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Underlying Issues Associated with Sleep Disorders and Stress Research Paper

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Updated: Nov 14th, 2019

Introduction

Refreshing sleep is critical for good health and well-being. Sleep presents the human body a period of time to restore energy, grow, repair cellular damage, detoxify vital organs, including allowing the brain a much needed opportunity to dream, generate neurotransmitters that are essential for stable mental health, and assimilate newly learned information (Vukovic, 2010).

More importantly, recent studies have identified a positive correlation between adequate sleep and enhanced capacity to cope with stress, while sleep deprivation have been positively associated with increased mood disturbances and impaired mental, emotional, and physical performance (Levy et al, 2006).

The need to understand about normal sleep and sleep disorders, therefore, has never been so urgent. It is the purpose of this paper to argue and demonstrate evidence that sleep disorders have a negative impact on our ability to handle stress and whether caused by stress or simply adding to our stress, they have a profound impact on our work life and our home life.

There exists compelling evidence to demonstrate that sleep research had been neglected for decades as this important facet of our own being was viewed to be of no germane consequence to the wellbeing of humans, and therefore was dropped back into a void (Sleep Mechanics, 2010).

Yet, new studies underscore a huge transformation in the way psychologists, scientists, and sleep researchers have taken a keen interest on sleep and sleep disorders (Carey, 2007). Human beings sleep for one third of their life (Levy et al, 2006), and the devastating effects caused by sleep disorders are too painful to imagine, necessitating a keen interest on this broad topic.

There has been a convergence of interest for many researchers on the topic of sleep disorder and stress. Indeed, among a multiplicity of factors affecting healthy sleep, a wealth of literature has reported the unfavorable influence of psychological stress and psychiatric disorders (Brand et al, 2010).

Some researchers are of the opinion that sleep disorders occasions psychological stress, while others support a more liberal view that sleep disorders and stress are geometrically related and affect each other proportionately depending on the variables at play (Overeem & Reading, 2010).

The situation is further compounded by the fact that it is exceedingly difficult to define stress as it encompass all types of stimuli of varying intensities and duration , not mentioning the fact that divergent types of stressors brings with them diverse impacts on sleep (Eui-Joong & Dimsdale, 2007). What is known at this stage is that sleep disorder and stress are inexorably linked, and both are associated with undesirable outcomes.

Normal Sleep and its Positive Effects

For decades now, it has proven difficult for researchers to offer an objective and unified definition of what normal sleep entails (Lichstein et al, 2004). Sleep researchers, aware of the complexities involved in offering a holistic definition, have developed benchmarks that could be used to offer a justifiable description of normal sleep.

In simple terms, however, normal sleep can be defined as “…normally distributed range of sleep” (Lichstein et al, 2004, p. 73). Normal sleep should be viewed and evaluated within the realms of both good and poor sleepers since it is not necessarily true that poor sleepers have a sleep disorder. Still, normal sleep can be defined as the lack of or absence of sleep disorder, known as a state of normality (Vukovic, 2010).

NINDS (2010a)1 posits that “…for most adults, a normal night’s sleep lasts about 8 hours and is composed of four to six separate sleep cycles…A sleep cycle is defined by a segment of non-rapid eye movement (NREM) sleep followed by a period of rapid eye movement (REM) sleep” (para. 4).

It is imperative to note that sleep, which is defined as a natural sporadic state of rest, comes in phases and different individuals forms their own conceptions of what is enough sleep for them. However, the inability to accomplish the sleep cycle in a single night must never be viewed as a sleep disorder (Brand et al, 2010).

The intrigues of definition notwithstanding, the positive effects of normal sleep have been confirmed and well-documented by researchers (Cai & Richard, 2009). On the physical front, numerous studies have demonstrated that normal sleep is positively correlated to improved vigilance, alertness, improved reaction time, vibrant energy, improved accuracy, and decreased fatigue, among others (Overeem & Reading, 2010).

