Why can't I sleep at night?

Psychiatry, psychosomatics & psychotherapy

2. Other brain diseases

Many neurological diseases such as multiple sclerosis, Parkinson's disease, epilepsy, brain tumors and strokes lead to considerable sleep disorders and, in some cases, to increased daytime sleepiness. Certain diseases of the diencephalon can cause severe daytime sleepiness as part of what is known as idiopathic hypersomnia or narcolepsy. Neurological disorders also include nocturnal movement disorders, the most important of which is Restless Legs Syndrome, in which unpleasant sensations of the lower extremities occur at night, making it difficult to fall asleep and leading to involuntary nocturnal leg movements that disrupt sleep continuity . A variety of other nocturnal movement disorders; E.g. also sleepwalking, can impair sleep.

3. Nocturnal breathing disorders

Nocturnal breathing disorders affect 2 to 5% of the population. Snoring, an alarm symptom of nocturnal breathing disorders, is even more common. Especially, but not exclusively, people who snore often have pauses in breathing while sleeping. During such breaks, known as apneas, there is a decrease in the level of oxygen in the blood. Sleep apnea lasts an average of 30 seconds, but can last for one to two minutes. The most common are so-called obstructive apneas, in which the airways collapse during sleep due to excessive relaxation of the muscles and too narrow anatomical conditions in the pharynx. At the end of every pause there is a wake-up reaction, which is why the sleep of such patients is significantly disturbed. Such pauses in breathing, which occur hundreds of times a night in severely affected patients, not only disrupt the continuity of sleep, but also lead to a considerable stress reaction with the release of stress hormones every time. This is why sleep apnea syndrome is a disease that is associated with an increased risk of vascular and metabolic diseases. The majority of patients do not notice this sleep disorder themselves and only suffer from increased daytime sleepiness.

A large number of diseases that do not primarily affect the brain can indirectly have a significant negative effect on sleep. These include hormonal diseases (e.g. thyroid diseases, pituitary diseases, adrenal cortical diseases) but also chronic inflammatory processes such as rheumatoid arthritis and cancer. All diseases that are associated with pain can significantly disrupt sleep and, conversely, chronic sleep disorders seem to increase pain sensitivity.