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 sticking 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 come and go (be transient), last as long as 2 to 3 weeks (be short-term), or be long-lasting (chronic).
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 that occurs when you stop or become tolerant to certain types of sleep medications
Stimulant-dependent sleep disorder -- insomnia that occurs when you stop or become dependent on certain types of stimulants
Problems may also occur when you do not maintain a consistent sleep and wake schedule. This occurs when traveling between times zones and with shift workers on rotating schedules, particularly nighttime workers.
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: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. Date: 01/23/2009
Obstructive sleep apnea (1 image)
Average Rating:
(Doctor-Reviewed information)
Obstructive sleep apnea is a condition in which a person has episodes of stopped breathing during sleep. See also: Central sleep apnea; Sleep disorders. Reviewer: Allen J. Blaivas, DO, Pulmonary, Critical Care, and Sleep Medicine, Department of Veteran Affairs, VA New Jersey Health Care System, East Orange , NJ . Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 09/11/2008
Irregular sleep-wake syndrome (1 image)(Doctor-Reviewed information)
Irregular sleep-wake syndrome involves different and disorganized periods of sleeping and wakeful behavior. Reviewer: Allen J. Blaivas, DO, Pulmonary, Critical Care, and Sleep Medicine, Department of Veteran Affairs, VA System, East Orange, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 04/25/2008
Insomnia concerns (1 image)(Doctor-Reviewed information)
Insomnia is difficulty falling or staying asleep. In many cases, it can be relieved with a few simple behavioral changes or medication. Talk with your health care provider if you have any of the following symptoms: Difficulty falling asleep; Excessive sleepiness during the day; History of falling asleep during the day at inappropriate times; Nightmares or disturbing thoughts that keep you awake; Pain, frequent urination, or unusual sensations that keep you awake; Significant trouble getting out of bed in the morning; Sleep that does not refresh you; Waking up several times throughout the night; Waking up early in the morning. Here are some simple tips to get a better night's sleep: If possible, go to bed and wake up at the same time each day. Avoid performing activities such as eating and working in your bed. Avoid strenuous activity 2 hours before going to bed. Avoid caffeinated and alcoholic beverages in the evening. Avoid eating heavy meals at least 2 hours before going to sleep. Develop a bedtime routine that includes calming, relaxing activities. Make sure your sleep environment is quiet, dark, and is at a comfortable temperature. Do something relaxing just before bedtime (such as reading or taking a bath) so that you don't dwell on worrisome issues. Watching TV or using a computer may be stimulating to some people and disturb their ability to fall asleep. If you can't fall asleep within 30 minutes, get up and move to another room and engage in a quiet activity until you feel sleepy. One method of preventing worries from keeping you awake is to keep a journal before going to bed. List all issues that worry you. By this method you transfer your worries from your thoughts to paper, leaving your mind quieter and more ready to fall asleep. See also: Sleep disorders HOW MUCH SLEEP IS ENOUGH? While 7 - 8 hours a night is recommended for most people, children and teenagers need more. Older people tend to do fine with less sleep at night, but still require approximately 8 hours of sleep over a 24-hour period. The quality of sleep is as important as how much sleep you get. See also: Sleep disorders; Sleep disorders in the elderly. Reviewer: Allen J. Blaivas, DO, Pulmonary, Critical Care, and Sleep Medicine, Department of Veteran Affairs, VA System, East Orange, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 04/25/2008
Sleeping difficulty (1 image)(Doctor-Reviewed information)
Sleeping difficulty, called insomnia, can involve difficulty falling asleep when you first go to bed at night, waking up too early in the morning, and waking up often during the night. Reviewer: Christos Ballas, M.D., Attending Psychiatrist, Hospital of the University of Pennsylvania, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed byDavid Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 02/06/2008
Aging changes in sleep (1 image)(Doctor-Reviewed information)
Sleep occurs in multiple stages. The sleep cycle includes dreamless periods of light and deep sleep, with occasional periods of active dreaming (REM sleep. The sleep cycle is repeated several times during the night. AGING CHANGES With aging, sleep patterns tend to change. Most people find that aging causes them to have a harder time falling asleep, and that they awaken more often. Total sleep time remains the same or is slightly decreased (6.5 to 7 hours per night. It may be harder to fall asleep. The transition between being asleep and awake is often abrupt, giving older people the feeling of being more of a "light sleeper" than when they were younger. Less time is spent in deep, dreamless sleep. Older people average three or four awakenings each night, with increased recall of being awake. Awakenings are related to less time spent in deep sleep, and to factors such as the need to get up to urinate (nocturia), anxiety, and discomfort or pain associated with chronic illnesses. EFFECT OF CHANGES Sleeping difficulty is an annoying problem, but it is seldom dangerous. Because sleep is lighter and awakenings more frequent, older people may feel deprived of sleep even when total sleep time has not changed. Sleep deprivation can eventually