Sleep disorders
Definition:
A disruptive pattern of sleep that may include 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 within 4 main categories: problems with staying and falling asleep, problems with staying awake, problems with adhering to a regular sleep schedule, and sleep disruptive behaviors.
PROBLEMS WITH STAYING AND FALLING ASLEEP
Insomnia includes any combination of difficulty with falling asleep, staying asleep, intermittent wakefulness, and early-morning awakening. Episodes may be transient, short-term (lasting 2 to 3 weeks), or chronic. Illness, depression, anxiety, stress, poor sleeping environment, caffeine, abuse of alcohol, heavy smoking, physical discomfort, daytime napping, certain medical conditions, and other counterproductive sleep habits such as early bedtimes, and excessive time spent awake in bed are common factors associated with insomnia.
Disorders include: - psychophysiological (learned insomnia)
- delayed sleep phase syndrome
- hypnotic dependent sleep disorder
- stimulant dependent sleep disorder
PROBLEMS WITH STAYING AWAKE
Disorders of excessive sleepiness are called hypersomnias. These include: Sleep apnea affects middle-aged obese males, causes breathing to stop intermittently during sleep, and results in excessive daytime sleepiness. Narcolepsy is a condition of daytime sleep attacks in spite of adequate sleep at night that can affect either sex in early adult life. Nocturnal myoclonus is a condition of periodic lower-leg movements during sleep with associated daytime sleepiness, or complaints of insomnia.
PROBLEMS WITH ADHERING TO A REGULAR SLEEP SCHEDULE
Problems may also occur with maintaining a consistent sleep and wake schedule as a result of disruptions of normal times of sleeping and wakefulness. This occurs when traveling between times zones and with shift workers on rotating schedules, particularly with nighttime workers.
These 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 is an abrupt awakening from sleep with fear, sweating, rapid heart rate, and confusion. Sleep walking is not remembered by the person doing it and affects children 2 to 12 years old. It may also be caused by an organic brain syndrome, reactions to drugs, psychopathology and medical conditions in adults.
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