Sleep Disorders: An Emerging Public Health Issue

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Sleep Disorders: An Emerging Public Health Issue

Apr 14, 2021

Sleep is essential for the physical and mental health of the person. If a person didn’t get proper sleep, it might lead to many health complications. In recent time, due to various reasons such as busy work schedule, changes in sleep patterns, stress, environmental factors, certain medical conditions or medications use, a disturbing trend in sleep quality and quantity has been observed worldwide. People struggling with sleep disturbance often experience many other associated health issues such as fatigue, low energy, irritability, chronic diseases and conditions. 

What are sleep disorders?

Sleeping disorder is characterised by abnormal sleep patterns. A disturbance in sleep timing, duration and quality lead to a sleep disorder that can result in daytime distress and functioning. Apart from harmful health consequences over time, it also impacts daily life activities, including work performance, thinking, relationships, mental health, weight, safety, etc. More than 80 types of sleeping disorders are identified, and among them, Insomnia, Sleep Apnea, Narcolepsy, Restless Leg Syndrome, Circadian Rhythm Disorders are most common. 

What are the symptoms of sleep disorders?

The signs and symptoms of sleep disorders vary from person to person and according to the severity and type of disorder. Falling asleep during the daytime and struggling to get a good night’s sleep are the most common sleep disorders symptoms. Similarly, unusual breathing patterns during sleep, heavy snoring, movement, uncomfortable urge to move during sleep are other symptoms. Likewise, the lack of concentration, daytime dozer, irritability or anxiety, irregular sleep and wake pattern, low or impaired performance in academics or work also signify sleeping disorder prevalence. 

What are the risk factors for sleep disorders?

A large number of mental and physical factors may influence the occurrence of Sleep disorders. Stress being the major contributing factors; similarly, depression and anxiety are the other two key factors. The lifestyle factors such as unhealthy habits and routines, lack of regular exercise, using electronic screens and consuming excessive alcohol or caffeine before bedtime, smoking can also give rise to sleep-related problems. The sleeping disorder such as obstructive sleep apnoea and narcolepsy is found to be linked with genetics. Iron deficiency anaemia, being overweight or obese, intake of particular medication can also cause sleep disorders.

What are the complications associated with Sleep Disorders?

Sleeping disorder is associated with many health complications such as hypertension, type 2 diabetes, stroke, cardiovascular disease, obesity, heart attack, and many others. Depression, mood change, and anxiety disorders may also develop over a while if it remains untreated. Similarly, the person might experience poor concentration at work, and slow reaction time. 

What are the most common sleep disorders and their treatments options?

More than 80 different types of sleep disorders are identified based on symptoms such as difficulty initiating or maintaining sleep, abnormal movements and behaviours, excessive daytime sleepiness, abnormal events or sensations during sleep and many others. However, among different types of sleeping disorder, some of the most common disorder include:

Insomnia –  Insomnia is one of the most common sleep disorders that affect a significant proportion of the population worldwide. In insomnia, the affected person can’t fall asleep at night, resulting in daytime impairment. As per Ancoli et al., “insomnia symptoms occur in approximately 33–50% of the adult population, among which insomnia symptoms with distress or impairment are observed in 10–15% cases, whereas specific insomnia disorders occur in 5–10% cases”. The causing factor for insomnia varies from person to person. Unhealthy lifestyle, financial difficulties, certain medical conditions, sleep habits, job, relationships, use of medications and other substances are common causes of insomnia. 

If a person faces trouble in falling asleep or stays asleep at least three nights per week for three months or longer, it is considered chronic insomnia. The treatment goal for chronic insomnia focuses on improving sleep and alleviating distress or dysfunction caused by the disorder. Psychological therapy, pharmacologic therapy, or a combination of both are available to manage chronic insomnia. To provide an effective therapeutic option for chronic insomnia, companies such as Eisai, Idorsia Pharmaceuticals, Minerva Neurosciences, Janssen, Evotec, and others are diligently involved in developing therapies. As per DelveInsight, the launch of the emerging therapies is expected to significantly impact the treatment scenario for chronic insomnia in the coming years.

