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What are Sleep Disorders?

Patients with sleep disorders not only associate their problems or complaints with sleep but also with wakefullness.

The most common conditions are sleep related breathing problems; they include obstructive and central sleep apnea. According to recent literature more than 80 million people suffer from sleep apnea in the United States. The prevalence of sleep apnea in general population is 4 % in adult males and approximately 2 % in adult females. Most commonly, patients with sleep apnea wake up gasping for air or choking.

The incidence of sleep apnea in children is expected to be approximately 3-4% amongst the pediatric population.

In adults restless or fragmented sleep, fatigue and feeling tired in the morning are the tell tale signs of sleep apnea.

There is a high association between sleep apnea and obesity, hypertension and cardiac diseases including coronary artery disease, congestive heart failure or stroke. More than half of the patients with acute myocardial infarction or stroke are found to have some form of sleep apnea or other sleep, lung or breathing problems in sleep, often these problems are initially seen in sleep or are worse during sleep.

The Breath and Lung Institute at HackensackUMC provides a wide array of diagnostic and treatment options for various lung conditions like asthma, emphysema, and chronic bronchitis, which are likely to be associated with sleep disorders.

Sleep Disorders are briefly classified as follows;

  • Sleep Related Breathing Disorders:The disorders in this subgroup are characterized by disordered respiration during sleep. Central sleep apnea syndromes include those in which respiratory effort is diminished or absent in an intermittent or cyclic fashion due to central nervous system or cardiac dysfunction. The obstructive sleep apnea syndromes include those in which there is an obstruction in the airway resulting in continued breathing effort but inadequate ventilation. The other disorders in this group include; Sleep Related Hypoventilation syndromes due to alveolar hypoventilation or other medical conditions like pulmonary parenchymal or vascular pathology.
  • Hypersomnia of Central Origin Not due to Circadian Rhythm Sleep Disorders, Sleep Related Breathing Disorder, or Other Cause of Disturbed Nocturnal Sleep: These groups of disorders have the primary complaint of daytime sleepiness. Daytime sleepiness is defined as the inability to stay awake and alert during the major waking episodes of the day, resulting in unintended lapses into drowsiness or sleep. These include the following disorders: Narcolepsy with or without cataplexy, Hypersomnias (Recurrent, Idiopathic, or due to medical conditions or drug abuse and physiological)
  • Insomnia: This includes a group of sleep disorders all of which have in common the complaint of insomnia, which is defined by a repeated difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate time and opportunity of sleep and results in some form of daytime impairments including but not limited to Fatigue, Attention, Memory or concentration impairment, social or vocational dysfunction, mood disturbances, daytime sleepiness etc.
  • Circadian Rhythm Sleep Disorders: The general criteria for this type of disorders are: A. Persistent or recurrent pattern of sleep disturbances due to primarily to one of the following; i) Alterations of the circadian timekeeping system, ii) Misalignment between endogenous circadian rhythm and exogenous factors that affect the timing or duration of sleep. B. The circadian related sleep disruption leads to insomnia, excessive daytime sleepiness or both. C. The sleep disturbance is associated with impairment of social, occupational, or other areas or functioning. This group include the following disorders: Delayed Sleep Phase Disorder, Advanced Sleep Phase Type Disorder, Irregular Sleep-Wake Rhythm, Jet Lag Type Disorder, Shift Work Disorder, or due to other Medical Conditions or Substance Abuse.
  • Parasomnias:  These are undesirable physical events or experiences that occur during entry into sleep, within sleep, or during arousals from sleep. Parasomnia behaviors are disconnected from conscious awareness and are devoid of sound judgment- with or without associated dreaming. The core categories of parasomnias are: Confusional Arousals, Sleep Walking, Sleep Terrors, REM Sleep Behavior Disorder, Nightmare Disorders, Sleep Enuresis, Sleep Related Groaning or Catathrenia, Sleep Related Eating Disorder/Hallucinations and exploding head syndrome.
  • Sleep Related Movement Disorders:  Sleep related movement disorders are conditions that are primarily characterized by relatively simple, usually stereotyped, movements that disturb sleep or by other sleep related monophasic movement disorders such as sleep related leg cramps. This group includes the following condition: Restless Leg Syndrome, Periodic Leg Movement Disorder, Sleep Related Leg Cramps, Sleep Related Bruxism, Sleep Related Rhythmic Movement Disorder, Some of them is due other medical conditions or substance abuse.

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