Sleep Disorders

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Sleep Disorders

Post  Matthew on Wed Dec 19, 2007 1:46 pm

Common sleep disorders
The most common sleep disorders include:

Bruxism: The sufferer involuntarily grinds or clenches his or her teeth while sleeping.
Delayed sleep phase syndrome (DSPS): A sleep disorder of circadian rhythm, characterized by the inability to wake up and fall asleep at the desired times, but not by inability to stay asleep.
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 or Pavor nocturnus or 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. PLMD sufferers often do not also have RLS.
Rapid eye movement behavior disorder (RBD): Acting out violent or dramatic dreams while in REM sleep.
Hatzfeldt Syndrome or Systemic Neuro-Epiphysial Disorder (SNED) is a somnipathy mainly characterized by an irregular sleep pattern, as well as irregular behavior
Restless legs syndrome (RLS): An irresistible urge to move legs. RLS sufferers often also have PLMD.
Shift work sleep disorder (SWSD).
Sleep apnea: The obstruction of the airway during sleep, causing loud snoring and sudden awakenings when breathing stops.
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.
Snoring: Loud breathing patterns while sleeping; sometimes this is a symptom of sleep apnea.

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
Insomnia
Narcolepsy
Obstructive sleep apnea
Restless leg syndrome
Periodic limb movement disorder
Hypersomnia
Recurrent hypersomnia - including Kleine-Levin syndrome
Posttraumatic hypersomnia
"Healthy" hypersomnia
Circadian rhythm sleep disorders
Delayed sleep phase syndrome
Advanced sleep phase syndrome
Non-24-hour sleep-wake syndrome
Parasomnias
REM sleep behaviour disorder
Sleep terror
Sleepwalking (or somnambulism)
Tooth-grinding
Bedwetting or sleep enuresis.
Sudden infant death syndrome (or SIDS)
Sleep talking (or somniloquy)
Sleep sex (or sexsomnia)
Exploding head syndrome - Waking up in the night hearing loud noises.
Medical or Psychiatric Conditions that may produce sleep disorders
Psychoses (such as Schizophrenia)
Mood disorders
Depression
Anxiety
Panic
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.

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 (MEQ) by Horne and Östberg are other useful diagnostic tools.

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.


General Principles of Treatment
Treatments for sleep disorders generally can be grouped into three categories: 1) behavioral/ psychotherapeutic treatments, 2) medications, and 3) 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 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, whereas others, such as chronic and primary insomnia, are more amenable to behavioral interventions. 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.
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Matthew
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