So you had a bad night of sleep. You tossed and turned, and it felt like it took forever to finally fall asleep. A night of insomnia may seem like a horrible thing – and make for a long next day – but think of it this way: At least you can control your sleep.
Some sleep disorders, on the other hand, are strictly neurological, which means there isn't much you can do to change the condition you have. As National Sleep Better Month comes to a close, consider these five neurological sleep disorders, which are rare and have few cures or effective treatments.
[See: A Guide to Overcoming Insomnia.]
Exploding Head Syndrome
Have you ever gotten that "falling off a cliff" feeling the second you are about to fall asleep or felt like the bed is falling out from under you? Exploding Head Syndrome is a similar parasomnia experience.
Parasomnias are unintentional movements or behaviors that occur during sleep-wake transitions and Rapid Eye Movement sleep, which are the deepest periods of sleep consisting of sporadic eye movements and dreams. "There is a switch in our brain that sends neurotransmitter signals to our muscles and senses," says Joseph Kaplan, director of the Mayo Sleep Center in Jacksonville, Fla.
Although Exploding Head Syndrome is often frightening, it's not dangerous, says Ronald Kramer, an American Academy of Sleep Medicine spokesman.
"Just as a person with Exploding Head Syndrome falls asleep, they will be hit with a loud noise, frequently reported as a loud boom or banging sound, and a bright flash of light that jerks them awake," Kramer says. "However, it is all neurological. No noise or sound actually occurred."
Exploding Head Syndrome is thought to be brought on by extreme stress and fatigue, according to the American Sleep Association. What actually causes the sensations associated with the condition is still unknown, Kaplan says, but they usually appear in people ages 58 to 70. "There also isn't a lot of good treatment for it at the moment either, unfortunately," Kaplan says.
Recurrent Isolated Sleep Paralysis
Recurrent Isolated Sleep Paralysis typically occurs as you begin to fall asleep or wake up. Those affected by the disorder are suddenly fully aware of their surroundings, but cannot move their body. "Paralysis during REM sleep is normal," Kaplan says. "[But] if you awake during that REM stage while the paralysis is still in effect, you will actually feel like you can't move."
Episodes can last from seconds to minutes. In some cases, the temporary paralysis can also block the ability to speak, but it will not affect breathing.
There is no cure for the disorder, but REM suppressant medication, antidepressants and reassurance from doctors can help reduce symptoms. "Coping mechanisms are important," Kaplan says. "People have to realize that [the paralysis] will pass momentarily."
Kleine-Levine Syndrome is a rare example of a hypersomnia sleep disorder. Hypersomnia conditions are characterized by excessive sleepiness, but aren't improved by getting that extra sleep that may feel necessary. Having KLS means going through periods of excessive sleep and mood swings, which can last from hours to weeks. Once the episode ends, behavior returns to normal until the next episode strikes. "The condition consists of prolonged episodes of weird behaviors dominated by sleep," Kramer says. "Basically, you become a total slug for about three or four months, a couple of times a year."
According to the National Institutes of Health, approximately 70 percent of those diagnosed with Kleine-Levine Syndrome are adolescent males. Onset of episodes is usually abrupt and similar to how intense migraines begin, Kramer says. Signs of an episode include overeating, mood swings, hallucinations, flu-like symptoms and childish behavior. The syndrome is related to the malfunction of the hypothalamus and thalamus, the parts of the brain that govern appetite and sleep.
Fortunately, it doesn't last forever. KLS episodes eventually decrease in frequency and intensity. Though it may take years, there's an end at some point. As of now, there is no definitive treatment for KLS.
This syndrome, characterized by an irregular sleep cycle that shifts later each day, is one of the hardest circadian rhythm disorders to correct, according to the American Sleep Association. Circadian rhythm disorders result in timing problems with a person's sleep-wake cycle.
Most people have an internal biological clock that keeps them on a fairly regular 24-hour schedule and is set by visual cues of light and dark. However, people with free-running syndrome don't have internal clocks and instead have a sleep schedule that's pushed back one or two hours each day, creating a cycle between sleep and wake time that is considered unconventional by society's standards. "[Affected individuals] can never really get it together with the working world," Kramer says. "Their brain timing is off, which constantly moves around their internal clocks."
The disorder is most prevalent among the visually impaired, Kramer says: "The blind don't have the number one thing needed to differentiate between day and night: sense of light." Other factors that can spark free-running syndrome include unstructured or irregular daily routines, poor sleeping habits and a lack of consistent sunlight exposure.
Although it's hard to correct, a few treatment options exist. "We are getting better at stimulating people's brain clocks," Kramer says. "Things like behavioral modifications, light therapy and melatonin can all help the situation over time." A fixed schedule can also be helpful. "You have to structure the day so cues other than light become the regimented signals," Kaplan says.
Fatal Familial Insomnia
Fatal Familial Insomnia is an extremely rare neurodegenerative brain disease in which the thalamus portion of a brain deteriorates, causing people to eventually lose the ability to sleep and subsequently die. It can also lead to agitation, seizures, fevers, a loss of appetite and heart and lung failure, Kaplan says.
FFI is a hereditary condition, and children of those who have it are 50 percent more likely to inherit the disease if one parent is already a carrier.
Little is known about FFI, but scientists have identified a gene responsible for the disorder, Kaplan says. There's no treatment, and those affected typically die within six to 12 months of showing symptoms.
Treating Sleep Disorders
Although sleep can seem like an unproductive activity, it's an important part of maintaining health and long-term well-being. One of the most important things you can do if you're struggling with sleep is to look for help. "People don't put enough priority on getting sleep," Kaplan says. "It all starts with visiting a doctor for a good general checkup. There's also a lot of good information available online and in other outlets for self-help treatment methods. But you have to start somewhere."