sleep-related eating disorder (SRED), which will be the point of focus in this article. To bring more light to the subject, continue reading.

What are Sleep-Related Eating Disorders?

It is common knowledge that you aren’t supposed to eat right before bedtime, especially when it comes to high-fat junk foods. You may be guilty of doing that anyway, or even of grabbing a bite if you happen to wake up during the night – but that’s not SRED, exactly. What makes the difference between such moments in an otherwise healthy person and an SRED scenario is that you are awake and aware of what’s happening. Now, imagine getting up, walking to the fridge and devouring whatever you found in there – while being asleep!

This blend of binge eating disorder and sleepwalking is a type of parasomnia displaying through recurring episodes of eating during one’s sleep. It causes a person to eat a large portion of highly caloric food and wake up in the morning feeling foggy, confused, disoriented and in most cases without any recollection of what had happened during the night. People who experience SRED often eat inedible items, too – paper, washing detergents, anything that they come across in their episode, which usually lasts about ten minutes and happens at least once every night. Needless to say, this is extremely dangerous, even deadly, as the person can unconsciously eat a toxic chemical, or get injured during the food preparation by using a knife or the oven. Too many things can go wrong. Even in less extreme scenarios, sleep-eating can disrupt the normal cycle and cause weight gain or insomnia, which then contributes to the development of a new wave of difficulties.

SRED is classified as a sort of parasomnia. Often confused with this disorder is the Nocturnal Eating Syndrome (NES), which is classified as a type of eating disorder – the two are sometimes hard to differentiate and regularly merged into a single term. The difference between them consists in the fact that SRED includes partial or complete amnesia after a nightly eating episode, doesn’t cause insomnia or hunger prior to sleep onset and has a greater link with other sleep disorders than NES does.

It is estimated that over 5% of the population has SRED, with the incidence rate in people who have a type of eating disorder climbing up to 17%. At the greater risk are women, making over 65% of the general population statistic, while roughly 40% of people with this disorder are overweight.

Causes

The cause of sleep-related eating disorder is unclear, with most precise research so far leading to abnormalities in ghrelin and leptin hormones, which regulate one’s hunger. Other triggering factors include:

• Dieting, stress, and sudden cessation of substance or alcohol abuse
• Sleep disorders like narcolepsy, restless leg syndrome, sleepwalking, periodic limb movement, obstructive sleep apnea, irregular sleep-wake rhythm disorder, and sleep-related dissociative disorders
• Autoimmune hepatitis
• Some medications like antipsychotics, antidepressants or some hypnotic drugs used to treat insomnia like Ambien, Intermezzo, Zolpimist, etc.
• Mental disorders like anxiety or depression
• Suffering from another eating disorder like anorexia, bulimia, peca, and so forth
• Being closely related to a person who experiences SRED or sleepwalking
• Sleep deprivation

Symptoms

The symptoms of SRED include:

• Regularly eating or drinking during sleep, mostly in its first half, with this pattern repeating every night
• Impaired alertness while preparing and eating food, and eating it in a very sloppy, uncontrollable manner
• Little to no memory of the event the next morning
• Eating high-fat, calorie-rich foods or strange combinations of foods
• Eating inedible items like detergents, cigarettes, napkins, uncooked, frozen foods or foods still wrapped in foil
• Being clumsy while preparing food or eating in such an episode, potentially even getting injured while cutting or using some hot appliance like the oven, kettle, etc.
• Not being easily woken up or redirected from engaging in such actions

Diagnosis

The diagnostic of this disorder has no single fool-proof method. After you’ve been admitted into a sleep clinic, a doctor might begin with a few questionnaires and a physical exam, but not before taking your thorough medical history. This will typically be done to confirm whether you have a second existing condition or any allergies, the types of medication you were using in the past, recently stopped taking or still take, your overall health status and your age.

For a more concise and accurate, although subjective status report, your doctor might instruct you to start filling out a sleep journal. This will include writing an entry every single day for about two weeks minimum, recording everything you deem significant during both day and night – and don’t be shy here. Anything remotely associated with your sleep, health and emotional state is welcome. The more you write, the easier it will be later to assess the information, distinguish patterns from circumstantial events and ultimately help diagnose you. In fact, having your partner, parent or other household member keep their own log at the same time would be even better, especially in a case like this, as they might notice some behaviors that you might be unaware of and add valuable input as a third party. This ensures that, although you may not be conscious while binging in your sleep, your partner will be able to explain how and when it happened and how long it lasted.

Besides that, you may be asked and tested for insomnia, excessive sleepiness, and polysomnography might be ordered to eliminate the possibility of obstructive sleep apnea.

Treatment

Similarly to the diagnostic part of this equation, treating SRED isn’t a one-size-fits-all situation. If you have previously read other articles on this website, you might have noticed an approach that is similar for various types of sleep disorders when it comes to sleep hygiene. However, in this particular case, as well as in the case of many other eating disorders, some of the tips commonly listed in this area are best not to be followed. In fact, doing the exact opposite in certain scenarios might be just what you need. For example, a rule of thumb is, you should reduce calorie-rich foods in the evening to promote better sleep. Except, in this case, your problem is more likely to be undereating and dangerous restrictions that your body attempts to compensate for during the night, which means you should increase the amount and volume of the foods you eat, not decrease it. Even the simple “keeping your weight in check” might trigger the disordered eating mindset and would best be avoided.

Being one of the most health-threatening parasomnias, the treatment of SRED will require a meticulous approach from your doctor, and the therapy plan will depend on the particular cause of your problem. To address a few possible scenarios, the treatment may take one or more of these routes:

• Discontinuing Intermezzo or other sleep meds and reevaluating all other medication use. Discuss this with your doctor and remember to stay in contact even if the first solution didn’t work for you. It’s smarter to explore options under supervision than to risk putting your life on the line by conducting your own experiments.
• Therapy change. Reconsidering the therapy options for insomnia, attempting cognitive behavioral therapy (CBT) or some less invasive supplementing system. Ask your doctor to walk you through the different possibilities.
• Addressing anxiety, depression and any other present medical condition. You need to tackle all the health problems if you hope to be successful in treating any single one.
• No extreme dieting. Do your best to eat abundantly during the day, and even before bedtime, contrary to what we usually suggest here. This may satiate your body enough to stop it from taking its own measures in survival mode during your sleep. Making sure you eat enough calories from balanced foods and not skip meals is essential here.
• Avoid overly strenuous exercise. Especially if you are likely to undereat or barely reach the average bar, wasting that energy so recklessly isn’t a good idea.
• Stress management. Meditation, yoga, engaging in a hobby or even booking some time with a therapist to learn how to cope with difficult situations and setbacks is another critical factor for treating any problem. Stress is linked with a lot of extremes – weight gain, weight loss, hair loss, poor sleep, impaired metabolism, and immunity system, etc.
• Light therapy. Using light therapy to help keep the circadian rhythm in check, promoting a regular sleep schedule and quality but also reintroducing regular mealtimes.

