Adult Sleep Disorders

Sleep can be disrupted in many different ways, and the disruptions can stem from many different underlying causes. Some kinds of sleep problems are more common in people with heart defects than in other people. When you talk to your doctor about your sleep problems, they will likely put it into one or more of these categories:

1. Insomnia: trouble falling asleep or staying asleep

2. Sleep-related breathing disorders: changes in breathing during sleep

3. Hypersomnolence: being too sleepy during the day

4. Circadian rhythm disorders: difficulty waking up and falling asleep at the right times

5. Parasomnias: moving and talking while asleep

6. Sleep-related movement disorders: moving or wanting to move in a way that disrupts sleep

When a young adult has a sleep problem, sometimes they show symptoms that are obviously connected to sleep. For example, they might:

• be tired during the day

• fall asleep during the day

• be awake at night

• complain of problems sleeping

Other times, sleep problems can show up in symptoms that do not seem as clearly related. For example, people with sleep problems may:

• be irritable

• have trouble with attention

• be moody

• have learning problems

• have trouble at work

• be an unsafe driver

There are many different sleep disorders, and a doctor can help you to understand what is going on with your sleep. Make sure your doctor understands your full medical history, including your cardiac history, when you discuss your sleep problems.

Below are some of the most common sleep disorders in early adulthood.

When someone has obstructive sleep apnea, their throat muscles relax and block their throat while they are sleeping. This makes them briefly stop breathing, then start to wake up, and then start breathing again.

Obstructive sleep apnea can cause problems such as:

• not enough deep sleep

• snoring

• moodiness

• trouble concentrating

• mouth breathing

• waking up gasping and choking

• dry mouth and sore throat

• bedwetting

Treatments for obstructive sleep apnea include:

• surgery to remove adenoids and/or tonsils

• wearing a device that widens the lower jaw and pushes it forward

• nasal steroids

• wearing a device that pushes air into the airway and keeps it open (CPAP)

Families should always consult a doctor if they suspect someone has sleep apnea.

Delayed sleep phase usually appears in adolescents or young adults. When a person has delayed sleep phase, they have a lot of trouble falling asleep and waking up at the typical times for their culture. It can take them 2 hours or longer to fall asleep on most nights unless they stay up very late.

Delayed sleep phase can be a problem if it affects a person's ability to get to school or work on time, if it disrupts family life, or if it negatively influences a person's mood.

Delayed sleep phase can get better when young people practice sleep hygiene, including:

• no screens before bedtime

• low light before bedtime

• regular sleep/wake times and routines

• cool, dark bedroom

• a fan or white noise

• only using the bed for sleep

Families should consult a doctor if delayed sleep phase is causing a person to not get enough sleep, to miss out on activities, or to feel grumpy or sad.

People who have restless leg syndrome feel a strong urge to move their legs while they are resting. Their legs may feel uncomfortable but not painful, and the discomfort is reduced when they move.

In most cases restless leg syndrome is not a serious problem. In some cases it can be a problem if it makes it hard for a person to sleep, and results in their being overtired or distressed. Doctors can sometimes treat restless leg syndrome with iron supplements or other medications.

People with narcolepsy cannot control whether they stay awake or fall asleep. As a result, people fall asleep during the day at times that are unwanted and sometimes unsafe.

Symptoms of narcolepsy can include:

• getting very sleepy during the day

• having sudden, short-term muscle weakness

• sleep-related hallucinations: seeing or hearing things that are not really there right before falling asleep, or while waking up

• sleep-related paralysis: waking up and being unable to move

Narcolepsy should always be treated by a doctor, since it can significantly disrupt a person's life. Usually, doctors can prescribe a treatment that greatly improves symptoms.

People with shift work sleep disorder have trouble with sleep because of their schedule. It is common in people who work at night, or who have irregular schedules from day to day.

When a person has a shift work sleep disorder, they often have trouble falling asleep when they want to, and remaining alert when they want to. They may become sleepy at work or when driving, and they may lie awake when in bed.

Doctors can help people with shift work sleep disorders with interventions such as light therapy, medication, and avoiding alcohol and caffeine.

When a person has REM Sleep Behavior Disorder (RBD), they physically act out their dreams while they are asleep.

While episodes of RBD can be harmless, they can also be dangerous both to the sleeper and to others in their room or house. Especially when they are having a nightmare, people with RBD can do dangerous behaviors such as jumping out of bed, attacking a partner, or running from their room or house. Usually, it is easy to wake people during an episode of RBD.

People with RBD should seek treatment from their doctor, since the condition can lead to injuries.

When a person has a heart defect, sleep is central to their wellbeing, and to the wellbeing of everyone they live with. Sleep disturbances can lead to physical problems, as well as problems with attention, work, mood, social skills, and learning.

When a young adult has developmental concerns, families and providers should always discuss their sleep, and consider if a sleep problem may be part of their profile. In some cases, improving sleep can lead to drastic improvement across many areas of functioning.

This content was reviewed by a psychologist at Boston Children's Hospital.

Families local to Boston can get help for sleep concerns from the Cardiac Neurodevelopmental Program and the Sleep Center. Click below for more information.