How To Classify A Sleep-Wake Disorder & When To Receive Help

Reviewed by Laura Angers, LPC

Published 12/14/2020

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Sleep is one of the most important things we do on a daily basis. It’s our body’s main opportunity to repair and rejuvenate itself, as well as prepare itself for the day that lies ahead. Without sleep, our bodies struggle to develop, grow, and maintain themselves every single day.

Unfortunately, many of us experience complications when attempting to get the necessary amount of sleep each night. As a result, many people have difficulty falling asleep, staying asleep, or waking up — making it difficult for your body to repair and recover itself.

If this sounds like you, there’s a chance you’re suffering from something called a sleep-wake disorder, also known as a sleeping disorder. It affects over 70 million Americans and is just as harmful to an individual’s quality of life as any other disorder.

So, what is a sleep-wake disorder?

Those struggling with a sleep-wake disorder either have difficulty with the timing, quality, or amount of sleep they receive each night. Their lack of sleep is often contributed to mental health issues, behavioral issues, or other medical conditions.

In fact, there are so many different reasons why people have difficulty sleeping that researchers started classifying the symptoms to better distinguish one sleep-wake disorder from another. Since each symptom needs to be treated differently, these classifications ensure the individual receives the proper care and treatment.

It might surprise most people, but there are over 80 different classifications of sleep-wake disorders, and they’re all just as important as the next. Don’t worry, researchers make it a little easier to navigate by further grouping those classifications into the six major sleep disorders.

Classifying The Different Sleep-Wake Disorders

We know that sleep is important for the body — especially the brain. It’s something we should never take for granted and something we should place at the top of our priorities as the day winds down — especially after a long, hard day.

With that being said, we should also know all the different issues that might arise with our sleeping patterns. As with all medical and health conditions, early detection is extremely important with sleep disorders. Of course, it’s only possible if we know what to look for when monitoring our sleep.

Let’s take a closer look at the six major classifications of sleeping disorders — including insomnias, hypersomnias, parasomnias, sleep-related breathing disorders, circadian rhythm sleep-wake disorders, and sleep movement disorders.

1.     Insomnias

Insomnias include some of the most common sleep disorders in the world. They’re generally characterized by difficulty falling or staying asleep, but this can cause a lot of confusion when diagnosing insomnias because there are plenty of reasons why someone might experience this.

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For example, drinking caffeine before bed can have this effect on someone, but it doesn’t mean they’re suffering from insomnia. To limit the confusion, researchers further categorize insomnias into either primary insomnias or secondary insomnias.

In order to be considered a primary insomniac, the individual must’ve had a quality opportunity and prime environment to sleep well but still have difficulty. In other words, the person isn’t an insomniac if their sleeping improves once they stop drinking caffeine before bed.

Secondary insomnias, on the other hand, are the result of an outside illness, disorder, medical condition, behavior, or substance abuse (including caffeine!).

Some of the most common insomnias are:

  • Adjustment Insomnia
  • Psychophysiological Insomnia
  • Paradoxical Insomnia
  • Idiopathic Insomnia
  • Inadequate Sleep Hygiene
  • Behavioral Insomnia of Childhood

Insomnias can have a lasting negative effect on someone’s life, especially considering how valuable sleep is on a daily basis. Since the treatment changes depending on the diagnosis (primary or secondary), knowing the difference is crucial to receiving the right help.

2.     Hypersomnias

Where insomnias referred to difficulty falling or staying asleep, hypersomnias refer to daytime sleepiness, excessive sleeping, and an inability to stay awake or alert during the day. Much like insomnias, hypersomnias cause a lot of distress in an individual’s life.

While hypersomnia might sound like more of a side effect of insomnia, hypersomnias are often experienced in individuals that receive enough quality sleep each night. Despite that, they still find it hard to stay awake during the day — which often leads to additional sleep during the day.

In order to be considered a hypersomniac, the individual’s symptoms can’t result from issues with their circadian rhythm, breathing, movement, or disturbed nocturnal sleep.