Biologically, enjoying normal sleeping patterns is not only critical to the proper functioning of the brain, but also enhances its performance, including concentration, learning capacities and memory formation. As such, normal sleep is indispensable for our mental health, vitality, and intellectual development.

In equal measure, normal sleep is ingeniously needed to give our bodies an opportunity to repair worn out body cells, a process that makes us wake up feeling refreshed and ready to face the challenges of the day. This is indeed important as it necessitates us to fulfill our work and family responsibilities without feeling fatigued or stressed out to unhealthy limits (Levy et al, 2006).

The debate about normal sleep is multifaceted in nature and scope owing to the very fact that it not only benefits people at an individualized level, but it also benefits the organizations that these people work for. Seminal studies by Shaw and Bernard2 on 500 employees working for different organizations demonstrated that employees who received adequate sleep were more likely to be productive and creative at work than those who slept less than 3 hours a night or those who worked in nightshifts.

Productive employees are an asset to the organization. According to Patlak (2005), “…as many as 70 million Americans may be affected by chronic sleep loss or sleep disorders, at an annual cost of $16 billion in health care expenses and $50 billion in lost productivity” (p. 2). This serves as a wake up call for organizations to allow their employees adequate time for sleep since it becomes counterintuitive to the management’s performance objectives if they deny their employees adequate time for sleep and rest.

Sleep Disorders and their Negative Effects

Sleep disorders are a category of syndromes or medical disorders characterized by disturbances in a person’s sleep patterns, quality of sleep, or in psychological or physiological conditions that must come into play for one to fall asleep (Overeem & Reading, 2010). Epidemiological studies on sleep have identified about 70 diverse sleep disorders affecting populations worldwide, bringing with them different ramifications ranging from mild complications to life-threatening episodes (Levy et al, 2006).

According to Patlak (2005), an estimated 40 million Americans are affected by sleeping disorders. It is also estimated that more than 50 percent of U.S. citizens aged 65 and older suffers from a sleeping disorder (Levy et al, 2006).

It should be noted at this early juncture that lack of sleep for a few days cannot be equated to a sleep disorder. On the contrary, a sleep disorder is a far more serious and persistent condition that causes the sufferer substantial emotional distress and impede his or her social or work-related functioning (Sleep Mechanics, 2010).

Sleep researchers and psychologists have particularly focused attention to the correlation between sleep disorders and stress. It is a well known fact that psychological stress affects the amount and quality of sleep, making it extremely difficult to sleep normally or attain REM sleep (Patlak, 2005).

Stoppler & Marks (2010) are of the opinion that “stress is simply a fact of nature — forces from the outside world affecting the individual…The individual responds to stress in ways that affect the individual as well as their environment” (para. 1). Such forces may arise from the death of a loved one, medical condition, job-related experiences, family relationships, financial difficulties, and alcohol and substance dependence, among others.

Internal determinants determine our bodies’ capacity to react to, and deal with, the forces that induce stress. Of fundamental importance to this research paper is the realization that the amount of sleep that an individual gets is one of the internal factors that influence his or her own capacity to handle stress (Stoppler & Marks, 2010). As such, it can be logically concluded that sleeping disorders are positively correlated to enhanced stress levels.

Sleep disorders brings with them a myriad of negative effects, especially on an individual’s social, physical, emotional, and mental wellbeing.

According to the National Institute of Neurological Disorders and Stroke, the severity of sleep disorders is further compounded by well-entrenched rules of modern living, which is fast-paced and aggressive, thereby keeping sleep in extreme disregard (Levy et al, 2006). The reality is that sleep disorders can lead to a range of negative outcomes, causing mild to potentially life-threatening ramifications, from weight gain to cardiovascular seizures. Below, some of the most common sleep disorders are discussed.

Sleep Apnea

Sleep researchers and medical professionals have for years tried to understand the dynamics and causative agents of these condition that is far more widespread than holistically understood. By description, sleep apnea is a breathing disorder typified by short interruptions of breathing occasioned by muscle relaxation during sleep (Levy et al, 2006).

