Sleep disorders and Hypnosis

Let’s start by first understanding sleep…

‘Sleep is a naturally recurring state of mind and body, characterized by altered consciousness, relatively inhibited sensory activity, inhibition of nearly all voluntary muscles, and reduced interactions with surroundings.’

Everyone goes through 2 types of sleep –

Slow Wave Sleep (Non-REM sleep) –

During this stage, our body temperature, heart rate, blood pressure, respiratory rate, basal metabolic rate, goes down.

REM (Rapid Eye Moment Sleep) –

Is characterized by rapid eye movements, more dreaming and bodily movement, and faster pulse and breathing.

Most sleep during each night is of the Non-REM variety; this s the deep, restful sleep that the person experiences during the first hour of sleep after being awake for many hours. REM sleep, on the other hand, occurs in episodes during sleep and occupies about 25 percent of the sleep of young adults. Each episode normally recurs about 90 minutes. This type of sleep is not so restful, and it is usually associated with vivid dreaming. Deprivation of REM sleep causes tiredness, irritability, and impaired judgment.

So … what is ‘Sleep Disorder’?

A sleep disorder is a medical condition of the sleep patterns of a person. Some sleep disorders are serious enough to interfere with normal physical, mental, social, and emotional functioning.

While it’s normal to occasionally experience difficulties in sleeping, it’s not normal to regularly have problems getting to sleep at night, to wake up feeling exhausted, or to feel sleepy during the day. The lack of sleep can have a negative impact on energy, mood, concentration, and overall health.

Types Of Sleep Disorders –

According to ASDC (Association for Sleep Disorders Centres) sleep disorders are divided into two sub-types:

1.  Dyssomnias
2. Parasomnias

Dyssomnias:

They are primary disorders of initiating or maintaining sleep or of excessive sleepiness and are characterized by a disturbance in the amount, quantity, or timing of sleep. These are the commonest disorders of sleep. This consists of Insomnia, Hypersomnia, and Disorders of sleep-wake schedule.

Insomnia :

Also known as the Disorder of Initiation and/or Maintenance of sleep(DIMS). It may also include – frequent awakenings during the night, early morning awakening with inability to go back to sleep, or non-restorative sleep even after the adequate duration of sleep.

Common causes –

1. Medical Illnesses
2. Painful conditions
3. Heart and respiratory diseases
4. Old age
5. Periodic Movements in sleep – it consists of two different syndromes; Periodic Limb Movement Disorder and ‘Restless Legs’ Syndrome
   1. Periodic Limb Movement Disorder – sudden, repeated contraction of one or more muscle groups during sleep. Lasting for few seconds and at an interval of 20-60 sec. It occurs during Non-REM stage of sleep and hence the person is unaware of the movement. But he usually complains of non-restorative sleep.
   1. ‘Restless Legs’ Syndrome – irresistible urge to move the legs due to aching, tingling, burning or crawling sensation in the calves, relieved by movements of legs, like walking or kicking. Making it difficult to fall asleep or maintain sleep.
6. Alcohol and drugs
7. Psychiatric disorders – mania, clinical depression, dysthymia, anxiety disorders, stressful life situations, etc
8. Idiopathic insomnia

Types  –

1. Transient insomnia – lasts for less than a week. Can be due to an emotional change, stress, anxiety, shift work or jet lag, etc.
2. Acute insomnia – consistent difficulty is sleeping well, for a period of less than a month. It can be due to an illness, bigger stress or loss of someone close to you.
3. Chronic insomnia – insomnia at least three nights a week for a month or longer.

Hypersomnia:

Involves excessive sleepiness even when getting enough sleep and difficulty waking up (maybe confused, not fully awake, for a period of time). In some cases, patients with primary hypersomnia have difficulty waking in the morning and may appear confused or angry. This condition is sometimes called sleep drunkenness and is more common in males. A few common causes are Narcolepsy, Sleep apnea, Menstrual-associated, Hypothyroidism, Alcohol, and Drugs, etc.

• Narcolepsy – it is characterized by excessive, uncontrollable daytime sleepiness Classically the symptoms include:
  1. ‘Sleep Attack’ – even in the middle of talking, working, or even driving. Usually, there is a gap of 2-3 hrs between two attacks
  2. Cataplexy – sudden loss of muscle tone, while the person is awake. Eg. Jaw drop, fall, etc may be precipitated by sudden strong emotions
  3. Hypnagogic Hallucinations – vivid dreams like perceptions, which occur at the onset of sleep. Unlike dreams, they feel very real, and the person may be convinced that he saw or felt something
  4. Sleep Paralysis – a temporary inability to move or speak while falling asleep or upon waking up. The episode may last from 30 secs to a few minutes and may cause significant distress

• Sleep Apnea – cessation of airflow at the nostrils (and mouth) for 10 seconds or longer. It is characterized by very loud snoring and waking up at night gasping or choking. The person is unaware of it and often complains of sleepiness during the day and non-refreshing sleep. It can be a dangerous condition as it can cause cardiac arrhythmias, pulmonary and systemic hypertension, and death.

Disorders of Sleep-wake Schedule

It results from a discrepancy between the person’s daily sleep/wake pattern and demands of social activities, shift work, or travel. The person with this disorder is not able to sleep when he wishes to, although at other times he is able to sleep adequately.

