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Sleep patterns in the young and aged

Irregular sleep

Sleep disorders

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 falling and staying asleep
  • Problems with staying awake
  • Problems with adhering to a regular sleep schedule
  • Sleep-disruptive behaviors

PROBLEMS WITH FALLING AND STAYING ASLEEP

Insomnia includes any combination of difficulty with falling asleep, staying asleep, intermittent wakefulness and early-morning awakening. Episodes may be transient (come and go), short-term (lasting as long as 2 to 3 weeks), or chronic (long-lasting).

Common factors associated with insomnia include:

  • Physical illness
  • Depression
  • Anxiety or stress
  • Poor sleeping environment such as excessive noise or light
  • Caffeine
  • 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 -- where a patient's internal clock is constantly out of synch with the "accepted" day / night phases; for example, patients feel best if they can sleep from 4AM to noon
  • Hypnotic-dependent sleep disorder -- insomnia resulting from building tolerance to, or stopping, certain types of sleep medications
  • Stimulant-dependent sleep disorder -- insomnia resulting depending on, or stopping, certain types of stimulants

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 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 (hallucinations that happen at the time between wakefullness and sleep). Sleep attacks occur despite adequat

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Sleep disorders in the elderly (1 image) (Doctor-Reviewed information)
Sleep disorders in the elderly involve any disruptive pattern of sleep such as problems with falling or staying asleep, excessive sleep, or abnormal behaviors associated with sleep. Reviewer: Updated by: A.D.A.M. Editorial Team: Greg Juhn, M.T.P.W., David R. Eltz, Kelli A. Stacy. Previously reviewed by Sandra W. Cohen, M.D. Private Practice specializing in geriatrics, Brooklyn, NY. Review provided by VeriMed Healthcare Network. (June 2006)Date: 03/22/2007

Sleep apnea (1 image) Average Rating: (Doctor-Reviewed information)
Sleep apnea is a condition characterized by episodes of stopped breathing during sleep. See also: Sleep disorders Reviewer: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary, Critical Care & Sleep Medicine, Mount Sinai School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.Date: 08/07/2006

Irregular sleep-wake syndrome (1 image) (Doctor-Reviewed information)
Irregular sleep-wake syndrome involves different and disorganized periods of sleeping and wakeful behavior. Reviewer: Paul Ballas, D.O., Department of Psychiatry, Thomas Jefferson University Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network.Date: 05/19/2006

Insomnia concerns (1 image) (Doctor-Reviewed information)
Reviewer: Paul Ballas, D.O., Department of Psychiatry, Thomas Jefferson University Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network.Date: 12/22/2006

Sleeping difficulty (1 image) (Doctor-Reviewed information)
Sleeping problems, called insomnia, can take several forms: Difficulty falling asleep when you first go to bed at night; Waking up too early in the morning; Waking up frequently throughout the night. All types of insomnia can lead to daytime drowsiness, poor concentration, and the inability to feel refreshed and rested in the morning. Reviewer: Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.Date: 03/22/2007

Aging changes in sleep (1 image) (Doctor-Reviewed information)
Reviewer: Sandra W. Cohen, M.D. Private Practice specializing in geriatrics, Brooklyn, NY. Review provided by VeriMed Healthcare Network.Date: 08/22/2006

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Reviewer: Paul Ballas, D.O., Department of Psychiatry, Thomas Jefferson University Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network.Date: 12/22/2006

Sleep walking (Doctor-Reviewed information)
Sleep walking is a disorder that occurs when a person walks or does another activity while they are still asleep. Reviewer: Allen J. Blaivas, D.O., Pulmonary, Critical Care, and Sleep Medicine, Department of Veteran Affairs, VA System, East Orange, NJ. Review provided by VeriMed Healthcare Network.Date: 06/04/2007

Central sleep apnea (Doctor-Reviewed information)
Central sleep apnea is when you stop breathing during sleep. It is caused by problems with how the brain controls breathing. This is not the more common obstructive sleep apnea, which is caused by obesity or other problems and involves loud snoring. Reviewer: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary, Critical Care & Sleep Medicine, Mount Sinai School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.Date: 11/13/2006

Narcolepsy (1 image) (Doctor-Reviewed information)
Narcolepsy is a sleep disorder that causes uncontrollable sleepiness and frequent daytime sleeping. Reviewer: Kenneth Gross, M.D., Neurology, North Miami, FL. Review provided by VeriMed Healthcare Network.Date: 09/07/2006

Isolated sleep paralysis (1 image) (Doctor-Reviewed information)
Isolated sleep paralysis is a type of paralysis associated with a sleep disorder. Sleep paralysis is the inability to perform voluntary muscle movements during sleep. Though it may be associated with narcolepsy, it occurs in many people who do not have narcolepsy. See: Narcolepsy Reviewer: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary, Critical Care & Sleep Medicine, Mount Sinai School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.Date: 08/03/2007

Night terror (Doctor-Reviewed information)
Night terrors are a sleep disorder in which a person quickly awakens from sleep in a terrified state. Reviewer: Allen J. Blaivas, D.O., Pulmonary, Critical Care, and Sleep Medicine, Department of Veteran Affairs, VA System, East Orange, NJ. Review provided by VeriMed Healthcare Network.Date: 06/04/2007

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