At a general level, the condition usually arises in association with lack of fitness, fat accumulation, and loss of muscle tone that comes with aging (Overeem & Reading, 2010). This potentially life-threatening condition is a serious concern for vital body organs such as the brain and cardiovascular system.

The condition, which was first identified in 1965, is much feared for its episodes of pausing of breathing. During an episode, a person’s attempt to inhale air during sleep produces suction that occasions the windpipe to collapse. According to Levy et al (2006), the collapsed windpipe obstructs the air flow for duration of time ranging from ten seconds to a minute, while the person, already in sleep mode, tries to grasp for breathe.

As the episode progresses, the blood oxygen level drops forcing the brain to react by waking up the person in a response that is aimed at contracting the upper airway muscles and open the collapsed windpipe (Overeem & Reading, 2010). The person may grunt or gasp for a while as he or she attempts to respond before resuming normal breathing. This most excruciating cycle can be repeated numerous times in a single night, compounding the condition even further.

The frequent awakenings brought about by sleep apnea are counterintuitive to the health and wellbeing of an individual. A study conducted on subjects with known condition of sleep apnea identified a strong relationship between the condition and personality problems such as irritability, stress, depression, and perceived instability of mental health.

The deprivation of oxygen during the seizures may have grave consequences, including brain damage, decline in mental functioning and performance, enhanced risk of suffering from stroke, heart failure, coronary heart disease, injury from accidents, and high blood pressure, among others (Lichstein et al, 2004). In the U.S., sleep apnea and its complications accounts for an estimated $42 million in treatment and hospital bills.

Hypersomnia

Hypersomnia is a sleep disorder characterized by recurring and excessive amounts of daytime sleepiness or extended nighttime sleep (Grohol, 2010). Available literature demonstrates that hypersomnia is a rare disorder, occurring in less than 5 percent of the adult population worldwide (Levy et al, 2006).

The condition usually affects people between ages 15-30, and progresses gradually over a period of years. Unlike feelings of tiredness or fatigue felt by people largely as a result of lack of adequate sleep at night, people suffering from this condition are compelled to sleep frequently during daytime, often at unsuitable times such as working hours thereby lessening their productivity.

Of particular interest is the fact that these daytime naps hardly offer any relief from symptoms of fatigue and disorientation experienced by people with this condition (Overeem & Reading, 2010).

Hypersomnia is evaluated along a continuum of duration and level of severity. According to Overeem & Reading (2010), an individual must exhibit symptoms related to the condition for at least three weeks to be diagnosed with hypersomnia, not mentioning the fact that the symptoms must have a substantial effect on the person’s life for the person to be categorized as suffering from hypersomnia. Studies conducted over time has identified some unique symptoms or behaviors exhibited by people suffering from the condition.

In one particular study, Levy et al (2006) identified excessive daytime sleep (EDS), diminished levels of alertness and energy, anxiety, depression, disorientation, prolonged sleep at night, diminished mental functioning, memory difficulty, and enhanced irritation. Other symptoms include restlessness, slow or retarded speech, antisocial behavior, appetite loss, and hallucinations (Brand et al, 2010). In severe cases, a person suffering from this condition loses his ability to undertake his or her family, social, or occupational responsibilities.

Hypersomnia is occasioned by the presence of another sleeping disorder, medications, drug or alcohol dependence, injury or impairment of the central nervous system, and head tumors, among others (Brand et al, 2010). The condition, according to Levy et al (2006), can also be caused by other medical complications such as multiple sclerosis, epileptic seizures, post traumatic stress disorder, and obesity.

Of importance to the broad objective of this report is that this condition can be caused by medications used to alleviate stress. As such, a correlation between sleep disorders and the negative outcomes brought about by stress can be drawn.

Narcolepsy

There is no known cause for this chronic disorder, which is described as excessive and overwhelming sleep attacks especially during daytime even after having adequate sleep at night (Levy et al, 2006). Some sleep researchers defines narcolepsy as a chronic neurological disorder which weaken the capacity of the central nervous system to regulate normal sleep patterns (Overeem & Reading, 2010).

