Sleep Disorders in Dubai: What You Need to Know and How to Treat Them

In Dubai and generally worldwide the two most common sleep clinic presenting complaints are insomnia and snoring at night, which can be indicative of more serious problem such as obstructive sleep apnea.

The third edition of the International Classification of Sleep Disorders (ICSD-3) classifies sleep disorders into seven major categories: insomnia, sleep-related breathing disorders, central disorders of hypersomnia, circadian rhythm sleep-wake disorders, parasomnias, sleep-related movement disorders, and other sleep disorders.

There are three distinct types of insomnia: short-term insomnia (lasting less than three months), chronic insomnia (lasting more than three months), and other insomnia (when the patient has insomnia symptoms but does not meet criteria for the other two types of insomnia).

Insomnia can go often untreated for years partly due to under reporting by patients to the physicians and partly due to the lack of screening for it from the healthcare professionals’ side. The most common mistake seen in the treatment of insomnia is self medication with alcohol or the prescription of sleeping pills by physicians.

Neither of these two options is the ideal treatment strategy. Behavioral changes and patient education are the best way to treat chronic insomnia.

Sleep-related breathing disorders are characterized by abnormal respiration during sleep; they occur in both adults and children.

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There are four major groups of sleep-related breathing disorders:

• Central sleep apnea syndromes, where the brain does not send proper signals to the respiratory muscles to breathe
• Obstructive sleep apnea syndromes, where there is a mechanical obstruction of airflow to the lungs during sleep
• Sleep-related Hypoventilation disorders, where there is insufficient airflow in and out of the lungs during sleep
• Sleep-related Hypoxemia disorder, in which oxygen level is low during sleep

The most common type of sleep-related breathing disorder is obstructive sleep apnea which is diagnosed with a sleep study and treated with CPAP (continuous positive airway pressure).

The central disorders of hypersomnolence include those disorders in which the primary complaint is daytime sleepiness that is not due to another sleep disorder, including disturbed sleep or misaligned circadian rhythms.

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This condition is usually difficult to treat; behavioral changes and daytime stimulants are the best options at present.

Circadian rhythm sleep-wake disorders are characterized by a chronic or recurrent sleep disturbance due to alteration of the circadian system or misalignment between the environment and an individual's sleep-wake cycle.

This is a common problem for teenagers who stay up late at night and they’re required to get up in the morning and go to school. Bright light therapy in the morning and melatonin pills at night is the treatment of choice.

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Parasomnias are undesirable physical events (movements, behaviours) or experiences (emotions, perceptions, dreams) that occur during entry into sleep, within sleep, or during arousals from sleep. When confirmed with a sleep study, these disorders are usually treated with a variety of oral pills based on the type of parasomnia identified.

Sleep-related movement disorders are characterized by simple, stereotypic movements that disturb sleep. Restless legs syndrome/Willis-Ekbom disease is the most common sleep-related movement disorder. Iron deficiency is a common cause of this problem; iron repletion abolishes the symptoms in this case.

If the cause of the disease is not secondary to iron deficiency then treatment might involve other neurologic medications that a sleep specialist or a neurologist can prescribe.