Lastly, if a combination of the above isn’t enough, SRED can be treated with medications like dopamine agonists, opiates, topiramate, and trazodone. Remember that this isn’t indicated to replace proper physical and mental hygiene. You still need to do your best to keep a healthy mindset and build sustainable habits. It is entirely okay to need medication, but don’t rely on them first and foremost.

Everybody experiences nightmares occasionally. Though they may be disturbing momentarily, for the majority, they don’t lead to any long-term problems related to sleep. It’s generally accepted as a normal occurrence, similar to being disturbed by noise from the environment or needing to use the bathroom in the middle of the night (though nightmares are more frightening). If nightmares are rare or only mildly disruptive, there’s no need for a medical examination to determine their cause. Yet, for about 4% of the population in the United States, nightmares pose a serious issue.

Nightmare disorder (otherwise known as dream anxiety disorder) can cause severe problems in a person’s daily routine, usually stemming from their tendency to avoid sleep after experiencing nightmares as often as they do with this condition. It can be hard to get proper rest when your brain starts associating bedtime and your bed itself with fear and stress, and this issue can then affect your work performance, libido, overall health, and other aspects of life. In order to deal with nightmare disorder, one must first understand it, and that’s where we come in. This article contains all the information you need to recognize nightmare disorder and take the right steps towards making your life easier with this condition. Let’s get into it.

What is Nightmare Disorder and How Do You Recognize It?

As its name may imply, nightmare disorder is a condition characterized by frequent and intense nightmares. It belongs to the parasomnia category, and the nightmares only occur during REM sleep. These nightmares can often cause severe anxiety and dysphoria, if not full-blown depression. This condition ruins your sleep in two major ways, which have a huge number of negative consequences when it comes to your health and personal safety. The first way nightmare disorder destroys your sleep is straightforward – you wake up often during the night because of nightmares, causing fragmented sleep which ruins your circadian rhythm. In case you don’t know what a circadian rhythm is, it’s a rhythm that dictates processes in your body, and things like appetite, libido, daily energy levels, etc. You have a clock in your brain that uses photoreceptors to tell the time of day, and then decides how your body operates depending on whether it’s day or night.

By disrupting your circadian rhythm, you throw your entire body off-balance in terms of hormone production and general functioning. Your immune system takes a hit, which can lead to seemingly unrelated illnesses that are hard to trace back to nightmare disorder or any other sleep disorder. The second thing that happens is that your brain starts to harbor very negative associations with the bed. Without your direct knowledge, you begin to imagine your bed as a source of fear, stress, and anxiety, which can convince a lot of people to indirectly or directly avoid sleeping. Eventually, fatigue builds up to a point where the person is unable to function properly in any environment, including work, traffic, social situations, etc. This means that it’s much easier for nightmare disorder to throw you off-balance than most other sleep disorders, at least when it comes to the effective amount of rest you get (it’s one thing to sleep for 7 hours total, and another to do so uninterrupted).

There are several ways to notice nightmare disorder, and ways it differs from other parasomnias that make it unique. The most obvious way to spot nightmare disorder is the resulting nightmares. Whether it’s you or your loved ones, nightmares often wake the person up and put them in a very alert state where they’re aware of their surroundings. Other parasomnias like sleepwalking make the sleeper almost completely unresponsive to their environment. These nightmares are frequent, often intense and they appear on their own, without a trigger like substance abuse or medication side-effects.

Additionally, nightmares are much easier to remember than the episodes of any other sleep disorder. People feel fear and anxiety, which tend to stick for a while after the person wakes up, making them much more capable of remembering nightmares, even if only partially. One benefit of this is that nightmares are easy to document in a sleep journal, which helps you determine whether you have this disorder in the first place, and it helps doctors when they try to diagnose you properly.

A lot of parasomnias involve motor activity, usually leg jerking or arm flailing (if not walking around and doing other things). Nightmare disorder doesn’t come with any of these symptoms, at least usually. The most intense movement you can expect to see is a sudden stir as you wake up from the nightmare. Waking up from a nightmare leaves you in a state where you’re almost perfectly aware of what’s going on, whereas a lot of similar disorders come with a dose of confusion and disorientation.

There are three levels of nightmare disorder severity that sleep experts agree on, and they’re separated based on how frequent the nightmares are. Mild nightmare disorder comes with one or fewer nightmares per week on average, making it a nuisance, but nothing to obsessively worry over. Moderate nightmare disorder is considered a condition where you experience more than one nightmare per week, but not every night. Severe nightmare disorder is defined by nightly or almost nightly episodes and is a huge problem for the person in question.

What Causes Nightmare Disorder?

Unfortunately, much like many other sleeping disorders, nightmare disorder doesn’t have a single cause we can point to. A lot of other parasomnias are at least partially caused by genetics, but this isn’t the case for nightmare disorder. The main similarity this condition shares with others in its category is that it occurs primarily in children. Children are also the most vulnerable when it comes to the amount of fear caused by nightmares and sleep avoidance. Around 30% of all children experience frequent nightmares, whereas another 40% experience them occasionally. Once adulthood kicks in, nightmare disorder becomes much less common, with only around 2% of adults having to face this condition.

Nightmares, in general, are linked to mental health issues and psychiatric disorders, such as schizophrenia and BPD (borderline personality disorder). Nightmare disorder can also come out of these problems, but it’s not guaranteed. Because it occurs only during REM sleep, older adults are much less likely to experience this disorder, as their time spent in REM sleep is drastically reduced. The contributing factors should sound familiar by now, as they’re shared among most sleeping disorders. Bad sleep hygiene, stress, anxiety, trauma, substance abuse – these are only some of the potential contributing factors for nightmare disorder and should be paid attention to during daily life. Nightmares can cause stress and anxiety, which can, in turn, generate more nightmares, meaning it’s very hard to get proper rest once the vicious cycle kicks in. If you are forced to take prescription or over-the-counter medication for other conditions (even if they’re completely unrelated), make sure the side-effects don’t include an increased chance or severity of nightmares. Any medication that messes with your REM sleep can contribute to nightmares in one way or another, but the most common offenders are hypnotics, beta blockers and SSRIs (selective serotonin reuptake inhibitors).

Doctors rarely have trouble diagnosing nightmare disorders, because the symptoms are either unique or very easy to notice, especially if you bring them a sleep journal. They will examine your medical history, perform a selection of basic examinations, and possibly get you to fill out a questionnaire or two. These questionnaires are often specialized diagnostic tests developed specifically to test for sleep disorders and fatigue levels, and filling them out can not only help diagnose nightmare disorder but any other sleep-related problem as well. When checking for medicine side-effects, no one does it better than a doctor, so consult them if you’re unsure about anything.

