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Caregiving & from a sleep disorder.Housing Sleep disorders and other sleeping problems cause more than just sleepiness. Poor quality sleep can have a negative impact on your energy, emotional balance, productivity, and health. If you’re experiencing sleeping problems, learn about the signs and symptoms of common sleep disorders, what you can do to help yourself, and when to see a doctor. In This Article: Understanding sleeping problems Signs and symptoms Insomnia Other common sleep disorders Circadian rhythm sleep disorders Self-help for sleep disorders Do sleeping pills help? When to call the sleep doctor Related links Print Authors Text Size Understanding sleep disorders and sleeping problems Sleep can often be a barometer of your overall health. In many cases, people in good health tend to sleep well, whereas repeated sleeping problems may indicate an underlying medical or mental health problem, be it minor or serious. Sleeping well is essential to your physical health and emotional well-being. Unfortunately, even minimal sleep loss can take a toll on your mood, energy, efficiency, and ability to handle stress. Ignoring sleep problems and disorders can lead to poor health, accidents, impaired job performance, and relationship stress. If you want to feel your best, stay healthy, and perform up to your potential, sleep is a necessity, not a luxury. It’s not normal to feel sleepy during the day, to have problems getting to sleep at night, or to wake up feeling unrefreshed. But even if you’ve struggled with sleep problems for so long that it does seem normal, you can learn to sleep better. You can start by tracking your symptoms and sleep patterns, and then making healthy changes to your daytime habits and bedtime routine. If self-help doesn’t do the
trick, you can turn to sleep specialists who are trained in sleepmedicine. Together, you can identify the underlying causes of yoursleeping problem and find ways to improve your sleep and quality oflife.Signs and symptoms of sleep disorders andsleeping problemsEveryone experiences occasional sleeping problems. So how do youtell whether your sleeping problem is just a minor, passingannoyance or a sign of a more serious sleep disorder or underlyingmedical condition?Start by scrutinizing your symptoms, looking especially for thetelltale daytime signs of sleep deprivation. If you are experiencingany of the following symptoms on a regular basis, you may bedealing with a sleep disorder.Is it a 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 trouble controlling your emotions? feel like you have to take a nap almost every day? require caffeinated beverages to keep yourself going?If you answered ―yes‖ to any of the previous questions, you mayhave a sleep disorder.Insomnia: The most common type of sleepdisorderInsomnia, the inability to get the amount of sleep you need to wakeup feeling rested and refreshed, is the most common sleep complaint.Insomnia is often a symptom of another problem, such as stress,anxiety, depression, or an underlying health condition. It can also becaused by lifestyle choices, including the medications you take, lack
of exercise, jet lag, or even the amount of coffee you drink.Common signs and symptoms of insomnia include: Difficulty falling asleep at night or getting back to sleep after waking during the night. Waking up frequently during the night. Your sleep feels light, fragmented, or unrefreshing. You need to take something (sleeping pills, nightcap, supplements) in order to get to sleep. Sleepiness and low energy during the day.Whatever the cause of your insomnia, being mindful of your sleephabits and learning to relax will help you sleep better and feel better.The good news is that most cases of insomnia can be cured withlifestyle changes you can make on your own—without relying onsleep specialists or turning to prescription or over-the-countersleeping pills. Putting a stop to the problem of sleeplessnightsInsomnia takes a toll on your energy, mood, and ability to functionduring the day. But you don’t have to put up with insomnia. Simplechanges to your lifestyle and daily habits can end sleepless nights.Read ArticleOther common types of sleep disordersIn addition to insomnia, the most common sleep disorders are sleepapnea, restless legs syndrome (RLS), and narcolepsy.Sleep disorder 1: Sleep apneaSleep apnea is a common sleep disorder in which your breathingtemporarily stops during sleep due to blockage of the upper airways.These pauses in breathing interrupt your sleep, leading to manyawakenings each hour. While most people with sleep apnea don’tremember these awakenings, they feel the effects in other ways, suchas exhaustion during the day, irritability and depression, anddecreased productivity.
Sleep apnea is a serious, and potentially life-threatening, sleepdisorder. If you suspect that you or a loved one may have sleepapnea, see a doctor right away. Sleep apnea can be successfullytreated with Continuous Positive Airway Pressure (CPAP), a mask-like device that delivers a stream of air while you sleep. Losingweight, elevating the head of the bed, and sleeping on your side canalso help in cases of mild to moderate sleep apnea.Symptoms of sleep apnea include: Loud, chronic snoring Frequent pauses in breathing during sleep Gasping, snorting, or choking during sleep Feeling unrefreshed after waking and sleepy during the day, no matter how much time you spent in bed Waking up with shortness of breath, chest pains, headaches, nasal congestion, or a dry throat.Sleep disorder 2: Restless legs syndrome (RLS)Restless legs syndrome (RLS) is a sleep disorder that causes analmost irresistible urge to move your legs (or arms). The urge tomove occurs when you’re resting or lying down and is usually due touncomfortable, tingly, aching, or creeping sensations.Common signs and symptoms of restless legs syndrome include: Uncomfortable sensations deep within the legs, accompanied by a strong urge to move them. The leg sensations are triggered by rest and get worse at night. The uncomfortable sensations temporarily get better when you move, stretch, or massage your legs. Repetitive cramping or jerking of the legs during sleep.Sleep disorder 3: NarcolepsyNarcolepsy is a sleep disorder that involves excessive, uncontrollabledaytime sleepiness. It is caused by a dysfunction of the brainmechanism that controls sleeping and waking. If you havenarcolepsy, you may have ―sleep attacks‖ while in the middle oftalking, working, or even driving.Common signs and symptoms of narcolepsy include: Seeing or hearing things when you’re drowsy or starting to
dream before you’re fully asleep. Suddenly feeling weak or losing control of your muscles when you’re laughing, angry, or experiencing other strong emotions. Dreaming right away after going to sleep or having intense dreams Feeling paralyzed and unable to move when you’re waking up or dozing off.Circadian rhythm sleep disordersWe all have an internal biological clock that regulates our 24-hoursleep-wake cycle, also known as our circadian rhythms. Light is theprimary cue that influences circadian rhythms. When the sun comesup in the morning, the brain tells the body that it’s time to wake up.At night, when there is less light, your brain triggers the release ofmelatonin, a hormone that makes you sleepy.When circadian rhythms are disrupted or thrown off, you may feelgroggy, disoriented, and sleepy at inconvenient times. Circadianrhythms have been linked to a variety or sleeping problems and sleepdisorders, including insomnia, jet lag, and shift work sleepdifficulties. Abnormal circadian rhythms have also been implicatedin depression, bipolar disorder, and seasonal affective disorder, or thewinter blues.Jet lag sleeping problemsJet lag is a temporary disruption in circadian rhythms that occurswhen you travel across time zones. Symptoms include daytimesleepiness, fatigue, headache, stomach problems, and insomnia. Thesymptoms typically appear within a day or two after flying acrosstwo or more time zones. The longer the flight, the more pronouncedthe symptoms. The direction of flight also makes a difference. Flyingeast tends to cause worse jet lag than flying west.In general, it usually takes one day per time zone crossed to adjust tothe local time. So if you flew from Los Angeles to New York,crossing three time zones, your jet lag should be gone within threedays. However, jet lag can be worse if you: lost sleep during drink too much alcohol or caffeine travel didn’t move around enough during are under a lot of your flight stress
Shift work sleeping problemsShift work sleep disorder is a circadian rhythm sleep disorder thatoccurs when your work schedule and your biological clock are out ofsync. In our 24-hour society, many workers have to work night shifts,early morning shifts, or rotating shifts. These schedules force you towork when your body is telling you to go to sleep, and sleep whenyour body is signaling you to wake.While some people adjust better than others to the demands of shiftwork, most shift workers get less quality sleep than their daytimecounterparts. As a result of sleep deprivation, many shift workersstruggle with sleepiness and mental lethargy on the job. This cutsinto their productivity and puts them at risk of injury.There are a numbers of things you can do to reduce the impact ofshift work on sleep: Take regular breaks and minimize the frequency of shift changes. When changing shifts, request a shift that’s later, rather than earlier as it’s easier to adjust forward in time, rather than backward. Naturally regulate your sleep-wake cycle by increasing light exposure at work (use bright lights) and limiting light exposure when it’s time to sleep. Avoid TV and computer screens, use black-out shades or heavy curtains to block out daylight in your bedroom. Consider taking melatonin when it’s time for you to sleep.Delayed sleep phase disorderDelayed sleep phase disorder is a sleep disorder in which your 24-hour cycle of sleep and wakefulness—your biological clock—issignificantly delayed. As a result, you go to sleep and wake up muchlater than other people. For example, you may not get sleepy until 4a.m., at which time you go to bed and sleep soundly until noon, or at
least you would if your daytime responsibilities didn’t interfere.Delayed sleep phase disorder makes it difficult for you to keepnormal hours—to make it to morning classes, get the kids to schoolon time, or keep a 9-to-5 job.It’s important to note that this sleeping problem is more than just apreference for staying up late or being a night owl. People with delayed sleep phase disorder are unable to get to sleep earlier than 2 to 6 a.m. no matter how hard they try. They struggle to go to sleep and get up at socially acceptable times. When allowed to keep their own hours (such as during a school break or holiday), they fall into a regular sleep schedule. Delayed sleep phase disorder is most common in teenagers, and many teens will eventually grow out of it. For those who continue to struggle with a biological clock that is out of sync, treatments such as light therapy and chronotherapy can help. To learn more, schedule an appointment with a sleep doctor or local sleep clinic.Self-help for sleeping problems and sleepdisordersLearn more about the medical causes of sleep problems anddisorders.Read Article by Harvard Health PublicationsWhile some sleep disorders may require a visit to the sleep doctor,you can improve many sleeping problems on your own. The first stepto overcoming a sleep problem is identifying and carefully trackingyour symptoms and sleep patterns.Keep a sleep diaryA sleep diary is a very useful tool for identifying sleep disorders andsleeping problems and pinpointing both day and nighttime habits thatmay be contributing to your difficulties. Keeping a record of yoursleep patterns and problems will also prove helpful if you eventuallyfind it necessary to see a sleep doctor.
