SLEEP DISORDER

SLEEPING DISORDER STATISTICS.

Insomnia Statistics

	20-40% of all adults have insomnia in the course of any year
	1 out of 3 people have insomnia at some point in their lives
	Over 70 million Americans suffer from disorders of sleep and wakefulness
	Of those, 60% have a chronic disorder

Sleep Apnea Statistics

	Over 18 million Americans suffer from sleep apnea
	An estimated 10 million Americans remain undiagnosed
	Over 50% of all apnea cases are diagnosed in people aged 40 and over
	More prevalent in men than women
	4 to 9% of middle-aged men suffer from apnea
	2 to 4% of middle-aged women suffer from apnea

Narcolepsy Statistics

	Affects as many as 200,000 Americans
	Fewer than 50,000 are diagnosed
	8 to 12% have a close relative with the disease
	Affects men slightly more than women
	20 to 25% of people with narcolepsy have all four symptoms (excessive daytime sleepiness, sudden loss of muscle function, sleep paralysis, hallucinations)

Restless Leg Syndrome Statistics

	Affects as many as 10% of Americans
	Can begin at an early age and worsens with age
	Pregnancy or hormonal changes can temporarily worsen this disorder

Children & Sleep Statistics

	Over 2 million children suffer from sleep disorders
	Estimated that 30 to 40% of children to not sleep enough
	Children require an average of 9 to 10 hours of sleep each night

Women & Sleep Statistics

	Women are twice as likely as men to have difficulty falling and staying asleep
	Pregnancy can worsen sleep patterns
	Menopause and hormone changes cause changes in sleep

Older Adult Statistics

	Over half of those over the age of 65 experience disturbed sleep
	Those over 65 make up about 13% of the US population, but consume over 30% of prescription drug and 40% of sleeping pills

General Statistics

	Adults require an average of 8 to 8.5 hours of sleep each night
	Sleep problems add an estimated $15.9 billion to national health care costs
	84 classifications of sleep disorders exist

 
SOURCE: SLEEP MED

SLEEP DISORDER

What is the Treatment of Sleeping Disorder?

There are many effective ways for the sleeping disorder treatment. Some of the various alternates are stated as below:

• Sleeping Disorder Treatment by Medication:

Drugs may be prescribed when the cause of insomnia includes a particularly stressful situation (i.e., bereavement or the loss of a job) or a pain from some physical condition, or if a person's efficiency and sense of well-being are seriously impaired by sleeplessness. Hypnotic (sleep-inducing) drugs should never be combined with even a small amount of alcohol, a sedative that enhances gastrointestinal absorption of the drugs and compounds their effects.
Always follow your doctor's specific instructions for treating insomnia. Alcohol consumption may cause initial drowsiness, but this is usually followed by sudden wakefulness after the alcohol is metabolized. It may be more difficult to get back to sleep than it was beforehand.

• Sleeping Disorder Treatment by self help:

There is no other better option than to naturally get good nights sleep.Some of the good habits for sound and good night sleep are as follows:

• Make your sleeping place comfortable. Be sure that it is dark, quiet, and not too warm or too cold.
• Try to go to sleep at the same time each night and get up at the same time each morning.
• Get regular exercise. Try not to exercise close to bedtime. Experts suggest not exercising for 3 hours before the time you go to sleep.
• Don't eat a heavy meal late in the day. A light snack before bedtime, however, may help you sleep.
• Avoid using your bed for anything other than sleep or sex.
• If you can't fall asleep and don't feel drowsy, get up and read or do something that is not overly stimulating until you feel sleepy.
• If you have trouble lying awake worrying about things, try making a to-do list before you go to bed. This may help you to relieve of those worries for whole night.
• Keep the lights low before bedtime.
• Follow a routine to help relax and wind down before sleep, such as reading a book, listening to music, or taking a bath.
• Try not to take naps during the day because naps may make you less sleepy at night.
• Avoid caffeine, nicotine, and alcohol late in the day. Caffeine and nicotine are stimulants and can keep you from falling asleep. Alcohol can cause waking in the night and interferes with sleep quality.

So, good night and sleep tight. No matter how and when you sleep, do sleep.

