Sleep disorder reference

A sleep disorder (somnipathy) is a medical disorder of the sleep patterns of a person or animal. Some sleep disorders are serious enough to interfere with normal physical, mental and emotional functioning. A test commonly ordered for some sleep disorders is the polysomnogram.

Common sleep disorders

The most common sleep disorders include:

* Bruxism: Involuntarily grinding or clenching of the teeth while sleeping.
* Delayed sleep phase syndrome (DSPS): inability to awaken and fall asleep at socially acceptable times but no problem with sleep maintenance, a disorder of circadian rhythms. Other such disorders are advanced sleep phase syndrome (ASPS) and Non-24-hour sleep-wake syndrome (Non-24), both much less common than DSPS.
* Hypopnea syndrome: Abnormally shallow breathing or slow respiratory rate while sleeping.
* Narcolepsy: The condition of falling asleep spontaneously and unwillingly at inappropriate times.
* Night terror, Pavor nocturnus, sleep terror disorder: abrupt awakening from sleep with behavior consistent with terror.
* Parasomnias: Include a variety of disruptive sleep-related events.
* Periodic limb movement disorder (PLMD): Sudden involuntary movement of arms and/or legs during sleep, for example kicking the legs. Also known as nocturnal myoclonus. See also Hypnic jerk, which is not a disorder.
* Rapid eye movement behavior disorder (RBD): Acting out violent or dramatic dreams while in REM sleep.
* Restless legs syndrome (RLS): An irresistible urge to move legs. RLS sufferers often also have PLMD.
* Shift work sleep disorder, (SWSD), a situational circadian rhythm sleep disorder
* Obstructive sleep apnea: Obstruction of the airway during sleep, causing lack of sufficient deep sleep; often accompanied by snoring. Central sleep apnea is less common.
* Sleep paralysis is characterized by temporary paralysis of the body shortly before or after sleep. Sleep paralysis may be accompanied by visual, auditory or tactile hallucinations. Not a disorder unless severe.
* Sleepwalking or somnambulism: Engaging in activities that are normally associated with wakefulness (such as eating or dressing), which may include walking, without the conscious knowledge of the subject.

[edit] Broad classifications of sleep disorders

* Dysomnias - A broad category of sleep disorders characterized by either hypersomnolence or insomnia. The three major subcategories include intrinsic (i.e., arising from within the body), extrinsic (secondary to environmental conditions or various pathologic conditions), and disturbances of circadian rhythm. MeSH
o Insomnia
o Narcolepsy
o Obstructive sleep apnea
o Restless leg syndrome
o Periodic limb movement disorder
o Hypersomnia
+ Recurrent hypersomnia - including Kleine-Levin syndrome
+ Posttraumatic hypersomnia
+ "Healthy" hypersomnia
o Circadian rhythm sleep disorders
+ Delayed sleep phase syndrome
+ Advanced sleep phase syndrome
+ Non-24-hour sleep-wake syndrome
* Parasomnias
o REM sleep behaviour disorder
o Sleep terror
o Sleepwalking (or somnambulism)
o Bruxism (Tooth-grinding)
o Bedwetting or sleep enuresis.
o Sudden infant death syndrome (or SIDS)
o Sleep talking (or somniloquy)
o Sleep sex (or sexsomnia)
o Exploding head syndrome - Waking up in the night hearing loud noises.
* Medical or Psychiatric Conditions that may produce sleep disorders
o Psychoses (such as Schizophrenia)
o Mood disorders
o Depression
o Anxiety
o Panic
o Alcoholism
* Sleeping sickness - can be carried by the Tsetse fly
* Snoring - Not a disorder in and of itself, but it can be a symptom of deeper problems.

[edit] Common causes of sleep disorders

Changes in life style, such as shift work change (SWC), can contribute to sleep disorders.

Other problems that can affect sleep:

* Anxiety
* Back pain
* Chronic pain
* Sciatica
* Neck pain
* Environmental noise
* Incontinence
* Various drugs - Many drugs can affect the ratio of the various stages of sleep, thus affecting the overall quality of sleep. Poor sleep can lead to accumulation of Sleep debt.
* Endocrine imbalance mainly due to Cortisol but not limited to this hormone. Hormone changes due to impending menstruation or during the menopause transition years.
* Chronobiological disorders, mainly Circadian rhythm disorders

A sleep diary can be used to help diagnose, and measure improvements in, sleep disorders. The Epworth Sleepiness Scale and the Morningness-Eveningness Questionnaire.[1]

According to Dr. William Dement, of the Stanford Sleep Center, anyone who snores and has daytime drowsiness should be evaluated for sleep disorders.

Any time back pain or another form of chronic pain is present, both the pain and the sleep problems should be treated simultaneously, as pain can lead to sleep problems and vice versa.

[edit] General principles of treatment

Treatments for sleep disorders generally can be grouped into three categories:

* behavioral/ psychotherapeutic treatments
* medications
* other somatic treatments

None of these general approaches is sufficient for all patients with sleep disorders. Rather, the choice of a specific treatment depends on the patient's diagnosis, medical and psychiatric history, and preferences, as well as the expertise of the treating clinician. In general, medications and somatic treatments provide more rapid symptomatic relief from many sleep disturbances. On the other hand, some emerging evidence suggests that treatment gains with behavioral treatment of insomnia may be more durable than those obtained with medications.

Some sleep disorders, such as narcolepsy, are best treated pharmacologically. Others, such as chronic and primary insomnia, may be more amenable to behavioral interventions. Still others, such as obstructive apnea, the circadian rhythm disorders and bruxism, may require special equipment in their treatment. The management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.

For most sleep disorders, behavioral/psychotherapeutic and pharmacological approaches are not incompatible and can be effectively combined to maximize therapeutic benefits.

[edit] Blood pressure and short sleep

People who sleep less than 5 hours a night are 5 times more likely to have high blood pressure than people who sleep well, according to researchers from Penn State College of Medicine, Pennsylvania in June 2008. Researchers studied 1,741 people and the link between sleep problems and high blood pressure to find those people at the highest risk of hypertension had a low number of hours slept and insomnia.[2]

[edit] See also