Download and print Helpguide’s sleep diary.Your sleep diary should include: what time you went to bed and woke up total sleep hours and perceived quality of your sleep a record of time you spent awake and what you did (―stayed in bed with eyes closed,‖ for example, 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 your feelings and moods before bed (e.g. happiness, sadness, stress, anxiety) any drugs or medications taken, including dose and time of consumptionThe details can be important, revealing how certain behaviors can beruining your chance for a good night’s sleep. After keeping the diaryfor a week, for example, you might notice that when you have morethan one glass of wine in the evening, you wake up during the night.Improve your sleep hygiene and daytime habitsLearn to recognize & reduce hidden stressWatch 4 min. video: Quick Stress ReliefRegardless of your sleep problems, a consistent sleep routine andimproved sleep habits will translate into better sleep over the longterm. You can address many common sleep problems throughlifestyle changes and improved sleep hygiene. For example, you mayfind that when you start exercising regularly and managing yourstress more effectively, your sleep is much more refreshing. The keyis to experiment. Use your sleep diary as a jumping off point.Try the following simple changes to your daytime and pre-bedtimeroutine: Keep a regular sleep schedule, going to sleep and getting up at the same time each day, including the weekends. Set aside enough time for sleep. Most people need at least 7 to 8 hours each night in order to feel good and be productive. Make sure your bedroom is dark, cool, and quiet. Cover electrical displays, use heavy curtains or shades to block light from windows, or try an eye mask to shield your eyes. Turn off your TV, smartphone, iPad, and computer a few
hours before your bedtime. The type of light these screens emit can stimulate your brain, suppress the production of melatonin, and interfere with your body’s internal clock. Simple tips for better sleepThe cure to sleeping problems and daytime fatigue can often befound in your daily routine. Making some simple lifestyle changescan help ensure you get the sleep you need. Read ArticleDo sleeping pills help sleep disorders andsleeping problems?When taken for a brief period of time and under the supervision ofyour doctor, sleeping pills may help your sleeping problems.However, they are just a temporary solution. Insomnia can’t be curedwith sleeping pills. In fact, sleeping pills can often make insomniaworse in the long run.In general, sleeping pills and sleep medications are most effectivewhen used sparingly for short-term situations, such as travelingacross many time zones or recovering from a medical procedure. Ifmedications are used over the long term, they are best used ―asneeded‖ instead of on a daily basis to avoid dependence andtolerance.Safety guidelines for sleeping pills Only take a sleeping pill when you will have enough time to get a full 7 to 8 hours of sleep. Otherwise, you may be drowsy the next day. Read the package insert that comes with your medication. Pay careful attention to the potential side effects, dosage instructions, and list of food and substances to avoid. Never mix alcohol and sleeping pills. Alcohol disrupts sleep and can interact dangerously with sleep medications. Never drive a car or operate machinery after taking a sleeping pill, especially when you first start taking a new sleep aid, as you may not know how it will affect you.To learn more, see Sleeping Pills, Sleep Aids and Medications:What’s Best for You?
When to call a doctor about sleep disordersIf you’ve tried a variety of self-help sleep remedies without success,schedule an appointment with a sleep specialist or ask your familydoctor for a referral to a sleep clinic, especially if: Your main sleep problem is daytime sleepiness and self-help hasn’t improved your symptoms. You or your bed partner gasps, chokes, or stops breathing during sleep. You sometimes fall asleep at inappropriate times, such as while talking, walking, or eating.At your appointment, be prepared with information about your sleeppatterns and provide the sleep doctor with as much supportinginformation as possible, including information from your sleep diary.What to expect at a sleep clinic or centerIf your physician refers you to a sleep center, the latest technologywill be used to monitor you while you sleep. A sleep specialist willobserve your sleep patterns, brain waves, heart rate, rapid eyemovements and more using monitoring devices attached to yourbody. While sleeping with a bunch of wires attached to you mightseem difficult, most patients find they get used to it quickly.The sleep specialist will analyze the results from your sleep studyand design a treatment program if necessary. A sleep center can alsoprovide you with equipment to monitor your activities (awake andasleep) at home.Related Links How to Sleep BetterTips for Getting a Good Night’s Sleep How Much Sleep Do You Need?Sleep Cycles & Stages, Lack of Sleep & Getting the Hours You
NeedMore Helpguide Articles: How to Stop Snoring: Cures, Remedies, and Tips For You and Your Partner Sleeping Pills, Sleep Aids, and Medications: What’s Best for You? Cant Sleep? Insomnia Causes, Cures, and Treatments Sleeping Well As You Age: Helpful Sleep Tips for SeniorsResources and references for sleepdisorders and sleeping problemsGeneral information about sleep disorders and sleepingproblemsAn Overview of Sleep Disorders – Guide to the symptoms andtreatment of common sleep disorders . Includes video clips fromsleep expert Dr. Lawrence Epstein. (Division of Sleep Medicine,Harvard Medical School)Sleep Disorders – Introduction to common sleep disorders andsleeping problems, as well as sleep hygiene tips for combattinginsomnia. (Healthier You, UBM Medica)Common Adult Sleep Problems/Disorders – Information on anumber of sleep disorders and treatment options. Learn what toexpect during an overnight sleep test at a sleep clinic or hospital.(University of Maryland Medical Center)Sleep problems in children – Discusses common sleep issues withyoung children including babies, young children and teenagers.(University of Michigan Health System)Signs and symptoms of sleep disorders and sleepingproblemsFacts About Problem Sleepiness (PDF) – Downloadable fact sheet onproblem sleepiness, including its symptoms, causes, and link tocommon sleep disorders. (National Heart, Lung, and Blood Institute,National Institutes of Health)
Restlessness is a common side effect of the over-the-counter products that can be used as sleep aidsbecause the active ingredient is an antihistamine. I would advise making an appointment with yourdoctor or health care provider for further evaluation, and advise them of the side effect you experiencewith the OTC products. You may require prescription medication instead because they work differentlyand are not antihistamines.http://women.webmd.com/pharmacist-11/answers-sleep-restlessnessoes your child with ADHD toss and turn all night long? The reason might be a sleep disorder. Ina recent study, researchers said that about half the parents in the study said their child withADHD had difficulty sleeping. Parents reported that their child felt tired on awakening, hadnightmares, or had other sleep problems such as sleep apnea or restless legs syndrome. Anotherstudy involving children with ADHD found the children had less refreshing sleep, difficultygetting up, and significantly more daytime sleepiness.Sleep problems and ADHD seem to go hand-in-hand. Lets find out why.Is snoring related to ADHD?Large tonsils and adenoids can partially block the airway at night. This can cause snoring, poorsleep quality, and perhaps ADHD.Because snoring can result in poor sleep, it may lead to attention problems the next day. A studyinvolving 5- to 7-year-olds found that snoring is significantly more common among childrenwith mild ADHD than it is in the general population. In another study, children who snored werealmost twice as likely as their peers to have ADHD.Children who snore perform significantly worse on tests of attention, language abilities, andoverall intelligence.Some studies have shown that taking out the tonsils and adenoids may resultin better sleep and improved behavior without the need for medications.What is sleep apnea?In simplest terms, apnea literally means without breathing. The word is used to describe aninterruption of airflow of at least ten seconds. While there are three different kinds of apneas, themost common type is obstructive. Obstructive apnea makes up 65 percent of all apneas.During obstructive sleep apnea, there is no airflow from the nose and mouth to the lungs. This isbecause the entrance to the trachea is completely blocked. The cause of the blockage is differentstructures in the pharynx that have collapsed. During this closure the respiratory musclescontinue to make efforts to get air into the lungs.People with sleep apnea have episodes of breathing cessation. They are aroused then from deepsleep to lighter stages of sleep. But they have these arousals while remaining completelyunaware of the apneas or awakenings. These episodes can happen frequently throughout thenight.
