Sleep Disturbance


Patients often present to ENT clinics with sleep disturbance. Their symptoms can include insomnia, interrupted sleep, interrupted sleep of the sleeping partner, poor energy levels and daytime sleepiness. The stages of sleep Sleep is divided into five stages. The first four are associated with deepening sleep, decreased muscle activity and slowed breathing and pulse rate. The fifth stage is reached when rapid eye movement occurs. It is in this stage that dreaming occurs. The fourth stage is the deepest form of sleep during which the patient is the least arousable. It is associated with delta waves on the electroencephalogram. How many people are affected? Sleep disorder, in its various forms, is very common. A third of adults report sleep disorder at some point in their lives. 20-40% of adults report sleep disorder at some time in the year. 17% rate their sleep disorder as serious. 20% of adults complain of chronic insomnia. Gender Sleep disorder is more common in women with a female:male ratio of 3:2. Men are more likely to have obstructive sleep apnoea (OSA). 4% of men have OSA compared with 2.5% in women. Age Sleep disturbance gets worse with age. In the 30 to 50 year old age group, 5% suffer. Over 50 years this rises to 30%. The elderly experience decrease sleeping periods, awake more often in the night and are more likely to take medications which disrupt sleep. Causes The causes of sleep disturbance can be split into medical, psychological and environmental problems

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