Distinguishing Disordered Sleep & Sleep Disorders
THE GENESIS OF “DISORDERED SLEEP”
In 1996, the impact of my spouse’s snoring on my sleep was becoming all too apparent. While helping in my daughter’s kindergarten classroom, my exhaustion was evidenced by my struggle to keep my eyes open. In a moment of weary inspiration, I took a piece of construction paper and wrote the first draft of My Daddy Snores. 10 years later, in 2007, Scholastic Books published the book. The 400,000+ copies of My Daddy Snores sold are indicative of just how huge an issue snoring and sleep struggles are in homes everywhere.
My ensuing fascination with sleep, and a recognition that sleep deprivation and sleep disorders were playing havoc in far too many lives, sparked my quest as The Sleep Ambassador®, dedicated to heightening awareness and finding solutions to a growing health epidemic.
My professional expertise in financial risk management was transformed as I began to recognize the risks presented by insufficient sleep. From productivity and health to safety and health care costs, I was on mission to make the business case for bedtime. Identifying the return on investment of a good night’s sleep, I set out to help corporations provide sleep education and training for their increasingly sleep deprived employees.
Standing on the stage in 2012 at the headquarters of a Fortune 50 company to present a first-ever keynote on Sleep Wellness, I was committed to providing basic sleep science, an overview of sleep disorders, and practical strategies for sleep improvement. I recognized that compelling language to discuss sleep issues was needed including clarifying the differences and connections of medical sleep disorders and good “sleep hygiene,” a term that was never my favorite. Seeking better ways to discuss this, I was inspired by the terminology used to differentiate an eating disorder from disordered eating, noting that “disordered eating is used to describe a range of irregular eating behaviors that may or may not warrant a diagnosis of a specific eating disorder.”[1] [2] A parallel with sleep, sleep disorder vs. disordered sleep, caught my attention.
Intent on being thorough and before committing to the term “disordered sleep,” I Googled it and found, “poor sleep quality is often caused by sleep disordered breathing, a term reflecting compromised breathing due to airway obstruction or other factors. Obstructive sleep apnea is a form of sleep disordered breathing.” The more I searched, the more I realized that the term “disordered” when associated with sleep was used as a reference to sleep disorders. Yet, as with eating disorder and disordered eating, I also realized that the reversal of the words sleep disorder into disorder(ed) sleep elicits a long list of issues that may or may not be associated with a bona fide medical sleep disorder. As with sleep disorders, disordered sleep also has significant ramifications on sleep, both quality and quantity. In fact, disordered sleep plagues an even greater percentage of our population than those with bona fide sleep disorders, for both adults and children. According to the CDC, at least 35% of adults in the US are getting less than the recommended 7 to 9 hours of sleep per night, and that is just referencing quantity.[3] In 2014, the National Sleep Foundation reported that 45% of Americans report that poor or insufficient sleep is affecting their daily activities.[4] This percentage is growing. These are indicative of disordered sleep issues, as well as the prospect of an untreated sleep disorder. Studies show that one in three adults have or will have a sleep disorder at some point in their lives.[5] The statistics continue to rise, as do the ramifications of insufficient sleep. A commitment to getting our sleep in order is critical.
DISORDERED SLEEP:
Making Choices to Support Your Sleep
I decided to use the term “DISORDERED SLEEP” as a substitute for poor sleep hygiene or poor sleep habits. I created a slide for my 2012 corporate Keynote with the heading “Is Your Sleep in Order?” Under this were two columns: DISORDERED SLEEP and SLEEP DISORDERS. I have been using this depiction ever since to distinguish and align the two categories. See image.
Some listings of disordered sleep may not be of your choosing, such as improper breathing, (mouth vs. nasal breathing[6]) or shift work (which can cause irregular bedtimes). Yet, there are ways to manage such challenges to optimize your sleep. Other examples of disordered sleep offer an opportunity to choose to modify your habits and behaviors such as tuning out from technology an hour before bedtime and creating a bedtime routine to transition to sleep in peace. Additional personal choices to enhance sleep include not looking at the clock once in bed and not consuming alcohol, caffeine, or a large meal close to bedtime.[7] All of these issues can be addressed in some way to support healthy sleep, quality and quantity. Simple shifts can make a big difference on the road to sleep improvement, but chronic poor habits take time to transform into healthy ones. Give yourself some time to identify what you need to modify and to experience the impact on your sleep of the changes you make.