Hypersomnias are further broken down into more specific disorders, depending on what the individual is experiencing. For example, narcolepsy is a hypersomnia disorder that’s characterized by excessive daytime sleepiness and sudden/random sleeping.

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Recurrent hypersomnia includes Kleine-Levin Syndrome (KLS) and menstrual-related hypersomnia. KLS is characterized by episodes of excessive sleepiness combined with mood changes, binge eating, or hypersexuality. Menstrual-related hypersomnia occurs when episodes of excessive sleepiness appear during the menstrual cycle.

There’s also idiopathic hypersomnia, which is characterized by excessive sleeping and frequent naps that aren’t refreshing or revitalizing.

3.     Parasomnias

The third classification of sleeping disorders is a parasomnia, which sounds a lot like the last two. Parasomnias occur when the individual experiences abnormal behavior, emotions, sleep movements, perceptions, and dreaming patterns. It can be experienced during REM sleep or non-REM sleep.

Parasomnias associated with non-REM sleep include sleepwalking, confusional arousals, and sleep terrors. We all know what sleepwalking is, but confusional arousals might be new to you. It’s when the individual experiences confusion or confusional behavior during or after waking up. Sleep terrors are cries or screams that occur during sleep.

Let’s take a look at some of the other parasomnias included in this classification:

  • REM-Sleep Behavior Disorder – abnormal behaviors during REM sleep that either result in injury or sleep disruption.
  • Recurrent Isolated Sleep Paralysis – the inability to perform voluntary movements before falling asleep or while waking up.
  • Nightmare Disorder – consistent nightmares that happen during REM sleep and contribute to waking up, anxiety, or fear.
  • Sleep-Related Dissociative Disorder – loss of memory, identity, or perception before falling asleep or while waking up.
  • Sleep Enuresis – involuntary urination while sleeping, which is often called ‘wetting the bed.’
  • Sleep-Related Groaning – uncontrollable Groaning that can occur when the individual’s air pathways aren’t clear.
  • Exploding Head Syndrome – when the individual imagines loud noises and violent explosions inside the head before sleeping or while waking up.
  • Sleep-Related Hallucinations – hallucinating before falling asleep or after waking up that might seem like vivid dreams.
  • Sleep-Related Eating Disorder – often associated with sleepwalking and characterized by recurrent eating upon arousal.
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Parasomnias associated with REM sleep include REM-sleep behavior disorder (abnormal behaviors), recurrent isolated sleep paralysis (inability to perform voluntary movements), nightmare disorder, sleep-related dissociative disorders (loss of memory, identity, or perception), sleep enuresis (involuntary urination).

4.     Sleep-Related Breathing Disorders

Believe it or not, breathing complications could lead to sleep disorders in some individuals. This is the case with most people that snore, gasp, cough or choke in their sleep. The most common sleep-related breathing disorder is sleep apnea, where breathing stops and starts during sleep.

Sleep apnea is often broken down into two subtypes — obstructive sleep apnea and central sleep apnea. With obstructive sleep apnea, the airways are obstructed, which leads to gasping, choking, or snoring throughout the night. Most people with this form also complain of insomnia and daytime sleepiness.

Central sleep apnea is similar in that breathing is disturbed while sleeping. The main difference between the two is that central sleep apnea is caused by the brain not sending the right signals to the muscles that control breathing — opposed to the airways being obstructed.

While most people with central sleep apnea don’t complain of daytime sleepiness, they do complain of frequently waking up throughout the night.

Some patients might suffer from a sleep-related hypoventilation/hypoxemia syndrome, which is when lung ventilation dips below normal. This either leads to high levels of carbon dioxide in the blood or low levels of oxygen in the blood. Either way, health issues could arise.

5.     Circadian Rhythm Sleep-Wake Disorders

Your circadian rhythm is extremely important to your ability to sleep when you need to sleep and wake up when you need to wake up. It’s our body’s 24-hour internal clock that helps the body function and process as needed throughout the day.