Sleep apnea – Sleep apnea is a sleeping disorder that is associated with abnormal breathing during sleep. In sleep apnea, the affected person’s breathing is interrupted frequently, due to which the brain and the body may not get enough oxygen. If remains untreated, it may result in heart attacks, heart failure, stroke, cardiomyopathy (enlargement of the muscle tissue of the heart), diabetes, hypertension, and other medical conditions. 

Sleep apnea is of two types, namely obstructive sleep apnea and central sleep apnea. In central sleep apnea, a normal breathing pattern stops when the brain temporarily ceases sending signals to the muscles that control breathing. Among the two types of sleep apnea, obstructive sleep apnea is more common, caused by a blockage of the airway for a short period of time during sleep. Old age, family history, small airways, and being overweight are the most common factors for obstructive sleep apnea. As per the DelveInsight, the diagnosed prevalent cases of obstructive sleep apnea in the 7MM was found to be 23,351,061 in 2017.  Among the 7MM, males were found to have a higher prevalence as compared to females.  

The OSA is manageable with medical, behavioural, and surgical options. The treatment scenario considers various potential factors contributing to the OSA, such as physical examination, upper airway imaging, history, and the severity of the condition. At present, the current therapeutic landscape of obstructive sleep apnea (OSA) has few approved therapy. The companies involved in the therapeutics development of obstructive sleep apnea aim to treat and decrease the apnea-hypopnea index (AHI) in patients. Some of the key companies in the OSA therapeutics market include Apnimed, Idorsia, and Bayer. 

Narcolepsy – Narcolepsy is a chronic sleep disorder that affects the wake and sleep pattern of the person. Usually started between the ages of 10 and 25, narcolepsy is marked by excessive and uncontrollable daytime sleepiness and poor sleep at night. The potential for the affected person to experience injuries, life-threatening situations and accidents are pretty higher. If it remains untreated, Narcolepsy can affect the person’s psychological, social, and cognitive functioning, resulting in poor academic and work performance, interpersonal relations and other social activities. Excessive daytime sleepiness, sleep paralysis, fragmented sleep, cataplexy, hallucinations are common symptoms of narcolepsy

As per Delveinsight’s estimates, in 2017, the total prevalent population of Narcolepsy in the 7MM was 499,888. In the US, there were 3,583 cases of narcolepsy in children and adolescents and 37,132 cases in adults in 2017. There is no cure for Narcolepsy; however, medications, behavioural and psychosocial interventions can help in managing the symptoms. Various studies have estimated that only about 25% of people suffering from narcolepsy get diagnosed and receive treatment. To provide effective therapeutics option, companies such as Avadel Pharmaceuticals and others are diligently involved in developing therapies for Narcolepsy

Restless legs syndrome, Sleep Paralysis, Circadian Rhythm Disorders, Chronic Fatigue Syndrome, Jet Lag, Seasonal Affective Disorder are some other common sleeping disorders. 

What lies ahead?

Good sleep is necessary for the mental and physical well being of the person. Apart from personal well-being, it also ensures the country’s high economic productivity by the citizens. But over the past few years, a negative trend has been observed. Sleeping disorders have emerged as a global health concern. Fast-paced lifestyle, hectic schedule, stress, changing working patterns, medication use, and various underlying medical conditions have worsened the situation. Almost every section of society is found to be affected by sleep disorder. If left untreated, sleeping disorders may give rise to many other adverse health conditions. Today, several pharmacological and behavioural treatments are available in the market to address sleeping disorders. Similarly, certain global players are also involved in the development of new therapeutic approaches. In the coming years, rising awareness towards the sleeping disorder, improvement in the diagnosis methodologies, rising investments in health care sectors, increasing demand for novel medication, and extensive research and development activities by the pharma companies are expected to remarkably improve the situation for the people affected with sleep disorders.

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