Insomnia Treatment

If sleep studies do not indicate a pathological (related to disease) cause, improving "sleep hygiene" is the best way to treat insomnia. This means consuming less caffeine, avoiding exercise late in the evening, and engaging in a regular relaxation routine before bedtime. For some people, watching TV at night is actually too stimulating and may keep them from falling asleep.
In most cases, sedatives should only be used on a short-term basis; however, some people require long-term drug therapy. Antidepressants (e.g., trazadone [Desyrel®]) may be effective in these patients.

Sleep Apnea Treatment

For patients who are overweight, a weight loss program can be helpful in treating obstructive sleep apnea. Avoiding sleeping on the back also can help relieve the condition.
Devices also are available that a person can wear during sleep. A CPAP (continuous positive airway pressure) machine can be used to apply pressure to the upper airway, preventing obstruction and keeping the airway open. Patients wear a small mask connected to the machine that provides pressure while they are sleeping.
Patients with treatable conditions, such as enlarged tonsils or a large deviated septum, may benefit from surgery. Patients with sleep apnea should never take sleeping pills because they can prevent the person from waking up enough to start breathing again.

Restless Legs Syndrome (RLS)and Periodic Limb Movement Disorder (PLMD) Treatment

These disorders may be treated using medication.

Narcolepsy Treatment

There is no cure for narcolepsy, but symptoms can be managed with medication. Drugs used to treat symptoms of narcolepsy include stimulants (e.g., methylphenidate [Ritalin®], modafinil [Provigil®]), tricyclic antidepressants (e.g., imipramine, chlorimimipramine), selective serotonin reuptake inhibitors (SSRIs; e.g., fluoxetine [Prozac®], and central nervous system depressants (e.g., sodium oxybate [Xyrem®]).
Many of these drugs are addictive and can have serious side effects. It is important for people with narcolepsy to get

Persistent insomnia in chronic hypnotic users presenting to a sleep medical center: a retrospective chart review of 137 consecutive patients.

Abstract

Chronic insomnia patients may fail pharmacotherapy. We reviewed charts on 137 chronic insomnia patients new to our sleep medical center who reported persisting insomnia despite long-term usage of pharmacotherapy. We examined 4 areas: (1) patient views on encounters with prescribing physicians; (2) self-reported medication efficacy; (3) treatment-seeking goals; and (4) completion of a sleep medicine workup. Insomnia chronicity averaged 13 years; use of prescription medication for sleep averaged 3.81 years. Encounters with prescribing physicians yielded few options beyond drugs. Drug efficacy was not optimal for most of these patients. Sleeping better or drug-free were their chief goals. Subjective and objective sleep measures confirmed moderately severe residual insomnia as well as fair to poor waking impairment and quality of life. Sleep workup revealed high rates of maladaptive behavioral influences (96%), psychiatric complaints (89%), and obstructive sleep apnea (71%). In chronic insomnia patients who failed pharmacotherapy, comorbid mental and physical factors indicated a sleep disturbance complexity unlikely to respond fully to medication.

Sleep Disorder Drug Information

Once you’ve been diagnosed with a sleep disorder, your doctor may prescribe a specific drug regimen. Below you’ll find a list of common drugs prescribed for such disorders with links to information about how to take them, interactions with other medications and common side effects.

Featured

• Lunesta Oral
  This medication is used to treat sleep problems (insomnia). It may help you fall asleep faster, sleep better during the night, and stay asleep longer. Eszopiclone belongs to a class of drugs known as hypnotics.
• Doral Oral
  This medication is used for the short-term treatment of patients with trouble sleeping (insomnia). It is generally used for 7-10 days. It may help you fall asleep faster and decrease the number of times you awaken during the night. It may also help you sleep for a longer period of time. Quazepam belongs to a class of medications called sedative/hypnotics. It acts on your brain to produce a calming effect.
• Halcion Oral
  This medication is used for the short-term treatment of patients with trouble sleeping (insomnia). It is generally used for 7-10 days. It may help you fall asleep faster and decrease the number of times you awaken during the night. It may also help you sleep for a longer period of time. Triazolam belongs to a class of medications called sedative/hypnotics. It acts on your brain to produce a calming effect.

