Sleep Disorders Overview

Sleep disorders are conditions characterised by difficulty getting a good night’s sleep. Many people experience sleeping issues throughout their lives, but a sleep disorder such as insomnia can have severe adverse effects on someone’s quality of life. Two-thirds of UK adults say they have sleepless nights.

What are the signs and symptoms of sleep disorders?

Sleep disorders are characterised by symptoms which can stop a person getting a good night’s sleep, or which can cause them to have abnormal sleeping patterns. Two of the most common types of sleep disorders are:

  • Insomnia
  • Sleep apnoea.

Insomnia involves difficulties falling asleep despite feeling tired, including waking up early and being unable to fall asleep again, feeling tired in the morning, and having tiredness interfere with your daily activities throughout the day.

Sleep apnoea symptoms occur when a person is asleep, such as their breathing stopping temporarily and waking them up, loud snoring that can wake them up, and gasping and choking.

A rarer sleep disorder is narcolepsy. This is a brain condition which causes a person to fall asleep spontaneously, as the brain cannot regulate sleeping and waking properly.

Symptoms include:

  • Sleep attacks (falling asleep spontaneously)
  • Cataplexy (uncontrollable, spontaneous muscle weakness leading to collapsing or laughter)
  • Sleep paralysis (temporary inability to move or speak upon waking).

How are sleep disorders diagnosed and treated?

Different types of sleep disorders are diagnosed and treated in different ways. Someone might go to a GP about their insomnia if they cannot manage it with sleeping medication obtained from a pharmacy or altering sleeping habits.

Recommended changes to sleeping habits to treat insomnia involve:

  • Going to bed at the same time everyday
  • Relaxing one hour before going to bed, but not with electronic devices
  • Making sure that there are no sensory distractions – use blackout curtains, an eye mask, earplugs
  • Exercising regularly, but not late at night
  • Making sure mattress and pillows are comfortable
  • Not napping during the day

GPs may suggest cognitive behavioural therapy to help tackle the underlying causes of insomnia such as stress, depression or anxiety.

GPs can refer someone with suspected sleep apnoea to a sleep specialist who can monitor heart rate and breathing while the person is asleep to determine the severity of their sleep apnoea. The specialist will then recommend treatment if the sleep apnoea is severe enough. This will most commonly involve wearing a mask, called a CPAP machine, during sleep. This pumps air into the mouth and nose and prevents the person’s temporary airway obstruction.

Many people are also advised to lose weight as a treatment for their sleep apnoea, as a large neck circumference can make breathing while sleeping, and snoring, worse.

Narcolepsy diagnoses are also carried out by a sleep specialist. There currently are not any cures for narcolepsy, but medicines can be prescribed to reduce the frequency of cataplexy attacks and daytime sleepiness.

Frequent, brief naps during the day are also a way some people with narcolepsy manage their condition.

There are a few ways to confirm what sort of reasonable adjustments should be made for an employee with a sleep disorder:

An employee may not disclose their sleep disorder upfront, but if they do, questions regarding the nature of an employee’s sleep disorder and what extra support they may need can be broached sensitively. For example:

  • Have they required adjustments in the past? For example, taking additional breaks to help with daytime drowsiness.
  • Encouraging the employee to express their strengths and interests and which tasks they might enjoy doing is a positive way of adapting to their needs.
  • Even if the employee does not wish to disclose their sleep disorder – or they have not even received a precise diagnosis – an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.

What reasonable adjustments are possible for employees with a sleep disorder?

Employers have a legal duty to make reasonable adjustments for employees with a sleep disorder if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has a sleep disorder. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance up front, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of sleep disorders:

  • Flexible working hours to accommodate medical appointments and periods of increased absence or decreased productivity following a flare-up in symptoms. Insomnia in particular can worsen or improve over time, altering the employee’s ability to work.
  • Additional breaks if the person’s medication or their condition causes their concentration to lapse or makes them drowsy shortly following taking it. An employee with narcolepsy may require breaks during which to briefly nap in the course of the working day.
  • Adjustments to duties depending on the severity of their symptoms, which may be variable and improve or deteriorate from one week to the next. For example, in the case of narcolepsy, it may be dangerous to have an employee operate machinery if they are at risk of cataplexy or sleep attacks.
  • Raising awareness so that colleagues understand the employee’s sleep disorder and can help ensure the employee feels comfortable at work, for example, when taking additional breaks.
  • Regular communication with the employee so that they can express when their work duties may be exacerbating stress and worsening their sleep disorder.

Sleep disorders Signposting

Sleep Council – organisation working to help people prevent sleeping difficulties through educating them and providing relevant health services, and advocating for better sleep quality among the general population.

The Sleep Charity – charity providing physical and mental wellbeing advice to aid better sleeping, ensuring that a good night’s sleep is accessible to all people in the UK, including parents and their children and employers and their employees (01302 751 416).

The Brain Charity – a charity working to improve the lives of people living with neurological conditions, including sleeping difficulties, with advice and resources on a variety of sleeping disorders (0151 298 2999).

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