About 2% of kids in the U.S. have some form of obstructed breathing during sleep. Enlargedtonsils and adenoids are the most common causes of sleep apnea in children. But obesity andchronic allergies can also be a cause. As with adults, children with sleep apnea will be tiredduring the day. They may have problems concentrating and might have other symptoms relatedto lack of sleep. For instance, they may display irritability.How is sleep apnea diagnosed and treated?Sleep apnea in children is treatable. Yet only your pediatrician or an ear, nose, and throatspecialist can determine whether your childs tonsils are enlarged enough to possibly block theairway and cause sleep apnea. Confirmation of sleep apnea should be determined by apolysomnogram. A polysomnogram is a sleep study thats done in a special laboratory. Not everychild with enlarged tonsils or with loud snoring has sleep apnea.Surgery is the treatment of choice for kids with enlarged tonsils and adenoids. Other treatmentsare available for those with restricted nighttime breathing due to allergies or other causes.Further Reading: Brain Scans Reveal ADHD Differences Divorce More Likely in ADHD Families? ADHD at 6, Alcoholic at 16? 10 ADHD Questions for Your Doctor Attention Deficit Hyperactivity Disorder Treatment Understanding the Basics of ADHD Diagnosis and Treatment of ADHD See All ADHD in Children TopicsADHD and Sleep Disorders(continued)Is restless legs syndrome related to ADHD?Studies show some correlation between sleep disruption and ADHD and restless legs syndrome(RLS) and ADHD. With restless legs syndrome, there is a creeping, crawling sensation in thelegs and sometimes in the arms. This sensation creates an irresistible urge to move. Restless legssyndrome causes sleep disruption and daytime sleepiness.People with restless legs syndrome and subsequent sleep disruption tell of feeling inattentive,moody, and/or hyperactive -- all symptoms of ADHD. Because of this and other findings, someresearchers believe that people with restless legs syndrome and a subset of people with ADHDmay have a common dysfunction in the neurotransmitter dopamine.Restless legs syndrome is diagnosed with a polysomnogram or sleep study. Medications can helpboth restless legs syndrome and ADHD.
How can I help my child with ADHD get the sleep he needs?Its important to establish a bedtime ritual for children with ADHD. A regular bedtime regimenwill help your child relax and get the healthful sleep thats needed. Try these tips: Meet with your doctor and discuss ADHD medications. Ask your doctor if you can give the morning dose of ADHD medication earlier in the day. Or talk to your doctor about shorter-acting medications. Find the right ADHD medication that lets your child relax at night and get healthy sleep. Be a "no caffeine" family.Watch for hidden caffeine in your childs diet. Caffeine is one of the few food products that mimic the stress response. When it does, it increases nervousness and causes sleepless nights. Keep caffeinated beverages and foods out of your kitchen. Be consistent. Have a consistent, daily routine with specific bedtimes, waking times, meals, and family times. Make sure the childs room is sound attenuated.If your child is bothered by noises while sleeping, try a "white noise" machine. Use one that produces a humming sound or turn the radio to a station that has gone off air. Get ear plugs for kids who are extra sensitive to noise. Avoid sleep medications. If medications are absolutely necessary, talk to your childs doctor about safe and effective treatments. Consider medical problems. Allergies, asthma, or conditions that cause pain can disrupt sleep. If your child snores loudly and/or pauses in breathing, medical evaluation is necessary. Consult your doctor for help with the possible medical causes of sleep problems. See that your child gets plenty of exercise. Make sure your child gets daily exercise. But avoid exercising right before bedtime. Studies show that regular exercise helps people sleep more soundly. Give your child a hot bath well before bedtime. Sleep usually follows the cooling phase of the bodys temperature cycle. After your child takes a bath, keep the temperature in your childs bedroom cool to see if you can influence this phase.Further Reading: Brain Scans Reveal ADHD Differences Divorce More Likely in ADHD Families? ADHD at 6, Alcoholic at 16? 10 ADHD Questions for Your Doctor Attention Deficit Hyperactivity Disorder Treatment Understanding the Basics of ADHD Diagnosis and Treatment of ADHD See All ADHD in Children Topics http://www.webmd.com/add-adhd/guide/adhd-sleep-disorders
Dictionary, Encyclopedia and TE XT forum Join the Word of the Day Mailing List For webmastersThesaurus - The Free Dictionary 3,276,263,290 visitors served. TheFreeDictionary Google Bing New: sleep disorders Search Language ? forums Word / Article Starts with Ends with Text Medical dictionaryDictionary/ Legal Financial Acronyms Idioms Encyclopedia Wikipedia ?thesaurus dictionary dictionary encyclopedia Also found in: Dictionary/thesaurus, Legal, Encyclopedia,sleep Wikipedia, Hutchinson 0.01 se c.disordersAds by Google ?Page toolsSnoring solution for you Printer FeedbackStop snoring next night. The Worlds Best Jaw Supporter. friendly Addsquidoo.com/my-snoring-solution-2 Cite / definition linkParkinsons disease EmailLearn how one can react to the daily challenges of living with PDwww.parkinsons-voices.eu Related AdsSleep Disorders ▪ Fibro ▪ Mental sleep HealthDefinition ▪ sleep ▪ Disorder InsomniaSleep disorders are a group of syndromes characterized by disturbance in the ▪ Curespatients amount of sleep, quality or timing of sleep, or in behaviors or Insomnia ▪ sleepphysiological conditions associated with sleep. There are about 70 different sleeping Sweatingsleep disorders. To qualify for the diagnosis of sleep disorder, the condition ▪ sleep ▪ Osamust be a persistent problem, cause the patient significant emotional distress, Apnea sleepand interfere with his or her social or occupational functioning. ▪ sleep ▪
Although sleep is a basic behavior in animals as well as humans, researchers RemediesWomenstill do not completely understand all of its functions in maintaining health. In sleepthe past 30 years, however, laboratory studies on human volunteers haveyielded new information about the different types of sleep. Researchers have ?My Word Listlearned about the cyclical patterns of different types of sleep and their Add current pagerelationships to breathing, heart rate, brain waves, and other physical to the listfunctions. These measurements are obtained by a technique calledpolysomnography. ?CharityThere are five stages of human sleep. Four stages have non-rapid eye Feedmovement (NREM) sleep, with unique brain wave patterns and physical achanges occurring. Dreaming occurs in the fifth stage, during rapid eye hungmovement (REM) sleep. ry child - donate to school feeding Stage 1 NREM sleep. This stage occurs while a person is falling asleep. program It represents about 5% of a normal adults sleep time. Stage 2 NREM sleep. In this stage, (the beginning of "true" sleep), the persons electroencephalogram (EEG) will show distinctive wave forms called sleep spindles and K complexes. About 50% of sleep time is stage 2 REM sleep. Stages 3 and 4 NREM sleep. Also called delta or slow wave sleep, these are the deepest levels of human sleep and represent 10-20% of sleep time. They usually occur during the first 30-50% of the sleeping period. REM sleep. REM sleep accounts for 20-25% of total sleep time. It usually begins about 90 minutes after the person falls asleep, an important measure called REM latency. It alternates with NREM sleep about every hour and a half throughout the night. REM periods increase in length over the course of the night.Sleep cycles vary with a persons age. Children and adolescents have longerperiods of stage 3 and stage 4 NREM sleep than do middle aged or elderlyadults. Because of this difference, the doctor will need to take a patients ageinto account when evaluating a sleep disorder. Total REM sleep also declineswith age.The average length of nighttime sleep varies among people. Most people sleepbetween seven and nine hours a night. This population average appears to beconstant throughout the world. In temperate climates, however, people oftennotice that sleep time varies with the seasons. It is not unusual for people inNorth America and Europe to sleep about 40 minutes longer per night duringthe winter.DescriptionSleep disorders are classified based on what causes them. Primary sleep
