An episode of Keeping Up with the Kardashians saw model Kendall Jenner reveal her fear of going to sleep because of a condition called sleep paralysis. “I wake up in the middle of the night and I can’t move,” she said in the reality TV show.
It can be frightening. “Sleep paralysis renders a person unable to speak or move just as they are about to fall asleep, or while they are transitioning to the wakeful state,” says Dr Cheryl Kam, a functional medicine coach who has an interest in sleep disorders.
But sleep paralysis is actually a fairly common sleep disorder, affecting four in 10 people. There are others with less obvious symptoms, which make them harder to spot.
(also known as sleep state misperception)
What it is: “People with paradoxical insomnia believe they’re getting little or no sleep,” says Dr Lim Li Ling, medical director of the Singapore Neurology & Sleep Centre at Gleneagles Medical Centre. “They generally overestimate how long they take to fall asleep, and underestimate how much sleep they get. Objectively measured, their sleep quality is normal.”
While it may all be in the sufferer’s mind, the condition becomes a sleep disorder when the misperception becomes ingrained or chronic.
And those with this condition do feel sleep-deprived and mildly fatigued. Experts say this may be due to the nocebo effect – where a person’s health appears to deteriorate because of psychological factors, among other things.
It’s more common in women, as well as people who have depressive traits, or who have a lot of mental stimulation before bedtime. It can be diagnosed through an overnight sleep study, where brainwave activity will indicate whether you have slept.
Treatment: It can be managed with medication and cognitive behavioural therapy – which coaxes the body into uninterrupted sleep and minimises the anxiety that can come with the condition.
Insufficient Sleep Syndrome
What it is: This refers to a chronic voluntary lack of sleep (by that, we mean what is less than the recommended number of hours for your age, over a period of three months and longer). Sufferers are normally unaware that they need more sleep.
You’re at risk of developing the disorder if you regularly don’t get enough sleep – say, if you do shift work, are a parent of young children, or if you choose other activities, such as watching TV, over sleep.
As a result, you may feel excessively sleepy or tired in the day, which may lead to more serious symptoms like dizziness, slurred speech, and an increased risk of accidents. You may also suffer from mood disturbances, high blood pressure and a reduced lifespan, says Dr Lim.
Treatment: It’s easily treatable – just get enough good-quality sleep regularly, says Dr Lim. How? Develop good sleep habits such as going to bed and waking up at the same time every day, and avoiding eating or drinking alcohol, as well as using tech devices, close to bedtime.
What it is: Equally common in women and men, narcolepsy – where a person suddenly falls asleep at inappropriate times – is more likely to affect young adults.
It’s caused by a deficiency in orexin (a neurotransmitter that regulates arousal, wakefulness and appetite), which leads to excessive daytime sleepiness, sleep paralysis, cataplexy (a sudden loss of muscle tone), and hypnagogic hallucinations (seeing or hearing things which are not there, upon waking up).
Treatment: Narcolepsy has no cure, but brain stimulants can be used to treat excessive daytime sleepiness, Dr Lim adds.
Restless Legs Syndrome (RLS)
What it is: A nerve disorder that causes sufferers to experience an uncomfortable sensation in their legs, and have the urge to move them.
The symptoms are generally worse at night, and while the person is lying still. This makes it tough to get comfortable enough to fall asleep.
RLS can occur in association with pregnancy, iron deficiency or kidney failure.
Treatment: Regular exercise and relaxing activities like yoga and meditation can help relieve symptoms.
“A cure is possible if there is an underlying secondary cause – so, if you are iron deficient, you would have to make sure you were getting enough iron,” says Dr Lim. “If there is no curable secondary cause, this condition can be treated with drugs.”
Medication intended for other diseases, such as Parkinson’s disease or epilepsy, have been helpful in treating RLS.
This story was first published in the March 2017 issue of Her World.