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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
  • Surgery- A number of surgical options are available to help people who suffer from severe cases of obstructive sleep apnea.
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