Shift work sleep disorder by definition is a circadian sleep disorder occurring due to work schedule taking place during normal sleep period. This schedule requires the person to work when that person’s body wants sleep and vice versa happens when body wants to be awake. This timing is different than what the internal body clock of the person expects.

This clock is the controller of circadian rhythms in the body. These rhythms are responsible for make a person feel alert or sleepy at regular time every day. It tells your body the time to awake. This clock works or set by the person’s exposure to sunlight.
Several types of the shift work schedules are:

• Night shifts
• Rotating shifts
• Early morning shifts

These types of sleep problem cause the person to have trouble in sleeping or report severe tiredness. It is often reported because of early morning and night shifts. Such people have sleep 1 to 4 hours less than an average person. Feeling of refreshes’ is absent when such people wake up as a result their performance at work is hindered.

This condition usually lasts only up till the person keeps a shift-work schedule. Once the person begins sleeping at normal time again, this problem tends to go away. In some cases it does not end. The severity and the length of the problem can vary from the person to person. There are different types of the work schedules. Some people may work overnight shift. Their problem would be certainly very brief. For regular night shift worker this problem may go on and on. A person working extra hours can add a fatigue to their problems.

This problem can affect a person even if that person is away from the job as that person will spend most of the free time in compensating the sleep by sleeping. This disorder also increases risk of drowsy driving. This may also the make person’s heart or stomach disorders worse. If a person thinks that using alcohol can improve the situation then the person is wrong as it can lead only to abuse.

Sleep problem from shift work can affect to all age groups of any sex. People having unusual working hours are most likely to suffer from it. Estimated 2% to 5% of the population is affected by this. Early morning shifts people are not included in it.

People in habit of sleeping late night daily may suffer from delay sleep phase disorder.

This can be treated. Many employers have planned up to help their co-shift workers to stay better rested. Their goal is simple, to make their shift worker rest better. This keeps them safer at job and healthier overall. Some techniques used by the employers are as following:

• Reducing number of times that a worker changes his/her shifts
• Offering the employees option of an exercise breaks
• Giving workers regularly few rest periods
• Change of shifts forward instead of backward in time
• Using bring light

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Restless legs syndrome is when the person have strong urge of moving his/her legs. It is hard to resist. It may come with uneasy feeling deep inside the person’s legs. It can be very hard to explain this strange feeling. It might feel like burning, tingling, itching or prickling. It can be very extreme and painful. Sitting still can also be very hard. The person can feel temporary but immediate relief on walking or moving the legs.

The urge of moving your legs eases in the morning and grows at night. This makes a person unable sleep or take a rest and may get a sleep of even less than 5 hours. Mild RLS do not disturb sleep that much. People suffering from this may feel tired or lack of energy. They may even suffer from anxiety or depression. This problem can come for a short period and then return after a long while. It starts from legs and then can spread to the whole body. Its intensity can vary day to day. This attack can come at any time, while driving or while working at the office, anywhere. A related problem that a person can get effected to is of flexing or tightening of leg’s muscles while the person is still and are not controllable too. As this can occur while a person is awake so it makes it even harder for the person to go asleep. Almost 90% of the patients affected by RLS are also affected by PLMS.

Chances of women getting effected with this problem is more than of men. As like PLMS this can also occur to any age group. This can be result of the following conditions:-

• Pregnancy
• Iron deficiency
• End- stage renal disease
• Due to some medication

This disease has genetic links like if your blood relative has this problem then your chances of getting affected by it grows to 3 to 6 times. It has following symptoms:-

• Urge to moving legs
• This urges more when doing rest.
• Your legs feeling better when moving.
• You feeling worse during night or evening.

If this is true then the person might be suffering from RLS. But it can be also due to the following reasons:

• A medical condition
• Another sleep disorder
• Substance abuse
• A mental health disorder
• Medication use

If a person is suffering from mild Restless Legs Syndrome then that person might not feel like taking experts help but if that person is suffering from severe RLS then that person has to go to a sleep specialist as it can greatly disturb your sleep and hence your mind and daily schedule.

It is treated by an exercise program that may help both restless legs. Reducing smoking, alcohol and caffeinated drinks may also help. This can also be reduced by keeping mind active. When restless legs, any of the following activities may help:

• Walking
• Riding an exercise bike
• Massaging the legs
• Soaking in a hot tub

Medications can also be opted for the treatment.

