Specialised Clinical Physiologist (Neuro) and Somnologist, Lecturer, School of Medicine, Kenyatta University & Senior Practitioner, Brain and Nerve Diagnostic Services, KMA Center Upper hill
Like other human needs such as food, sleep is a fundamental human need. Although humans spend roughly one-third of their life in asleep, its purpose remains one of the unsolved scientific mysteries.
However, sleep is believed to be essential for physical and mental restoration and is recognised for its role in optimum daily functioning. Emotional state, cognitive function and performance at school or work, family cohesion, mental health and physical wellbeing can be affected by persistent sleep-related disturbances. Furthermore, there is evidence suggesting that normal sleep is vital for growth and development.
People experiencing sleep disturbances typically present with one of four broad types of sleep complaints:
- Insomnia (complaint of difficulty falling or staying asleep),
- Hypersomnia (complaint of excessive sleepiness),
- Parasomnia (abnormal behavioural or physiological events occurring during sleep),
- Circadian rhythm sleep disorders (disorders associated with the timing of sleep).
These four broad presentations of sleep complaints combine to form multi-faceted, complex sleep disorder entities characterised by disturbances in the patients’ quantity, quality, and timing of sleep, or in unusual behaviours associated with sleep.
Impact of sleep disorders
Sleep disorders are not uncommon and have been widely reported throughout the world. At least 10% of the population suffers from a sleep disorder that is clinically significant and of public health importance.
The cumulative effects of sleep disturbances have been associated with a wide range of health problems including an increased risk of hypertension, diabetes, obesity, depression, heart attack and stroke.
Sleep disorders have a significant effect on health and quality of life compromising many aspects of general health and psychological wellbeing.
Furthermore, sleep disturbances present considerable problems to family life. For instance, studies have suggested that spouse’s sleep problems negatively impact partners’ health and wellbeing.
Sleep disorders have a high direct and indirect costs and present a considerable burden to the individual and society. For example, sleep-related vehicle accidents account for a considerable proportion of vehicle accidents, particularly in those drivers with excessive sleepiness either due to lack of sleep at night or as a consequence of a sleep disorder such as narcolepsy which is characterised by excessive and irresistible daytime sleepiness. In USA, it is estimated that a quarter of all car accidents are caused by the driver falling asleep at the wheel.
Sleep disturbances have also been associated with major catastrophes including incidents in commercial nuclear power plants such as the Three Mile Island plant in Pennsylvania and the nuclear plant at Chernobyl as well as the Space Shuttle Challenger Accident.
Many of the behaviours expressed at night in some sleep disorders such as sleep walking and Rapid Eye movement sleep behaviour disorder can become potentially dangerous for both the individual sleeper and those within their vicinity. These aberrant behaviours range from strange behaviour at night such excessive sleep eating, walking outside naked at night, violence and even murder.
Compared to healthy individuals, individuals suffering from sleep disorders, are less productive and have an increased likelihood of accidents. Sleep deficiency, therefore, has side effects not only at a personal level but also can cause harm on a larger scale including major accidents. These potential adverse effects of sleep disturbance on health, well-being, and productivity have far-reaching societal and economic consequences.
The concept of sleep has changed dramatically in a modern 24-hour society. Time asleep is viewed as wasted time, and spending many hours sleeping is often associated with laziness. Although sleep problems are experienced as inconvenient, they are often not viewed as a medical problem. Hence, only a minority of persons with sleep disturbances consult their physicians and receive medical attention.
The reality is; sleep disturbances are non-communicable chronic disorders and despite their devastating consequences, the majority of sleep disorders can be diagnosed and treated effectively. However, little is known about sleep disorders, let alone their impact in Kenya. It is, therefore, crucial that appropriate public awareness campaigns and educational programs emphasizing the importance of restorative sleep to the general population are put in place to inform and empower them for appropriate and informed decisions regarding their work and lifestyles.
Furthermore, it is critical that the medical professionals are equipped with the knowledge and resources necessary to allow for adequate investigations for the correct diagnosis in good time to allow for appropriate treatment of interventions.