Symptoms of Sleep Disorders

Many common symptoms may suggest the presence of a sleep disorder. Some of these symptoms, such as fatigue, may also occur with other medical disorders. In addition, each sleep disorder may have specific symptoms unique to it.

Snoring and Sleep Apnea

Not everyone who snores has a serious sleep disorder, but loud snoring with other symptoms may suggest the presence of sleep apnea. These symptoms may include:

• Loud snoring
• Witnessed cessation of breathing (apnea) while asleep
• Gasping or snorting while asleep
• Excessive daytime sleepiness, including falling asleep at inappropriate times (i.e., in meetings or while reading, watching television, talking to someone, or driving)
• Feeling unrefreshed upon awakening
• Difficulties with concentration or memory
• Personality changes or depression
• Morning headaches
• Dry mouth and throat upon awakening
• Lethargy
• Restless sleep
• Leg swelling
• Hyperactive behavior in children

Insomnia

Insomnia is generally defined as difficulty in staying or falling asleep. This often results in an inadequate amount of sleep and feeling tired. Individuals with insomnia will often wake up several times and may lie awake for extended periods of time at night. There is often a component of distress about not being able to sleep.

Parasomnias

Parasomnias include many abnormal sleep behaviors, such as: night terrors, sleepwalking, sleep eating, sleep sex, and rapid eye movement (REM) behavior disorder which may involve the acting out of dreams while asleep.

Night terrors

• Common among children, especially boys
• Persistent fear or terror at night that occurs in a semi-conscious state with inability to fully wake up
• Screaming
• Sweating
• Rapid heart rate
• Confusion with no memory of the event
• Difficult to console

Sleepwalking

• Semi-purposeful movements, including walking, while asleep
• Eyes may be open without responsiveness
• Confusion with no memory of the event

Sleep Paralysis

Sleep paralysis involves an inability to move while transitioning from sleep to wakefulness. It can be extremely frightening as the person may seem to be awake and be unable to move. With other symptoms, it may suggest narcolepsy, but it can also occur normally among the healthy, especially during periods of stress.

Restless Leg Syndrome

Restless legs syndrome (RLS) consists of unpleasant feelings in the legs associated with a need to move to relieve the discomfort.

• Abnormal sensations may include aches, burning, tingling, or the feeling of bugs crawling
• Symptoms occur mostly at rest or at night when lying down
• May make it hard to fall or stay asleep
• Associated irresistible urge to move the legs with movement causing relief of the symptoms

Circadian Rhythm Disorders

These disorders relate to misalignment of an individual's sleep-wake cycle with the nighttime hours when sleep typically occurs. This may lead to insomnia or hypersomnia at inappropriate times. This misalignment may result from medical conditions such as total blindness or may be secondary to social reasons (such as in shift workers). It can include jet lag, advanced sleep phase syndrome, and delayed sleep phase syndrome. Jet lag is a temporary condition caused by rapid travel across time zones and it may result in fatigue, insomnia, nausea, and other symptoms.

Narcolepsy

Four classic symptoms are diagnostic of narcolepsy, including:

• Excessive daytime sleepiness, including falling asleep at inappropriate times (i.e., in meetings or while reading, watching television, talking to someone, or driving)
• Cataplexy, which is the loss of muscle tone in response to an emotional stimulus, such as surprise or laughter.
• Sleep paralysis, which is the inability to move one's body while being awake, usually while falling asleep or awakening.
• Hypnagogic hallucinations, which are vivid dream-like auditory, visual, or tactile sensations that occur while falling asleep.

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS) is unexplained fatigue lasting six months that is not improved by rest and is often worsened by physical or mental activity. This fatigue is often severe and incapacitating, and can cause a substantial reduction in daily activities. Other associated symptoms may include:

• Muscle aches or joint pains
• Muscle weakness
• Lymph node tenderness
• Sore throat
• Headache
• Difficulties with concentration or memory
• Irritability
• Mild fever

Seasonal Affective Disorder

Seasonal affective disorder (SAD) is a recurrent mood disorder associated with depression and excessive sleepiness during the fall and winter months when there is a lack of bright light. Many of the symptoms are common to depression, but may include:

• Increased sleep with afternoon slumps
• Decreased interest in work or activities
• Feelings of guilt
• Decreased energy
• Difficulties with concentration
• Increased appetite, especially for carbohydrates, and weight gain
• Slow and sluggish movements or lethargy
• Social withdrawal

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