How to Live With Nightmare Disorder

As is the case with many other sleeping disorders, nightmare disorder doesn’t have a perfect cure. Instead, sleep experts and doctors recommend several steps you can take to change your lifestyle and avoid things that increase the chances or severity of a nightmare episode. Following these tips can also improve your general health, and that’s a good reason to do it even if nightmares temporarily subside. Don’t think you’re in the clear if you go for one whole week without nightmares or something like that. Here’s what you can do to make your life easier despite having to deal with this annoying condition:

• Try to avoid and relieve stress whenever possible. Relaxation exercises are a wonderful habit to pick up for people who experience frequent nightmares because they can alleviate anxiety and stress – two common contributing factors for nightmare disorder. Alternatively, regular visits to a local sauna can do the trick, especially because saunas relieve your body of many toxins that cause discomfort.
• Exercising regularly has a similar effect as performing relaxation exercises and visiting saunas, almost acting as a mixture of the two. When combined with these other positive habits, exercise can really help you air out frustrations, achieve better health overall and avoid nightmares in some cases.
• Medications like prazosin can alleviate symptoms and reduce nightmare frequency, but they should never be consumed without consulting your primary care physician. Don’t experiment with medicine. If you are taking medication for other conditions, and the side-effects cause nightmares, you may want to discontinue that treatment plan and request alternatives from your doctor.

Most folks who toss and turn at night suffer from the same headache: their sleep gets chopped up, making them feel like a zombie during the day. Picture your sleep cycle as a movie – when it gets paused and played over and over, you miss out on the good parts, leaving you worn out and foggy. The big scare about not catching enough Z’s? It’s like leaving your body’s guard down, opening the door for sickness and mishaps whether you’re at your desk or behind the wheel. You’ll find out why snoozing properly is your best armor against these unwelcome guests. Keep reading, and you’ll discover secrets to lock down a fortress of rest every night.

Night terrors (also known as sleep terrors or pavor nocturnus) are different. This sleep disorder occurs in episodes somewhere around 3-4 hours after the person has fallen asleep, and it’s characterized by extreme fear, flailing limbs and screaming. One of the main risks to worry about here is potential injury, not just to the person experiencing sleep terrors, but anyone in their vicinity. This sleep disorder can hurt a person’s feeling of self-worth and impact their relationships with those around them.

The purpose of this article is to provide enough information on night terrors that anyone dealing with them (whether through first-hand or second-hand experience) can take proper steps to ensure the safety of everyone involved. We will be covering potential causes, how it’s diagnosed, as well as what you can do to make your life easier while fighting off night terrors.

An Overview of Night Terrors

Night terrors are a sleep disorder that is primarily seen in children, usually before or during early teenage years. After that, most people grow out of this condition – the percentage of affected people drops from 7-20% (in children) to only around 2-4% post-adulthood. Most of the time, night terrors are outgrown after roughly eight years of age. The most common issue with night terrors can be the fact that it’s often misinterpreted as regular nightmares, which is barely similar in any way. These are two separate problems, and treating them as one thing can lead to complications for the patient in question, even if those complications don’t directly impact their health.

One of the biggest and most reliable ways to separate night terrors from nightmares is based around how much the person remembers their episode. Nightmares stick out in our mind because we can often recall the details, and they can also wake us up frequently. On the other hand, the person dealing with night terrors often has no recollection of what happened the previous night (even if they went through an episode). This isn’t the only way to differentiate between nightmares and night terrors – the other major difference is that nightmares very rarely involve any kind of motor activity, especially thrashing. We advise seeking medical help if the problem keeps repeating.

Recognizing night terrors is easy if someone in your household is experiencing them. The symptoms are very obvious and include screaming, intense fear, limb flailing, and similar actions, usually while the person in question is sitting up. Often, they will wake up anyone else that is in their home when they go through an episode of night terrors. If you talk to this person about their problem, be sure to comfort them to avoid any unnecessary embarrassment that can have a negative impact on some people.

In terms of frequency, night terror episodes can vary heavily and differ between person to person. You can expect to face night terror episodes anywhere from weekly to multiple times per night, with varying levels of severity depending on your biological quirks and medical history. The higher the frequency, the more disruption night terrors will cause to your circadian rhythm through fragmented sleep. Because your circadian rhythm (a biological rhythm regulated by a “clock” in your brain stem using photoreceptors to determine the time of day) affects such a large number of processes in your body, this can be catastrophic for your health.

Night terrors typically occur within the first 3-4 hours after falling asleep. A connection has been made by researchers between night terrors and slow-wave sleep (otherwise known as deep sleep or delta sleep). Because slow wave sleep is more common in the early hours of a person’s rest, it makes sense that night terrors wouldn’t take very long to trigger during the arousal periods. In the past, it was hard to differentiate night terrors and nightmares, but that problem was solved since the discovery of rapid eye movement.

Causes, Symptoms, and Diagnosis Methods

In order to start dealing with night terrors and confirm that the patient is facing them, you have to know how to identify the symptoms. Sleep disorders tend to make their symptoms obvious, fortunately, so this is not difficult to do. In most cases, you want to look for the following telltale signs of night terrors:

• A look of intense fear is one of the main ways to tell if night terrors are occurring. While this can happen when someone wakes up from a nightmare, the person dealing with night terrors often isn’t very responsive to their surroundings.
• Screaming is not uncommon during night terror episodes. This is probably the easiest symptom to spot, so identifying an episode should be straightforward.
• Arm and leg flailing is another telltale sign of night terror episodes and the most dangerous one at that. Depending on the person’s surroundings, this flailing can result in injuries.
• Much like with panic attacks, you can expect to notice intense, fast breathing and a rapid heart rate. Their eyes may zoom from side to side, searching for threats. It’s incredibly hard to console a person experiencing a night terror episode.
• Sweating is a common symptom, and it isn’t exactly hidden from observers. When combined with any of the above symptoms, it is almost impossible to mistake night terrors for anything else.

If you’re concerned about night terrors and consult your doctor about them, you can expect to participate in polysomnography. Commonly called a “full sleep study,” polysomnography is a thorough and effective method of diagnosing every single sleep disorder out there, night terrors not being an exception. This process takes a full night to perform, and a follow-up test can take up the entire following day if you want to be thorough. Organize your schedule around this.

Most sleep disorders have unclear causes, and night terrors are more sensible than average in that regard. Night terrors are directly caused by the extreme arousal of the central nervous system somewhere between late NREM sleep and REM sleep. Several factors contribute to the likelihood of night terrors occurring. Sleep deprivation is a common one, and unfortunately, it also results from night terrors, due to how fragmented sleep reduces the amount of effective rest you get (even if you get the “right” amount of sleep on paper). Other important contributing factors include heavy caffeine intake (this one tends to contribute to most other sleep disorders, too), illness and sleeping in an uncomfortable location, one that the sleeper hasn’t adjusted to efficiently.

Dealing With Night Terrors

Fortunately, night terrors don’t require any real treatment, as they’re outgrown by the vast majority of children that experience them. Unfortunately, if you’re one of those people that still have this issue well into adulthood, the bad news is that night terrors have no real cure. The best you can do is minimize the impact they have on your life by reducing the risk of injury. Much like with sleepwalkers, this is done by moving sharp corners and other obstacles away from the bed and common movement paths through the house. In rare cases, someone dealing with night terrors might get up and move around in a state of panic, and you don’t want them tripping on anything, falling down a flight of stairs or hitting themselves on any edges.