• Klonopin Oral
  Clonazepam is used to treat seizure disorders and panic attacks. It belongs to a class of medications called benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect. This drug works by enhancing the effects of a certain natural chemical in the body (GABA).
• Ambien Oral
  Zolpidem is used to treat sleep problems (insomnia). It may help you fall asleep faster, stay asleep longer, and reduce the number of times you awaken during the night. Zolpidem belongs to a class of drugs called sedative/hypnotics. It acts on your brain to produce a calming effect.
• Mirapex Oral
  Pramipexole is used alone or with other medications to treat Parkinson's disease. It can improve your ability to move and decrease shakiness (tremor), stiffness, slowed movement, and unsteadiness. It may also decrease the number of episodes of not being able to move ("on-off syndrome").
• Provigil Oral
  Modafinil decreases extreme sleepiness due to narcolepsy and other sleep disorders such as difficult/irregular breathing during sleep (e.g., obstructive sleep apnea/hypopnea syndrome-OSAHS). It is also used to help you stay awake during work hours for people with work schedules that interfere with a normal sleep routine (shift work sleep disorder-SWSD).
• Restoril Oral
  This medication is used for the short-term treatment of patients with trouble sleeping (insomnia). It is generally used for 7-10 days. It may help you fall asleep faster and decrease the number of times you awaken during the night. It may also help you sleep for a longer period of time. Temazepam belongs to a class of medications called sedative/hypnotics. It acts on your brain to produce a calming effect.
• Rozerem Oral
  This medication is used to treat sleeplessness (insomnia). It helps you fall asleep faster so you can get a full night's rest. Sleep is important for your ability to function, think clearly, and remain alert. Lack of sleep can cause problems such as depression, heart disease and accidents. Getting enough sleep allows your mind and body to repair itself and increases your energy throughout the day.
• Sonata Oral
  This medication is used for a short time to treat people who have trouble falling asleep. If you have other sleep problems such as not being able to sleep through the night, this medication may not be right for you. Zaleplon is known as a hypnotic. It works on certain centers in the brain to relax you and help you fall asleep faster.
• Nuvigil Oral
  Armodafinil decreases extreme sleepiness due to narcolepsy and other sleep disorders such as difficult/irregular breathing during sleep (e.g., obstructive sleep apnea/hypopnea syndrome-OSAHS). It is also used to decrease sleepiness due to work schedules that interfere with a normal sleep routine (shift work sleep disorder-SWSD).
• Edluar SL
  Zolpidem is used for short-term treatment of sleep problems (insomnia). It may help you fall asleep faster, stay asleep longer, and reduce the number of times you awaken during the night. Zolpidem belongs to a class of drugs called sedatives/hypnotics. It acts on your brain to produce a calming effect.
   
  SOURCE: Health Central

SLEEP DISORDER

Sleep Disorder Test Types of Sleep Disorder Tests Since there are many types of sleep disorders, there are also many types of sleep disorder tests that can be done to determine what type of sleep disorder that a person has.  Sleep disorder clinics specialize in these tests, although medical doctors will also have different questionnaires to use with their patients who seem to be suffering from a sleep disorder.  There are sleep disorder tests that help to determine insomnia and the possible reasons for it.  There are sleep disorder tests that help to determine restless leg syndrome, REM sleep disorder, sleep terrors and more.  Each of these tests requires a different process to be involved in the test.  Some of the more in depth tests involve a sleep study, where the person will have to come into the facility to be monitored while they sleep in a laboratory setting.  This is often the case with sleep apnea patients, since the doctor has to determine the type that the person has and what treatment method might work the best. Other Tests There are some sleep disorder tests that require the person to keep a diary of their sleeping patterns.  They will need to record when they go to bed and when they get up in the morning.  They will need to tell whether they woke up in the night and what happened when they did awaken.  They will also need to record how they feel in the morning and any other pertinent information that might be useful to the doctor in making the diagnosis. They might also be required to do a questionnaire which measures the amount of daytime sleepiness that the person has.  This test is called the Epworth Sleepiness Scale and is useful in diagnosing insomnia.  There is also the polysomnogram, which is a test that helps to measure the amount of activity that the person has while sleeping during the night.  Another, similar test is called the actigraphy, which is a simple device which is worn on the wrist which can measure the movements that the person makes in the night.  These sleep disorder tests can help doctors to determine what might be going on with that person so that they can prescribe something that can help them get better sleep at night. There are also times when a mental health exam is the best sleep disorder test that the person can do, since the exam can help the person to sort out the events in his life and see what might be affecting his sleeping patterns.

