Professor Laplane, a neurologist and father of a disabled child, surveys the main sleep disorders: insomnia, hypersomnia, sleep apnea, snoring, night terrors, and sleepwalking. Whether a person is handicapped or not, the problems these disturbances cause are remarkably similar.
INSOMNIA should be considered pathological only when accompanied by daytime fatigue and drowsiness. Otherwise it may be constitutional—often running in families—since sleep needs vary widely from person to person. The average of seven to eight hours a day should not be treated as a standard.
Sleep loss (shortened sleep time compared to usual patterns) can stem from concurrent illnesses, but more often from anxiety (when someone has trouble falling asleep) or depression (waking too early). This is where we should look for the cause of pathological insomnia, which is often hard to diagnose in people with limited communication abilities. We must watch for indirect signs and try to understand certain behaviors.
Minor insomnia and difficulty falling asleep can be treated with simple hygiene measures: daytime exercise, a balanced life, bedtime rituals (a calming herbal tea), and reducing psychological tension. Tranquilizers and sleeping pills should never be prescribed automatically.
HYPERSOMNIA — Before diagnosing hypersomnia, we must rule out medication side effects or simple sleep deprivation. Many adults retain a childhood sleep pattern. The need for a nap is not inherently pathological. But a nap should be brief—no more than half an hour for an adult.
In most disabled people with irregular sleep schedules, complaints of hypersomnia are uncommon. When it does appear clearly, however, specialized testing and treatment are needed.
SNORING, SLEEP APNEA, AND NIGHT TERRORS — Snoring accompanied by apnea (breathing stops for a minute or more) can cause physical problems, especially high blood pressure, and requires specialist evaluation.
Night terrors are common in children and usually harmless. When they occur frequently and always in the same way, consultation may be warranted. Some cases have been treated as epilepsy.
Sleepwalking is often familial and generally insignificant.
A sleepless night is stressful. We all need to rest our bodies, our spirits, and our minds.
— D. Laplane
(Ombres et Lumière no. 99)