The common causes are –

• Jet lag : is caused by travel to a new time zone
• Work shift : from day to night or vice versa
• Some people are unable to sleep early. They typically sleep late at night and get up late in the morning. They are called as ‘owls’
• Others are similarly unable to remain awake at night. They typically sleep early at night and get up early in the morning. They are called as ‘larks’
• Some others have a longer than 24 hours sleep-wake cycle

Parasomnias:

Dysfunctions or episodic nocturnal events occur with sleep, sleep stages, or partial arousals. They mainly consist of Non-REM related disorders and REM-related disorders.

• Non-REM related disorders
  • Sleep walking (Somnambulism) – the person can perform a range of activity from simple to complex activities like walking, driving a vehicle, moving objects, etc
  • Sleep terrors or night terrors – the person suddenly gets up with loud scream and panic. They can rarely recall the episode on awakening
  • Bruxism – grinding of teeth in the sleep leading to wear and fracture of teeth and sever jaw pains
  • Sleep talking – person talks in sleep but doesn’t remember anything in morning
  • Confusional arousal – a condition in which the individual’s partially awakens and sits up looking around consumed. They usually remain in bed and then go back to sleep. They also have –
    • Severe morning inertia – sleep drunkenness, similar to the confusion, disorientation and slowed responses seen on awakening from slow wave sleep
    • Sleep-related sexual behaviour- commonly known as sexsomnia. Sexual behaviour e.g. vocalizations, fondling, masturbation, intercourse and sexual assault; without conscious awareness

• REM related disorders
  • REM sleep behaviour disorder – the person lives out his dreams at night and can kick out, shout, and talk. They may inadvertently hurt themselves, their sleeping partner, or someone else in their household. The condition can be dangerous, so must be diagnosed and treated without delay. It occurs later in the night and the patient can remember what they were dreaming.
  • Recurrent isolated sleep paralysis – inability to move your body either at awakening in morning (usually) or at sleep onset, while the person is fully conscious. Last for few seconds to few minutes. Or can be aborted by sensory stimuli like being touched, spoken to or with great efforts. While paralysis at the onset of sleep may be a sign of narcolepsy, awakening with sleep paralysis is benign.
  • Nightmare disorder (sleep anxiety disorder) – person has fearful dreams occurring mostly in later one-third of night sleep. The person wakes up very frightened and remembers the dream vividly. More common in children from age 2 to 5 yrs of age.

• Other disorders
  • Sleep related enuresis (bed wetting) – involuntary and recurrent voiding of urine during sleep, after the age at which staying dry at night can be reasonably expected.

Sleep Hygiene –

Along with various Psychotherapies and Medications for sleep problems, it’s important to maintain good sleep hygiene.

• Regular, daily exercise (preferably not in the evenings)
• Minimize day time napping
• Avoid fluid intake and heavy meals just before bedtime
• Avoid caffeine intake (e.g. tea, coffee, cola drinks) before sleeping hours
• Avoid regular use of alcohol
• Avoid reading or watching television while in bed
• Sleep in a dark, quiet and comfortable environment
• Regular time to going to sleep and waking up
• Use your bed only for sleeping and not for working

Now let’s understand what is Hypnosis –

The term ‘hypnosis’ comes from the Greek word ‘Hypnos’ meaning ‘sleep’.

Hypnosis is a state of altered awareness in which access is available to the subconscious mind. It’s a state in which your mind becomes highly aware and highly suggestible. It’s a state of deep relaxation, in which the conscious mind is able to concentrate acutely on a specific thought, emotion, memory, or sensation while blocking out all other distractions.

Unlike the ‘sleep state’, in which you are oblivious of what is happening around you, the hypnotic state is one in which the conscious mind is awake and aware of what is going on, simultaneously providing access to the subconscious mind.

Because of its ability to increase responsiveness, hypnosis is frequently used to alter behavior and reactions that could be contributing to chronic health problems (such as insomnia and other sleep disorders).

Hypnosis For Sleep Disorders –

Hypnosis only works if you are willing.

For chronic sleep problems, it’s important to consult your physician to rule out any underlying medical conditions. It’s also important to remember, that Clinical Hypnotherapy is one of the techniques which should be used, along with complete psychological and medical treatment protocol, along with good sleep hygiene.

Hypnotherapy helps you understand and become aware of your negative pattern or underlying reason leading to sleep problems. The cause of the problem will vary for each individual, so the approach will also vary from person to person.

Researches have shown that acute and chronic insomnia, respond to the relaxation and positive suggestion of Hypnotherapy. The therapy helps your mind and body to relax, which in turn helps to let go of the anxiety created by not falling asleep.

In cases of sleepwalkers, hypnotic suggestion can help you learn to wake up, the moment your feet touches the floor. It also helps to increase the amount of time that you spend in Non-REM sleep, as much as 80 percent.

Studies show that hypnotherapy has helped cases of Nightmares and Night Terrors; in both children and adults both.

There are several reports of successful use of hypnotherapy for parasomnias, specifically for head and body rocking, bedwetting, and sleepwalking.

Homoeopathy And Sleep Disorders –

Homeopathy is one of the safest and effective modes of treatment for all types of Sleep Disorders, esp. in the early stages. Homeopathy can take care of various symptoms of Sleep Disorders.

In the treatment, the cause is first found out. It’s one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using a holistic approach. Some of the very commonly used remedies are – Nux vomica for alcohol or substance-related insomnia, Ignatia for insomnia caused by grief, and Passiflora for insomnia related to mental stress.