SLEEP DISORDER

Sleep Disorders and Problems

Symptoms, Studies, Treatment, and Self-Help

Sleep problems cause more than just sleepiness – a lack of quality sleep can cause accidents, affect your relationships, health, and mental prowess; and make you feel generally “disconnected” from the world. If your sleeplessness is caused by a tough deadline or a common cold, you might not have trouble getting your sleep back on track after the deadline or cold go away, but if you have trouble sleeping on a regular basis, this guide to managing common sleep problems and disorders can help you be well on your way to experiencing healthy, restorative sleep.

In This Article:

• Sleep disorder symptoms
• Common types of sleep problems
• Diagnosing sleep disorders

Symptoms of sleep problems and disorders

Everyone experiences occasional sleep problems, but getting a good night’s sleep is essential for feeling refreshed and alert during the day. Lack of sleep might make you feel foggy and unable to concentrate, or just a lesser version of your normal self. Sleep problems will eventually disrupt your work, family and personal relationships.
How do you tell if your sleepless night is an isolated occurrence or if it is related to a chronic sleep problem or disorder? Start by identifying your symptoms. Particular behaviors during the day are telltale signs of sleep deprivation. If you are experiencing any of the following symptoms on a regular basis, your sleeplessness might be part of an ongoing problem or sleep disorder.

Do you . . .

• feel irritable or sleepy during the day?
• have difficulty staying awake when sitting still, watching television or reading?
• fall asleep or feel very tired while driving?
• have difficulty concentrating?
• often get told by others that you look tired?
• react slowly?
• have emotional outbursts?
• feel like taking a nap almost every day?
• require caffeinated beverages to keep yourself going?

Common types of sleep problems and sleep disorders

Insomnia

Almost everyone will be affected by insomnia at some point during life. Insomnia – a short term or chronic inability to get high quality sleep – is a common sleep problem and can be caused by a variety of things including stress, a change in time zones, an altered sleep schedule or poor bedtime habits. Whether your problem is an occasional sleepless night or a series of them, plenty of solutions exist to help you get better sleep.

Pay Attention to Insomnia

Insomnia often acts as a flashing yellow light in terms of sleep problems. Your insomnia might be a symptom of a more significant sleep problem or disorder, or a starting point for dealing with a physical, mental or emotional challenge. Your inability to go to sleep or stay asleep might be related to your partner’s snoring, your own sleep apnea or restless legs syndrome, or it might be related to an urgent situation at work, or a difficult family issue. Whatever the cause of your insomnia, being mindful of your sleep habits and learning to relax will help you sleep better and feel better.

The great news is that insomnia doesn’t have to be a permanent problem. In many cases, self help techniques, including improved sleep hygiene, relaxation and cognitive behavioral therapy (CBT), can alleviate insomnia and promote better health as well as better sleep. Helpguide has two articles devoted to a wide range of insomnia cures and self help tips for improving your sleep.
Medications should be a last resort for insomnia – they do not provide lasting treatment and have numerous possible side effects.

See Insomnia: Causes and Cures and Tips for Getting Better Sleep and Sleeping Pills, Sleep Aids and Medications.

Sleep apnea sleep disorders

Sleep apnea is a common sleep disorder that can be potentially very serious, and even life-threatening. In sleep apnea, your breathing stops or gets very shallow while you are sleeping. Each pause in breathing typically lasts 10 to 20 seconds or more, and the pauses can occur 20 to 30 times or more an hour. During the episodes of apnea, the sleeper wakes up to breathe again, disrupting sleep, and also suffers from a brief lack of oxygen.
Symptoms of sleep apnea include:

• Frequent gaps in breathing during sleep (apnea)
• Gasping or choking for air to restart breathing, often causing sleeper or partner to wake
• Loud snoring
• Feeling unrefreshed after a night’s sleep and excessive daytime tiredness

The most common type of sleep apnea is obstructive sleep apnea. Causes of sleep apnea are generally physical in nature, including excess weight or tissue (sometimes from being overweight or obese), large tonsils or adenoids, nasal congestion or blockage or a unique shaped head, neck or chin.
CPAP, a mechanical device worn while sleeping which provides continuous air pressure to keep the airway open, is the most recommended treatment for moderate to severe sleep apnea. CPAP can take some getting used to, but provides effective relief when used correctly.
Self help treatments, like losing weight, elevating the head of the bed or sleeping on your side, can also be effective remedies for mild to moderate sleep apnea. Dental appliances and surgery are also treatment options.