Parents are advised to improve their children’s sleeping environment and train them to practice better sleep habits. You may hear the term “sleep hygiene” tossed around, but in basic terms, you want to establish a strict and healthy sleep schedule for kids dealing with night terrors. Prevent them from consuming foods with high sugar content or caffeine (in case they get their hands on something like coffee). If the problem persists, gently wake them up around the time you expect night terrors to occur, since that can completely stop an episode from happening. Don’t go overboard, as interrupting someone’s sleep too often is never good for their health.

Often referred to as Familial Hibernation Syndrome, Kleine-Levin Syndrome (KLS) is an uncommon disorder characterized by altered behaviors such as heightened libido, an overwhelming need for sleep, and increased food consumption. This condition predominantly impacts adolescent males. Although such behaviors can be typical for teenagers, individuals with KLS experience these symptoms to an extreme degree.

When awake, patients exhibit excessive daytime sleepiness; they might be lethargic, apathetic, disoriented, and can even have hallucinations. The symptoms show up in cycles, with periods of normal behavior in between. Cause of this disease is still unknown, and the weird thing about it is that the episodes become less frequent with age, and then they disappear entirely. They might reappear later in adulthood, but these cases are sporadic.

Scientists believe that genetic predispositions play a role in some cases, and some individuals are more prone to KLS because of that. Malfunctioning of the hypothalamus, a part of the brain that regulates sleep, appetite, body temperature, and many other things, is another suspect when it comes to the cause of KLS. Some experts think that it could be an autoimmune disease due to the high percentage of cases that exhibit signs of inflammation before the development of symptoms connected to KLS.

Symptoms

KLS is an extremely rare disorder characterized by the excessive need for prolonged periods of sleep (hypersomnia), excessive eating (hyperphagia), and abnormal behaviors. The onset of symptoms is very rapid, and they might persist between a few days and a few weeks. People with this condition might have 2 to 12 episodes each year, and they usually show no symptoms of the disease between the events. In most cases, the frequency of these episodes decreases with age and then suddenly disappears. However, there are reported cases of people experiencing these symptoms throughout late adulthood.

Individuals with KLS might sleep up to 20 hours a day, and they only wake up to eat and go to the bathroom. They can be awakened during the sleeping periods, but they are often overly tired, irritable and show the lack of emotions. They might also seem disoriented and confused and have difficulties speaking. In some cases, patients might experience vivid hallucinations where they feel detached from reality or have disconnected thinking.

Another big sign of KLS is an urge to overeat. Affected individuals don’t seem to feel hunger or even satisfaction and fullness after a meal. They simply consume all the available food no matter the type, condition or quality. Overeating combined with long periods of sleep and no activity can lead to weight gain. Unfortunately, obesity leads to several other health conditions such as high blood pressure, heart disease, diabetes, as well as sleep disorders such as sleep-related breathing disorders like obstructive sleep apnea.

Increased sex drive is also a symptom in some individuals. Others might experience behavioral abnormalities such as memory problems, lack of focus and motivation, and impaired concentration. Some patients were observed to show signs of aggression, anxiety, and depression. Hypersomnia affects all people with KLS, cognitive changes (96%), eating disturbances (80%), depressed mood (48%), hypersexuality (43%), and compulsions (29%).

Causes

KLS mostly affects adolescent males, and the symptoms usually start at the age of 15. However, there are reported cases of KLS affecting older males as well as females. While men are twice as more likely to develop KLS, women usually have longer disease course. Since it is a very rare disorder, it is hard to determine its precise frequency in the general population. Medical professionals even think because of the unknown cause of the disease, and its rarity, that the KLS is underdiagnosed, making it even harder to predict its prevalence.

The exact cause of KLS is still unknown, and scientists are working hard to figure this one out. It is speculated that the malfunction or damage to the hypothalamus might be the cause, as it is the part of the brain that helps regulate functions of appetite, sleep, thermoregulation, as well as many other things.  Since the flu-like symptoms and inflammation often show up before the signs of KLS, it led scientists to believe that the autoimmune process plays a role in the development of the condition. Autoimmune diseases happen when our body’s natural defense system that is protecting us against outside pathogens and diseases starts attacking our healthy tissues and organs.

Scientists have even proposed that KLS can be a result of head trauma or some other problem. In some sporadic cases, KLS has affected members of the same family, implicating that there might be genetic factors that may cause the development of this condition.

In a 2015 systematic review, researchers determined that infection or flu-like symptoms were present in more than two-thirds of cases, 3-5 days before the onset of KLS. Other triggers were more variable and rare, and they included heavy alcohol and marijuana consumption, head trauma, sleep deprivation, stress, mental exhaustion, menses, lactation, and other smaller factors. The disease symptoms lasted between 0.5 to 41 year, with an average duration of 8 years. Episodes lasted for ten days on average, with 3.5-month intervals in between. There were patients with secondary KLS, where the development of the condition was linked to prior stroke, post-traumatic brain hematoma, genetic and developmental diseases, multiple sclerosis, autoimmune encephalitis, or severe infectious encephalitis. Compared to patients with primary KLS, symptoms here appeared later on in life. The patients also experienced three times more episodes, with a longer duration of these events. The disease, however, didn’t last longer on average.

Diagnosis

KLS robs the affected individuals of their time, energy, and health. When you are bed-driven, sleeping most of the time, and waking up just to fulfill your most basic needs, there is no room for anything else. People’s quality of life is severely reduced; they can’t go to school, work, or merely do some basic things that occupy our time. Episodes of KLS are terrible, and even though the symptoms are so severe, diagnosing the disease isn’t as easy as it seems. Experts need to rule out any other underlying causes, and the disorders that might show some similar symptoms like narcolepsy.

People with KLS are often diagnosed with a psychiatric disorder by mistake. Periods of hypersomnia, overeating, and withdrawal are all similar to severe clinical depression, and some people even experience periods of high energy after these episodes that mimic the manic events, so they can be misdiagnosed with a bipolar disorder. Narcolepsy, temporal lobe epilepsy, Kluver-Bucy syndrome, and multiple sclerosis can also produce similar symptoms, so doctors need to rule them out first.

And that is pretty much how the medical professionals diagnose KLS, they rule out every other possible disorder first, and then use the comprehensive medical history of a patient to determine if a person suffers from KLS. There are many medical professionals involved in this process, and they work together for quite some time to make the diagnosis of KLS. The description of symptoms and abnormal behaviors by the family is extremely helpful in setting the right diagnosis. Doctors will need to take several tests like EEG, MRI, cerebrospinal fluid and hormonal analysis.

Related Disorders

Narcolepsy is described by excessive sleepiness throughout the day, sudden muscle weakness, hallucination, sleep paralysis, and disrupted sleep during the night. People with narcolepsy also experience lack of energy, irresistible urge to fall asleep, and inability to stay awake during these “sleep attacks.” The symptoms of narcolepsy begin in the second decade of life, and the cause of this sleep disorder is unknown as well.

