Human sleep is a relief to the weary, while sometimes despised by the hard driven. Essential and mundane, human sleep is still mysterious, enticing determine researchers with its enigmas. And when affected by physical or psychological disorders just as any aspect of human existence may be, sleep is often anything but restful, bringing disturbance and sometimes, disaster. In this list, we explore the most startling facts about sleep and learn what happens when slumber goes dramatically wrong.
10. Fatal Familial Insomnia
Insomnia might seem to be a garden variety annoyance, and indeed it is only that in the vast majority of cases. However, a far more dangerous kind of inherited insomnia than the mundane version experienced by the stressed or overexcited can lead to death over a period of worsening bouts. Caused by a hereditary prion condition that targets the thalamus, the part of the brain responsible for controlling the sleep/wake cycle, Fatal Familial Insomnia brings an inorexible cessation of sleeping ability. The disorder usually activates between ages 32 and 62, causing death within 12 to 18 months. Unable to gain any meaningful sleep, sufferers die as a result of both neurological degeneration and increasing, extreme sleep deprivation.
Prions, made infamous by “Mad Cow Disease” are bizarre protein agents that kill by converting healthy proteins in an infected organism into a similar folded form, destroying their function. The effect is somewhat analogous to the takeover of a human body by a virus, bacteria or cancerous condition, but completely unique in nature. In the case of Fatal Familial Insomnia, a genetic mutation triggers the prion forming process and the damage to nerve cells that defines the disease. Fortunately the disease, for which there is no cure, is extremely rare, affecting only a handful of families worldwide. In a couple where one member carries the mutation for Fatal Familial Insomnia, there is a 50 percent chance of passing the genetically dominant disorder onto their children. In rare cases, the disorder may occur spontaneously, when proteins in a person’s body shift into the disease forming structure due to unknown causes.
9. Sudden Unexplained Nocturnal Death Syndrome
A rare and by default always fatal condition most frequently reported from Southeast Asia, Sudden Unexplained Nocturnal Death Syndrome (SUNDS) has disproportionately affected those of Southeast Asian backgrounds and led to intense scientific investigation. Initially described in 1917, the condition causes victims, generally young men in apparently OK health and no serious medical history, to die suddenly in their sleep, with deaths being the most frequent in the early morning hours. Primarily affecting defined genetic groups in different parts of Asia, SUNDS affects different groups to varying degrees, with much higher levels among certain populations from Thailand and the Philippines as an example, with far lower rates of occurrence in Southern China.
The condition rose to prominence in the United States as significant numbers of refugees fleeing conflict in Southeast Asia came to the United States and gained notoriety by causing frequent, mysterious deaths through sudden nocturnal heart failure. Stress related causes, shock and cardiac conditions have all been posited, with research from Oxford suggesting heart failure through ventricular fibrillation brought about by genetic mutation based abnormalities affecting sodium channel currents. At night, the heart beats in a weaker pattern, according to Matteo Vatta, Baylor College of Medicine in Houston, making the victims of the disease. The ability of the condition to cause sudden death at night inspired the 1984 movie A Nightmare on Elm Street and has a number of traditional names in different Asian cultures reflecting awareness of the deadly condition.
8. Hypnic Jerks
While restless leg syndrome is well known, less frequently described but more often experience is a sensation of literally falling while falling asleep. Technically not a sleep disorder but simply a sometimes unsettling occurrence affecting sleep, the phenomenon known as Hypnic Jerks is strange and the cause of some disturbing or even traumatic experiences while asleep and may lead to a loss of rest. The occurrence reflects a complex physiological conflict between the motor system and the paralysis that our body goes into when we sleep in a transition between the two states of sleeping and being awake.
As we fall into sleep, the reticular activating system that controls wakeful activity surrenders to the control of the ventrolateral preoptic nucleus, which puts us into a sleep state. When the ability of the sleep state to take over is impaired, Hypnic Jerks occur more commonly and prominently. Under stress, the conflict is more apparent as our ability to fall asleep is impaired, causing the waking state to have an “unfair advantage” over the action of the ventrolateral preoptic nucleus, creating a greater struggle in the form of more Hypnic Jerks. Hypnic Jerks reflect how the stress that makes the process of falling asleep more difficult can cause further disruptions through the jerking action right when one is finally about to fall asleep, further delaying entry into REM deep sleep.