See Sleep Apnea: Symptoms, Causes, Diagnosis, and Treatment

Snoring

Snoring, which is sometimes confused with sleep apnea, can be a significant obstacle to quality sleep both for yourself and your partner.
Snoring is caused by a narrowing of your airway, either from poor sleep posture, excess weight or physical abnormalities of your throat. A narrow airway gets in the way of smooth breathing and creates the sound of snoring. The snoring noise doesn’t necessarily that the airway is obstructed, as it is in sleep apnea. Snoring may accompany sleep apnea, but not always.
There are many self help remedies and cures for snoring. If you are a mild snorer, sleeping on your side, elevating the head of your bed, or losing weight may stop the snoring. Don’t give up trying to find a solution for your snoring – it will make you and your partner sleep better.

See Snoring Causes and Cures for more helpful snoring cures.

Restless Legs Syndrome (RLS) and Periodic Limb Movements in Sleep (PLMS)

Restless legs syndrome (RLS) is a disorder causing an almost irresistible urge to move the legs (or arms). The urge to move occurs when resting or lying down and is usually due to uncomfortable, tingly, or creeping sensations in the legs or affected limbs. Movement eases the feelings, but only for a while.
Periodic Limb Movement Disorder (PLMD) is a related condition involving involuntary, rhythmic limb movements, either while asleep or when awake. While most people who have Restless Legs Syndrome also have PLMD, only some people with PLMD also have RLS.
RLS can occur on its own or be related to other medical conditions, such as anemia, kidney disease, pregnancy, thyroid problems, Parkinson’s or alcoholism. RLS may run in families.
Alternative therapies, lifestyle changes, and even nutritional supplements have proven helpful for RLS and PLMD sufferers.

See Restless Legs Syndrome (RLS): Finding Relief for Symptoms and Choosing a Treatment

Narcolepsy

Narcolepsy is a neurological disorder that causes extreme sleepiness and may even make a person fall asleep suddenly and without warning. Specific causes of narcolepsy are not known but people with narcolepsy are lacking hypocretin, a brain chemical which regulates sleep and wakefulness.
The “sleep attacks” experienced by people with narcolepsy occur even after getting enough sleep at night, and make it difficult for people to live normal lives. Falling asleep during activities like walking, driving or working can have dangerous results.
Symptoms of narcolepsy include:

• Intermittent, uncontrollable episodes of falling asleep during the daytime
• Excessive daytime sleepiness
• Sudden, short-lived loss of muscle control during emotional situations (cataplexy)

Narcolepsy may be genetic, but it also appears to be influenced by environmental triggers. Treatment requires a combination of medication, behavioral treatments, and counseling.

See Narcolepsy: Symptoms, Causes, Diagnosis and Treatment

Learning more about your sleep problem or disorder

Self-diagnosis

To determine if you have a sleep disorder, first pay attention to your sleep habits and daily routine. Keeping a record of your sleep patterns will help you and your doctor find the cause of your sleep problems.
A sleep diary, compiled by you and your sleep partner, can highlight lifestyle factors related to sleep disorders, and help your doctor or sleep specialist, if you choose to see one. A sleep diary should record all sleep-related information, including:

• time you went to bed and woke up (total sleep hours)
• quality of your sleep - times that you were awake and activity (e.g., stayed in bed with eyes closed, or got up, had a glass of milk, and meditated)
• types and amount of food, liquids, caffeine, or alcohol you consumed before bed, and times of consumption
• feelings and moods before bed ­– happiness, sadness, stress, anxiety
• drugs or medications taken, amounts taken, and times of consumption

The details can be important, and a sleep diary might reveal that your pre-bedtime behavior is ruining your chance for a good night’s sleep. For example, after keeping the diary for a week your might notice that more than two alcoholic drinks in the evening disrupts your sleep or that regular exercise helps you sleep better.