Many other sleep disorders show some similar symptoms and are causing disturbed sleep. These include cataplexy, sleep apnea, idiopathic hypersomnia, delayed sleep phase syndrome, and others. Depression and bipolar disorder are mostly mistaken with KLS because of the similar symptoms that the individuals go through. KLS can, in fact, lead to the development of depression since these episodes are very exhausting and might seem like there is just no way out. That’s why you should see your doctor if you notice any of the mentioned symptoms. They are trained to help you and can determine what is the underlying problem of your symptoms and sleep disruption.

Treatment

After the clinical evaluation and diagnosis of Kleine-Levin Syndrome, there are different ways to combat the disease. There is no universal cure, and the treatment depends on the case, and is mostly aimed at battling individual symptoms. As with diagnosis, the treatment might also require a team of specialist. Pediatricians, psychologists, psychiatrists, neurologists, and other medical professionals need to work together to work out a plan for the treatment of adolescents with KLS.

Numerous medications have been used to treat the episodes of KLS so far, and none of them showed to be a good effective solution. Amphetamines are mostly used to treat sleepiness symptoms, but they are not useful in eliminating cognition impairment and other abnormal behaviors. Lithium was successful in improving strange behavior and the recovery of symptoms. The effectiveness of lithium was maybe because of the similarity of KLS with bipolar disorder, but whatever it is, the important thing is that the duration of the episodes was significantly shorter. Carbamazepine had similar effects in few cases. Different medications have shown no significant improvement, while some even worsened the condition. During the time in between the episodes, only lithium showed beneficial in delaying the relapses of the events. The affected individuals shouldn’t be left to wander around unattended, shouldn’t drive a car, or operate heavy machinery. The family of the patient should learn to recognize the symptoms of the upcoming episode in the very beginning and minimize the damage it might produce. The development of depression and anxiety should also be closely monitored and treated if needed. It is essential to maintain proper sleep hygiene between the episodes, keep a sleep-wake schedule, avoid alcohol, and contact with sick people.

The disease usually shows up during the adolescence and lasts, up until the beginning or mid-20s, and then resolves it on its own. Because of this and the ineffectiveness of various approaches, some medical professionals might suggest no medical treatment. Instead, they might suggest informing yourself, connecting to the other families affected by this condition, and trying to improve all aspects of like, so that the disease passes as quickly as possible. The parents of affected adolescents should create a safe and relaxing environment, and all the school and other obligations should be postponed or adjusted until the symptoms disappear.

Scientists are saying that we need to investigate further the genetic component and treatment options for KLS. They are suggesting that we might need immunosuppressants and antivirals as the onset of the disease could be due to infection and autoimmune problems. One thing is sure, KLS requires a lot more research and understanding, but it is hard to do so since the condition is infrequent.

Lately, it appears that YouTube has become inundated with ASMR videos. They’ve become quite the trend, with everyone trying their hand at creating unique takes on it. If you’re on the fence about whether to give that suggested ASMR video a watch, you’ve landed in the perfect spot. This piece will enlighten you on what ASMR is, and the ways it can assist with sleep.

We have been overflowed with similar overhyped abbreviations before, remember YOLO, FOMO, etc.? We guess now the ASMR got its five minutes, but how did it become so widely popular and how can it be related to sleep?

There are so many different ways to help us fall asleep, from melatonin supplements to acupuncture, but it can take some time until you find the right one for you, one of the easiest and most available ways is to play an ASMR video. Currently, there are around 51 million of ASMR videos on YouTube, with even more millions of views, so plenty to choose from if you decide to enter this world. Those videos also vary in their content, and you might see and hear someone just chewing pickles, or whispering about some random things, so be prepared to see some things too closely and hear some weird stuff. And, although it all can be described as too odd, somehow it works, since people love to watch those annoying, and at the same time satisfying videos. Another important thing to mention is that ASMR videos or recordings are longer than the average YouTube video, they last roughly around one hour, so you can listen to them long enough to relax while you are falling asleep.

What is ASMR?

To solve the central enigma first, ASMR stands for the autonomous sensory meridian response, and the term was coined in 2010 by a healthcare worker Jennifer Allen. However, that is not the first time it was mentioned since it was mentioned in a novel from 1926, called  Mrs. Dalloway. Also, have you ever watched some of the Bob Ross painting tutorials? That is ASMR at its best, and he can be perceived as a forerunner of what the ASMRtists are doing today. This somewhat bizarre digital phenomenon is now changing the way we go to sleep, pushing away traditional sleep inducing tricks such as yoga and meditation.

The ASMR is still relatively new, but it already gained enormous popularity, and people are curious to try it out.

If the definition behind the abbreviation was not helpful, we are going to simplify it, ASMR provides the feeling of relaxation followed by tingling sensations which a person can experience while watching specific videos or hearing certain sounds, an emotional and physical reaction to a gentle stimulus. But, those sounds and videos are not the typical YouTube content. In ASMR videos, people are slowly doing some basic tasks, such as flipping the pages of a magazine, cutting vegetables, cutting soap bars, folding towels or brushing hair. The atmosphere is always calming, relaxing, quiet, and if people talk in those videos, they are always whispering which may sound creepy sometimes.

People can experience ASMR in two ways, through meditation or just by thinking about some pleasant scene or sound, and through videos and recordings of whispering stories. Nobody is sure how and why ASMR works, it could be that those sounds act comforting and as a lullaby for adults, or some of the performed tasks reminds us of something from our childhood.  

ASMR will not work for everyone, and it all may sound too abstract and ridiculous until you experience it first-hand. Most people who have experienced it, say that those tingling sensations begin in your scalp, and then they travel throughout the body, to the legs and arms. As a result, people feel genuinely more relaxed before bedtime, and they sleep more soundly. Researchers are still trying to find out exactly how it works, and it appears that this phenomenon has been present since forever, but it was discovered recently.

One of the theories implies that ASMR initially functions as a bonding process between people. Most of the common ASMR techniques include low voices and touching, and for the outcome, we have positive feelings such as happiness, safety, feel of safeness, etc. and those are all the things that people who are close to each other or in relationships experience frequently. Another theory claims that the ASMR sensations take us back to childhood, since we relate those triggers to some emotional, carefree, happy and restful memories, people feel again the euphoria they have not felt since their childhood.

ASMR Triggers

Although it owes its popularity to YouTube videos, ASMR can be reached and triggered through numerous ways off the screen. We differ three main categories of ASMR triggers, and most people will react just to one of them, while the other two would not cause any response.

• Visual – this first group gathers a bunch of visual stimulants such as eye contact, writing, hand movement, page flipping, etc.

• Auditory – this group stands for any stimuli that we can hear, such as whispering, crinkling, tapping, chewing, blowing, scratching, and so on.

• Tactile – this group covers various acts, from massages and light touches, to grooming pets, or playing with hair. Also, the feel of different textures can as well be a trigger.

There is plenty of things that can trigger the ASMR response, but they all share some characteristics, they are all repetitive, gentle, with a low volume or without it. A survey showed that the most popular ASMR trigger is whispering, followed by some repetitive, slow movements, and crispy sounds.

