Causes of Sleep Problems, Sleep & Other Diseases

What the common sleep problems faced by Singaporeans?
The most common problems seen in specialist Sleep Disorders clinics in Singapore are insomnia and obstructive sleep apnoea (OSA). Other frequently encountered sleep related issues are chronic sleep deprivation, jet lag, shift work related sleep problems and dependence on sleeping pills. All of these conditions are treatable, but unfortunately are often overlooked because many people may not be aware of the significant impact of sleep disturbance on health, or accept the typical symptoms of sleep disorders such as daytime tiredness, unrefreshing sleep and snoring as normal or part of “stress”. Greater awareness of sleep disorders is needed.

How will one know if one has a sleep disorder – any tell-tale signs?
Common symptoms of a sleep disorder include excessive daytime sleepiness in spite of getting enough sleep at night, snoring, difficulty breathing in sleep, difficulty falling or staying asleep, and the perception of unrefreshing sleep. Less common are abnormal behaviours in sleep, or excessive dreams which disturb sleep.

Is there such a thing as sleeping too much? What are the dangers of that, if any?
Sleeping much longer than the recommended average for age is associated with higher mortality (or a shortened life span). Sleeping too much may be a sign of an underlying sleep disorder. For example, someone who gets enough sleep but still feels sleepy and falls asleep during the day in spite of getting at least 7-8 hours of sleep at night, may be suffering from obstructive sleep apnoea (OSA), a condition in which there is disturbed breathing during sleep, which leads to interrupted sleep and therefore, daytime sleepiness because the quality of sleep is poor. Untreated, OSA can lead to significant health problems, like weight gain, high blood pressure, heart disease and depression.

I sleep for 8 hours every night, but I still wake up feeling tired and unrested. What could be the cause of this?
Unrefreshing sleep in spite of an adequate duration is usually suggestive of an underlying sleep disorder or mood disturbance, such as obstructive sleep apnoea (which is the blockage of the upper air passage during sleep, giving rise to symptoms of snoring and excessive daytime sleepiness because the frequent breathing disruptions during sleep prevent the person from getting consolidated, deep restorative sleep) or depression/anxiety. These are the most common disorders causing unrefreshing sleep. If one feels tired and unrested in spite of sleeping 8 hours every night, they are encouraged to consult a doctor for a medical evaluation.

What causes sleep problems?
Sleep problems can be (1) Lifestyle related – Too much coffee, lack of exercise and excessive late night overstimulation from electronic media (eg iPad, social media) are common examples (2) Due to psychological factors like stress, depression, anxiety; or due to (3) Physical factors like primary sleep disorders such as Obstructive Sleep Apnoea (OSA), Restless Legs Syndrome (RLS); or

secondary to disease of other organ systems which cause physical discomfort, such as heart disease (eg. causing chest pain, shortness of breath), stroke and other brain disorders, joint pains, lung problems causing difficulty breathing like asthma, skin disorders causing itch, etc. The treatment depends on the underlying cause.

Is there a link between Sleep and Obesity and also Mood?
Yes, lack of sleep is associated with increased risk of obesity and depression.

Is there a link between Sleep and Diabetes?
Yes, lack of sleep is associated with impaired glucose tolerance, which is a precursor to diabetes.

Is there a link between Sleep and or other health issues/diseases?
Lack of sleep can lead to several physical and emotional health problems – including depression, weight gain, high blood pressure, heart disease, and ultimately severe chronic sleep deprivation is associated with a higher mortality (ie reduced life span).