7. Sleep Driving
We all should know the dangers of driving while drowsy, but a bizarre form of “complex automatic behavior” as it is known in the medical field has become of inquiry into the safety of anti-insomnia medication, bringing a host of legal issues. Sufferers of sleep driving episodes have been arrested in various states of consciousness while operating their vehicles. Following such perplexing, potentially fatal and legally problematic incidents, survivors of sleep driving have been noted to suffer amnesia, having no recollection of the incidents.
In certain cases, those affected by this automatism condition have been found in their vehicles clothed fully in bedroom wear or stopped at green lights in their vehicles. Legal cases have led to discourse highlighting a lack of awareness among some physicians and other clinical practitioners of the fact that use of the hypnotic sedative Zolpidem may cause complex automatic behavior in the form of driving while in a sleep state. Although complex behaviors and sleep driving after Zolpidem ingestion have been described, the timing of the ingestion and the legal ramifications of the behaviors are not commonly appreciated by the clinician. The most popular sleeping pill known to be used in the United States, Zolpidem may deserve closer scrutiny by medical professionals to reduce the risk of tragedy by driving while asleep.
6. Obstructive Sleep Apnea
Snoring may seem to be the greatest possible annoyance when sleeping in close quarters with other human beings. Yet, snoring can also be a sign of a potentially life shortening condition called Obstructive Sleep Apnea (OSA) where repeated closure of the airway create cycles of oxygen deprivation and complete breathing cessation, waking, a return to sleep, and another breathing interruption and waking. With hundreds of cycles occurring per night, the oxygen deprivation resulting from attacks of Obstructive Sleep can be substantial.
Adequate oxygen is a key factor in circulatory health, and without it, the heart suffers as it runs less efficiently and under greater strain that impacts the entire body negatively. places great strain on the cardiovascular system. The condition thus brings an increased risk of high blood pressure and heart conditions including heart attack, stroke, heart failure, and arrhythmia. Increased risk factors for development of Obstructive Sleep Apnea do not only include innate physiological features. Along with collapse of soft tissue located at the rear of the throat, obesity with excess fatty tissue in the throat area increases the chance of developing OSA by obstructing breathing and causing bouts of OSA. Attempting a reduction in unnecessary body fat and sleeping in alternative positions are among the options available to potentially mitigate OSA’s harmful effects.
5. Sleeping Beauty Syndrome
Kleine-Levin Syndrome (KLS), popularly known as Sleeping Beauty Syndrome, is a peculiar sleep disorder that actually affects young people, especially males, in the majority of cases despite its name. Persisting for several years after onset in most cases, the exceptionally rare but life-disrupting disorder involves sleeping like a cat, in fact more than a cat would. Coming in recurring episodes that may last multiple weeks or even for months, KLS sufferers suffer greatly extended sleeping hours, sleeping for most of the hours of a given day, at times only getting up to eliminate.
The disorder usually disappears as one progresses a little further into adulthood, but may last as long as 10 years after onset. Strangely, the apparently drugged state in which the afflicted find themselves may bring on a suite of bizarre behaviors and predilections, including childlike talking, naivety, and a spaced out, disoriented demeanor. The disorder is severe to the point where those afflicted cannot care for themselves, yet sufferers are apparently normal in between the attacks. The disorder can lead to serious harm to social, personal and academic performance, and may also be accompanied by binge eating and confusion between real life and dreaming.
4. Exploding Head Syndrome
While the name Exploding Head Syndrome makes this disorder sound as if it is the worst of all sleep disorders, Exploding Head Syndrome is more of a disturbing and perplexing phenomenon than a directly harmful condition. However, the disorder may cause an appreciable level of distress as it is defined by the perception of loud noises in the process of falling asleep or waking up. Sounds heard may resemble doors slamming, static or metallic clashes. In certain cases, the anxiety produced from attacks may be enough to bring about heart palpitations and tachycardia.
