Sleep fragmentation is exactly what it sounds like, fragmented sleep. Fragmented sleep is continually disrupted sleep due to a variety of causes. This is an issue because fragmented sleep leads to less time overall sleeping, and especially less time in more restorative stages of sleeping like deep sleep. It's important to determine the cause of fragmented sleep in order to begin a treatment or recovery plan for it. The interruptions are not considered a sleep disorder, but maybe the manifestations or symptoms of a sleep disorder, which is why it's so important to recognize if you have fragmented sleep and begin the work up to determine why.
Symptoms of fragmented sleep
Individuals who have fragmented sleep may present with a number of symptoms. One of the most obvious symptoms is feeling tired during the day and having no idea why. Perhaps you're aware of the number of times that you wake up in the middle of the night, but for some sleep disorders like sleep apnea, you may be unaware that you are waking up multiple times. Therefore, if you just feel randomly tired during the day but swear that you got the right amount of sleep, it may be possible that you are experiencing fragmented sleep. If you are aware that you wake up multiple times throughout the night and just think that it's normal, it's important to realize that it is not normal and it is actually considered fragmented sleep.
Another symptom is morning headaches. Morning headaches are a hallmark symptom of obstructive sleep apnea. This could be due to the lack of oxygen getting to the brain consistently throughout the night. Or it could be due to just being tired and having vasodilation that creates more pressure in the brain. There are a variety of reasons why an individual could have an headache after not getting enough sleep at night. If you wake up with headaches every morning, that may be a sign that you are experiencing fragmented sleep.
Other struggles that one may face after a night of fragmented sleep are similar to those experienced by sleep deprived individuals. This includes memory lapses, trouble concentrating, mood disturbances, increased risk of depression and anxiety, and health issues such as hypertension, increased cardiovascular disease, obesity, and diabetes.
Causes
Sleep fragmentation can be caused by a number of things, most likely a sleep disorder like narcolepsy or sleep apnea. Narcolepsy is a sleep disorder that is characterized by an overwhelming desire to fall asleep. There are two types of narcolepsy, one includes cataplexy which is the complete loss of muscle tone, and the other lacks cataplexy. Narcolepsy is normally associated with the symptom onset after an extreme emotion. It's also associated with fragmented sleep because individuals sleep during the day and then have fragmented sleep at night due to the lack of need to sleep. Essentially their circadian rhythm is completely altered, making it more difficult for them to sleep through the night.
As mentioned earlier, obstructive sleep apnea is also a disease of fragmented sleep. Obstructive sleep apnea is the process of an airway blockage by tissues or a large tongue that makes it impossible for one to breathe. During this time, the body wakes up to begin breathing again and move the muscles out of the way. These constant awakenings throughout the night can lead to fragmented sleep period however most of the time, these awakenings are unknown to the sleeper. This is why it's possible to wake up with the symptoms of sleep deprivation without any idea as to the cause. If your partner says that you snore, or choke throughout the night, then it's highly likely that you have sleep apnea.
Other causes of sleep fragmentation may have to do with the change in circadian rhythm as we age, trouble with rumination, anxiety, or depression, and uncomfortable sleep environment, a suboptimal sleep environment, or something else.
Effects
The biggest effect of sleep fragmentation is excessive fatigue the next day. Fatigue after a poor night of sleep can lead to mental fog, mood disturbances, memory lapses, learning difficulties, and just an inability to concentrate. Just one night of sleep fragmentation can lead to a variety of symptoms. Multiple nights of sleep fragmentation in a row can lead to an accumulation of sleep debt, and a number of chronic changes that may never go away.
After a prolonged period of sleep deprivation, physical symptoms such as high blood pressure, obesity, diabetes are all diseases that can develop. Mental health can struggle, too, due to sleep fragmentation. A lack of sleep can lead to increased risk of developing depression and anxiety. And in a bidirectional fashion, worsening depression and anxiety can lead to increased fragmented sleep. Therefore, each one affects the other, and treatment of one can impact the other in a positive way.
Treatments
Testing and treating for an underlying sleep disorder can help with sleep fragmentation. There are other treatments that involve improving sleep hygiene, like going to bed and waking up at the same time every day. Sleep trackers can help you see how you sleep throughout the night, that way you can determine if there is a specific time of night that you wake up every day. They can also determine how much you move, how many hours you take to fall asleep, and how many hours you actually are asleep. Adults require 7 to 9 hours of sleep at night, and sleep fragmentation can whittle this number down to five or six.
If you can't find the sleep disorder to treat, then you may just have a type of insomnia. This is where a therapy called cognitive behavioral therapy dash insomnia, or CBTi, can come in handy. This type of therapy will teach you to recognize the behaviors and thoughts that are contributing to increased insomnia, and how to align them for better sleep moving forward.
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