Sleep Disorders

Sleep disorders are conditions that disturb how much you sleep, how well, or when. The main groups are insomnia, sleep-related breathing disorders such as obstructive sleep apnoea, restless legs syndrome, body clock disorders, parasomnias such as sleepwalking and dream enactment, and disorders of excessive sleepiness such as narcolepsy.

Insomnia is by far the most frequent, and it is closely tied to anxiety, depression and stress in both directions. Poor sleep affects concentration, mood, blood pressure, weight and road safety. Most sleep disorders can be treated well once correctly identified, and tablets are seldom the best long-term answer.

Symptoms

• Trouble falling asleep, waking often, or waking too early on 3 or more nights a week
• Unrefreshing sleep and daytime tiredness or irritability
• Loud snoring, pauses in breathing seen by a partner, waking choking
• Dozing off unintentionally while reading, in meetings or when driving
• An urge to move the legs in the evening, relieved by walking
• Falling asleep and waking much later or earlier than you want
• Sleepwalking, night terrors, or acting out dreams with shouting and thrashing
• Sudden loss of muscle strength with laughter, which suggests narcolepsy

Causes and risk factors

Insomnia usually starts with a trigger such as stress, illness or a new baby and is kept going by habits and worry: long hours in bed, clock watching, naps, and fear of not sleeping. Caffeine, alcohol, nicotine, evening screen use, shift work and jet lag add to it. Depression, anxiety, chronic pain, menopause, an overactive thyroid and medicines such as steroids and some antidepressants are common contributors. Sleep apnoea relates to weight and airway shape. Restless legs is linked to low iron stores, pregnancy and kidney disease. Narcolepsy follows loss of the brain chemical orexin.

How it is diagnosed

• Sleep history and diary: Two weeks of bed times, wake times, naps, caffeine and alcohol. This is the basis for diagnosing insomnia and body clock problems.
• Questionnaires: The Epworth Sleepiness Scale, Insomnia Severity Index and STOP-Bang screen for apnoea.
• Home sleep apnoea test or polysomnography: Overnight recording of breathing, oxygen and, in the laboratory, brain waves and limb movements. Not needed for straightforward insomnia.
• Blood tests: Ferritin for restless legs, thyroid function and others as indicated.
• Multiple sleep latency test: Daytime nap testing after an overnight study when narcolepsy is suspected.
• Mental health assessment: Looks for depression, anxiety or trauma driving the sleep problem.

Treatment options

• Cognitive behavioural therapy for insomnia: The first-line treatment. Over 4 to 8 weekly sessions it uses sleep restriction, stimulus control and work on unhelpful beliefs. Digital programmes are effective too.
• Sleep habits: Fixed rising time, daylight in the morning, exercise, limits on caffeine and alcohol. Helpful, but not enough alone for chronic insomnia.
• Sleeping tablets: Short courses of days to a few weeks only. Tolerance, dependence, falls and next-day drowsiness limit long-term use.
• CPAP or oral appliance: For obstructive sleep apnoea, alongside weight reduction.
• Iron and specific medicines: Iron replacement when ferritin is low, and other medicines for restless legs when needed.
• Timed light and melatonin: For delayed sleep phase, jet lag and shift work disorder.

When it is urgent

Seek help locally without delay if sleeplessness comes with thoughts of self-harm, with several days of almost no sleep and unusually high energy or racing ideas, or with confusion. Stop driving and see a doctor if you have fallen asleep at the wheel or nearly done so. Violent behaviour during sleep that causes injury also needs prompt assessment.

Travelling to Türkiye for treatment

A sleep study can reasonably be part of a health check during a visit: one night of monitoring, a consultation, and CPAP titration if apnoea is found. Insomnia is different. Its proven treatment is a weekly course of therapy best delivered in your mother tongue by someone who can follow you up, and where low mood or anxiety lies behind it, continuity with a local clinician matters more than anything a short trip can provide. Travel is rarely the right route for that.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

Frequently Asked Questions