As such, a person suffering from this condition is more likely to become sleepy and fatigued at inappropriate times and situations. According to the NINDS (2010a), “…people may involuntarily fall asleep while at work or at school, when having a conversation, playing a game, eating a meal, or, most dangerously, when driving an automobile or operating other types of potentially hazardous machinery” (para. 2).

If the urge to sleep becomes irresistible, people with this condition fall asleep for periods ranging from a few seconds to one hour or even for longer periods of time.

Other symptoms that characterize narcolepsy include abrupt loss of voluntary muscle tone, hallucinations, and brief periods of total paralysis especially at the beginning or end of every episode (NINDS, 2010a). It is inarguably difficult to diagnose narcolepsy. For a person to be fully diagnosed as suffering from the condition, he or she must have suffered repeated episodes of sleep attacks for a period not less than three months (Sleep Mechanics, 2010).

The situation is further compounded by the fact that the condition is not ultimately diagnosed in most victims until 10 to 15 years after the onset of the first symptoms (NINDS, 2010a). Scientists have now formed the opinion that narcolepsy is occasioned by disease processes which affects the brain’s capacity to regulate REM sleep. Of particular relevance to this report is the fact that narcoleptic sleep seizures can occur anywhere at any given time, profoundly disabling the victim’s productive capabilities.

Restless Legs Syndrome

Restless legs syndrome (RLS) is a neurological sleep disorder characterized by uncomfortable, stinging sensations in the legs followed by spontaneous urge to move the legs when at rest or sleeping in an attempt to relieve these unpleasant and often painful feelings (NINDS, 2010b). According to Buchfuhrer & Kushida (2007), “…the medical term for these sensations is dysesthesia, which is defined as disagreeable or abnormal sensation” (p. 3).

These sensations normally occur in the calf sections of the legs but may also be felt elsewhere. The most unique or extraordinary characteristic of RLS is that relaxing or lying down for prolonged periods of time automatically activates the symptoms. The sensations vary in severity from slight uncomfortable feelings to painful episodes. Some individuals have reported experiencing the sensations in the arms too.

Accounts of people with RLS reveals a trend whereby the sensations are more pronounced at night than during the day (NINDS, 2010b). In most occasions, the uncomfortable sensations disappear by early morning, allowing the person some time to sleep. Despite extensive research, the causative agents of RLS remain unknown.

Although many people don’t take the condition seriously, especially in mild cases, severe cases of RLS can disrupt daytime functions due to the onerous interruption of sleep during the night. More importantly, the syndrome is known to cause exhaustion, stress, and daytime fatigue if left untreated (NINDS, 2010b).

Such a scenario bears obvious ramifications on the victims’ work-related responsibilities, personal and family relations, and other activities of daily living. In addition, people with RLS are unable to concentrate, and therefore are unable to accomplish their daily roles (NINDS, 2010b; Buchfuhrer & Kushida, 2007).

Exploding Head Syndrome

According to American Sleep Association (2007), “…exploding head syndrome is a rare and relatively undocumented parasomnia event in which the subject experiences a loud bang similar to a bomb exploding, a gun going off, a clash of cymbals or any other form of loud, indecipherable noise that seems to originate from the head” (para. 1). This condition is not associated with pain or any other physical characteristic.

Many people have only reported shortness of breath after experiencing the syndrome. This noise occurs just before a person enters into deep sleep, and occasionally upon waking up. Attacks can, on their own volition, increase or decrease with time or even disappear altogether.

People with this condition often experience fear and distress after an episode, followed by elevated heart rate. Though the condition is not life-threatening, it is highly associated with stress and overbearing fatigue in most people. At this stage, the cause of this syndrome is not yet known (ASA, 2007).