Seeing a doctor

You can address many common sleep problems through lifestyle changes and improved sleep hygiene, but see your doctor or a sleep specialist if your sleep does not improve.
What can you expect when you go to see a doctor about your sleep problem? Doctors will consider many things before making a diagnosis including:

• description of symptoms
• age and gender
• psychological and medical history
• sleep diary and sleep questionnaire
• possible medical conditions
• medical tests
• sleep center data

Your doctor will probably suggest behavioral and environmental changes as first steps of your treatment. Regardless of your sleep problem, a consistent sleep routine and improved sleep habits will translate into better sleep over the long term.

SOURCE:Suzanne Barston, Gina Kemp, M.A., and Robert Segal, M.A.

SLEEP DISORDER

SLEEP DISORDER

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 polysomnography.
Disruptions in sleep can be caused by a variety of issues, from teeth grinding (bruxism) to night terrors. When a person suffers from difficulty in sleeping with no obvious cause, it is referred to as insomnia.^[1] In addition, sleep disorders may also cause sufferers to sleep excessively, a condition known as hypersomnia. Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.

Contents 1 Common disorders 2 Classifications 3 General principles of treatment 4 Sleep medicine 5 See also 6 References 7 External links

 Common disorders

The most common sleep disorders include:

• Primary insomnia: Chronic difficulty in falling asleep and/or maintaining sleep when no other cause is found for these symptoms.
• 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), non-24-hour sleep-wake syndrome (Non-24), and irregular sleep wake rhythm, all much less common than DSPS, as well as the transient jet lag and shift work sleep disorder.)
• Hypopnea syndrome: Abnormally shallow breathing or slow respiratory rate while sleeping.
• Narcolepsy: Excessive daytime sleepiness (EDS) often culminating in falling asleep spontaneously but unwillingly at inappropriate times.
• Cataplexy: a sudden weakness in the motor muscles that can result in collapse to the floor.
• Night terror: Pavor nocturnus, sleep terror disorder: abrupt awakening from sleep with behavior consistent with terror.
• Parasomnias: Disruptive sleep-related events involving inappropriate actions during sleep; sleep walking and night-terrors are examples.
• 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.
• Sleep Apnea, and mostly Obstructive sleep apnea: Obstruction of the airway during sleep, causing lack of sufficient deep sleep; often accompanied by snoring. Other forms of sleep apnea are 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. Often seen as part of Narcolepsy.
• 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.
• Nocturia: A frequent need to get up and go to the bathroom to urinate at night. It differs from Enuresis, or bed-wetting, in which the person does not arouse from sleep, but the bladder nevertheless empties.^[2]
• Somniphobia: a dread of sleep.

 Classifications

• Dyssomnias - 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
  • Sleep Disordered Breathing (SDB), including (non exhaustive):
    • Several types of Sleep apnea
    • Snoring
    • Upper airway resistance syndrome
  • 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 - A category of sleep disorders that involve abnormal and unnatural movements, behaviors, emotions, perceptions, and dreams in connection with sleep.
  • REM sleep behaviour disorder
  • Sleep terror
  • Sleepwalking (or somnambulism)
  • Bruxism (Tooth-grinding)
  • Bedwetting or sleep enuresis.
  • 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
  • Psychosis (such as Schizophrenia)
  • Mood disorders
    • Depression
    • Anxiety
  • Panic
  • Alcoholism
• Sleeping sickness - a parasitic disease which can be transmitted by the Tsetse fly.

 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.
Chronic sleep disorders in childhood, which affect some 70% of children with developmental or psychological disorders, are under-reported and under-treated. Sleep-phase disruption is also common among adolescents, whose school schedules are often incompatible with their natural circadian rhythm. Effective treatment begins with careful diagnosis using sleep diaries and perhaps sleep studies. Modifications in sleep hygiene may resolve the problem, but medical treatment is often warranted.^[3]
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.
Some sleep disorders have been found to compromise glucose metabolism.^[4]

 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.

Pediatric Polysomnography.

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."^[5]

Competence in sleep medicine requires an understanding of a myriad 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.^[6] 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).^[7] The qualified dentists collaborate with sleep physicians at accredited sleep centers and can provide oral appliance therapy and upper airway surgery to treat or manage sleep-related breathing disorders.^[8]
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."^[9] The Imperial College Healthcare site^[10] shows attention to obstructive sleep apnea syndrome (OSA) and very few other sleep disorders.

SOURCE: AMERICA BOARD OF DENTAL SLEEP MEDICINE