cause confusion and other mental changes. It is treatable, and symptoms should lessen when adequate sleep is obtained. Sleep problems are also a common symptom of depression, so you should be evaluated and treated for depression if it might be causing the sleep problem. COMMON PROBLEMS Insomnia is one of the more common sleep problems for the elderly; Other sleep disorders, such as narcolepsy or hypersomnia, can also occur; Sleep apnea, where the breathing stops for a time during sleep, can cause severe problems. PREVENTION The elderly respond differently to medications than do younger adults, so it is VERY important to consult with a health care provider before taking medications for sleep. Avoid sleep medications if at all possible. Medications for depression, on the other hand, can be very helpful if depression contributes to the cause of the sleep problem. Most antidepressants do not produce the problems associated with sleeping medications. Sometimes a mild antihistamine is more effective than an actual sleeping pill for relieving short-term insomnia, but even non-prescription drugs can have side effects. Sleeping medications (such as benzodiazepines) should be used only as recommended, and only for a short time. Some can lead to dependence (needing to take the drug to function) or addiction (compulsive use despite adverse consequences) in some cases. Some build up in your body, and toxic effects can develop if you take them for a long time. Confusion, delirium, falls, and other side effects can develop. You can take measures to promote sleep: A light bedtime snack may be helpful. Many people find that warm milk increases sleepiness, because it contains a natural, sedative-like amino acid; Avoid stimulants such as caffeine (found in coffee, tea, cola drinks, and so on) for at least 3 or 4 hours before bed; Do not take naps during the day; Exercise (moderately) in the afternoon; Try to go to bed at the same time every night and wake at the same time each morning; Use the bed only for sleep or sexual activity. If you can't fall asleep after 20 minutes, get out of bed and do a quiet activity such as reading or listening to music. When you feel sleepy, get back in bed and try again. If not successful in 20 minutes, repeat. Drinking alcohol at bedtime may make you sleepy, but it is best to avoid it, because alcohol increases awakenings later in the night. RELATED TOPICS Aging changes in the nervous system; Insomnia. Reviewer: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine.Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 08/10/2008
Insomnia concerns (1 image)(Doctor-Reviewed information)
Insomnia is difficulty falling or staying asleep. In many cases, it can be relieved with a few simple behavioral changes or medication. Talk with your health care provider if you have any of the following symptoms: Difficulty falling asleep; Excessive sleepiness during the day; History of falling asleep during the day at inappropriate times; Nightmares or disturbing thoughts that keep you awake; Pain, frequent urination, or unusual sensations that keep you awake; Significant trouble getting out of bed in the morning; Sleep that does not refresh you; Waking up several times throughout the night; Waking up early in the morning. Here are some simple tips to get a better night's sleep: If possible, go to bed and wake up at the same time each day. Avoid performing activities such as eating and working in your bed. Avoid strenuous activity 2 hours before going to bed. Avoid caffeinated and alcoholic beverages in the evening. Avoid eating heavy meals at least 2 hours before going to sleep. Develop a bedtime routine that includes calming, relaxing activities. Make sure your sleep environment is quiet, dark, and is at a comfortable temperature. Do something relaxing just before bedtime (such as reading or taking a bath) so that you don't dwell on worrisome issues. Watching TV or using a computer may be stimulating to some people and disturb their ability to fall asleep. If you can't fall asleep within 30 minutes, get up and move to another room and engage in a quiet activity until you feel sleepy. One method of preventing worries from keeping you awake is to keep a journal before going to bed. List all issues that worry you. By this method you transfer your worries from your thoughts to paper, leaving your mind quieter and more ready to fall asleep. See also: Sleep disorders HOW MUCH SLEEP IS ENOUGH? While 7 - 8 hours a night is recommended for most people, children and teenagers need more. Older people tend to do fine with less sleep at night, but still require approximately 8 hours of sleep over a 24-hour period. The quality of sleep is as important as how much sleep you get. See also: Sleep disorders; Sleep disorders in the elderly. Reviewer: Allen J. Blaivas, DO, Pulmonary, Critical Care, and Sleep Medicine, Department of Veteran Affairs, VA System, East Orange, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 04/25/2008
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 repeatedly stop breathing during sleep because the brain temporarily stops sending signals to the muscles that control breathing. See also: Obstructive sleep apnea; Sleep disorders. Reviewer: Allen J. Blaivas, DO, Pulmonary, Critical Care, and Sleep Medicine, Department of Veteran Affairs, VA New Jersey Health Care System, East Orange , NJ . Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 09/11/2008
Narcolepsy (1 image)(Doctor-Reviewed information)
Narcolepsy is a sleep disorder that causes excessive sleepiness and frequent daytime sleep attacks. Reviewer: Luc Jasmin, MD, PhD, Department of Neurosurgery and Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 09/09/2008
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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