Be mindful that the symptoms and signs of disordered sleep also merit attention as they can be associated with an actual sleep disorder or evolve into a sleep disorder such as insomnia. Chronic insufficient sleep may also spark serious health problems such as depression[8] and weight gain.[9] In addition, research is confirming the correlation of inadequate sleep to early onset dementia.[10]
Many people with disordered sleep are not aware of the physical, mental, or emotional health ramifications of their poor sleep habits and patterns, particularly the cumulative impact on their health and well-being. They may be so chronically tired that they become numb to the slowly creeping deterioration of their mental and physical capacity and functionality. Buoyed by caffeine and long weekend naps, they think they are doing just fine. Furthermore, the individual may mistakenly attribute the symptoms and signs associated with disordered sleep to other causes when the basic culprit may be inadequate sleep, be it quality or quantity.
SLEEP DISORDERS:
Diagnosis and Treatment are Central to Health & Well Being
Concurrent with addressing disordered sleep, it is critical to assess the risk of a sleep disorder,of which there are dozens in myriad categories.[11] These medical conditions beckon attention and care from a sleep expert for assessment, diagnosis, treatment, and ongoing care/monitoring. The primary sleep disorders are insomnia, obstructive sleep apnea, restless legs syndrome, and narcolepsy. Left untreated, a sleep disorder can lead to physical and mental health issues and diseases, the connections often unrecognized by both individuals and physicians. For example, a person with undiagnosed and untreated sleep apnea may incur cardiovascular disease, weight gain, hypertension, or depression. Add to that the safety concerns due to drowsy driving from insufficient sleep. With about 85% of those with sleep apnea undiagnosed, the ramifications for health deficits and health care costs are staggering.[12]
Furthermore, those with a sleep disorder may also have disordered sleep due to chronic poor sleep and falling into a pattern of poor sleep habits, thereby exacerbating the consequences of the untreated sleep disorder. A vicious cycle ensues, beckoning medical attention, beginning by addressing a possible sleep disorder.
PUT YOUR SLEEP IN ORDER
As a non-medical professional, my goal to address disordered sleep for the public at large, including offering sleep education and training for the public and to sleep-friendly corporations and the employees who serve them.[13] That said, my colleagues and I are always vigilant to ensure that those we serve, including our corporate clients, offer a pathway to steer those at risk for a sleep disorder to seek diagnosis, treatment, and ongoing support from a sleep expert, in addition to supporting their sleep improvement journey with strategies and tools to experience optimal outcomes.
No one can sleep for you but you! You have the choice and the obligation for your personal health and for those whose lives you impact, be it at home, at work, or on the road, to get the best, healthiest sleep you can. If your sleep is disordered, make a commitment to modify and change poor sleep habits and behaviors to support sustainable sleep optimization. If you are at risk for a sleep disorder, see a sleep specialist trained to address sleep disorders. All the great sleep habits in the world will not be effective if you have an untreated sleep disorder.
In order to live
well, you must sleep well. Make sleep a priority. Order it as #1 on your To Do
list for 2020 and beyond.
[1] HealthLine, 6 Common Types of Eating Disorders. https://www.healthline.com/nutrition/common-eating-disorders#what-they-are
[2] Eatright.org, What is Disordered Eating? https://www.eatright.org/health/diseases-and-conditions/eating-disorders/what-is-disordered-eating
[3] CDC, Short Sleep Duration Among US Adults. https://www.cdc.gov/sleep/data_statistics.html
[4] National Sleep Foundation. https://www.sleepfoundation.org/press-release/lack-sleep-affecting-americans-finds-national-sleep-foundation
[5] American Sleep Association. https://www.sleepassociation.org/sleep-disorders/
[6] The ABCs of ZZZs, Thrive Global, 2019. https://community.thriveglobal.com/stories/the-abcs-of-zzzs/
[7] Harvard Healthy Sleep, Adopt Good Sleep Habits, http://healthysleep.med.harvard.edu/need-sleep/what-can-you-do/good-sleep-habits
[8] Harvard Mental Health Letter, Sleep and Mental Health, https://www.health.harvard.edu/newsletter_article/sleep-and-mental-health
[9] HealthLIne, How Losing Sleep Can Cause You to Pack On the Pounds. https://www.healthline.com/health-news/how-your-lack-of-sleep-may-be-causing-you-to-gain-weight#A-domino-effect-on-your-health
[10] NIH, Lack of sleep may be linked to risk factor for Alzheimer’s disease. https://www.nih.gov/news-events/lack-sleep-may-be-linked-risk-factor-alzheimers-disease
[11] Sleep Education, from the AASM. Sleep Disorder Categories. http://sleepeducation.org/sleep-disorders-by-category
[12] American Academy of Sleep Medicine, Economic burden of undiagnosed sleep apnea. https://aasm.org/economic-burden-of-undiagnosed-sleep-apnea-in-u-s-is-nearly-150b-per-year/
[13] See Sleep Well/Live Well at www.mysleepprogram.com and Resonea at https://www.resonea.com