Dyssomnias: characteristics of these sleep disorders

A set of sleep disorders that affect the ability to sleep.

Sleep is a vital need that accompanies us throughout our lives. We spend an average of 25 years of our lives sleeping.

In fact, a good night's sleep is essential to be able to carry out our daily life normally, and it is a very important factor that favors our quality of life. In this article we will talk about one group of sleep disorders: dyssomnias.. Among them, we will also talk about one in particular: insomnia.

What does a dyssomnia imply for the person who suffers from it? How can it be treated? We are going to see it next.

Dyssomnias: definition and causes

The dyssomnias are disturbances of the quantity, quality, schedule and duration of the sleep. These are psychogenic and primary sleep disorders, i.e. they cannot be explained by an underlying medical disease.

The usual causes are usually psychological: altered or intense emotional states (anxiety, stress,...), ruminative thinking style, etc., or extrinsic to the subject: rhythm of life, bad sleep habits (sleep hygiene), etc.

Classification of dyssomnias

According to the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders), within the group of sleep disorders, dyssomnias are classified as follows are in turn classified within the primary sleep disorders along with parasomnias..

Dyssomnias include primary insomnia (or insomnia disorder in DSM-5), primary hypersomnia (hypersomnia disorder in DSM-5), narcolepsy, breathing-related sleep disorder, circadian rhythm disorder, and dyssomnia not otherwise specified.

Dyssomnia not otherwise specified includes restless legs syndrome (discomforting sensations in the limbs-primarily the legs-during rest) and nocturnal myoclonus (periodic limb movements during sleep).

In the DSM-5, however, the term dyssomnias disappears, and insomnia disorder, hypersomnia disorder and narcolepsy remain as independent categories, without being within any particular group.

Symptoms and characteristics associated with insomnia

Insomnia is the most common dyssomnia in the general population.. Studies establish that approximately 30% of the population has at least some of the characteristics of insomnia.

Based on the DSM-IV definition, the prevalence of people diagnosed with insomnia is reduced to 6%. According to ICD-10 (International Classification of Diseases), between 1 and 10% of the adult population suffers from insomnia.

The predominant symptom of insomnia is difficulty in initiating or maintaining sleep. difficulty initiating or maintaining sleepThe predominant symptom of insomnia is difficulty initiating or maintaining sleep, or not having a restful sleep, for at least 1 month (DSM-IV-TR) (DSM-5 establishes 3 months). The sleep disturbance or associated daytime fatigue causes clinically significant distress or impairment in the subject.

According to ICD-10, symptoms must appear at least 3 times a week for at least 1 month. It is more prevalent in women and its prevalence increases with increasing age.

Types of insomnia

There are three types of primary insomnia: onset insomnia (appearing at the onset of sleep), maintenance insomnia (during sleep) and termination insomnia (where the main symptoms are early morning awakening and inability to fall back to sleep).

Psychological treatments for insomnia

Some of the psychological treatments that have been shown to be most effective for insomnia are: - psychological treatments for insomnia for insomnia are:

1. stimulus control 2.

It is considered the treatment of choice. It is based on classical conditioning, and it is about associating the use of the bed with sleepIt is based on classical conditioning, and involves associating the use of the bed with sleep, by restricting activities that serve as signals to stay awake and setting a wake-up time to stabilize the sleep-wake rhythm.

Thus, the objective is that the bedroom/bed is associated with a rapid onset of sleep.

2. Progressive relaxation

This is the second most effective for this type of dyssomnia. One of the modalities applied is Jacobson's progressive Muscle relaxation, where all muscles are relaxed to facilitate sleep induction.

3. Paradoxical intention

This is the third most effective. It consists of thinking precisely the opposite of what one wants to achieve, i.e., to think that "I don't want to sleep".that is to say, to think that "we do not want to sleep". By reducing the pressure or anxiety associated with being able to sleep, as well as the discomfort of not doing so, it is easier for sleep to occur naturally.

4. Multi-component programs

These include stimulus control techniques, sleep hygiene and cognitive techniques that help reduce the inappropriate cognitions associated with the disorder.

5. Sleep restriction

This technique is intended to produce a state of slight sleep deprivation that facilitates falling asleep earlier, sleeping with fewer interruptions and achieving a more restful night's sleep.sleep with fewer interruptions and achieve a deeper sleep.

The aim is to reduce the number of hours spent in bed, trying to bring them as close as possible to the time that is considered adequate. Subsequently, the time in bed is increased until an optimal duration of sleep is achieved.

6. Sleep hygiene

They are a set of routines, recommendations and healthy habits before going to sleep.that should be applied in order to obtain a healthy and restorative form of sleep.

The final objective is to sleep better, by means of the acquisition of better habits that allow to obtain a healthy lifestyle or the change of those that interfere with the sleep.