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Sleep disorder
Classification & 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 See also 6 References

The most common sleep disorders include:

• Bruxism: The sufferer involuntarily grinds or clenches his or her teeth while sleeping.
• Delayed sleep phase syndrome (DSPS): A sleep disorder of circadian rhythm, characterized by the inability to wake up and fall asleep at the desired times, but not by inability to stay asleep.
• 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 or Pavor nocturnus or 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. PLMD sufferers often do not also have RLS.
• Rapid eye movement behavior disorder (RBD): Acting out violent or dramatic dreams while in REM sleep.
• Hatzfeldt Syndrome or Systemic Neuro-Epiphysial Disorder (SNED) is a somnipathy mainly characterized by an irregular sleep pattern, as well as irregular behavior
• Restless legs syndrome (RLS): An irresistible urge to move legs. RLS sufferers often also have PLMD.
• Shift work sleep disorder (SWSD).
• Sleep apnea: The obstruction of the airway during sleep, causing loud snoring and sudden awakenings when breathing stops.
• 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.
• Snoring: Loud breathing patterns while sleeping; sometimes this is a symptom of sleep apnea.

• 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)
  • 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 - can be carried by the Tsetse fly
• Snoring - Not a disorder in and of itself, but it can be a symptom of deeper problems.

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] (MEQ) by Horne and Östberg are other useful diagnostic tools.

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.

Treatments for sleep disorders generally can be grouped into three categories: 1) behavioral/ psychotherapeutic treatments, 2) medications, and 3) 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. In general, medications and somatic treatments provide more rapid symptomatic relief from sleep disturbances. On the other hand, some emerging evidence suggests that treatment gains with behavioral treatment of insomnia may be more durable than those obtained with medications.

Some sleep disorders, such as narcolepsy, are best treated pharmacologically, whereas others, such as chronic and primary insomnia, are more amenable to behavioral interventions. The management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.

For most sleep disorders, behavioral/psychotherapeutic and pharmacological approaches are not incompatible and can be effectively combined to maximize therapeutic benefits.

• Excessive Daytime Sleepiness
• Auditory masking
• American Academy of Sleep Medicine
• Environmental noise health effects
• Reversed vegetative symptoms
• Sleep hygiene
• White noise machine

This article does not cite any references or sources. (July 2007) Please help improve this article by adding citations to reliable sources. Unverifiable material may be challenged and removed.

1. ^ http://www.ncbi.nlm.nih.gov/sites/entrez?Db=PubMed&Cmd=ShowDetailView&TermToSearch=1027738&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus

v • d • e WHO ICD-10 mental and behavioural 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) · Delirium · Post-concussion syndrome
Psychoactive substance	alcohol (drunkenness, alcohol dependence, delirium tremens, Korsakoff's syndrome, alcohol abuse) · opiods (opioid dependency) · sedative/hypnotic (benzodiazepine withdrawal) · cocaine (cocaine dependence) · general (Intoxication, Drug abuse, Physical dependence, Withdrawal)
Psychotic disorder	Schizophrenia (disorganized schizophrenia) · 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) · 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 behavioural	Eating disorder (anorexia nervosa, bulimia nervosa) · Sleep disorder (dyssomnia, insomnia, hypersomnia, parasomnia, night terror, nightmare) · Sexual dysfunction (erectile dysfunction, premature ejaculation, vaginismus, dyspareunia, hypersexuality) · Postpartum depression
Adult personality and behaviour	Personality disorder · Passive-aggressive behavior · Kleptomania · Trichotillomania · Voyeurism · Factitious disorder · Munchausen syndrome · Ego-dystonic sexual orientation
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
Behavioural 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 Nervous system pathology, primarily CNS (G00-G47, 320-349)
Inflammatory diseases of the CNS	Meningitis (Arachnoiditis) - Encephalitis - Myelitis - Encephalomyelitis (Acute disseminated) - Tropical spastic paraparesis
Systemic atrophies primarily affecting the CNS	Huntington's disease - Spinocerebellar ataxia (Friedreich's ataxia, Ataxia telangiectasia, Hereditary spastic paraplegia) Spinal muscular atrophy: Werdnig-Hoffman disease - Kugelberg-Welander disease - Fazio Londe syndrome - MND (Amyotrophic lateral sclerosis (ALS), Progressive muscular atrophy (PMA), Progressive bulbar, Pseudobulbar, PLS)
Extrapyramidal and movement disorders	Parkinson's disease - Neuroleptic malignant syndrome - Postencephalitic parkinsonism - Pantothenate kinase-associated neurodegeneration - Progressive supranuclear palsy - Striatonigral degeneration - Dystonia (Spasmodic torticollis, Meige's syndrome, Blepharospasm) - Essential tremor - Myoclonus - Chorea (Choreoathetosis) - Restless legs syndrome - Stiff person syndrome
Other degenerative / demyelinating diseases	Alzheimer's disease - Pick's disease - Alpers' disease - Dementia with Lewy bodies - Leigh's disease - Multiple sclerosis - Devic's disease - Central pontine myelinolysis - Transverse myelitis
Seizure/epilepsy	Focal (Simple partial, Complex partial) - Generalised (Tonic-clonic, Absence, Atonic, Benign familial neonatal) - Lennox-Gastaut - West - Epilepsia partialis continua - Status epilepticus (Complex partial status epilepticus)
Headache	Migraine (Familial hemiplegic) - Cluster - Vascular - Tension
Vascular	Transient ischemic attack (Amaurosis fugax, Transient global amnesia) - Cerebrovascular disease (MCA, ACA, PCA, Foville's syndrome, Millard-Gubler syndrome, Lateral medullary syndrome, Weber's syndrome, Lacunar stroke)
Sleep disorders	Insomnia - Hypersomnia - Sleep apnea (Ondine's curse) - Narcolepsy - Cataplexy - Kleine-Levin syndrome
Other	Hydrocephalus (Normal pressure) - Idiopathic intracranial hypertension - Encephalopathy - Brain herniation - Cerebral edema - Reye's syndrome - Syringomyelia - Syringobulbia - Spinal cord compression

v • d • e Articles on sleep
Sleep stages	Rapid eye movement sleep · Non-rapid eye movement sleep · Slow-wave sleep · Beta wave sleep · Delta wave sleep · Gamma wave sleep · Theta wave sleep
Sleep disorders	Advanced sleep phase syndrome · Automatic behavior · Circadian rhythm sleep disorder · Delayed sleep phase syndrome · Dyssomnia · 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 · Nightmare · Exploding head syndrome · Lucid dream · False awakening · Sleep paralysis · Hypnagogia · Hypnic jerk · Nocturnal emission · Somnolence
Bedding	Pillow · Sheet · Duvet · Blanket · Quilt · Sleeping bag
Nightwear	Babydoll · Blanket sleeper · Chemise · Negligee · Nightgown · Nightshirt · Nightcap · Peignoir · Pajamas · Slip nightgown
Other Sleep-related Topics	Bed (Bunk bed, Four poster bed, Futon, Hammock, Mattress) · Bed bug · Bedroom · Bedtime · Bedtime story · Chronotype · Dream worlds · Jet lag · Lullaby · Polyphasic sleep · Power nap · Siesta · Sleep and learning · Sleep debt · Sleepover · Snoring