Sleep Disorders

The value of undisturbed sleep often becomes apparent only by its absence. Long sleep latency (i.e. the time spent in bed before falling asleep), frequent awakening during the night and early awakening in the morning can seriously impede our performance and concentration during the day. Weariness, fatigue, and irritability may follow. In many cases, such abnormalities do not last and we return to normal, restful sleep. According to recent investigations, though, some 20 per cent of the population suffer from persistent sleep disturbances. Especially elderly people and women often report periods of insomnia or disturbed sleep.

Causes

The causes for sleep disturbances are manifold. Apart from external factors such as noise or working shifts, medical factors such as hormonal imbalances or chronic pain, there are also a number of psychological factors that may be responsible for the development or maintenance of a sleep disturbance. In case of a major role of a psychological condition, the sleep disturbance is called primary insomnia. Often, stressful life events that lead to worrying and persistent ruminating are at the root of the sleep problem. Negative thoughts, coupled with feelings of anxiety and apprehension can lead to a heightened bodily arousal that interferes with falling and staying asleep. In many cases, a vicious circle ensues: reduced quantity and quality of sleep enhance nervous apprehension which in turn reduces the probability of restorative sleep.
Finally, sleep disturbances occur in a number of clinical disorders, such as depression or anxiety disorders.

The large number of possible etiological factors involved calls for a comprehensive workup, including medical tests, questionnaires, and sleep inventories. Based on this information an invidual treatment strategy is developed, that may include deep-muscle relaxation as well as a range of psychological interventions designed to reestablish normal sleep patterns.