SLEEP WAKE DISORDER

 A sleep disorder, or somnipathy, is a medical disorder of the sleep patterns of a person or animal.
 Polysomnography is a test commonly ordered for some sleep disorders.

Polysomnography is a test commonly ordered for some sleep disorders:

1. insomnia disorder
2. hypersomnolence disorder,
3. narcolepsy
4. breathing-related sleep disorders
5. circadian rhythm sleep-wake disorders,
6. non–rapid eye movement (NREM) sleep arousal disorders
7. nightmare disorder
8. rapid eye movement (REM) sleep behavior disorder
9. restless legs syndrome
10. substance/ medication-induced sleep disorder.

These disorders are divided into two major categories:

1. Dyssomnias
 Involve difficulties in getting enough sleep, problems with sleeping when you want to
(not being able to fall asleep until 2 a.m. when you have a 9 a.m. class), and complaints
about the quality of sleep, such as not feeling refreshed even though you have slept the
whole night.
 Difficulty getting to sleep, remaining asleep, or of excessive sleepiness.
 Difficulty getting to sleep or staying asleep, intermittent wakefulness during the night,
early morning awakening, or combinations of any of these.
 Transient episodes are usually of little significance.
 Stress, caffeine, physical discomfort, daytime napping, and early bedtimes are common
factors.

Dyssomnias Description

• They have trouble falling asleep at night (difficulty initiating sleep), if they
Insomnia Disorder wake up frequently or too early and can’t go back to sleep (difficulty
maintaining sleep), or even if they sleep a reasonable number of hours but are
still not rested the next day (nonrestorative sleep).

• Hypersomnolence disorders involve

sleeping too much (hyper means “in great
Hypersomnolence amount” or “abnormal excess”).
Disorders
• sleep through the night and appear rested upon awakening but still
complain of being excessively.
 • sleep through the night and appear rested upon awakening but still complain
of being excessively tired throughout the day.

• Another sleep problem that can cause a similar excessive sleepiness is a

breathing-related sleep disorder called sleep apnea. People with this problem
have difficulty breathing at night. They often snore loudly, pause between
breaths, and wake in the morning with a dry mouth and headache.

• Daytime sleepiness, some people with narcolepsy experience cataplexy, a

sudden loss of muscle tone.

• Cataplexy occurs while the person is awake and can range from slight
Narcolepsy weakness in the facial muscles to complete physical collapse.

• it is usually preceded by strong emotion such as anger or happiness.

Imagine that while cheering for your favorite team, you suddenly fall asleep;
while arguing with a friend, you collapse to the floor in a sound sleep.

• People whose breathing is interrupted during their sleep often experience

numerous brief arousals throughout the night and do not feel rested even after
Breathing-Related 8 or 9 hours asleep.
Sleep
Disorders • muscles in the upper airway relax during sleep, constricting the passageway
somewhat and making breathing a little more difficult.

• When they stop breathing altogether (10 to 30 seconds), called sleep apnea.

• Disturbed sleep (either insomnia or excessive sleepiness during the day)

Circadian rhythm brought on by the brain’s inability to synchronize its sleep patterns with the
sleep–wake disorder current patterns of day and night.

2. Parasomnias
 Are characterized by abnormal behavioral or physiological events that occur during sleep,
such as nightmares and sleepwalking.
 Talk while sleeping
 Had troublesome nightmares
 Grind your teeth in your sleep
 It is not problem with sleep itself but abnormal events that occur either during sleep or
during that twilight time between sleeping and waking.
  not unusual if they happen while you are awake (e.g., walking to the kitchen to look into
the refrigerator) but can be distressing if they take place while you are sleeping.

Parasomni Description

Disorder of Arousal • Difficulty falling asleep at bedtime, problems

staying asleep throughout the night, or sleep
that does not result in the person feeling rested
even after normal amounts of sleep.

Rapid Eye Movement Sleep • Episodes of arousal during REM sleep that
Behavior Disorder result in behaviors that can cause harm to
the individual or others.

Substance-Induced Sleep Disorder • Severe sleep disturbance that is the result of

substance intoxication or withdrawal.

Etiology of Somnipathies

 all sleep disorders are a disruption or distortion of the normal cycle of slumber and daytime
wakefulness of the body.

Factors that can cause sleep problems include:

 Physical disturbances (for example, chronic pain from arthritis, headaches, fibromyalgia)
 Medical issues (for example, asthma)
 Psychiatric disorders (for example, depression and anxiety disorders)
 Environmental issues (for example, it's too bright, your partner snores)

Short-term or acute insomnia

 Caused by life stresses (such as job loss or change, death of a loved one, or moving), illness, or
environmental factors, such as light, noise, or extreme temperatures.

Long-term or chronic insomnia

 (Insomnia occurs at least three nights a week for at least three months) can be caused by factors
such as depression, chronic stress, and pain or discomfort at night.
Other factors that can interfere with sleep include:

 Genetics: Researchers have found a genetic basis for narcolepsy, a neurological disorder of sleep
regulation that affects the control of sleep and wakefulness.
 Night shift work: People who work at night often experience sleep disorders, because they
cannot sleep when they start to feel drowsy. Their activities run contrary to their biological
clocks.
 Medications: Many drugs can interfere with sleep, such as certain antidepressants, blood
pressure medication, and over-the-counter cold medicine.
 Aging: About half of all adults over the age of 65 have some sort of sleep disorder. It is not clear
if it is a normal part of aging or a result of medications that older people commonly use.

Treatments of Somnipathies
A number of biological and psychological interventions have been designed and
evaluated to help people regain the benefits of normal sleep:
1. Medical Treatments
People who complain of insomnia to a medical professional are likely prescribed one of
several benzodiazepine or related medications, which include short-acting drugs such as;
 triazolam (Halcion)
 zaleplon (Sonata), and
 zolpidem (Ambien) and
 long-acting drugs such as flurazepam (Dalmane).

2. Environmental Treatments
 One general principle for treating circadian rhythm disorders is that phase delays (moving
bedtime later) are easier than phase advances (moving bedtime earlier).
 People can best readjust their sleep patterns by going to bed several hours later each night
until bedtime is at the desired hour.
 Bright light (also referred to as phototherapy) may help people with circadian rhythm
problems readjust their sleep patterns.

3. Psychotherapy Treatments
 CBT can be more effective than sleeping pills—but without the unpleasant side effects or
long-term health concerns.
4.