Dyssomnias: characteristics of these sleep disorders

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

In fact, sleeping well is essential to be able to carry out our daily lives normally, and it is a very important factor that favors our quality of life. In this article we will talk about a group of sleep disorders: dyssomnias. Within them, we are also going to talk about one in particular: insomnia.

What does dyssomnia mean for the person who suffers from it? How can it be treated? Let's see it below.

• Related article: "The 7 main sleep disorders"

Dyssomnias: definition and causes

Dyssomnias are disorders of quantity, quality, timing and duration of sleep. These are psychogenic and primary sleep disorders, that is, they cannot be explained by an underlying medical condition.

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

• You may be interested in: "What is anxiety: how to recognize it and what to do"

Classification of dyssomnias

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

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

Unspecified dyssomnia includes restless legs syndrome (discomfortable sensations in the extremities -mainly the legs- during rest) and nocturnal myoclonus (periodic movements of the extremities During the dream).

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

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 drops to 6%. According to the ICD-10 (International Classification of Diseases), between 1 and 10% of the adult population suffers from it.

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

According to the 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: the onset (which appears when you start to sleep), the maintenance (during sleep) and termination (where the main symptoms are an early morning awakening and the inability to return to fall sleep).

Psychological treatments for insomnia

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

1. Stimulus control

It is considered the treatment of choice. It is based on the classical conditioning, and it is about associate the use of bed with sleep, by restricting activities that serve as wake signals and setting wake times to stabilize the sleep-wake rhythm.

So the goal is for the bedroom/bed to be associated with a rapid onset of sleep.

2. progressive relaxation

It is the second most effective for this type of dyssomnia. One of the modalities that is applied is the Jacobson's progressive muscle relaxation, where all the muscles relax to facilitate the induction of sleep.

3. paradoxical intention

It is the third most effective. It consists of thinking precisely the opposite of what you want to achieve, that is, thinking that "we don't 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

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

5. sleep restriction

This technique is intended to produce a state of slight lack of sleep that makes it easier to fall asleep earlier, sleep with fewer interruptions and get a deeper sleep.

It is about reducing the number of hours spent in bed trying to get as close as possible to the time that is considered appropriate. Subsequently, the time in bed is increased until optimal sleep duration is achieved.

6. sleep hygiene

They are a set of routines, recommendations and healthy habits before going to sleep, which must be applied in order to obtain a healthy and restful sleep.

The ultimate goal is to sleep better, through the acquisition of better habits that allow you to achieve a healthy lifestyle or change those that interfere with sleep.