disorders are distinguished from those that are not caused by other mentaldisorders, prescription medications, substance abuse, or medical conditions.The two major categories of primary sleep disorders are the dyssomnias andthe parasomnias.DyssomniasDyssomnias are primary sleep disorders in which the patient suffers fromchanges in the amount, restfulness, and timing of sleep. The most importantdyssomnia is primary insomnia, which is defined as difficulty in falling asleep orremaining asleep that lasts for at least one month. It is estimated that 35% ofadults in the United States experience insomnia during any given year, but thenumber of these adults who are experiencing true primary insomnia isunknown. Primary insomnia can be caused by a traumatic event related tosleep or bedtime, and it is often associated with increased physical orpsychological arousal at night. People who experience primary insomnia areoften anxious about not being able to sleep. The person may then associate allsleep-related things (their bed, bedtime, etc.) with frustration, making theproblem worse. The person then becomes more stressed about not sleeping.Primary insomnia usually begins when the person is a young adult or in middleage.Hypersomnia is a condition marked by excessive sleepiness during normalwaking hours. The patient has either lengthy episodes of daytime sleep orepisodes of daytime sleep on a daily basis even though he or she is sleepingnormally at night. In some cases, patients with primary hypersomnia havedifficulty waking in the morning and may appear confused or angry. Thiscondition is sometimes called sleep drunkenness and is more common inmales. The number of people with primary hypersomnia is unknown, although5-10% of patients in sleep disorder clinics have the disorder. Primaryhypersomnia usually affects young adults between the ages of 15 and 30.Nocturnal myoclonus and restless legs syndrome (RLS) can cause eitherinsomnia or hypersomnia in adults. Patients with nocturnal myoclonus wake upbecause of cramps or twitches in the calves. These patients feel sleepy the nextday. Nocturnal myoclonus is sometimes called periodic limb movementdisorder (PLMD). RLS patients have a crawly or aching feeling in their calvesthat can be relieved by moving or rubbing the legs. RLS often prevents thepatient from falling asleep until the early hours of the morning, when thecondition is less intense.Kleine-Levin syndrome is a recurrent form of hypersomnia that affects a personthree or four times a year. Doctors do not know the cause of this syndrome. Itis marked by two to three days of sleeping 18-20 hours per day, hypersexual
behavior, compulsive eating, and irritability. Men are three times more likelythan women to have the syndrome. Currently, there is no cure for thisdisorder.Narcolepsy is a dyssomnia characterized by recurrent "sleep attacks" that thepatient cannot fight. The sleep attacks are about 10-20 minutes long. Thepatient feels refreshed by the sleep, but typically feels sleepy again severalhours later. Narcolepsy has three major symptoms in addition to sleep attacks:cataplexy, hallucinations, and sleep paralysis. Cataplexy is the sudden loss ofmuscle tone and stability ("drop attacks"). Hallucinations may occur just beforefalling asleep (hypnagogic) or right after waking up (hypnopompic) and areassociated with an episode of REM sleep. Sleep paralysis occurs during thetransition from being asleep to waking up. About 40% of patients withnarcolepsy have or have had another mental disorder. Although narcolepsy isoften regarded as an adult disorder, it has been reported in children as youngas three years old. Almost 18% of patients with narcolepsy are 10 years old oryounger. It is estimated that 0.02-0.16% of the general population suffer fromnarcolepsy. Men and women are equally affected.Breathing-related sleep disorders are syndromes in which the patients sleep isinterrupted by problems with his or her breathing. There are three types ofbreathing-related sleep disorders: Obstructive sleep apnea syndrome. This is the most common form of breathing-related sleep disorder, marked by episodes of blockage in the upper airway during sleep. It is found primarily in obese people. Patients with this disorder typically alternate between periods of snoring or gasping (when their airway is partly open) and periods of silence (when their airway is blocked). Very loud snoring is a clue to this disorder. Central sleep apnea syndrome. This disorder is primarily found in elderly patients with heart or neurological conditions that affect their ability to breathe properly. It is not associated with airway blockage and may be related to brain disease. Central alveolar hypoventilation syndrome. This disorder is found most often in extremely obese people. The patients airway is not blocked, but his or her blood oxygen level is too low. Mixed-type sleep apnea syndrome. This disorder combines symptoms of both obstructive and central sleep apnea.Circadian rhythm sleep disorders are dyssomnias resulting from a discrepancybetween the persons daily sleep/wake patterns and demands of socialactivities, shift work, or travel. The term circadian comes from a Latin wordmeaning daily. There are three circadian rhythm sleep disorders. Delayed sleepphase type is characterized by going to bed and arising later than most people.
Jet lag type is caused by travel to a new time zone. Shift work type is caused bythe schedule of a persons job. People who are ordinarily early risers appear tobe more vulnerable to jet lag and shift work-related circadian rhythm disordersthan people who are "night owls." There are some patients who do not fit thepattern of these three disorders and appear to be the opposite of the delayedsleep phase type. These patients have an advanced sleep phase pattern andcannot stay awake in the evening, but wake up on their own in the earlymorning.PARASOMNIAS. Parasomnias are primary sleep disorders in which the patientsbehavior is affected by specific sleep stages or transitions between sleepingand waking. They are sometimes described as disorders of physiologicalarousal during sleep.Nightmare disorder is a parasomnia in which the patient is repeatedlyawakened from sleep by frightening dreams and is fully alert on awakening.The actual rate of occurrence of nightmare disorder is unknown.Approximately 10-50% of children between three and five years old havenightmares. They occur during REM sleep, usually in the second half of thenight. The child is usually able to remember the content of the nightmare andmay be afraid to go back to sleep. More females than males have this disorder,but it is not known whether the sex difference reflects a difference inoccurrence or a difference in reporting. Nightmare disorder is most likely tooccur in children or adults under severe or traumatic stress.Sleep terror disorder is a parasomnia in which the patient awakens screamingor crying. The patient also has physical signs of arousal, like sweating, shaking,etc. It is sometimes referred to as pavor nocturnus. Unlike nightmares, sleepterrors typically occur in stage 3 or stage 4 NREM sleep during the first third ofthe night. The patient may be confused or disoriented for several minutes andcannot recall the content of the dream. He or she may fall asleep again and notremember the episode the next morning. Sleep terror disorder is mostcommon in children four to 12 years old and is outgrown in adolescence. Itaffects about 3% of children. Fewer than 1% of adults have the disorder. Inadults, it usually begins between the ages of 20 and 30. In children, more malesthan females have the disorder. In adults, men and women are equallyaffected.Sleepwalking disorder, which is sometimes called somnambulism, occurs whenthe patient is capable of complex movements during sleep, including walking.Like sleep terror disorder, sleepwalking occurs during stage 3 and stage 4NREM sleep during the first part of the night. If the patient is awakened duringa sleepwalking episode, he or she may be disoriented and have no memory ofthe behavior. In addition to walking around, patients with sleepwalking
disorder have been reported to eat, use the bathroom, unlock doors, or talk toothers. It is estimated that 10-30% of children have at least one episode ofsleepwalking. However, only 1-5% meet the criteria for sleepwalking disorder.The disorder is most common in children eight to 12 years old. It is unusual forsleepwalking to occur for the first time in adults.Unlike sleepwalking, REM sleep behavior disorder occurs later in the night andthe patient can remember what they were dreaming. The physical activities ofthe patient are often violent.Sleep disorders related to other conditionsIn addition to the primary sleep disorders, there are three categories of sleepdisorders that are caused by or related to substance use or other physical ormental disorders.SLEEP DISORDERS RELATED TO MENTAL DISORDERS. Many mental disorders,especially depression or one of the anxiety disorders, can cause sleepdisturbances. Psychiatric disorders are the most common cause of chronicinsomnia.SLEEP DISORDERS DUE TO MEDICAL CONDITIONS. Some patients with chronicneurological conditions like Parkinsons disease or Huntingtons disease maydevelop sleep disorders. Sleep disorders have also been associated with viralencephalitis, brain disease, and hypo- or hyperthyroidism.SUBSTANCE-INDUCED SLEEP DISORDERS. The use of drugs, alcohol, andcaffeine frequently produces disturbances in sleep patterns. Alcohol abuse isassociated with insomnia. The person may initially feel sleepy after drinking,but wakes up or sleeps fitfully during the second half of the night. Alcohol canalso increase the severity of breathing-related sleep disorders. Withamphetamines or cocaine, the patient typically suffers from insomnia duringdrug use and hypersomnia during drug withdrawal. Opioids usually make short-term users sleepy. However, long-term users develop tolerance and may sufferfrom insomnia.In addition to alcohol and drugs that are abused, a variety of prescriptionmedications can affect sleep patterns. These medications includeantihistamines, corticosteroids, asthma medicines, and drugs that affect thecentral nervous system.Sleep disorders in children and adolescentsPediatricians estimate that 20-30% of children have difficulties with sleep thatare serious enough to disturb their families. Although sleepwalking and nightterror disorder occur more frequently in children than in adults, children can
