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07-SEPTEMBER-2008 03:17:44 - Sleep disorder Sleep disorder Classification and external resources ICD-10 F51., G47. ICD-9 307.4, 327, 780.5 DiseasesDB 26877 eMedicine med/609 MeSH D012893 A sleep disorder somnipathy is a medical disorder of the sleep patterns of a person or animal. Some sleep disorders are serious enough to interfere with normal physical, mental and emotional functioning. A test commonly ordered for some sleep disorders is the polysomnogram. Contents 1 Common sleep disorders 2 Broad classifications of sleep disorders 3 Common causes of sleep disorders 4 General principles of treatment 5 Blood pressure and short sleep 6 Sleep medicine 7 See also 8 References 9 External links Common sleep disorders The most common sleep disorders include: Bruxism: Involuntarily grinding or clenching of the teeth while sleeping Delayed sleep phase syndrome DSPS: inability to awaken and fall asleep at socially acceptable times but no problem with sleep maintenance, a disorder of circadian rhythms. Other such disorders are advanced sleep phase syndrome ASPS and Non-24-hour sleep-wake syndrome Non-24, both much less common than DSPS. 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, Pavor nocturnus, 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. Rapid eye movement behavior disorder RBD: Acting out violent or dramatic dreams while in REM sleep Restless legs syndrome RLS: An irresistible urge to move legs. RLS sufferers often also have PLMD. Situational circadian rhythm sleep disorders: shift work sleep disorder SWSD and jet lag Obstructive sleep apnea: Obstruction of the airway during sleep, causing lack of sufficient deep sleep; often accompanied by snoring. Central sleep apnea is less common. Sleep paralysis is characterized by temporary paralysis of the body shortly before or after sleep. Sleep paralysis may be accompanied by visual, auditory or tactile hallucinations. Not a disorder unless severe. 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 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 Bruxism 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 - a parasitic disease which can be transmitted 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.1 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 four categories: behavioral/ psychotherapeutic treatments rehabilitation/management medications 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. Often, behavioral/psychotherapeutic and pharmacological approaches are not incompatible and can effectively be combined to maximize therapeutic benefits. Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions. Medications and somatic treatments may provide the most rapid symptomatic relief from some sleep disturbances. Some disorders, such as narcolepsy, are best treated pharmacologically. Others, such as chronic and primary insomnia, may be more amenable to behavioral interventions, with more durable results. Special equipment may be required for treatment of several disorders such as obstructive apnea, the circadian rhythm disorders and bruxism. In these cases, when severe, an acceptance of living with the disorder, however well managed, is often necessary. Blood pressure and short sleep People who sleep less than 5 hours a night are 5 times more likely to have high blood pressure than people who sleep well, according to researchers from Penn State College of Medicine, Pennsylvania in June 2008. Researchers studied 1,741 people and the link between sleep problems and high blood pressure, and found that those people at the highest risk of hypertension had a low number of hours slept and insomnia.2 Sleep medicine main article: Sleep medicine Due to rapidly increasing knowledge about sleep in the 20th century, including the discovery of REM sleep and sleep apnea, the medical importance of sleep was recognized. The medical community began paying more attention than previously to primary sleep disorders, such as sleep apnea, as well as the role and quality of sleep in other conditions. By the 1970s in the USA, clinics and laboratories devoted to the study of sleep and sleep disorders had been founded, and a need for standards arose. Sleep Medicine is now a recognized subspecialty within internal medicine, family medicine, pediatrics, otolaryngology, psychiatry and neurology in the United States. Certification in Sleep Medicine shows that the specialist: has demonstrated expertise in the diagnosis and management of clinical conditions that occur during sleep, that disturb sleep, or that are affected by disturbances in the wake-sleep cycle. This