Sleeping disorders

• Insomnia


  • Difficulty initiating and maintaining sleep
  • Early-morning awakening with inability to return to sleep
  • At least 3 nights/week, for at least 3 months
• Rebound Insomnia


  Sleep problems re-appearing, but sometimes worst
• Types of Insomnia


  • Situational
  • Persistent
  • Recurrent
  • Episodic
• Hypersomnolence Disorder


  • Excessive sleepiness despite having at least 7 hours of main sleep
  • Recurrent periods of sleep or lapses into sleep within the same day
  • Take longer naps, have trouble waking from naps, and do not feel alert afterward
  • At least 3x/week, for at least 3 months
• Narcolepsy


  • Recurrent episodes of irrepressible need to sleep, lapsing into sleep, or napping with cataplexy, hypocretin deficiency, and evidence from polysomnography showing REM sleep latency less than or equal to 15 mins
  • 3x/week, for at least 3 months
• Obstructive Sleep Apnea Hypopnea

  • At least 4 obstructive apneas or hypopneas per hour of sleep or evidence from polysomnography of 15 or more obstructive apneas and/or hypopneas per hour of sleep
  • Apnea: absence of airflow
  • Hypopnea: reduction in airflow
• Central Sleep Apnea


  • Evidence by polysomnography of 5 or more central apneas per hour of sleep
  • Cheyne-Stokes Breathing: an abnormal pattern of breathing characterized by progressively deeper, and sometimes faster, breathing followed by a gradual decrease that results in a temporary stop in breathing called an apnea
• Sleep-Related Hypoventilation


  Polysomnography demonstrates episodes of decreased respiration associated with elevated CO2 levels
• Circadian Rhythm Sleep-Wake Disorders


  • Persistent or recurrent pattern of sleep disruption due to alteration of the circadian system or misalignment between the endogenous circadian rhythm
  • Leads to excessive sleepiness or insomnia, or both
• Non-REM Sleep Arousal Disorders

  • Incomplete awakening from sleep: sleepwalking or sleep terrors
  • Cannot remember anything when they woke up
• Night Terrors


  • Occur mostly in childhood and non-REM sleeps
  • Produce rapid and complete awakening without confusion, amnesia, or motor activity
• Nightmare Disorder


  • Repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that usually involve efforts to avoid threats to survival, security, or physical integrity
  • Upon awakening, they become oriented and alert
• Nightmare Disorder


  • Appear in children exposed to acute or chronic psychosocial stressors
  • Occur during REM Sleep
• REM Sleep Behavior Disorder


  • Repeated episodes of arousal during sleep associated with vocalization and/or complex motor behaviors
  • Upon awakening, the individual is completely awake, alert, and not confused
• REM Sleep Behavior Disorder


  • Occur during REM sleep
• Restless Legs Disorder


  • Urge to move the legs, usually accompanied or in response to uncomfortable and unpleasant sensations of the legs
  • Sense of relief during the movement
  • Worse in evening
• Restless Legs Disorder


  • Occurs during rests
  • Occurs 3x/week, for at least 3 months