also suffer from narcolepsy and sleep apnea syndrome.Causes and symptomsThe causes of sleep disorders have already been discussed with respect to theclassification of these disorders.The most important symptoms of sleep disorders are insomnia and sleepinessduring waking hours. Insomnia is by far the more common of the twosymptoms. It covers a number of different patterns of sleep disturbance. Thesepatterns include inability to fall asleep at bedtime, repeated awakening duringthe night, and/or inability to go back to sleep once awakened.DiagnosisDiagnosis of sleep disorders usually requires a psychological history as well as amedical history. With the exception of sleep apnea syndromes, physicalexaminations are not usually revealing. The patients sex and age are usefulstarting points in assessing the problem. The doctor may also talk to otherfamily members in order to obtain information about the patients symptoms.The familys observations are particularly important to evaluate sleepwalking,kicking in bed, snoring loudly, or other behaviors that the patient cannotremember.Sleep logsMany doctors ask patients to keep a sleep diary or sleep log for a minimum ofone to two weeks in order to evaluate the severity and characteristics of thesleep disturbance. The patient records medications taken as well as the lengthof time spent in bed, the quality of the sleep, and similar information. Somesleep logs are designed to indicate circadian sleep patterns as well as simpleduration or restfulness of sleep.Psychological testingThe doctor may use psychological tests or inventories to evaluate insomniabecause it is frequently associated with mood or affective disorders. TheMinnesota Multiphasic Personality Inventory (MMPI), the Millon ClinicalMultiaxial Inventory (MCMI), the Beck Depression Inventory, and the ZungDepression Scale are the tests most commonly used in evaluating thissymptom.SELF-REPORT TESTS. The Epworth Sleepiness Scale, a self-rating form recentlydeveloped in Australia, consists of eight questions used to assess daytimesleepiness. Scores range from 0-24, with scores higher than 16 indicating
severe daytime sleepiness.Laboratory studiesIf the doctor is considering breathing-related sleep disorders, myoclonus, ornarcolepsy as possible diagnoses, he or she may ask the patient to be tested ina sleep laboratory or at home with portable instruments.POLYSOMNOGRAPHY. Polysomnography can be used to help diagnose sleepdisorders as well as conduct research into sleep. In some cases the patient istested in a special sleep laboratory. The advantage of this testing is theavailability and expertise of trained technologists, but it is expensive. As of2001, however, portable equipment is available for home recording of certainspecific physiological functions.MULTIPLE SLEEP LATENCY TEST (MSLT). The multiple sleep latency test (MSLT)is frequently used to measure the severity of the patients daytime sleepiness.The test measures sleep latency (the speed with which the patient falls asleep)during a series of planned naps during the day. The test also measures theamount of REM sleep that occurs. Two or more episodes of REM sleep underthese conditions indicates narcolepsy. This test can also be used to helpdiagnose primary hypersomnia.REPEATED TEST OF SUSTAINED WAKEFULNESS (RTSW). The repeated test ofsustained wakefulness (RTSW) is a test that measures sleep latency bychallenging the patients ability to stay awake. In the RTSW, the patient isplaced in a quiet room with dim lighting and is asked to stay awake. As with theMSLT, the testing pattern is repeated at intervals during the day.TreatmentTreatment for a sleep disorder depends on what is causing the disorder. Forexample, if major depression is the cause of insomnia, then treatment of thedepression with antidepressants should resolve the insomnia.MedicationsSedative or hypnotic medications are generally recommended only forinsomnia related to a temporary stress (like surgery or grief) because of thepotential for addiction or overdose. Trazodone, a sedating antidepressant, isoften used for chronic insomnia that does not respond to other treatments.Sleep medications may also cause problems for elderly patients because ofpossible interactions with their other prescription medications. Among thesafer hypnotic agents are lorazepam, temazepam, and zolpidem. Chloralhydrate is often preferred for short-term treatment in elderly patients becauseof its mildness. Short-term treatment is recommended because this drug may
be habit forming.Narcolepsy is treated with stimulants such as dextroamphetamine sulfate ormethylphenidate. Nocturnal myoclonus has been successfully treated withclonazepam.Children with sleep terror disorder or sleepwalking are usually treated withbenzodiazepines because this type of medication suppresses stage 3 and stage4 NREM sleep.PsychotherapyPsychotherapy is recommended for patients with sleep disorders associatedwith other mental disorders. In many cases the patients scores on the Beck orZung inventories will suggest the appropriate direction of treatment.Sleep education"Sleep hygiene" or sleep education for sleep disorders often includesinstructing the patient in methods to enhance sleep. Patients are advised to: wait until he or she is sleepy before going to bed avoid using the bedroom for work, reading, or watching television get up at the same time every morning no matter how much or how little he or she slept avoid smoking and avoid drinking liquids with caffeine get some physical exercise early in the day every day limit fluid intake after dinner; in particular, avoid alcohol because it frequently causes interrupted sleep learn to meditate or practice relaxation techniques avoid tossing and turning in bed; instead, he or she should get up and listen to relaxing music or readLifestyle changesPatients with sleep apnea or hypopnea are encouraged to stop smoking, avoidalcohol or drugs of abuse, and lose weight in order to improve the stability ofthe upper airway.In some cases, patients with sleep disorders related to jet lag or shift work mayneed to change employment or travel patterns. Patients may need to avoidrapid changes in shifts at work.Children with nightmare disorder may benefit from limits on television ormovies. Violent scenes or frightening science fiction stories appear to influencethe frequency and intensity of childrens nightmares.SurgeryAlthough making a surgical opening into the windpipe (a tracheostomy) for
sleep apnea or hypopnea in adults is a treatment of last resort, it is occasionallyperformed if the patients disorder is life threatening and cannot be treated byother methods. In children and adolescents, surgical removal of the tonsils andadenoids is a fairly common and successful treatment for sleep apnea. Mostsleep apnea patients are treated with continuous positive airway pressure(CPAP). Sometimes an oral prosthesis is used for mild sleep apnea.Alternative treatmentSome alternative approaches may be effective in treating insomnia caused byanxiety or emotional stress. Meditation practice, breathing exercises, and yogacan break the vicious cycle of sleeplessness, worry about inability to sleep, andfurther sleeplessness for some people. Yoga can help some people to relaxmuscular tension in a direct fashion. The breathing exercises and meditationcan keep some patients from obsessing about sleep.Homeopathic practitioners recommend that people with chronic insomnia seea professional homeopath. They do, however, prescribe specific remedies forat-home treatment of temporary insomnia: Nux vomica for alcohol orsubstance-related insomnia, Ignatia for insomnia caused by grief, Arsenicumfor insomnia caused by fear or anxiety, and Passiflora for insomnia related tomental stress.Melatonin has also been used as an alternative treatment for sleep disorders.Melatonin is produced in the body by the pineal gland at the base of the brain.This substance is thought to be related to the bodys circadian rhythms.Key termsApnea — The temporary absence of breathing. Sleep apnea consists ofrepeated episodes of temporary suspension of breathing during sleep.Cataplexy — Sudden loss of muscle tone (often causing a person to fall),usually triggered by intense emotion. It is regarded as a diagnostic sign ofnarcolepsy.Circadian rhythm — Any body rhythm that recurs in 24-hour cycles. The sleep-wake cycle is an example of a circadian rhythm.Dyssomnia — A primary sleep disorder in which the patient suffers fromchanges in the quantity, quality, or timing of sleep.Electroencephalogram (EEG) — The record obtained by a device that measureselectrical impulses in the brain.