specialist is skilled in the analysis and interpretation of comprehensive polysomnography, and well-versed in emerging research and management of a sleep laboratory.3 Competence in sleep medicine requires an understanding of a plethora of very diverse disorders, many of which present with similar symptoms such as excessive daytime sleepiness, which, in the absence of volitional sleep deprivation, is almost inevitably caused by an identifiable and treatable sleep disorder, such as sleep apnea, narcolepsy, idiopathic central nervous system CNS hypersomnia, Kleine-Levin syndrome, menstrual-related hypersomnia, idiopathic recurrent stupor, or circadian rhythm disturbances.4 Another common complaint is insomnia, a set of symptoms which can have a great many different causes, physical and mental. Management in the varying situations differs greatly and cannot be undertaken without a correct diagnosis. Sleep dentistry bruxism, snoring and sleep apnea, while not recognized as one of the nine dental specialties, qualifies for board-certification by the American Board of Dental Sleep Medicine ABDSM. The resulting Diplomate status is recognized by the American Academy of Sleep Medicine AASM, and these dentists are organized in the Academy of Dental Sleep Medicine USA.5 The qualified dentists collaborate with sleep physicians at accred sleep centers and can provide oral appliance therapy and upper airway surgery to treat or manage sleep-related breathing disorders.6 In the UK, knowledge of sleep medicine and possibilities for diagnosis and treatment seem to lag. Guardian.co.uk quotes the director of the Imperial College Healthcare Sleep Centre: One problem is that there has been relatively little training in sleep medicine in this country - certainly there is no structured training for sleep physicians.7 The Imperial College Healthcare site8 shows attention to obstructive sleep apnoea syndrome OSA and very few other disorders, specifically not including insomnia. See also Auditory masking Chronotypes International Classification of Sleep Disorders Environmental noise health effects Reversed vegetative symptoms Sleep hygiene White noise machine References ^ Horne J A Jim, Ostberg O Olov Östberg 1976. A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. International journal of chronobiology 4 2: 97-110. PMID 1027738. ^ Lack of sleep increases blood pressure. ^ American Board of Medical Specialties : Recognized Physician Specialty and Subspecialty Certificates. Retrieved on 2008-07-21. ^ Mahowald, M.W. March 2000. What is causing excessive daytime sleepiness?: evaluation to distinguish sleep deprivation from sleep disorders Online, full text. Postgraduate Medicine 107 3: 108-23. Retrieved on 2008-07-27. ^ About AADSM. Academy of Dental Sleep Medicine 2008. Retrieved on 2008-07-22. ^ About the ADBSM. American Board of Dental Sleep Medicine. Retrieved on 2008-07-22. ^ Wollenberg, Anne July 28 2008. Time to wake up to sleep disorders, Guardian News and Media Limited. Retrieved on 2008-08-03. ^ Sleep services. Imperial College Healthcare NHS Trust 2008. Retrieved on 2008-08-02. External links Australian fact sheets v d e WHO ICD-10 mental and behavioral disorders F · 290-319 Neurological/symptomatic Dementia Alzheimer's disease, multi-infarct dementia, Pick's disease, Creutzfeldt-Jakob disease, Huntington's disease, Parkinson's disease, AIDS dementia complex, Frontotemporal dementia, Elopement, Sundowning, Wandering · Delirium · Post-concussion syndrome · Organic brain syndrome Psychoactive substance alcohol drunkenness, alcohol dependence, alcoholic hallucinosis, Alcohol withdrawal, delirium tremens, Korsakoff's syndrome, alcohol abuse · opioids opioid dependency · sedative/hypnotic benzodiazepine withdrawal · cocaine cocaine dependence · general Intoxication, Drug abuse, Physical dependence, Withdrawal Psychotic disorder Schizophrenia disorganized schizophrenia · Schizophreniform disorder · Schizotypal personality disorder · Delusional disorder · Folie à deux · Schizoaffective disorder Mood affective Mania · Bipolar disorder · Clinical depression · Cyclothymia · Dysthymia Neurotic, stress-related and somatoform Anxiety disorder Agoraphobia, Panic disorder, Panic attack, Generalized anxiety disorder, Social anxiety, Social phobia · OCD · Acute stress reaction · PTSD · Adjustment disorder · Conversion disorder Ganser syndrome · Somatoform disorder Somatization disorder, Body dysmorphic disorder, Hypochondriasis, Nosophobia, Da Costa's syndrome, Psychalgia · Neurasthenia Physiological/physical behavioral Eating disorder: Anorexia nervosa · Bulimia nervosa Sleep disorder: Dyssomnia