Sleep disorders

[Guest guest]

Sleep disorders Images

Irregular sleep

Sleep patterns in the young and aged

Definition

Sleep disorders involve any difficulties related to sleeping, including

difficulty falling or staying asleep, falling asleep at inappropriate times,

excessive total sleep time, or abnormal behaviors associated with sleep.

Causes, incidence, and risk factors

More than 100 different disorders of sleeping and waking have been

identified. They can be grouped in four main categories:

Problems with falling and staying asleep

Problems with staying awake

Problems with adhering to a regular sleep schedule

Sleep-disruptive behaviors

PROBLEMS WITH FALLING AND STAYING ASLEEP

Insomnia includes any combination of difficulty with falling asleep, staying

asleep, intermittent wakefulness and early-morning awakening. Episodes may be

transient (come and go), short-term (lasting as long as 2 to 3 weeks), or

chronic (long-lasting).

Common factors associated with insomnia include:

Physical illness

Depression

Anxiety or stress

Poor sleeping environment such as excessive noise or light

Caffeine

Alcohol or other drugs

Use of certain medications

Heavy smoking

Physical discomfort

Daytime napping

Counterproductive sleep habits:

Early bedtimes

Excessive time spent awake in bed

Disorders include:

Psychophysiological insomnia (learned insomnia)

Delayed sleep phase syndrome -- where a patient's internal clock is

constantly out of synch with the " accepted " day / night phases; for example,

patients feel best if they can sleep from 4AM to noon

Hypnotic-dependent sleep disorder -- insomnia resulting from building

tolerance to, or stopping, certain types of sleep medications

Stimulant-dependent sleep disorder -- insomnia resulting depending on, or

stopping, certain types of stimulants

PROBLEMS WITH STAYING AWAKE

Disorders of excessive sleepiness are called hypersomnias. These include:

Sleep apnea

Narcolepsy

Restless leg syndrome

Periodic limb movement disorder

Obstructive sleep apnea

Central sleep apnea

Idiopathic hypersomnia

Respiratory muscle weakness associated sleep disorder

Sleep apnea more commonly affects obese people, but it may affect anyone with

a short neck or a small jaw, regardless of weight. The disorder causes breathing

to stop intermittently during sleep, resulting in the person being awakened

repeatedly. People with sleep apnea often have difficulty achieving prolonged

deep sleep. This results in excessive daytime sleepiness.

Narcolepsy is a condition of daytime sleep attacks as well as other features

that may include sleep paralysis and hypnagogic hallucinations (hallucinations

that happen at the time between wakefullness and sleep). Sleep attacks occur

despite adequate sleep at night. A person with narcolepsy may suddenly fall

asleep in any situation, without warning.

Restless leg syndrome is characterized by an uncomfortable sensation, usually

in the legs, that occurs primarily at night and when a person is relaxed. The

uncomfortable sensation diminishes when the legs are moved. This is commonly

associated with periodic limb movement disorder, in which a patient has limb

movements during sleep. It usually causes insomnia and may cause daytime

sleepiness.

PROBLEMS WITH ADHERING TO A REGULAR SLEEP SCHEDULE

Problems may also occur when maintaining a consistent sleep and wake schedule

is disrupted. This occurs when traveling between times zones and with shift

workers on rotating schedules, particularly nighttime workers.

Sleep disruption disorders include:

Sleep state misperception (the person actually sleeps a different amount than

they think they do)

Shift work sleep disorder

Natural short sleeper (the person sleeps less hours than normal but suffers

no ill effects)

Chronic time-zone-change syndrome

Irregular sleep-wake syndrome

SLEEP-DISRUPTIVE BEHAVIORS

Abnormal behaviors during sleep are called parasomnias and are fairly common

in children. They include:

Sleep terror disorder

Sleep walking

REM sleep behavior disorder (a type of psychosis related to lack of REM sleep

and lack of dreaming)

Sleep terror disorder is an abrupt awakening from sleep with fear, sweating,

rapid heart rate, and confusion. Sleepwalking is usually not remembered by the

person doing it, and usually affects children 2 to 12 years old.

In adults, sleepwalking may also be caused by an organic brain syndrome,

reactions to drugs, psychological disorders, and certain medical conditions.

Symptoms

Awakening in the night

Difficulty falling asleep

Excessive daytime drowsiness

Loud snoring

Episodes of stopped breathing

Sleep attacks during the day

Daytime fatigue

Depressed mood

Anxiety

Difficulty concentrating

Apathy

Irritability

Loss of memory (or complaints of decreased memory)

Lower leg movements during sleep

The symptoms may vary with the particular disorder.

Signs and tests

Polysomnography (recording brain activity, muscle activity and breathing

during sleep)

Multiple sleep latency test -- a daytime test that uses polysomnography

during multiple brief nap periods

Treatment

INSOMNIA

The treatment is related to the cause, if the cause can be determined. If

there is an obvious physical or psychological disorder causing insomnia, it

should be treated. Depression is a very common cause of insomnia and can usually

be treated with medication, cognitive behavioral therapy, or interpersonal

therapy.

Attempts to control environmental and lifestyle factors should be made; these

factors include:

Erratic hours of wakefulness

Too much light

Too much noise

Too much caffeine or other stimulants

Sleeping drugs should be used only when prescribed by a health care provider.

HYPERSOMNIA

Sleep apnea is treated with weight reduction and the administration of air

under pressure through the nose. Occasionally, surgery or other measures may be

needed.

Narcolepsy is treated by use of stimulating medications during the daytime. A

new medication called modafanil seems to have fewer side effects than

traditional stimulants. It is FDA-approved for narcolepsy and has recently been

approved for shift work sleep disorder.

Restless leg syndrome is treated by treating the underlying disorder and with

opiate or dopaminergic agonists -- these are medications that work by

stimulating the receptors for dopamine and opiates in the brain.

PARASOMNIA

Night terrors are treated with hypnosis, guided imagery techniques and

benzodiazepines, but safety measures may be needed to prevent people from harm

during nighttime walking.

Sleep disorder clinics often are able to help people restore normal sleeping

patterns through various techniques.

Expectations (prognosis)

The outcome varies with the type of disorder. Some disorders may clear up on

their own.

Complications

A complication is dependence upon sedatives or other medications prescribed

for sleep disorders.

Calling your health care provider

Call for an appointment with your health care provider if lack of sleep or

too much sleep is interfering with daily living.

Also call if non-breathing spells are observed during sleep.

Prevention

Maintaining regular sleep habits and a quiet sleep environment may prevent

some sleep disorders.

Review Date: 7/25/2006

Reviewed by: Ballas, D.O., Department of Psychiatry, Jefferson

University Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare

Network.

https://www.iamshaman.net/affiliatewiz/aw.aspx?A=317