Can We All Experience ASMR?

The truth is that we can, or at least we should be able, but it all depends on how strong the stimulus has to be so that you can feel it. Sometimes you have to find out what is the right trigger for you because we are all capable of producing those neurochemicals which are presumed to be responsible for the ASMR effect. Neurochemicals such as endorphins, oxytocin, dopamine, and serotonin, all provide the feelings of sedation, pleasure, and relaxation.

Endorphins are responsible for the production of dopamine, tingling sensations and euphoria, oxytocin is the so-called bonding hormone, it increases the feeling of trust and stimulates the release of serotonin, dopamine gives you the motivation while the serotonin gives you the sense of well-being and satisfaction. But, the receptors in our brain are capable of becoming less sensitive when they are overly exposed to the same stimulus. That is why people who take certain medications like painkillers, have to increase their dosage over time to get the same effect. If you are interested in experiencing the ASMR, you can train your brain by exposing yourself repeatedly to the same ASMR trigger. If you want to increase your chances, you can try it in an environment that is safe and cozy for you, while comfortably sitting or laying in bed.

Research by psychologist Craig Richard showed that 40% of people who experience ASMR had also experienced a decrease or disappearance of the ASMR effects at some point. That is because the more we watch those videos, our brain and body develop a higher tolerance to it, causing its effects to fade away. However you can easily repeal the effect by not watching or listening ASMR videos for at least one week, after that, you will be able to feel tingling sensations all over.

So unless you have some particular medical condition, there is no reason why you should not be able to experience the ASMR effects, you have to find the proper trigger and the right intensity of it. It is like with anything else in life, for example, salty food, what may taste too salty for one person, can taste mildly or not salty at all for someone else.

ASMR for Sleep

ASMR can be used generally for relaxation and de-stressing, but the most common reason why people reach for it is that it can function as a sleep aid. If you have any type of sleep-related problems, difficulties with falling asleep or even insomnia, ASMR will get you in the right mental and physical state and prepare you for sleep.

ASMR video clips are very alike to guided meditation which has been proven to help with sleep difficulties.

Since ASMR videos are nowadays filmed about probably any topic that you can imagine, try narrowing your search by seeking the ones that claim to help with falling asleep faster and more profound. If you do not want to expose yourself to blue light before bedtime, skip videos and download voice recordings on your smartphone or play them on Spotify. ASMR will not only induce your sleep, but it will also relieve stress and chronic pains while promoting sleep.

You can create your own ASMR bedtime routine based on your preferences and considering which type of stimuli, visual or auditory, does the trick for you. Even 80% of people who watch ASMR videos reported that they play them to sleep better.

Similarities to Misophonia and Frisson

Misophonia is an adverse emotional reaction to some unpleasant auditory triggers, and it is usually associated with Tourette’s syndrome and many other neuropsychiatric disorders. These triggers include most random sounds such as tapping, chewing, whispering or engine roaring, so whatever works in a positive way for the ASMR audience, can affect negatively people who suffer from misophonia.

Another, more similar experience, is called frisson, it represents the experience of goosebumps and shivering when a person is having a brief and pleasurable emotional response to some stimuli like music. Although it seems that they appear through the same physiological mechanisms, frisson and ASMR do not have much in common according to the people who experienced both of them, they claim that they have different kinds of triggers.

Can ASMR be Uncomfortable?

We mentioned the three main categories of stimuli, usually only one will work for you while others will not cause any reaction. However, some people are claiming that they find some ASMR videos too creepy, disturbing and uncomfortable to watch or listen.

If you are new to the ASMR and still trying to find your niche, certain repetitive actions followed by whispering may cause the opposite feeling from what you were hoping to feel. People reported that they expected to be relaxed, but eventually they did not experience any of the tingling sensations or calmness, instead, they were spooked out. They also had troubles watching these videos longer than 5 minutes, especially the ones which included roleplay.

How you perceive a video is highly individual, so if you are looking at a stranger who is speaking softly and staring at you, your reaction depends on the way you perceive that person, as a sincere or insincere. If you find person’s behavior to be genuine, then you should not have any problems with relaxing, however, if your brain perceives the person as insincere, then you will creep out because your brain is signaling that that person is just pretending to be safe. Some ASMRtists have more following and subscribers because they manage to appear more reliable and trustworthy.

So it does not have to mean that ASMR is not for you if you disliked the first video you have seen. Numerous factors need to match, and as we have seen now, it also depends a lot on the person you are listening and watching.

For those who have been following our site for a while, you might be familiar with the numerous sleep disorders that seem to be everywhere. It wouldn’t be surprising if you’ve come to believe that certain common lifestyle habits could lead to sleep issues and negatively affect your health by impairing your immune system due to fatigue. What’s even more troubling is that it can be difficult to recognize these sleep problems and issues when you’re experiencing them firsthand, making it all too easy to dismiss symptoms as just another part of daily life.

If you ever run into a situation where you suspect you’re dealing with a sleeping disorder or regularly experience sleep problems, the single best course of action is visiting your primary care physician for initial tests and questioning. A quick examination is often only a starting point – if they notice anything worrying, you may be put through further examinations that determine what causes your sleeping problems. In this article, we will explain the process of a sleep study, as well as list some good reasons for getting examined early on, and what you can do to make the doctors’ jobs easier. Let’s get into it.

The First Diagnostic Stage

The rule of thumb is obvious – as soon as you notice regular sleeping problems, schedule an appointment with your doctor. If something is preventing you from seeing them this early, start keeping a sleep journal. A sleep journal can be a simple notebook where you write down details about your sleeping habits. A full-scale sleep study often involves a sleep journal, so you want to make sure you have something to present as soon as possible. Even if you don’t start at this point, your doctor will tell you to start once the first examination is done (assuming you pass the screening tests, more on that in a bit).

If you want to be helpful to them, you want to use your sleep journal notebook to document various pieces of information about your sleep. For example, they may want to know things like:

–          When you go to sleep and when you wake up

–          How long it normally takes you to fall asleep once you’re in bed (this is commonly known as sleep onset latency, and it’s often measured if you’re dealing with suspected narcolepsy or similar disorders)

–          How tired you feel when you wake up and right before bed (not necessarily in the late evening and morning – some disorders change when your body wants to go to sleep)

–          How often and when you wake up during the night. Fragmented sleep is a huge health concern, as it stops your body and mind from recovering properly during the last two stages of sleep.

–          How exhausted you feel during the day – fatigue makes you perform worse in most aspects of life, especially work and driving.

–          How often you consume alcohol and caffeine

When you visit your doctor for the first time and explain your problems, they may give you a questionnaire or two to fill out. These questionnaires are usually the first stage of sleep diagnosis and include tests like the Pittsburgh Sleep Quality Index or Epworth Sleepiness Scale. Each answer in these questionnaires carries a score that gets added up towards a final result. If you pass a certain threshold at the end, it serves to indicate the presence of a possible sleep disorder. These tests are often used as a sort of screening filter for early patients. If the result of these tests shows no signs of a sleep disorder, then the problem is often classified as a lifestyle thing, and no real further examination is done aside from basic blood and urine sample analysis.