Hypersomnia — An abnormal increase of 25% or more in time spent sleeping.Patients usually have excessive daytime sleepiness.Hypnotic — A medication that makes a person sleep.Hypopnea — Shallow or excessively slow breathing usually caused by partialclosure of the upper airway during sleep, leading to disruption of sleep.Insomnia — Difficulty in falling asleep or remaining asleep.Jet lag — A temporary disruption of the bodys sleep-wake rhythm followinghigh-speed air travel across several time zones. Jet lag is most severe in peoplewho have crossed eight or more time zones in 24 hours.Kleine-Levin syndrome — A disorder that occurs primarily in young males,three or four times a year. The syndrome is marked by episodes ofhypersomnia, hypersexual behavior, and excessive eating.Narcolepsy — A life-long sleep disorder marked by four symptoms: suddenbrief sleep attacks, cataplexy, temporary paralysis, and hallucinations. Thehallucinations are associated with falling asleep or the transition from sleepingto waking.Nocturnal myoclonus — A disorder in which the patient is awakenedrepeatedly during the night by cramps or twitches in the calf muscles.Nocturnal myoclonus is sometimes called periodic limb movement disorder(PLMD).Non-rapid eye movement (NREM) sleep — A type of sleep that differs fromrapid eye movement (REM) sleep. The four stages of NREM sleep account for75-80% of total sleeping time.Parasomnia — A primary sleep disorder in which the persons physiology orbehaviors are affected by sleep, the sleep stage, or the transition from sleepingto waking.Pavor nocturnus — Another term for sleep terror disorder.Polysomnography — Laboratory measurement of a patients basicphysiological processes during sleep. Polysomnography usually measures eyemovement, brain waves, and muscular tension.Primary sleep disorder — A sleep disorder that cannot be attributed to amedical condition, another mental disorder, or prescription medications orother substances.
Rapid eye movement (REM) sleep — A phase of sleep during which thepersons eyes move rapidly beneath the lids. It accounts for 20-25% of sleeptime. Dreaming occurs during REM sleep.REM latency — After a person falls asleep, the amount of time it takes for thefirst onset of REM sleep.Restless legs syndrome (RLS) — A disorder in which the patient experiencescrawling, aching, or other disagreeable sensations in the calves that can berelieved by movement. RLS is a frequent cause of difficulty falling asleep atnight.Sedative — A medication given to calm agitated patients; sometimes used as asynonym for hypnotic.Sleep latency — The amount of time that it takes to fall asleep. Sleep latency ismeasured in minutes and is important in diagnosing depression.Somnambulism — Another term for sleepwalking.Practitioners of Chinese medicine usually treat insomnia as a symptom ofexcess yang energy. Cinnabar is recommended for chronic nightmares. Eithermagnetic magnetite or "dragon bones" is recommended for insomniaassociated with hysteria or fear. If the insomnia appears to be associated withexcess yang energy arising from the liver, the practitioner will give the patientoyster shells. Acupuncture treatments can help bring about balance andfacilitate sleep.Dietary changes like eliminating stimulant foods (coffee, cola, chocolate) andlate-night meals or snacks can be effective in treating some sleep disorders.Nutritional supplementation with magnesium, as well as botanical medicinesthat calm the nervous system, can also be helpful. Among the botanicalremedies that may be effective for sleep disorders are valerian (Valerianaofficinalis), passionflower (Passiflora incarnata), and skullcap (Scutellarialateriflora).PrognosisThe prognosis depends on the specific disorder. Children usually outgrow sleepdisorders. Patients with Kleine-Levin syndrome usually get better around age40. Narcolepsy is a life-long disorder. The prognosis for sleep disorders relatedto other conditions depends on successful treatment of the substance abuse,medical condition, or other mental disorder. The prognosis for primary sleepdisorders is affected by many things, including the patients age, sex,
occupation, personality characteristics, family circumstances, neighborhoodenvironment, and similar factors.ResourcesBooksMoe, Paul G., and Alan R. Seay. "Neurologic & Muscular Disorders: SleepDisorders." In Current Pediatric Diagnosis & Treatment, edited by William W.Hay Jr., et al. Stamford: Appleton & Lange, 1997.Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rightsreserved.disorder /dis·or·der/ (dis-or´der) a derangement or abnormality of function; amorbid physical or mental state.acute stress disorder an anxiety disorder characterized by development ofanxiety, dissociative, and other symptoms within one month followingexposure to an extremely traumatic event. If persistent, it may becomeposttraumatic stress disorder.adjustment disorder maladaptive reaction to identifiable stress (e.g., divorce,illness), which is assumed to remit when the stress ceases or when the patientadapts.affective disorders mood ds.amnestic disorders mental disorders characterized by acquired impairment inthe ability to learn and recall new information, sometimes accompanied byinability to recall previously learned information.anxiety disorders mental disorders in which anxiety and avoidance behaviorpredominate, i.e., panic disorder, agoraphobia, social phobia, specific phobia,obsessive-compulsive disorder, posttraumatic stress disorder, acute stressdisorder, generalized anxiety disorder, and substance-induced anxiety disorder.attention-deficit/hyperactivity disorder a controversial childhood mentaldisorder with onset before age seven, and characterized by inattention (e.g.,distractibility, forgetfulness, not appearing to listen), by hyperactivity andimpulsivity (e.g., restlessness, excessive running or climbing, excessive talking,and other disruptive behavior), or by a combination of both types of behavior.
autistic disorder autism; a severe pervasive developmental disorder withonset usually before three years of age and a biological basis; it is characterizedby qualitative impairment in reciprocal social interaction, verbal and nonverbalcommunication, and capacity for symbolic play, by restricted and unusualrepertoire of activities and interests, and often by cognitive impairment.behavior disorder conduct d.binge-eating disorder an eating disorder characterized by repeated episodesof binge eating, as in bulimia nervosa, but not followed by inappropriatecompensatory behavior such as purging, fasting, or excessive exercise.bipolar disorders mood disorders with a history of manic, mixed, orhypomanic episodes, usually with present or previous history of one or moremajor depressive episodes; included are bipolar I d., characterized by one ormore manic or mixed episodes, bipolar II d., characterized by one or morehypomanic episodes but no manic episodes, and cyclothymic disorder. Theterm is sometimes used in the singular to denote either bipolar I disorder,bipolar II disorder, or both.body dysmorphic disorder a somatoform disorder characterized by a normal-looking persons preoccupation with an imagined defect in appearance.breathing-related sleep disorder any of several disorders characterized bysleep disruption due to some sleep-related breathing problem, resulting inexcessive sleepiness or insomnia.brief psychotic disorder an episode of psychotic symptoms with sudden onset,lasting less than one month.catatonic disorder catatonia due to the physiological effects of a generalmedical condition and neither better accounted for by another mental disordernor occurring exclusively during delirium.character disorders personality ds.childhood disintegrative disorder pervasive developmental disordercharacterized by marked regression in various developmental skills, includinglanguage, play, and social and motor skills, after two to ten years of initialnormal development.circadian rhythm sleep disorder a lack of synchrony between the schedule ofsleeping and waking required by the external environment and that of apersons own circadian rhythm.
collagen disorder an inborn error of metabolism involving abnormal structureor metabolism of collagen, e.g., Marfan syndrome, cutis laxa. Cf. collagendisease.communication disorders mental disorders characterized by difficulties withspeech or language, severe enough to interfere academically, occupationally,or socially.conduct disorder a type of disruptive behavior disorder of childhood andadolescence marked by persistent violation of the rights of others or of age-appropriate societal norms or rules.conversion disorder a somatoform disorder characterized by conversionsymptoms (loss or alteration of voluntary motor or sensory functioningsuggesting physical illness) with no physiological basis and not producedintentionally or feigned; a psychological basis is suggested by exacerbation ofsymptoms during psychological stress, relief from tension (primary gain), orgain of outside support or attention (secondary gains).cyclothymic disorder a mood disorder characterized by alternating cycles ofhypomanic and depressive periods with symptoms like those of manic andmajor depressive episodes but of lesser severity.delusional disorder a mental disorder marked by well-organized, logicallyconsistent delusions of grandeur, persecution, or jealousy, with no otherpsychotic feature. There are six types: persecutory, jealous, erotomanic,somatic, grandiose, and mixed.depersonalization disorder a dissociative disorder characterized by intense,prolonged, or otherwise troubling feelings of detachment from ones body orthoughts, not secondary to another mental disorder.depressive disorders mood disorders in which depression is unaccompaniedby manic or hypomanic episodes.developmental coordination disorder problematic or delayed development ofgross and fine motor coordination skills, not due to a neurological disorder orto general mental retardation, resulting in the appearance of clumsiness.disruptive behavior disorders a group of mental disorders of children andadolescents consisting of behavior that violates social norms and is disruptive.dissociative disorders mental disorders characterized by sudden, temporaryalterations in identity, memory, or consciousness, segregating normallyintegrated parts of ones personality from ones dominant identity.
