Sleep disorder

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Sleep disorder
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Insomnia, excessive daytime sleepiness, abnormal sleep behaviors
Complications	Cardiovascular disease, diabetes, depression
Onset	Any age
Duration	Varies
Types	Insomnia, sleep apnea, narcolepsy, restless legs syndrome, parasomnias
Causes	Genetic predisposition, environmental factors, lifestyle factors
Risks	Obesity, age, stress, shift work
Diagnosis	Polysomnography, actigraphy, sleep diary
Differential diagnosis	Depression, anxiety disorder, chronic fatigue syndrome
Prevention	N/A
Treatment	Cognitive behavioral therapy, medication, lifestyle changes
Medication	Sedative, stimulant, melatonin
Prognosis	N/A
Frequency	Common
Deaths	Rarely directly

A disturbance of the normal sleep pattern.

Risk of performance errors due to sleep loss

Sleep disorders are a group of conditions that affect the ability to sleep well on a regular basis, leading to negative effects on cognitive function, mood, and overall health. Some common sleep disorders include:

• Insomnia - Difficulty falling asleep or staying asleep
• Sleep apnea - Repeated interruptions in breathing during sleep
• Narcolepsy - Excessive daytime sleepiness and sudden attacks of sleep
• Restless legs syndrome - Uncomfortable sensations in the legs that interfere with sleep
• Circadian rhythm sleep disorders - Disruptions in the body's internal clock, such as delayed sleep phase disorder
• Parasomnias - Abnormal behaviors during sleep, such as sleepwalking or sleep sex

Types

Sleep disorders encompass a wide range of conditions that affect an individual's ability to sleep well on a regular basis. These disorders can be broadly classified as dyssomnias (characterized by either hypersomnia or insomnia) and parasomnias (involving abnormal movements, behaviors, emotions, perceptions, or dreams in connection with sleep).

Dyssomnias

Dyssomnias are sleep disorders characterized by either hypersomnia (excessive daytime sleepiness) or insomnia (difficulty falling or staying asleep). They can be categorized into three major subcategories: intrinsic, extrinsic, and circadian rhythm disturbances.

Intrinsic Dyssomnias

• Idiopathic hypersomnia: A chronic neurological condition causing excessive fatigue and sleep during the day.
• Narcolepsy: A chronic neurological disorder characterized by the brain's inability to control sleep and wakefulness.
• Primary hypersomnia: Hypersomnia of central or brain origin.
• Recurrent hypersomnia, including Kleine–Levin syndrome
• Post-traumatic hypersomnia
• Menstrual-related hypersomnia

Extrinsic Dyssomnias

• Insomnia disorder (primary insomnia): Chronic difficulty in falling asleep and/or maintaining sleep when no other cause is found for these symptoms.
• Sleep disordered breathing (SDB), including (non-exhaustive):
• Several types of sleep apnea
• Snoring
• Upper airway resistance syndrome

Circadian Rhythm Sleep Disorders

• Delayed sleep phase disorder (DSPD)
• Advanced sleep phase disorder (ASPD)
• Non-24-hour sleep–wake disorder
• Shift work sleep disorder (SWSD)

Jet lag (previously included as a situational circadian rhythm sleep disorder but not in DSM-5)

Parasomnias

Parasomnias are sleep disorders that involve abnormal and unnatural movements, behaviors, emotions, perceptions, and dreams in connection with sleep.

• Bedwetting or sleep enuresis
• Bruxism (tooth-grinding)
• Catathrenia (nocturnal groaning)
• Exploding head syndrome (waking up in the night hearing loud noises)
• Sleep terror (or Pavor nocturnus) – Characterized by a sudden arousal from deep sleep with a scream or cry, accompanied by some behavioral manifestations of intense fear.
• REM sleep behavior disorder
• Sleepwalking (or somnambulism)
• Sleep talking (or somniloquy)
• Sleep sex (or sexsomnia)

Medical or Psychiatric Conditions That May Produce Sleep Disorders

• 22q11.2 deletion syndrome
• Alcoholism
• Mood disorders
• Depression
• Anxiety disorder
• Nightmare disorder
• Panic
• Dissociative identity disorder
• Psychosis (such as schizophrenia)
• Sleeping sickness – a parasitic disease transmitted by the Tsetse fly

Additional Sleep Disorders

• Bruxism: Involuntary grinding or clenching of the teeth while sleeping.
• Catathrenia: Nocturnal groaning during prolonged exhalation.
• Hypopnea syndrome: Abnormally shallow breathing or slow respiratory rate while sleeping.
• Nocturia: A frequent need to get up and urinate at night. It differs from enuresis, or bed-wetting, in which the person does not arouse from sleep, but the bladder nevertheless empties.
• Periodic limb movement disorder (PLMD): Sudden involuntary movement of the arms and/or legs during sleep. In the absence of other sleep disorders, PLMS may cause sleep disruption and impair sleep quality, leading to periodic limb movement disorder (PLMD).
• Other limb movements in sleep, including hypnic jerks and nocturnal myoclonus.
• Rapid eye movement sleep behavior disorder (RBD): Acting out violent or dramatic dreams while in REM sleep, sometimes injuring bed partner or self (REM sleep disorder or RSD).
• Restless legs syndrome (RLS): An irresistible urge to move legs.
• Sleep apnea: Obstructive sleep apnea, obstruction of the airway during sleep, causing lack of sufficient deep sleep, often accompanied by snoring. Other forms of sleep apnea are less common. Obstructive sleep apnea (OSA) is a medical disorder that is caused by repetitive collapse of the upper airway (back of the throat) during sleep. For the purposes of sleep studies, episodes of full upper airway collapse

for at least ten seconds are called apneas. Sleep paralysis: Characterized by temporary paralysis of the body shortly before or after sleep. Sleep paralysis may be accompanied by visual, auditory, or tactile hallucinations. It is not a disorder unless severe and is often seen as part of narcolepsy. Somniphobia: One cause of sleep deprivation, a dread or fear of falling asleep or going to bed. Signs of the illness include anxiety and panic attacks before and during attempts to sleep.

Diagnosis and treatment

• Diagnosis of sleep disorders typically involves a thorough medical history, physical examination, and sleep studies, such as polysomnography or actigraphy. Treatment options for sleep disorders may include behavioral therapies, medications, lifestyle modifications, or medical devices, depending on the specific disorder and its underlying causes.

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