Expect to be asked a variety of questions about your daily life. Sleep problems can appear as a result of many seemingly unrelated habits and situations, so you want to give the doctor as much information as you can, even about things that don’t normally appear in a sleeping journal. If you’ve been maintaining a sleep journal or using other sleep tracking devices, it can speed up the diagnostic process and skip you right to the next phase – a full polysomnography procedure, or what is known as a “sleep study.”

How Does Sleep Studies Work?

The most common diagnostic technique or procedure used during a sleep study is polysomnography, to the point where the two terms are used interchangeably. Polysomnography is a thorough, detailed investigation into the patient’s sleeping patterns, looking at how their body behaves throughout a full night of sleep, as well as performing additional lab tests with blood and urine samples. In most cases, this procedure will involve reading the person’s sleep journal notes (or information provided by sleep tracking apps and devices, depending on what was agreed upon in advance and what the patient could afford). The information from previous examinations (including questionnaires like the Epworth Sleepiness Scale) also proves handy at some point. Here’s a step-by-step overview of what happens during a sleep study:

–          Before you even show up to the sleep lab, you will be given diet instructions. In simple form, these instructions boil down to avoiding alcohol, caffeine, sugary or greasy food, and anything that could produce “false alarm” readings or otherwise interfere with the results of the sleep study. The longer you maintain this preparation diet, the more accurate the readings will be, so stay disciplined.

–          Make sure you clear your schedule for days that immediately precede and follow the sleep study. Because this is a procedure that takes a whole night, you don’t want your work schedule or similar obligations to interfere with the procedure.

–          Most of the time when you arrive at the sleep lab (the place where sleep studies almost always take place), they will do a basic examination and explain the whole procedure to you (if your doctor didn’t already do that before). If you have a sleep journal prepared, which you should, you will be given a chance to present it and will often have to fill another questionnaire to make sure the results sync up with the previous examinations. Most sleep disorder-related questionnaires can easily be repeated multiple times in a short period, and it helps avoid biased answers and forgetfulness.

–          Once all of this is done, you will be hooked up to devices that monitor your bodily functions, usually after making sure that your sleep surface is comfortable. Electrodes will get attached to various spots on your body, and you will be constantly watched by sleep technicians and other specialists. Overall, the information that is tracked varies depending on what the technicians expect to see. If they suspect the presence of seizures, additional electrodes will be attached to you to keep track of seizure activity. The lights will get turned off, and the technicians will use low-light cameras to monitor your behavior. You can talk to each other if the need arises, but they will avoid interrupting your sleep whenever possible.

–          While you sleep, the experts will keep track of your heart rate, breathing patterns, brain wave patterns, nocturnal eye movement, the shifts in your sleeping positions, etc. All of this information is relevant because specific sleep disorders have specific “tells” that are crucial to making a correct diagnosis. For example, eye movement and brain wave patterns are important for detecting the REM stage of sleep, the stage where vivid dreams occur and a lot of brain activity resembles that of a waking person. Certain disorders affect this stage and are hinted at by abnormalities in the patient’s sleep architecture (the natural progression between sleep stages). Breathing patterns are essential for diagnosing problems such as obstructive sleep apnea, and so on.

–          You will usually be discharged around 7 am, and the results of this procedure are usually sent directly to your doctor for when you show up for a follow-up examination.

Overall, there’s nothing to be nervous about. No part of this procedure hurts or has any harmful consequences, so you shouldn’t worry. Even though you’re sleeping in a different bed (and could thus take extra time to adjust and find a comfortable position), the machines are accurate enough to nullify that detail.

The Follow-Up and Multiple Sleep Latency Test

Depending on what your doctor suggests beforehand and what they notice during the sleep study, you may be put through the Multiple Sleep Latency Test (MSLT) during the day following the polysomnography. This test is an incredibly common diagnostic technique for many disorders, and its purpose is to measure excessive daytime sleepiness and average sleep propensity. The procedure is incredibly simple and resembles a “smaller” version of a full sleep study. The idea is that the more daytime sleepiness a patient faces, the easier it is for them to doze off and start napping. The MSLT procedure involves the patient trying to take a nap multiple times during the day, usually around four times a day.

The napping periods last 20 minutes and are separated by breaks of two hours each. The less time it takes for the patient to fall asleep during each napping period, the more excessive daytime sleepiness (or daytime fatigue) they’re exposed to, on average. Obviously, external conditions can affect their level of fatigue, but the results are consistent with whatever ends up being diagnosed through a full sleep study.

Universal Treatment Advice

Most sleep disorders lack a proper cure. The prescribed therapy plan typically revolves around alleviating symptoms, and your doctor will offer lifestyle advice and similar recommendations to help you improve your quality of life while dealing with a sleeping disorder. For example, sleep apnea is dealt with through the use of positive air pressure (PAP) generator, but that doesn’t make the sleep apnea go away completely – it only helps you sleep better during the night. A lot of lifestyle advice you receive will sound the same regardless of which specific condition you’re facing. Here’s a list of steps you can take to improve your sleep quality in general:

–          Improve your diet. Much like how you have to spend a week avoiding unhealthy foods before a sleep study, train yourself to avoid sweets, greasy food, alcohol, carbonated drinks (especially energy drinks), etc. A good diet plan helps you in more ways than just through improved sleep.

–          Introduce regular exercise into your daily or weekly routine. If you’re out of shape, it’s definitely not unacceptable to start slow, and only work out once or twice per week. Exercise not only helps you develop your body (when maintained over a long period of time), but the resulting increase in sweating helps you remove toxins, which helps you relax when you need to relax the most.

–          Keep working on your sleeping journal. Eventually, you will have to get re-examined by your doctor, and the new information can be incredibly helpful for monitoring the treatment plan. If your sleep patterns improve, it will be obvious in the journal, and the doctors can recommend subtle adjustments that help you even more.

The past ten years have markedly improved our comprehension of how nightly slumber affects all facets of our daily existence. Medical professionals now advocate for quality sleep as being equally crucial to our general wellbeing as diet and exercise. With the proliferation of information accessible to the general public, technology designed to offer personalized insights into your sleeping patterns also emerged. As a result, the significance placed on restful sleep has led to the surge in popularity of sleep trackers, saturating the market with these devices.

But besides being a fancy little gadget, is there any benefit in using sleep trackers? Do they provide accurate information about your sleep or are they just showing some standard measurements? Can sleep trackers negatively affect your rest and health?

How Do Sleep Trackers Work?

Sleep trackers are useful pieces of technology that should help you learn more about your sleep. They can be in the form of a smartphone app, a device that is usually wearable around your wrist, or special pads that you put on or under your mattress that track you throughout the night.

No matter what option you go for, sleep trackers should be able to tell you how long you slept during the night and how good your sleep was. That estimation is based on whether you have woken up during the night or if you’ve been tossing and turning around. Some devices can measure sound, and they can warn you if you are prone to snoring or if they notice any other sounds during the night that might be an indication of a sleep-related breathing disorder. Some claim that they can show you how much time you spend in the various stages of sleep: deep, light, and REM. You can check out the extensive review and our favorite sleep trackers.

