Sunday, 27 January 2013

SLEEP DISORDER


Definition
Sleep disorders involve any difficulties related to sleeping, including difficulty falling or staying asleep, falling asleep at inappropriate times, excessive total sleep time, or abnormal behaviors associated with sleep.

Causes, incidence, and risk factors

More than 100 different disorders of sleeping and waking have been identified. They can be grouped in four main categories:
  • Problems with staying and falling asleep
  • Problems with staying awake
  • Problems with adhering to a regular sleep schedule
  • Sleep-disruptive behaviors
PROBLEMS WITH STAYING AND FALLING ASLEEP

Insomnia includes any combination of difficulty with falling asleep, staying asleep, intermittent wakefulness and early-morning awakening. Episodes may be transient, short term (lasting as long as 2 to 3 weeks), or chronic.
Common factors associated with insomnia include:
  • Physical illness
  • Depression
  • Anxiety
  • Stress
  • Poor sleeping environment (e.g., noise or too much light)
  • Caffeine
  • Abuse of alcohol or other drugs
  • Use of certain medications
  • Heavy smoking
  • Physical discomfort
  • Daytime napping
  • Counterproductive sleep habits:
    • Early bedtimes
    • Excessive time spent awake in bed
Disorders include:
  • Psychophysiological insomnia (learned insomnia)
  • Delayed sleep phase syndrome
  • Hypnotic dependent sleep disorder
  • Stimulant dependent sleep disorder
PROBLEMS WITH STAYING AWAKE
Disorders of excessive sleepiness are called hypersomnias. These include:
Sleep apnea more commonly affects obese people, but it may affect anyone with a short neck or a small jaw, regardless of weight. The disorder causes breathing to stop intermittently during sleep, resulting in the person being awakened repeatedly. People with sleep apnea often they have difficulty achieving prolonged deep sleep. This results in excessive daytime sleepiness.
Narcolepsy is a condition of daytime sleep attacks as well as other features that may include sleep paralysis and hypnagogic hallucinations. Sleep attacks occur despite adequate sleep at night. A person with narcolepsy may suddenly fall asleep in any situation, without warning.
Restless leg syndrome is a condition of periodic lower-leg movements during sleep with associated insomnia or daytime sleepiness.
PROBLEMS WITH ADHERING TO A REGULAR SLEEP SCHEDULE
Problems may also occur with maintaining a consistent sleep and wake schedule as a result of disruptions of normal times of sleeping and wakefulness. This occurs when traveling between times zones and with shift workers on rotating schedules, particularly nighttime workers.
These disorders include:
  • Sleep state misperception (the person actually sleeps a different amount than they think they do)
  • Shift work sleep disorder
  • Natural short sleeper (the person sleeps less hours than "normal" but suffers no ill effects)
  • Chronic time zone change syndrome
  • Irregular sleep-wake syndrome
SLEEP-DISRUPTIVE BEHAVIORS

Abnormal behaviors during sleep are called parasomnias and are fairly common in children. They include:
Sleep terror disorder is an abrupt awakening from sleep with fear, sweating, rapid heart rate, and confusion. Sleepwalking is usually not remembered by the person doing it and usually affects children 2 to 12 years old.
In adults, sleepwalking may also be caused by an organic brain syndrome, reactions to drugs, psychological disorders, and certain medical conditions.

Prevention
Maintaining regular sleep habits and a quiet sleep environment may prevent some sleep disorders.

Symptoms
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