Perplexing to medical scientists, various physiological causes have been proposed as mechanisms causing the symptoms of Exploding Head Syndrome. Mild seizure activity, neuron related challenges affecting the brainstem and even ear component problems have been put forward as potential triggers of Exploding Head Syndrome. The condition is correlated to an extent with stress and exhaustion, and occurs most commonly after 50 years of age with slightly more woman than men affected. As a patient falls asleep, the sound may be triggered, only to disappear upon awakening. When the patient tries again to fall asleep, symptoms may return, further inhibiting sleep. The occurrence of the attacks is not predictable, ranging from single episodes to frequent or occasional repeat bouts.
3. Nocturnal Hyperhidrosis
The idea of drowning in your sleep may seem like an unpleasant joke, but the worst instances of night sweats make the idea plausible to sufferers. Known technically as Nocturnal Hyperhidrosis, extreme nighttime sweating may leave sleepwear and bed sheets literally soaking wet as water is released from the body in massive quantities. Often used as a trope in horror movies, awakening drenched in sweat has a variety of medical causes, some minor and some life threatening. Frequently seen as a result of menopause, Nocturnal Hypohidrosis is not related to the temperature of the sleeping environment, but may result from disease conditions as diverse and serious as cancer, bone infections, sleep apnea, diabetes and intestinal disorders, as well as severe anxiety and stress.
Nocturnal hyperhidrosis is capable of causing great physical discomfort and may lead to becoming those affected feeling chilled as the waterlogging, copious quantities of perspiration begin to evaporate. The condition may indicate some of the most serious diseases known, including bone cancer, heart disease, lymphoma, and in some circumstances, serious psychiatric conditions requiring intervention. The International Hyperhydrosis Society notes the importance of seeking a medical evaluation in cases of Nocturnal Hyperhydrosis given the potentially health impairing or life threatening medical conditions the symptoms may indicate.
Catathrenia is a strange name, and even stranger is the nature of this sleep disorder. Categorized as a parasomnia until 2013, when it was re-classified as a breathing disorder by the International Classification of Sleep disorders manual ICSD-3. Sufferers of Catathrenia, which is also known by the name of Nocturnal Groaning, make peculiar sounds while sleeping that range from groans to shrieks. The sounds result when sleepers hold and then release their breath following a deep inhalation, most frequently during REM sleep.
The condition is essentially opposite to the situation that defines snoring, where sounds are made as a person inhales in an aberrant manner. Unlike many other sleep disorders, Catathrenia frequently fails to awaken those it affects. As a result, those experiencing the condition may not be aware of their condition. Lasting up to 30 seconds, the groaning sounds often wake up others sharing a sleep environment with the sufferer. Strangely, those with Catathrenia do not have any distress showing in their facial expressions despite the volume and length of the sounds made during sleep. The condition does not appear to be serious compared to other sleep disorders but may result in a sore throat in the hours following awakening.
Bedwetting is a commonly known affliction, yet another disorder involving liquid waste is perhaps more disruptive to sleep though it does not generally result in a wet bed. Nocturia, or Nocturnal Polyuria as it is also called may force a sufferer to rise from their sleep up to six times in a single night to urinate before trying to catch a brief rest in between episodes. Once incorrectly thought to result from bladder fullness, Nocturia is in fact frequently attributable to a failure in the body’s natural urine volume reduction system that would normally activate as we sleep, keeping us dry and well rested.
Typically, the human body automatically concentrates urine produced during sleep through diurnal excretion of solutes such as electrolytes, while the anti-diuretic hormone vasopressin is released at night to suppress urination. Thus, less urine is produced and the natural tendency to release it is inhibited. This biochemical functioning works well to prevent disturbance of sleep by the repeated need to eliminate fluid, but sufferers of Nocturia enjoy no such benefit and face serious sleep disruptions and deprivation as a result of constant trips to the bathroom in the most severe cases. Even a couple of trips to the washroom may cause tiredness in the daytime. Fortunately, the worst and most disruptive cases of Nocturia are quite uncommon.