This all sounds pretty useful, so how are they able to do that? There is a device called accelerometer embedded in the sleep tracking device, and it measures your movement. The principle behind tracking sleep is simple; lack of action means that you are sleeping. Unfortunately, that would mean that the device would think that you are sleeping even when you are laying down reading or watching television. Because of that, some devices track heart rate and combine the results to give you more accurate data about your sleep. Some sleep trackers also rely on infrared technology, and they can even track your respiration, which gives a useful additional set of information.

Are Sleep Trackers Accurate?

The thing that everybody is interested in is how accurate sleep trackers are. There is some research done on this subject, and the results are mixed. While it looks like sleep trackers can be pretty precise in determining whether you are sleeping or being awake in most cases, there is just no evidence that they are useful for determining how much time you spend in each stage of sleep. This is hard to decide based only on your body movements, as they are very similar in both deep and light sleep. There is an absence of action in the REM phase so that we don’t act out while we are dreaming, but our muscles might twitch which can be recognized as being awake. We also naturally turn around and move our body parts during the night, so that we maintain proper circulation in our body. This can be seen by the device as being awake and active.

To figure out which sleep stage you are in, you would need to measure your brain wave activity, and these devices can’t do that. To make things more complicated, it is not even important if your device precisely told you how much time you spent in each stage. Sleep is an individual activity, so these parameters vary based on many factors like your age, sex, race, and other demographic factors. A perfect rest for a 70-year old would be rated as terrible by a 20-year-old, so don’t think much about it. Just learn to recognize your body’s needs, and if you are feeling well-rested in the morning, it doesn’t matter what your sleep tracker says.

A 2011 study confirmed this when they looked at the abilities of wrist actigraphy. Actigraphy is a technique of measuring movement, and it is the essence of these devices. The method is good at determining total sleep time and night disturbances, and in combination with other sleep assessment tools can provide useful information about sleep patterns.

An article from 2013 looked into how wrist actigraphy compares to polysomnography, which is an overnight sleep study done in a laboratory by the professionals. It is used to detect sleep disorders and any problems with your sleep, and while it is currently our best option, researchers think that sleeping in a lab is not a natural environment and that it affects results as well. Like the previous study, they found that wrist actigraphy is useful in determining total sleep time and sleep disturbances.

The reviews of commercially available sleep trackers include Fitbit, Withings, Jawbone, and other popular brands. The results are all mostly similar. While they accurately describe total sleeping time, there is an inability of sleep trackers to determine time spent in each stage of sleep, and more importantly to recognize the symptoms of sleep disorders such as obstructive sleep apnea. Some other reviews are more positive and say that with the continual progress of technology, we will soon be able to see highly accurate devices, which will save time for sleep specialists and make their job a little easier.

Are You Sleeping Worse Because of Your Sleep Tracker?

Your sleep tracker can be beneficial if you use it correctly. You can learn more about how long it takes you to fall asleep if you have any nocturnal interruptions that you don’t remember in the morning, and how much you sleep on average. A data of a period of a month can tell you a lot about your habits, and if you fill out the questionnaire about your daily activities, you might also figure out what is causing your sleep problems. Many devices have these regular questionnaires where you state your actions, like exercise, alcohol consumption, stress, and other things that can affect your rest. This information is crucial in understanding your sleep habits and correcting them.

It all sounds pretty useful, but there is also a big downside for some users, and that is when psychology comes in play. A 2014 study researched the effects that placebo had on sleep and cognitive performance. The subjects in the study were told that the researchers were able to measure brain wave activity and determine how much time they spent in each stage of sleep. The researchers weren’t able to do that, and they randomly picked two groups, where they told that one had good quality sleep, and the other didn’t. Participants would rate their sleep before that, and this is when it gets interesting. Individuals who rated their sleep as good and were told by the researchers that the brain waves showed they didn’t sleep well, performed worse on tests measuring their cognitive ability. They acted so poorly that the results were actually similar as if they were sleep deprived. Inability to focus, concentrate, and form memories, learn things, and perform are all effects of sleep deprivation. These findings tell us that our minds are just so complex and that the attitude about sleep is essential to get sufficient rest.

Overthinking is the reason while sleep trackers can be problematic. People become so obsessed with getting sufficient sleep, sleeping correctly and the results that their devices show, that it has the opposite effect of what they want. Sleeping is a time of relaxation, and when you are thinking about how to get 8 hours of sleep or trying hard to fall asleep as fast as you can, it is the opposite of relaxation. It leads to increased stress and can even cause anxiety. It is important to remember, while these devices can be useful, you can’t completely rely on them. If your sleep tracker is showing you that you didn’t get enough deep or REM sleep, but you feel good and well-rested in the morning, believe your body. It is the best sign there is, and finding some stats on your phone more reliable than how you feel can make it seem like you are not getting sufficient sleep and that you are even suffering from a sleep disorder. People tend to overanalyze mild symptoms, and overthinking can also lead to insomnia that wasn’t there in the first place.

Researchers named this condition orthosomnia, and they describe it as the obsession with sleeping well so much, that it impairs the sleep quality. Orthorexia is a similar condition obsessing about eating well, where patients end up with terrible diet habits. They reported a few cases in this article, where the patients would see a doctor, and when the overnight study done by the professionals showed that they don’t have any sleep problems, they would dismiss those findings as their smartwatch showed otherwise. Waking up in the middle of the night and watching at your phone to see how well you are doing have terrible effects on your sleep. Screens emit blue light that tricks your brain into thinking that it is daytime, so whenever you are checking your phone at night, know that you are disrupting your natural rhythms.

How To Avoid the Negative Side of Sleep Trackers?

The usefulness of these devices depends on how you use them. Sleep trackers can help you stick to a regular schedule, get more sleep, and they can also give you useful personalized tips on how to improve your nightly rest. However, you need to remember that this is just a helpful tool that should benefit you. You should objectively observe the data that the sleep tracker provides, and you shouldn’t obsess and over-analyze the results.

The key is to recognize if a sleep tracker is doing more harm than good. Next step is to catch yourself during obsessive thoughts and take some action to make them go away. You can try meditation or finding a hobby that interests you, to keep your mind occupied, and to drift away from those negative thoughts.

If thinking about your sleeping results gives you stress and anxiety, maybe it’s time to throw away your sleep tracker for some time. To improve your nightly rest, you can try to maintain healthy sleep hygiene. Make a schedule where you go to bed and wake up at nearly the same time daily, create a relaxing sleeping routine, make your bedroom dark, quiet and cool, don’t use electronics half an hour before you go to bed, and remember to eat healthily and exercise regularly. Following these steps improves sleep quality in most people, and it can also be useful to you too, even more than some sleep gadget. If you experience sleep problems and disruptions regularly that make you fatigued and extensively sleepy during the day, you should see a doctor. They can refer you to a sleep facility, where they’ll do the overnight sleep study and determine what’s causing your sleep problems.