Any complications, changes, or misalignments with your circadian rhythm is likely to cause a disruption in your normal sleeping patterns. This is called a circadian rhythm sleep-wake disorder, and there are six major types that fall into this classification of sleep-wake disorders.

Let’s take a look at each one and what they mean:

  • Delayed-Sleep Phase – a disorder where the individual falls asleep later than anticipated.
  • Advanced-Sleep Phase – a disorder where the individual falls asleep earlier than anticipated.
  • Irregular Sleep-Wake – a disorder where the individual doesn’t have a clearly-defined circadian rhythm to follow throughout the day.
  • Jet Lag – changes in the circadian rhythm due to a rapid or sudden change in time zones.
  • Shift Work – when someone’s work schedule intervenes with their normal sleeping patterns, causing their circadian rhythm to fall out of whack.
  • Free-Running – circadian rhythms that aren’t caused by any lighting cues from the environment (popular among the blind).

Understanding which circadian rhythm sleep-wake disorder you’re suffering from is an essential part of the healing process. There are different forms of treatment for each type, and misdiagnosing the disorder could lead to the wrong treatment being performed.

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6.     Sleep Movement Disorders

Sleep movement disorders are exactly what they sound like. They’re characterized by simple and often stereotyped movements by the body during sleep. One of the most common and well-known sleep movement disorders is restless legs syndrome (RLS).

Let’s take a closer look at RLS, as well as the other disorders commonly grouped into this classification:

  • Restless Legs Syndrome – the sudden urge to move the legs when lying down or resting. It can also occur throughout the day as you try to relax.
  • Periodic Limb Movement Disorder – repetitive and stereotyped movements by the limbs during sleep.
  • Sleep-Related Leg Cramps – intense contractions by the muscle that normally occurs in the legs or calves while sleeping.
  • Sleep-Related Bruxism – frequent and uncontrollable clenching of the teeth, which normally results in damaged teeth or disrupted sleep.
  • Sleep-Related Rhythmic Movement Disorder – repetitive and rhythmic movements by the head, arms, or legs that occur during light sleep or when the individual is tired.

Sleep movement disorders are especially dangerous because you run a high risk of injuring yourself or the person you’re sleeping next to. Of course, it also creates a wide variety of stress in the individual’s life and makes it difficult to receive quality sleep each night.

7.     Isolated Symptoms Of Sleep Disorders

While they often fall under as symptoms of a sleep disorder listed above, there are a variety of symptoms that don’t yet have an official classification when discussing sleep-wake disorders.

Snoring and sleep talking are two of the most common. Many people might throw snoring into the ‘obstructive sleep apnea’ classification and sleep talking into the ‘parasomnia’ classification, but these two can be diagnosed without the addition of either sleep disorder.

The ‘short sleeper’ and ‘long sleeper’ are two other isolated symptoms that don’t need to be diagnosed with a sleep disorder listed above. Some people sleep excessively, despite sleeping normally and receiving quality sleep each night. Others don’t sleep enough yet don’t feel the side effects.

The final isolated symptom we’ll discuss is called sleep starts, also known as hypnic jerks. These are strong jerks of the body that happen during sleep onset. They’re uncontrollable, and many people associate them with the sense of falling.

When Is It Time To Receive Help?

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There are so many things that can go wrong with a sleep-wake disorder, no matter what classification it falls under. The problems won’t stop when you finally get out of bed and will creep their way into every area of your life. Not only that, but the problems overstay their welcome.

That’s why it’s important you detect a sleep-wake disorder as early as possible. The moment you notice a loss in quality of sleep, the amount of sleep, or abnormal timing of sleep, it’s time to call a professional. The sooner it’s detected, the sooner a healthcare professional can direct you towards the right help.

Of course, you can also take our online sleep disorder test to see if you’re at a high risk of developing (or already have) a sleep disorder. Many people use our test for reassurance when determining whether or not they need to seek professional help.

At Mind Diagnostics, we do much more than that. If you find yourself needing a professional’s help, we’ll match you with an accredited individual in your area. All you need to do is take the test, reach out, and we’ll do the rest