Sleep Disorders

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.

Insomnia

Insomnia is a symptom  which can accompany several sleep, medical and psychiatric disorders, characterized by persistent difficulty falling asleep and/or staying asleep despite the opportunity. Insomnia is typically followed by functional impairment while awake. Both organic and non-organic insomnia without other cause constitute a sleep disorder, primary insomnia.  One definition of insomnia is “difficulties initiating and/or maintaining sleep, or nonrestorative sleep, associated with impairments of daytime functioning or marked distress for more than 1 month.”According to the United States Department of Health and Human Services in the year 2007, approximately 64 million Americans regularly suffer from insomnia each year. Insomnia is 1.4 times more common in women than in men.

Dyssomnia

Dyssomnia is a chronic sleep disorder. The condition is characterized by excessive daytime sleepiness (EDS) in which a person experiences extreme fatigue and possibly falls asleep at inappropriate times, such as while at work or at school. A narcoleptic will most likely experience disturbed nocturnal sleep and also abnormal daytime sleep pattern, which is often confused with insomnia. When a person with narcolepsy falls asleep or goes to bed they will generally experience the REM stage of sleep (rapid eye movement/dreaming state), within 10 minutes; whereas for most people, this shouldn’t occur until generally 30 minutes of slumber.

Sleep apnea

is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called an apnea lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep. The standard definition of any apneic event includes a minimum 10 second interval between breaths, with either a neurological arousal , a blood  oxygen  desaturation of 3-4% or greater, or both arousal and desaturation. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or a “sleep study”.Clinically significant levels of sleep apnea are defined as five or more episodes per hour of any type of apnea (from the polysomnogram). There are three distinct forms of sleep apnea: central, obstructive, and complex (i.e., a combination of central and obstructive) constituting 0.4%, 84% and 15% of cases respectively. Breathing is interrupted by the lack of respiratory effort in central sleep apnea; in obstructive sleep apnea, breathing is interrupted by a physical block to airflow despite respiratory effort. In complex (or “mixed”) sleep apnea, there is a transition from central to obstructive features during the events themselves.

Restless legs syndrome

Restless legs syndrome (RLS), also known as Wittmaack-Ekbom’s syndrome, and colloquially as “the jimmylegs” is a condition that is characterized by an irresistible urge to move one’s body to stop uncomfortable or odd sensations. It most commonly affects the legs, but can also affect the arms or torso, and even phantom limbs.[1]  Moving the affected body part modulates the sensations, providing temporary relief.RLS causes a sensation in the legs or arms that can most closely be compared to a burning, itching, or tickling sensation in the muscles. Some controversy surrounds the marketing of drug treatments for RLS. It is a ’spectrum’ disease with some people experiencing only a minor annoyance and others experiencing major issues.

Periodic Limb Movement Disorder

Periodic Limb Movement Disorder (PLMD), previously known as Nocturnal myoclonus, is a sleep disorder where the patient moves limbs involuntarily during sleep, and has symptoms or problems related to the movement. If the patient moves limbs during sleep but there are no negative consequences, the condition is simply called periodic limb movements of sleep (PLMS). (Most people who have PLMS do not have a disorder, and do not require any treatment).PLMD should not be confused with Restless Leg Syndrome (RLS). RLS occurs while awake as well as when asleep, and when awake, there is a voluntary response to an uncomfortable feeling in the legs. PLMD on the other hand is involuntary, and the patient is often unaware of these movements altogether.

Hypersomnia

Hypersomnia is a disorder characterized by excessive amounts of sleepiness. There are two main categories of hypersomnia. Primary Hypersomnia, also called Idiopathic Hypersomnia, and Recurrent Hypersomnia, also called Primary Recurrent Hypersomnia. Both have the same symptoms but differ in the frequency of how often they occur. Patients with hypersomnia also often experience prolonged sleep at night and have difficulty waking from long sleep, feeling disoriented upon doing so. Other symptoms may include anxiety, increased irritation, decreased energy, restlessness, slow thinking, slow speech, loss of appetite, hallucinations, and memory difficulty. Some patients lose the ability to function in family, social, occupational or other settings. (…) Typically, hypersomnia is first recognized in adolescence or young adulthood.  These symptoms are present in both types of hypersomnia. Primary Hypersomnia displays these symptoms continually for months or even years. Recurrent Hypersomnia is characterized by recurring periods of symptoms many times throughout the year mixed with periods of normal sleep/wake cycles. Kleine-Levin syndrome  is the most well-known form of Recurrent Hypersomnia, though it is very rare, these people often sleep up to 18 hours a day and yet do not feel refreshed upon wakening.

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