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Periodic limb movement is a type of sleeping disorder. Periodic limb movements are said to occur when you have continues episodes of repetitive, simple muscle movements. The person suffering from this will not be able to control them. They have no influence on once ability to sleep but can severely disrupts the person’s sleep during the night. This can be due to the tiredness during the day. They have no effect in the change of body position, a cramp or stretching of muscles instead, movements tend to the flexing or tightening of muscles. They attack mostly lower legs.

Their occurrence can be at 2 different times:

• Periodic limb movement while you are sleep (PLMS)
• Periodic limb movement while awake (PLMW)

PLMS are more common. When they occur at the night, they disrupt your sleep periodically. A person is unaware of movements and/or of waking up. An example of this type of movement is that of big toe to stretch. Often hip, knee or the ankle will bend slightly. All though it is quite less common, the same can happen in the upper arms too. Degree of these movements may change from one night to other night. If these movements are severe, then they may happen while the person is wake (PLMW).

This movement last only for few minutes up to an hour. Within that time, the movement tends to occur every twenty to forty seconds. More often, they affect both legs. PLMS is quite common. Bed partner’s sleep tends to be more often affected than that the patient. They can disrupt daily life and sleep.

The other factors that can cause similar disorders are:

• Short attention span
• Depression
• Fatigue
• Bad memory

PLMS can occur in both adults and children. The probability of effecting with it increases with age and is common in elderly. The probability for people over 60 years to get effected by it is 0.34. It is found in the people who have at least one of the following sleep disorders:

1. Restless legs syndrome
2. Narcolepsy
3. REM sleep behavior disorder

People having low brain iron may show more severe effects. Severe type of PLMS has been discovered in people with:

• Spinal cord injury
• Sleep related eating disorder
• Multiple system atrophy (rare neurological disorder)

Normally, a person is unaware of the movement. This can makes it hard for the person to know if that person has periodic limb movements. Someone who sleeps with you in same bed would be in a better to notice the movements.

1. If the person’s body make strange movements while sleeping?
2. Do such movements occur in lower legs?
3. Feeling of never well-rested after having full night of asleep?
4. Feeling very tired during day?

If that’s so, then you might be suffering from PLMD.

It is important to know that is the above symptoms of some other disease. These can be:

• Another sleep disorder
• A medical condition
• Medication use
• A mental health disorder
• Substance abuse

And if not then the person should go to a doctor to get cure of PLM.

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Narcolepsy is a type of Sleeping Disorder. Actually it is used to represent group of people that are affected by excess sleepiness. A person suffering form it may also have problem of day dreaming. This problem is refreshed by few short naps, i.e. after 2 – 3 hours of nap a person feel sleepy again. A person suffering from it may feel asleep suddenly. This attack of sleeping suddenly can come anytime; it can be while walking, eating or even driving which can be too dangerous.

There are basically 2 kind of Narcolepsy:-

• Narcolepsy without cataplexy
• Narcolepsy with cataplexy

A person with cataplexy feels sudden weakening of muscles of arm, face or legs. This generally happens when the person experiences strong emotions like during laughter. People who are suffering from narcolepsy can experience following problems:-

• Sleep paralysis in which a person is not able to move for few minutes or seconds when waking up or falling asleep.
• Hypnagogic hallucinations in which a person start seeing things that aren’t there
• Disturbed night sleep in which a person woke up frequently and even have trouble falling to sleep again.
• Memory problem in which a person might even have problem in remembering things that other people tells that person as the person might not even be fully awake.

Almost 0.05% people are suffering from narcolepsy. This is not a genetic problem but still chances are higher to get this problem if your elders are suffering from it. Again, it is rare to have two people from same family to be suffering from this disease.

A person can know whether that person is suffering from this disease by looking at the following factors:-

• Your resistance to sleep during the day becomes worthless.
• Tendency to sleep again even after having a full night sleep.
• Tendency of feeling sleepy after the person had long nap.

If all the above is true then that person might be suffering from Narcolepsy. The worst part of this problem is that it can even last for life time if not properly treated. A person usually gets affected with this problem at the age group of 12 – 20. A person has to have the treatment. The person should also note that there can be other problem that are causing the above symptoms like another sleep disorder, medication use, substance abuse, a medical condition or even a mental health disorder.

If a person is suffering from Narcolepsy then that person must for and see a doctor, sleep specialist as other doctor might not be able to find the correct cause of the problem. The most important, it is not a common problem so only specialist gets to see such cases and will be able to give proper treatment. Doctor might need to know your full medical background before prescribing the right treatment for this problem. It is mostly treated by taking medicines that keeps you awake during day so that you can sleep well at night, but this can vary.