Population Affected by Sleeping Disorders

Sleep disorders are known to affect people based on their age, lifestyle behaviors, immediate environment, and their mental and health status, among other factors (Levy et al, 2006). It is difficult to draw a fine line between who is at risk of being affected by the sleep disorders because situations keep shifting and our experiences at an individual level keep on changing inline with the trends of modern living.

One thing that has reverberated all along the discussion, though, is the fact that sleep disorders and stress are inexorably linked, and that one variable triggers a spontaneous response from the other. This notwithstanding, extensive research carried out on these disorders has explicitly identified the percentage of Americans who may be at risk and, in some occasions, stated the age categories that are most affected.

A cohort study conducted in 1993 revealed that one in every 15 people in the U.S were affected by at least one form of sleep apnea, a figure that is equivalent to 18 million Americans (CureResearch.com, 2010). It is also estimated that 2-4 percent of Americans lives with the condition but are yet to be diagnosed.

People in middle-age are thought to be more at risk of being affected by the condition, with figures demonstrating that as many as 9 percent of American women and a massive 24 percent of American men in middle-age are affected by the condition yet they remain undiagnosed and untreated (Levy et al, 2006).

Available data on hypersomnia demonstrate that the condition affects an estimated 5 percent of the population as they progress through the lifespan (AllPsychOnline, 2004). However, hypersomnia is more widespread in males than in females. The symptoms appear before an individual celebrates his or her 30th birthday, and continue to advance as one ages unless treated.

Narcolepsy is a common sleep disorder in populations around the world, but it often goes unrecognized or misdiagnosed. It is therefore hard to account for the total percentage of the population suffering from the condition. But going by NINDS (2010a) estimates, one in every 2,000 people living in the U.S. is affected by the condition.

Narcolepsy is neither gender specific nor racial or ethnic specific; it affects people from all walks of life globally. It is feared that a larger segment of the population might be suffering from the condition in silence. According to NINDS (2010a), the disorder “…prevalence rates vary among populations…Compared to the U.S. population, for example, the prevalence rate is substantially lower in Israel (about one per 500,000) and considerably higher in Japan (about one per 600)” (para. 6).

Researchers put the figure of Americans suffering from restless legs syndrome (RLS) at 12 million (NINDS, 2010b). However, this is a provisional figure because RLS, as is the case with narcolepsy, is thought to be grossly misdiagnosed and, in some instances, under-diagnosed. Still, some people with the condition fail to go for medical checkup on the belief that theirs is not a serious condition that warrants medical attention. As such, the prevalence levels could be higher than currently estimated.

There exist no objective statistics on people affected by exploding head syndrome due to the fact that the disorder is relatively new. What is known at this stage is that individuals over the age of 50 stands more chance of being affected by the syndrome. It is also known that women are at higher risk of being affected by the disorder than men (ASA, 2007).

How Sleep Disorders Affect Family Life

Evidence adduced in this report has demonstrated that the amount of sleep that an individual gets is one of the internal factors that influence his or her own capacity to cope with stress (Stoppler & Marks, 2010). This therefore implies that sleep and the capacity to handle stress are proportionately linked, with the amount of sleep serving as a variable over the capacity to handle stress.

More importantly, it has been revealed that sleep disorders affect family life in numerous ways. A good starting point in this discussion would be to reinforce the proven concept that normal sleep is indispensable for our mental health, vitality, and intellectual development (Sleep Mechanics, 2010). In the absence of normal sleep, individuals will be deprived of these critical aspects that enhance their ability to cope with stress.

Fatigue and stress occasioned by sleep disorders makes a person to be unproductive at the family level. As a matter of fact, these undesirable characteristics are not only counterproductive to the family as a unit, but they also impact substantial harm on the victim and his or her own personal and social relationships (Brand et al, 2010).

The frequent awakenings occasioned by sleep apnea, according to available literature, are counterintuitive to the health and wellbeing of an individual.

According to Lichstein et al (2004), these individuals may be unable to maintain a long term relationship with their partners, not mentioning that the disorders takes a toll on their quality of life, denying them the confidence and vigor that is copiously needed for modern living. Subjectively, some of the sufferers of serious sleep disorders such as sleep apnea think of themselves as abnormal human beings.

