Sleep Disorder

Overview and facts

According to the National Institute of Neurological Disorders and Stroke, about 40 million people in the United States suffer from chronic long-term sleep disorders each year and an additional 20 million people suffer occasional sleep problems. There are several types of sleep disorders that enlist a wide range of sleep disorders. The sleep disorders can be classified as

Dyssomnias

Intrinsic Sleep Disorders

Psychophysiologic insomnia
Sleep–state misperception
Idiopathic insomnia
Narcolepsy
Recurrent hypersomnia
Idiopathic hypersomnia
Obstructive sleep apnea syndrome (OSAS)
Central sleep apnea syndrome
Central alveolar hypoventilation syndrome
Periodic limb movements in sleep disorder
Restless legs syndrome

Extrinsic Sleep Disorders

Inadequate sleep hygiene
Environmental sleep disorder
Altitude insomnia
Adjustment sleep disorder
Insufficient sleep disorder
Limit–setting sleep disorder
Sleep–onset association disorder
Food allergy insomnia
Hypnotic–dependent sleep disorder
Alcohol–dependent sleep disorder
Nocturnal eating (drinking) syndrome
Toxin–induced sleep disorder

Circadian Rhythm Sleep Disorders

Time–zone (jet lag) syndrome
Shift–work sleep disorder
Irregular sleep–wake pattern disorder
Delayed–sleep phase syndrome
Non–24–hour sleep–wake disorder
Advanced sleep phase syndrome

Parasomnias

Arousal Disorde

Confusional insomnia
Sleepwalking
Sleep terrors

Sleep-Wake Transition Disorders

Rhythmic movement disorders
Sleep starts
Sleep talking
Nocturnal leg cramps

Parasomnias usually associated with REM Sleep

Impaired sleep–related penile erections
Sleep–related painful penile erections
Sleep paralysis
REM–sleep–related sinus arrest
Nightmares
REM–sleep behavior disorder

Other Parasomnias

Sleep bruxism
Sleep enuresis
Sleep–related abnormal swallowing syndrome
Nocturnal paroxysmal dystonia
Sudden unexplained nocturnal death syndrome
Primary snoring
Infant sleep apnea
Congenital central hypoventilation syndrome
Sudden infant death syndrome
Benign neonatal sleep myoclonus

Medical/Psychiatric Sleep Disorders

Associated with Mental Disorders

Psychoses
Mood disorders
Anxiety disorders
Panic disorders
Alcoholism

Associated with Neurological Disorders

Cerebral degenerative disorders
Dementia
Parkinsonism
Fatal familial insomnia
Sleep–related epilepsy
Electrical status epilepticus of sleep
Sleep–related headaches

Associated with Other Medical Disorders

Sleeping sickness
Nocturnal cardiac ischemia
Chronic obstructive pulmonary disease
Sleep–related asthma
Sleep–related gastro-esophageal reflux
Peptic ulcer disease
Fibromyalgia

Proposed Sleep disorders

Short sleeper

Long sleeper
Sub wakefulness syndrome
Fragmentary myoclonus
Sleep hyperhidrosis
Menstrual–associated sleep disorder
Pregnancy–associated sleep disorder
Terrifying hypnagogic hallucinations
Sleep–related neurogenic tachypnea
Sleep–related laryngospasm
Sleep choking syndrome

Symptoms

Sleep disturbance itself can be a symptom of underlying mental, physical or emotional condition. However associated symptoms can be snoring, night sweats, frequent urination (nocturia), fatigue, lethargy, and lack of attention.

Diagnosis

Diagnosis for sleep disorder can be very complicated as there are dozens of causes for sleep disorders, and the diagnosis is directly based on them. Physical examination is of relatively less importance while medical history is very important. Patient is asked to note down every minutest details of what he did, what he ate, what he thinks, when he slept, how he felt during sleep along with other symptoms of sleep disorders. However a few tests can prove helpful in diagnosis of sleep disorders such as

Polysomnography A polysomnogram is a sleep study that involves using electroencephalography (EEG) to monitor the brain and muscle activity, heart rhythm, and breathing during sleep. Patients are usually tested in a sleep lab, or they are given portable equipment to take home. The EEG monitors the various stages of sleep, which is interpreted by the clinician. For example, the EEG shows the degree of muscle activity during the various NREM and REM sleep stages. This information may provide clues about the type and cause of the sleep disorder.

In people with suspected obstructive sleep apnea (OSA), overnight oximetry (measuring the oxygen saturation in the blood) may be performed to determine the oxygen level during the apnea episodes.

In people with suspected narcolepsy, there are various tests that can be performed. The multiple sleep latency test (MSLT), for example, measures the time it takes for REM sleep to occur in patients who fall asleep suddenly and repeatedly. In people with narcolepsy, REM occurs immediately

Treatment & care

There are various treatment options that are available all over the world. The treatment options primarily focus on removal of triggers for sleep disorders along with symptom control. A few common treatment options are

Bright light therapy: This is used to help treat disorders that result from a problem with the internal clock in your body. Two of these disorders are jet lag and advanced sleep phase.

Cognitive behavioral therapy (CBT): These methods teach you how to change actions or thoughts that hurt your ability to sleep well. They will help you develop habits that promote a healthy pattern of sleep.

Continuous positive airway pressure (CPAP): This is the most common and effective way to treat obstructive sleep apnea. A steady stream of air blows through a mask and into the back of the throat to keep the airway open

Medications: A number of drugs have been developed to help treat some sleep disorders. Always get help from a doctor before using any of these drugs.

Melatonin: As a nutritional supplement, melatonin is most effective in the treatment of certain circadian rhythm sleep disorders. These include jet lag, shift work and delayed sleep phase.

Oral appliances (night guards): Similar to sports mouth guards, these devices protect your teeth and open the airway as you sleep. They are used to treat bruxism, obstructive sleep apnea and snoring