Sleep disorders

Nervous disorders that may disturb sleep

Persistent mental stress situations, stress and depression can measurably alter autonomic nervous functions. As a result, this can lead to sleep disorders. Sleep as well as autonomic cardiovascular functions may show changes in the early course of a mental stress reaction such as the "burn out" or exhaustion before becoming aware of depressive mood changes.

Connections between disorders of blood pressure regulation and sleep disorders is often discovered late. In particular, sufferers who experience daytime dizziness, headache with severe pulse acceleration while standing (for example, in postural tachycardia syndrome, left circulatory disorders ), tend to be accompanied by sleep disorders. Typically, sufferers miss the feeling of well-being after waking in the morning. For example, they remind you that they are easily awakened by sounds and other external influences during the night. Sleeping through is harder and often interrupted.

Also other vegetative complaints can disturb the sleep considerably. These include, for example, nocturnal urination, which is frequent, i. forces you to get up more than twice at night. This is not only sleep disturbing. It can be excreted in this way over a short period of time, a large urine fluid. Not infrequently, sufferers complain in the morning about circulatory problems in a quick straightening up. Dizziness or difficulty concentrating then typically accompany the morning.

Nervous disorders, which cause discomfort, usually also burden sleep. Especially in the awake state before falling asleep the sensations such as tingling or burning of the feet and hands are perceived as very unpleasant and calm disturbing.

Sleep disorder in the early stage of Parkinson's disease

The question of a restful sleep and, above all, abnormalities in the course of the night is becoming increasingly important in the diagnosis of diseases of the brain and central nervous system. If there is repetition of speech, crying or intense movements during sleep, a sleep diagnosis with cerebral current drainage should be initiated. So it can be clarified whether the described vocal and movement expressions occurred during the dream sleep. This would apply to a dream sleep disorder. Not infrequently, the changes in the dream sleep may be heralds of a degenerative disease of the brain such as Parkinson's disease. The onset of Parkinson's slowing, stiffness of the arms and legs, or tremor (trembling) can be preceded by dream sleep behavior disorder by more than 10 years. In order to detect early signs, areas such as memory, attention, concentration and mental well-being are relevant for the early detection of Parkinson's disease in addition to questions and investigations of autonomic functions. In retrospect, many patients report a change in gastric and bowel functions, usually constipation which may precede the diagnosis of Parkinson's disease by up to 20 years. According to the current standard, all previously known early signs of Parkinson's disease are inquired and investigated.

An absolutely safe early diagnosis of Parkinson's disease has not been successful so far, but the improvement of examinations and observation of the development of complaints is currently the subject of research. For this reason, the scientific project PCompanion project (www.parkinson-companion.de), which co-ordinates Prof. Haubrich together with partners from engineering, clinical faculties, a research institution and two companies, should be mentioned here.

Paths to a restful sleep

Sleep and well-being during the day can be improved. The therapeutic approach depends on the accompanying circumstances or causes of the sleep disorder: The treatment of stress-related sleep disorders takes as a central focus the daily structure and grants the targeted relaxation a permanent place during the day. One of the treatment goals is to learn a relaxation technique that can be applied as well as possible daily with good effect. If necessary, a drug treatment is planned at the beginning. For example, if the sleep disorder is associated with some type of circulatory disorder, optimizing circulatory regulation may improve sleep. If falling asleep is hampered by mis sensations in the context of a polyneuropathy, then this annoying sleep impediment can be treated both non-medically, for example by TENS (transcutaneous electron neurostimulation) or medically. Depending on the symptom severity appropriate medications and treatments are selected. In many cases, the cause of the abnormal sensations can be treated successfully.

The dream sleep disorders described also do not always require treatment. The assessment of whether a drug treatment is necessary, requires a very precise balance. Occasional movements, speaking or singing during sleep may have attracted attention, for example. As described, these changes may be signs of Parkinson's disease. To detect the first additional signs of a movement disorder as early as possible, for example, annual neurological examinations can be useful.