There exists a strong relationship between sleep disorders such as sleep apnea and personality problems, including irritability, stress, depression, and perceived instability of mental health. Hypersomnia is known to decrease the level of alertness and energy while enhancing depression, disorientation, antisocial behavior, and enhanced irritation, among others (Levy et al, 2006).

These undesirable outcomes not only reduces our capacity to effectively cope with the stressors experienced in modern living, but also entraps the sufferers in a vicious cycle of unresponsiveness and low quality life on the family front. Studies have positively correlated these characteristics to increased suicide rates (Vokovic, 2010).

It is, therefore, not difficult to see that people suffering from sleep disorders stands a high risk of losing their ability to holistically undertake their family responsibilities. Family breakups and divorces may be witnessed in cases where the sufferer is the sole breadwinner of the family since the disorder will force him or her to forego family responsibilities.

Sleep disorders comes with profound financial obligations in medical costs that are bound to weigh heavily on the family. Statistics demonstrates that an estimated $16 billion is used annually in the U.S. to treat people with sleep disorders (Patlak, 2007). Such costs may have an overbearing effect on the family, affecting its ability to function normally and, in some cases, draining all the resources earmarked for other activities.

This only serves to increase stress levels. More importantly, some of the medical complications associated with sleep disorders such as stroke, brain damage, coronary heart disease, and high blood pressure have the capacity to bring permanent ramifications on family life (Eui-Joong & Dimsdale, 2007).

How Sleep Disorders Affect Work Life

It is indeed true that work environments are stressful environments. Our ability to handle and cope with stress therefore becomes of critical value if we are to perform to expectations and remain productive at work. However, this is better said than done when it comes to sleep disorders and work life as many of the negative outcomes associated with sleep disorders only serves to diminish our own abilities to handle stress.

Some symptoms such as fatigue, depression, loss of memory, disorientation, and daytime sleepiness (Eui-Joong & Dimsdale, 2007) curtails people’s productive and creative nature at work. Chances are that, such symptoms increases cases of absenteeism from work and enhances turnover.

According to Lichneistein et al (2004), productive employees are an asset to the organization. Sleep disorders, however, works against the grain to make people with such complications become less productive in their work and therefore a liability to the organization.

Patlak (2007) opines that the U.S. alone loses in excess of $50 billion annually in lost productivity due to complications associated with sleep disorders. This is an astronomical figure whose effect on the economy cannot be wished away. People with sleep disorders such as hypersomnia or narcolepsy are unable to optimize their work life owing to the fact that they are compelled to sleep frequently during daytime, often at unsuitable times such as work hours (O vereem & Reading, 2010).

In particular, people with narcolepsy cannot operate hazardous machinery or drive for long hours as they are bound to involuntarily fall asleep on the job and if they do, other expenses may have to be incurred in terms of covering for accidents and hospital bills. Other stress disorders such as RLS and exploding head syndrome are known to cause exhaustion, stress, lack of concentration, and daytime fatigue, profoundly disabling the person’s productive capabilities at work (NINDS, 2010b; Buchfuhrer & Kushida, 2007).

Conclusion

Clearly, the facts have been laid bare that not only does sleep disorders affects our ability to handle stress, but they also have a profound effect on our work and home life. Specifically, the paper has focused attention to the interrelations between sleep disorders and stress, and how the resulting multiplicity of negative outcomes affects our family and work life.

The paper has gone a step further to discuss some of the most common sleep disorders and the populations that are most at risk of being affected. The astronomical costs in terms of lost productivity, medical complications, family breakups, stress and stress-related complications, lack of creativity, among others calls for action among all stakeholders directed at offering practical yet manageable solutions to the millions of people suffering from these devastating yet treatable complications.

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Footnotes

1 National Institute of Neurological Disorders and Stroke

2 See: Lichstein et al (2004)

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