American Journal of Medicine, internal medicine, medicine, health, healthy lifestyles, cancer, heart disease, drugs

Sleep Disorders

Sleep disorders are frequent and can have serious consequences on patients’ health and quality of life. While some sleep disorders are more challenging to treat, most can be easily managed with adequate interventions. We review the main diagnostic features of 6 major sleep disorders (insomnia, circadian rhythm disorders, sleep-disordered breathing, hypersomnia/narcolepsy, parasomnias, and restless legs syndrome/periodic limb movement disorder) to aid medical practitioners in screening and treating sleep disorders as part of clinical practice.

Sleep is a universal function of living species, comprising one-third of human life. Poor or insufficient sleep has been associated with a wide variety of dysfunction in most body systems, including endocrine,1 metabolic,2 higher cortical function,3 and neurological disorders. Disorders of sleep can manifest as complaints of either insufficient sleep, excessive amount of perceived sleep, or abnormal movements during sleep. This review article focuses on the most commonly seen sleep disorders in neurological practice (Table).

Major Sleep Disorders

Insomnia

More than one-third of adults experience transient insomnia at some point in their lives. In about 40% of cases, insomnia can develop into a more chronic and persistent condition.4 The diagnosis of insomnia is made when the patient reports dissatisfaction with sleep (sleep-onset or sleep-maintenance insomnia) as well as other daytime symptoms (eg, sleepiness, impaired attention, mood disturbances) for at least 3 nights per week and last for more than 3 months.4 Although several insomnia subtypes have been delineated (eg, idiopathic, psychophysiological, and paradoxical), diagnosis and treatment is similar.

The precise pathophysiological mechanisms underlying insomnia have not been identified yet, but some neurobiological and psychological models have been proposed. Contributing factors include behavioral, cognitive, emotional, and genetic factors.5 These are often conceptually classified into predisposing, precipitating, and perpetuating factors.6

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– Milena K. Pavlova, MD, Véronique Latreille, PhD

-This article originally appeared in the March issue of The American Journal of Medicine.

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