dissociative identity disorder a dissociative disorder characterized by theexistence in an individual of two or more distinct personalities, with at leasttwo of the personalities controlling the patients behavior in turns. The hostpersonality usually is totally unaware of the alternate personalities; alternatepersonalities may or may not have awareness of the others.dream anxiety disorder nightmare d.dysthymic disorder a mood disorder characterized by depressed feeling, lossof interest or pleasure in ones usual activities, and other symptoms typical ofdepression but tending to be longer in duration and less severe than in majordepressive disorder.eating disorder abnormal feeding habits associated with psychological factors,including anorexia nervosa, bulimia nervosa, pica, and rumination disorder.expressive language disorder a communication disorder occurring in childrenand characterized by problems with the expression of language, either oral orsigned.factitious disorder a mental disorder characterized by repeated, intentionalsimulation of physical or psychological signs and symptoms of illness for noapparent purpose other than obtaining treatment.factitious disorder by proxy a form of factitious disorder in which one person(usually a mother) intentionally fabricates or induces physical (Munchausensyndrome by proxy) or psychological disorders in another person under theircare (usually their child) and subjects that person to needless diagnosticprocedures or treatment, without any external incentives for the behavior.female orgasmic disorder consistently delayed or absent orgasm in a female,even after a normal phase of sexual excitement and adequate stimulation.female sexual arousal disorder a sexual dysfunction involving failure by afemale either to attain or maintain lubrication and swelling during sexualactivity, after adequate stimulation.functional disorder a disorder of physiological function having no knownorganic basis.gender identity disorder a disturbance of gender identification in which theaffected person has an overwhelming desire to change their anatomic sex orinsists that they are of the opposite sex, with persistent discomfort about theirassigned sex or about filling its usual gender role.
generalized anxiety disorder (GAD) an anxiety disorder characterized byexcessive, uncontrollable worry about two or more life circumstances for sixmonths or more.hypoactive sexual desire disorder a sexual dysfunction consisting ofpersistently or recurrently low level or absence of sexual fantasies and desirefor sexual activity.impulse control disorders a group of mental disorders characterized byrepeated failure to resist an impulse to perform some act harmful to oneself orto others.induced psychotic disorder shared psychotic d.intermittent explosive disorder an impulse control disorder characterized bymultiple discrete episodes of loss of control of aggressive impulses resulting inserious assault or destruction of property that are out of proportion to anyprecipitating stressors.learning disorders a group of disorders characterized by academic functioningthat is substantially below the level expected on the basis of the patients age,intelligence, and education.lymphoproliferative disorders a group of malignant neoplasms arising fromcells related to the common multipotential lymphoreticular cell, includinglymphocytic, histiocytic, and monocytic leukemias, multiple myeloma,plasmacytoma, and Hodgkins disease.lymphoreticular disorders a group of disorders of the lymphoreticular system,characterized by the proliferation of lymphocytes or lymphoid tissues.major depressive disorder a mood disorder characterized by the occurrenceof one or more major depressive episodes and the absence of any history ofmanic, mixed, or hypomanic episodes.male erectile disorder a sexual dysfunction involving failure by a male toattain or maintain an adequate erection until completion of sexual relations.male orgasmic disorder consistently delayed or absent orgasm in a male, evenafter a normal phase of sexual excitement and stimulation adequate for hisage.manic-depressive disorder former name for a mood disorder now known asbipolar I d. or bipolar II d. and often called bipolar d. (q.v.).mendelian disorder a genetic disease showing a mendelian pattern of
inheritance, caused by a single mutation in the structure of DNA, which causesa single basic defect with pathologic consequences.mental disorder any clinically significant behavioral or psychological syndromecharacterized by the presence of distressing symptoms, impairment offunctioning, or significantly increased risk of suffering death, pain, or otherdisability.minor depressive disorder a mood disorder closely resembling majordepressive disorder and dysthymic disorder but intermediate in severitybetween the two.mixed receptive-expressive language disorder a communication disorderinvolving both the expression and the comprehension of language, eitherspoken or signed.monogenic disorder mendelian d.mood disorders mental disorders characterized by disturbances of moodmanifested as one or more episodes of mania, hypomania, depression, orsome combination, the two main subcategories being bipolar disorders anddepressive disorders.motor skills disorder any disorder characterized by inadequate developmentof motor coordination severe enough to restrict locomotion or the ability toperform tasks, schoolwork, or other activities.multifactorial disorder one caused by the interaction of genetic andsometimes also nongenetic, environmental factors, e.g., diabetes mellitus.multiple personality disorder dissociative identity d.myeloproliferative disorders a group of usually neoplastic diseases possiblyrelated histogenetically, including granulocytic leukemias, myelomonocyticleukemias, polycythemia vera, and myelofibroerythroleukemia.neurotic disorder neurosis.nightmare disorder repeated episodes of nightmares that awaken the sleeper,with full orientation and alertness and vivid recall of the dreams.obsessive-compulsive disorder (OCD) an anxiety disorder characterized byrecurrent obsessions or compulsions, which are severe enough to interferesignificantly with personal or social functioning. Cf. obsessive-compulsivepersonality disorder, under personality .
obsessive-compulsive personality disorder see under personality.oppositional defiant disorder a type of disruptive behavior disordercharacterized by a recurrent pattern of defiant, hostile, disobedient, andnegativistic behavior directed toward those in authority.organic mental disorder a term formerly used to denote any mental disorderwith a specifically known or presumed organic etiology. It was sometimes usedsynonymously with organic mental syndrome.orgasmic disorders sexual dysfunctions characterized by inhibited orpremature orgasm; see female orgasmic d., male orgasmic d., and prematureejaculation.pain disorder a somatoform disorder characterized by a chief complaint ofsevere chronic pain which is neither feigned nor intentionally produced, but inwhich psychological factors appear to play a major role in onset, severity,exacerbation, or maintenance.panic disorder an anxiety disorder characterized by attacks of panic (anxiety),fear, or terror, by feelings of unreality, or by fears of dying, or losing control,together with somatic signs such as dyspnea, choking, palpitations, dizziness,vertigo, flushing or pallor, and sweating. It may occur with or, rarely, withoutagoraphobia.paranoid disorder older term for delusional d.personality disorders a category of mental disorders characterized byenduring, inflexible, and maladaptive personality traits that deviate markedlyfrom cultural expectations and either generate subjective distress orsignificantly impair functioning. For specific disorders, see under personality.pervasive developmental disorders disorders in which there is impaireddevelopment in multiple areas, including reciprocal social interactions, verbaland nonverbal communications, and imaginative activity, as in autisticdisorder.phagocytic dysfunction disorders a group of immunodeficiency conditionscharacterized by disordered phagocytic activity, occurring as both extrinsic andintrinsic types. Bacterial or fungal infections may range from mild skin infectionto fatal systemic infection.phobic disorders see phobia.phonological disorder a communication disorder characterized by failure to
use age- and dialect-appropriate sounds in speaking, with errors occurring inthe selection, production, or articulation of sounds.plasma cell disorders see under dyscrasia.postconcussional disorder see under syndrome.posttraumatic stress disorder (PTSD) an anxiety disorder caused by anintensely traumatic event, characterized by mentally reexperiencing thetrauma, avoidance of trauma-associated stimuli, numbing of emotionalresponsiveness, and hyperalertness and difficulty in sleeping, remembering, orconcentrating.premenstrual dysphoric disorder premenstrual syndrome viewed as apsychiatric disorder.psychoactive substance use disorders substance use ds.psychosomatic disorder one in which the physical symptoms are caused orexacerbated by psychological factors, as in migraine headaches, lower backpain, or irritable bowel syndrome.psychotic disorder psychosis.reactive attachment disorder a mental disorder of infancy or early childhoodcharacterized by notably unusual and developmentally inappropriate socialrelatedness, usually associated with grossly pathological care.rumination disorder excessive rumination of food by infants, after a period ofnormal eating habits, potentially leading to death by malnutrition.schizoaffective disorder a mental disorder in which symptoms of a mooddisorder occur along with prominent psychotic symptoms characteristic ofschizophrenia.schizophreniform disorder a mental disorder with the signs and symptoms ofschizophrenia but of less than six months duration.seasonal affective disorder (SAD) depression with fatigue, lethargy,oversleeping, overeating, and carbohydrate craving recurring cyclically duringspecific seasons, most commonly the winter months.separation anxiety disorder prolonged, developmentally inappropriate,excessive anxiety and distress in a child concerning removal from parents,home, or familiar surroundings.sexual disorders
1. any disorders involving sexual functioning, desire, or performance.2. specifically, any such disorder that is caused at least in part by psychologicalfactors; divided into sexual dysfunctions and paraphilias.sexual arousal disorders sexual dysfunctions characterized by alterations insexual arousal; see female sexual arousal d. and male erectile d.sexual aversion disorder feelings of repugnance for and active avoidance ofgenital sexual contact with a partner, causing substantial distress orinterpersonal difficulty.sexual desire disorders sexual dysfunctions characterized by alteration insexual desire; see hypoactive sexual desire d. and sexual aversion d.sexual pain disorders sexual dysfunctions characterized by pain associatedwith intercourse; it includes dyspareunia and vaginismus not due to a generalmedical condition.shared psychotic disorder a delusional system that develops in one or morepersons as a result of a close relationship with someone who already has apsychotic disorder with prominent delusions.sleep disorders chronic disorders involving sleep, either primary (dyssomnias,parasomnias) or secondary to factors including a general medical condition,mental disorder, or substance use.sleep terror disorder a sleep disorder of repeated episodes of pavornocturnus.sleepwalking disorder a sleep disorder of the parasomnia group, consisting ofrepeated episodes of somnambulism.social anxiety disorder social phobia.somatization disorder a somatoform disorder characterized by multiplesomatic complaints, including a combination of pain, gastrointestinal, sexual,and neurological symptoms, and not fully explainable by any known generalmedical condition or the direct effect of a substance, but not intentionallyfeigned or produced.somatoform disorders mental disorders characterized by symptomssuggesting physical disorders of psychogenic origin but not under voluntarycontrol, e.g., body dysmorphic disorder, conversion disorder, hypochondriasis,pain disorder, somatization disorder, and undifferentiated somatoformdisorder.
