Neurological sleep disorders

Sleep disorders are quite common and are often underestimated as a health problem.

A lack of sleep and/or interrupted sleep quality can, while they persist, lead to problems with proper functioning during the day such as:

• memory problems
• concentration problems
• mood problems
• cardiovascular diseases
• obesity

Breathing-related sleep disorders

Pulmonologists treat sleep apnoea and snoring at the sleep centre.

Sleeplessness or insomnia

Everyone has trouble sleeping at times. This can manifest by not being able to fall asleep or not being able to stay asleep, or in a combination of both. The most common cause of insomnia is stress and worry. Chronic sleeplessness is when the problem occurs more than three nights a week and lasts for longer than three months. 10% of adults suffer from this sleep disorder. Treatment is best given by cognitive behavioural therapy or sleep training that we offer and is preferred over sleep medication.

Abnormal behaviour while sleeping, or parasomnia

Sleepwalkers belong to this group, as do sleep terrors (waking up at night in a panic). They frequently present in children and usually do not need any specific treatment. In adults, this abnormal behaviour may present while dreaming (REM sleep disorder). The patients, given the interruption of normal paralysis of the muscles while dreaming, actually perform the dream: laughing, talking, shouting, hitting, kicking, etc. If such symptoms are present, a neurological exam is indicated and treatment with medication can be useful.

Restless legs and periodic leg movements while sleeping

Patients with restless legs have an uncomfortable feeling in the lower extremities, especially the legs and feet, which can only be alleviated by moving them. This leads to restlessness, which makes falling asleep difficult. This condition is common and is often hereditary. Iron deficiency is an important risk factor. Some medicines can also aggravate these symptoms.

Some patients’ extremities move — often without realising it — in a repetitive, jerky way while they are sleeping. This makes sleeping quite difficult and often causes pain in the legs when waking up. The can also lead to fatigue during the day. A sleep study can be useful in order to examine the severity of the condition. Treatment generally consists of good sleep hygiene and, if necessary, initiation or modification of medication.

Narcolepsy

This is a less common condition where patients become sleepy during the day. Noctural sleep is also disturbed by very lively dreams and sleep paralysis. Patients often exhibit muscle weakness with sudden emotions (cataplexy). For symptoms such as these, a sleep study in the sleep laboratory is definitely indicated. Medication can also greatly alleviate the symptoms that accompany this condition.

Unregulated internal clock

With an unregulated internal clock, we refer to sleeplessness or disturbed sleep that is caused by shift work or jet lag, for example.

Good sleep hygiene can help someone sleep better in many cases. See below for a few tips (read more under the image).

• Keep a regular sleep schedule, with the same times for going to sleep and for waking up.
• Keep the bedroom comfortable: dark enough, quiet, good temperature (18°C is ideal), and good ventilation.
• Avoid caffeinated drinks (coffee, tea, colas) starting in the afternoon.
• Avoid alcoholic drinks and nicotine before bedtime.
• Avoid heavy meals in the evening, but do not go to bed hungry.
• Adopt a quiet evening ritual: reading, taking a bath, going for a walk.
• Avoid screens during the hour before going to sleep: especially the computer, tablet and smartphone.
• Do not exercise after 8pm.
• Avoid over exertion during the day, take time to relax during the day.
• Learn to relax with breathing and relaxation exercises.
• Avoid napping during the day: only a short, 20-minute power nap right after noon is allowed, if nothing else is possible.
• Get up out of bed if you cannot sleep at night. Do not keep tossing and turning, but do something relaxing in another room. Only go back to bed once you feel sleep again.
• Turn your alarm clock around so you cannot see it when you wake up.
• Keep a peak moment for during the day.
• Do not let your daytime activities rest too much on your sleep problem.
• Activate your biological clock during the morning with (sun)light and physical movement (e.g. a morning walk).

Latest publication date: 01/12/2023
Supervising author: Dr Aers Isabelle