Hypersomnia, Insomnia · Parasomnia REM behavior disorder, Night terror · Nightmare Sexual dysfunction: Erectile dysfunction · Premature ejaculation · Vaginismus · Dyspareunia · Hypersexuality · Female sexual arousal disorder Postpartum depression · Postnatal psychosis Adult personality and behavior Personality disorder · Passive-aggressive behavior · Kleptomania · Trichotillomania · Voyeurism · Factitious disorder · Munchausen syndrome · Ego-dystonic sexual orientation · Fetishism Mental retardation Mental retardation Psychological development developmental disorder Specific: speech and language expressive language disorder, aphasia, expressive aphasia, receptive aphasia, Landau-Kleffner syndrome, lisp · Scholastic skills dyslexia, dysgraphia, Gerstmann syndrome · Motor function developmental dyspraxia Pervasive: Autism · Rett syndrome · Asperger syndrome Behavioral and emotional, childhood and adolescence onset ADHD · Conduct disorder · Oppositional defiant disorder · Separation anxiety disorder · Selective mutism · Reactive attachment disorder · Tic disorder · Tourette syndrome · Speech stuttering · cluttering v d e Pathology of the nervous system, primarily CNS G00-G47, 320-349 Inflammatory Meningitis Arachnoiditis, Aseptic meningitis, Tuberculous meningitis - Encephalitis - Myelitis - Encephalomyelitis Acute disseminated - Tropical spastic paraparesis - Cavernous sinus thrombosis Systemic atrophies Huntington's disease - Spinocerebellar ataxia Friedreich's ataxia, Ataxia telangiectasia, Herary spastic paraplegia - Spinal muscular atrophy: Werdnig-Hoffman - Kugelberg-Welander - Fazio-Londe - MND ALS, PMA, PBP, PP, PLS Extrapyramidal and movement disorders Parkinson's disease - Neuroleptic malignant syndrome - Postencephalitic parkinsonism - Pantothenate kinase-associated neurodegeneration - Progressive supranuclear palsy - Striatonigral degeneration - Dystonia/Dyskinesia Spasmodic torticollis, Meige's, Blepharospasm - Essential tremor - Myoclonus - Lafora - Chorea Choreoathetosis - Restless legs - Stiff person Other degenerative/ demyelinating diseases dementia: Alzheimer's - Pick's - Dementia with Lewy bodies - Frontotemporal lobar degeneration mitochondrial disease: Leigh's demyelinating: Multiple sclerosis - Devic's - Central pontine myelinolysis - Transverse myelitis - Marchiafava-Bignami disease - CAMFAK syndrome - Alpers' Seizure/epilepsy Focal - Generalised - Status epilepticus - Myoclonic epilepsy Headache Migraine Familial hemiplegic - Cluster - Vascular - Tension Vascular Transient ischemic attack Amaurosis fugax, Transient global amnesia Cerebrovascular disease MCA, ACA, PCA, Foville's, Millard-Gubler, Lateral medullary, Weber's, Lacunar stroke Sleep disorders Insomnia - Hypersomnia - Sleep apnea Obstructive, Ondine's curse - Narcolepsy - Cataplexy - Kleine-Levin - Circadian rhythm sleep - Delayed sleep phase - Advanced sleep phase Intracranial hypertension Hydrocephalus Normal pressure - Idiopathic intracranial hypertension Other encephalopathy Brain herniation - Cerebral edema - Reye's Other spinal cord disease Syringomyelia - Syringobulbia - Morvan's syndrome - Spinal cord compression v d e Sleep Sleep stages Rapid eye movement sleep · Non-rapid eye movement sleep · Slow-wave sleep Brain waves Beta wave · Delta wave · Gamma wave · Theta wave Sleep disorders Advanced sleep phase syndrome · Automatic behavior · Bruxism · Circadian rhythm sleep disorder · Delayed sleep phase syndrome · Dyssomnia · Excessive daytime sleepiness · Hypersomnia · Insomnia · Narcolepsy · Night terror · Nocturia · Nocturnal myoclonus · Non-24-hour sleep-wake syndrome · Ondine's curse · Parasomnia · Sleep apnea · Sleep deprivation · Sleepeating · Sleeping sickness · Sleeptalking · Sleepwalking Benign phenomena Dream · Exploding head syndrome · False awakening · Hypnagogia · Hypnic jerk · Lucid dream · Nightmare · Nocturnal emission · Sleep paralysis · Somnolence Related topics Bed Bunk bed, Four poster bed, Futon, Hammock, Mattress · Bed bug · Bedding · Bedroom · Bedtime · Bedtime toy · Bedtime story · Chronotype · Dream journal · Jet lag · Lullaby · Nightwear · Polyphasic sleep · Power nap · Siesta · Sleep and learning · Sleep debt · Sleep diary · Sleep inertia · Sleep medicine · Sleepover · Snoring · Sleep and creativity Retrieved from http://en..org/wiki/Sleep_disorder Categories: Sleep | Sleep disorders | Circadian rhythms | Medicine Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Deutsch Eesti Español 한국어 Nederlands 日本語 Norsk bokmål Polski Simple English Suomi 中文 This page was last modified on 25 August 2008, at 06:41
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