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Every human body has a biological internal body clock that helps humans maintain a sense for the time zone that person is living in. Time zone is different for different places which changes with longitude and latitude of particular place. So, when a person is traveling by plane or jet to different locations the internal body clock takes time come in synchronization with the time zone of that particular place as the rhythm of the internal body clock is set according to particular time zone and its synchronization gets disturbed. Humans develop particular habits according to place they are living in i.e. the time of eating or sleeping these can change drastically according to different time zones.

Another major cause, that a major cause of trouble is for the people who have long or irregular working shift hours which causes potential loss for adapting to different changes in terms of day and night around them, on an average 65% of People who have long working hours have complained for similar symptoms as in jetlag.

A particular person can immediately find that whether the person is suffering from jet lag or not:-

• Irritability
• If a person doesn’t feel like eating
• Stomach upset Feels
• Feels unnecessarily tired
• Feeling somewhat depressed
• Grogginess
• Like dehydrating a lot(or dehydration)
• Uneven sleep patterns

As jetlag is a temporary phenomenon which may vary from person to person across different ages and across different sex. According to a study, it has been found out that younger people have more chances or they are more susceptible to jet lag and so are females .Females have more chances of developing jetlag then their counterpart i.e. males.

For example people travelling from London to Tokyo or vice versa have more chances of developing jetlag as people would have to cut across continent and through different time zones which would have more chances of developing jetlag. As more the distance a person travels and more the time zones are covered more are the chances of developing jetlag. As soon as more than 6 time zones are skipped the length and effects of jetlag start increasing adversely.

Though jetlag can considerably reduce by

1. Taking shower in between flights
2. Exercising before flight
3. Melatonin
4. Drinking lots of fluids

Taking shower in between flights

During long flights it is always a better idea to have a shower to freshen up and relax muscles. It helps to recover from jetlag much quickly.

Exercising before flight

A person should try to get as much exercise as much possible so that blood flow remains good.

Melatonin

This is one controversial method to counter jet lag which has always been a topic of debate as if done with even slightest of mistake it could lead to even further worsening of jetlag. It involves manipulating hormones in human body.

Drinking lots of fluids

Drinking lots of fluids is always a good Idea before a flight as it would help fight dehydration, it is important to remember only non-alcoholic drinks should be preferred even more so, drinking plain water should be preferred.

Note

Sleeping pills should not be taken to get rid of jet lag as it would only worsen its effects causing blood clots.

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Obstructive sleep apnea (OSA) is a breathing disorder that causes the person’s body to stop breathing during the sleep. Obstructive sleep apnea occurs when tissue at the back of throat collapses and even blocks the airway. This prevents the air from getting into the lungs. This is a common sleep disorder.

It happens due to the fact that the muscles present inside the throat relaxes as you sleep. Gravity causes tongue to fall backward and then block the airway. This Blockage of airway can happen several hundred times per night or a few times a night.

OSA can occur both in women and men of any age group, but is common in middle-aged, obese men.

There is a relationship between OSA and weight. Your neck can get thicker as your body gains weight. This can certainly increases the volume of fat present in back of throat resulting in narrowing of the airway. As the fat increase the chances of throat getting blocked increases.

People with Obstructive sleep apnea are often obese with neck size more than 17”. Many people with Obstructive sleep apnea are found to have a high blood pressure. Children having large tonsils can have OSA.

Symptoms of Obstructive sleep apnea are:-

1. Experience of any of the below problems?
   • Unintentionally falling asleep specially during the day
   • Fatigue
   • Un refreshing sleep
   • General daytime sleepiness
   • Insomnia
2. Waking from asleep with choking sound or with gasping for breath?
3. You stop breathing or snoring loudly while you sleep?

If you have reported such symptoms then you may be suffering from OSA. There can be other cases also possible like many people snore loudly but only 50% of then suffer from OSA. Snoring comes when the air is partially blocked. Some people think that they don’t snore but the right person to answer that is their bed partner. In this problem a person may feel sleepy during day time. They may feel tired even after taking a nap. The person may find him/her self awake suddenly form the sleep.

If a person is suffering from OSA then that person must visit specialist as this is a serious problem involving blockage of the air respiratory system of the person. A person can also go for overnight sleep study, also called as polysomnogram as this can help in evaluate the problem.

There is possibility that the person may be suffering from other problems such as:

• Another sleep disorder
• Mental health disorder
• Medication use
• A medical condition
• Substance abuse

Following things can help in the treatment process, which are:-

1. Continuous positive airway pressure treatment is most often used for the treatment of OSA. It works by wearing a mask and throwing air back into the throat making airway open and thus the person can breathe easily while asleep
2. One can also go for weight loss exercises.
3. Under severe cases one can also go for surgery.

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