NREM AND REM SLEEP. Prior to the discovery and reporting of rapid eyemovements during sleep, it was thought that sleep was a single state of passiverecuperation in which the central nervous system was deactivated. Studiesconcerned with the measurement of central and autonomic activities duringsleep have led to its division into two types: non–rapid eye movement (NREM)sleep, also called orthodox or synchronized (S) sleep; and rapid eye movement(REM) sleep (so called because of the rapid eye movements during this stage),also called paradoxical or desynchronized (D) sleep.On the basis of electroencephalographic (EEG) criteria, NREM sleep issubdivided into four stages. Stage 1 is observed immediately after sleep beginsor after momentary arousals and is characterized by low-voltage, mixed-frequency EEG tracing, with predominantly theta-wave activity (four to sevenhertz, that is, cycles per second). Stage 2 is characterized by intermittent wavesof 12 to 16 hertz, known as sleep spindles.Stages 3 and 4 consist of relativelyhigh voltage EEG tracings with a predominance of delta wave activity (one totwo hertz).The EEG patterns of NREM sleep suggest that this is the kind of apparentlyrestful state that supports the recuperative functions assigned to sleep. NREMsleep is increased after physical activity and has a relatively high priority amonghumans in the recovery sleep following extended periods of wakefulness.Within 90 minutes after sleep begins, an adult progresses through all fourstages of NREM sleep and then proceeds into the first of a series of REMperiods of sleep. Brief cycles of about 10 to 30 minutes of REM sleep recurthroughout the night, alternating with various stages of NREM sleep. With eachcycle, NREM sleep decreases and REM sleep increases so that by the end of thenight most of the sleep is REM sleep, which is when dreams occur. Whileeveryone dreams every night, many do not remember dreaming; most peopleare aware, however, that they dream more just before rising.In addition to the rapid eye movements that can be observed through closedeyelids, REM sleep can be recognized by complete relaxation of the lower jaw.Convulsions, myocardial infarction, and cardiac arrhythmias are more likely tooccur during REM sleep. This is probably because of increased autonomicactivity, irregular pulse, and fluctuations in blood pressure, which are all typicalof REM sleep.PATTERNS OF SLEEP. Although the average adult spends approximately 25 percentof total accumulated sleep in REM sleep and 75 percent in NREM sleep, thecyclic changes vary with individuals. The pattern of sleep, in addition to theREM and NREM states, also includes the periods of sleep and wakefulness
within a 24-hour period.Factors affecting the total sleep pattern include age, state of physical health,psychological state, and certain drugs. Newborns follow a pattern of severalhours of sleep followed by a period of wakefulness. REM sleep occurs at theonset of sleep in infants; it rarely does in adults. As the child matures there isan increasing tendency toward longer periods of nocturnal sleep. Elderlypersons sometimes return to the shorter periods of sleep that are typical ofinfants.BENEFITS OF SLEEP. Sleep requirements vary greatly among individuals. Infantsusually require 16 to 20 hours of total sleep during a 24-hour period, and theamount decreases as the child matures. An adult usually requires 6 to 9 hoursof total sleep, and requirements continue to decrease with aging.Most theorists agree that sleep has value as a recuperative and adaptivefunction in the lives of humans. The relatively high metabolic needs ofmammals and birds to maintain a constant body temperature in a wide rangeof environmental temperatures suggests that the periodic decreases inmetabolic rate and body temperature that occur in NREM sleep allow forrecuperation and restitution of body tissues. For example, even though thefunction of stage 2 NREM sleep is not clear, approximately half of human sleeptime is spent in this stage. It is also theorized that REM sleep provides a periodof recuperation of mental activities and preparation for wakefulness. DuringREM sleep it is believed that there is increased metabolic activity in the brainso that during waking hours it is more receptive to new information and canassimilate it more easily.sleep apnea syndrome episodes of APNEA (cessation of breathing) occurring atthe transition from NREM to REM sleep, with repeated wakening and excessivedaytime sleepiness; it occurs most often in middle-aged, obese males and isthought to have several causes, one being collapse or obstruction of the airwaywith the inhibition of muscle tone that characterizes REM sleep. The conditionis arbitrarily defined as more than five cessations of airflow for at least 10seconds each per hour of sleep.sleep disorders chronic disorders involving sleep; primary sleep disorders areclassified as DYSSOMNIAS or PARASOMNIAS. Among the minor disorders areSLEEPWALKING, SLEEPTALKING, ENURESIS, BRUXISM (tooth grinding), and NIGHTMARES.
A. melatonine, helps you relax and go to sleepQ. I dont want to take sleeping pills but how do I fix this!? I havebeen sleeping on and off for a long time. I have taken sleeping pills oncebecause I really needed the sleep, but I have just been letting it happenbecause I dont want to become addicted to sleeping pills. My minddoesnt stop! I toss and turn, sleep an hour, lie awake another... Some wayto help this without medicine?! Please and thank you.A. There is Valerian (it can be strong)also Hops (a potpori) bag under yourpillow ,if it is hot or where your pain if you have it Liac is good to spray underthe covers ,I dont know if their is a law again yet Kava Kava (look for highKavalectones)is verty relaxing ,I figure if someone found out it can relax peopleit will be made illegal .With Valerian mix Hops and Peppermint leaves andflowers (Peppermint is for your stomach also) I worked when I was 16 for DrWu a very old Chinese Herbalogist he would travel to the patientshouse,because each person is differebnt with different needs . I do know yogais wonderful and it got my wifes figure b ack for her after babies ,manyHealthfood Stores have experts in Herbalogy and other things that will helpyou sleep ,but be it a pill from the Doc or the inocuous herbal tea try not to useevery night and if your Doc is worth (his or her ,I have 9 specialist ,therapistNPs I see and all are women and I have the best health care I ever hadQ. My grandma passed away a month ago and since then mygrandpa has been drinking himself to sleep every night I know it’s hisway of grieving, but I am very worried about him. Right now he doesn’tstop drinking because he doesn’t want to, but if this will go on for awhile, can’t it happen that when he will want to stop he won’t be able to?Is it at all possible to become an alcoholic at the age of 83? I mean arethere even rehabs for seniors?A. everyones grieving period is different,try getting all the family involved insupporting him to quit,get him out of the alot more,find him ahobby,something that will take his mind off things,get him to talk about hisfeelings,every little thing can help.Read more or ask a question about sleep disordersThis content is provided by iMedix and is subject to iMedix Terms. TheQuestions and Answers are not endorsed or recommended and are madeavailable by patients, not doctors.How to thank TFD for its existence? Tell a friend about us, add a link to this
page, add the site to iGoogle, or visit webmasters page for free fun content.Link to this page: <a href="http://medical-dictionary.thefreedictionary.com/sleep+disorders"Please bookmark with social media, your votes are noticed and appreciated:? Mentioned in ? References in periodicals archivedyssomnia parasomnia This is why it is so important to try and raiseinsomnia Primary sleep disorder awareness about sleep disorders so that more people can learn to diagnose the problem before it is too late. Information About Sleep Disorder by alleysmith / Health, general community What are the common sleep disorders Work at night ? Can Sleep Disorder Affect Your Mental Health? by Semul Johnson / Food/cooking/nutrition community Cleveland Clinics "Top 10 Medical Innovations" features a wide range of new techniques and therapies that are being developed to treat everything from deafness and Parkisons disease to pneumonia and sleep disorders. Whole-slide imaging a "Top 10" innovation by Medical Laboratory Observer More resultsMedical browser ? ? Full browsersleep 2 Sleep bruxism Sleep Deprivation Sleep disturbance