Common Disorders

Side effects from sleep apneaSleep Apnea Syndrome
Signs and Symptoms: Heavy snoring and breath holding episodes during sleep.
Clinical: Can cause increase in daytime fatigue and sleepiness, auto accidents, high blood pressure, congestive heart failure, heart attacks, depressive symptoms, dementia.
Diagnosis: Polysomnogram (Sleep Study)
Treatment: CPAP, BiPAP, Mandibular Devices, rarely surgery

Upper Airway Resistance Syndrome
Signs and Symptoms: Heavy snoring and frequent brain arousals
Clinical: Can cause increased daytime sleepiness, fatigue, and auto accidents
Diagnosis: Polysomnogram
Treatment: CPAP

Excessive Snoring
Signs and Symptoms: Heavy snoring
Clinical: Socially disruptive snoring resulting in poor sleep of bedfellows
Diagnosis: Polysomnogram to exclude sleep apnea
Treatment: varies

Idiopathic Hypersomnia
Definition: Excessive daytime sleepiness despite enough sleep time on regular basis
Clinical: Can cause increase in motor vehicle accidents, social, school, and job dysfunctions
Diagnosis: Polysomnogram and Multiple Sleep Latency Test
Treatment: Counseling, Medications

Narcolepsy
Definition: Excessive sleepiness and fatigue with or without sleep paralysis, sleep hallucinations, and episodes of sudden muscle weakness
Clinical: Can cause increase in motor vehicle accidents, social, school, and job dysfunctions
Diagnosis: Polysomnogram and Multiple Sleep Latency Test
Treatment: counseling, medications

Periodic Limb Movement
Definition: Sleep disruptions caused by increase in nocturnal muscle activity in arms and legs causing increase in daytime fatigue and inappropriate sleepiness
Clinical: Can cause increase in motor vehicle accidents, social, school, and job dysfunctions
Diagnosis: Polysomnogram
Treatment: counseling, medications, other devices

Parasomnia
NREM
Definition:
Intrusion of wakefulness behavior during non-REM (non-dream) sleep. (e.g. sleepwalking, sleep eating)
Treatment: avoiding triggers, counseling, treatment

REM Sleep behavior disorder
Definition: Acting out dreams during REM (dream) sleep
Clinical: Parasomnia can result in injury during sleep to self and/or others
Diagnosis: Polysomnogram
Treatment: counseling, medications

Sleep-Wake Cycle Disorders
Definition: Unusual sleep cycles not conforming to regular night sleep cycle
Clinical: Can result in inappropriate sleepiness during morning hours or late afternoon hours. e.g. night-owls, early-birds, shiftworkers. May result in social, school and job dysfunction
Diagnosis: Sleep Diary
Treatment: counseling, light therapy, medications

Disorders of Initiating and Mantaining Sleep (Insomnia)
Definition: Inability to obtain a refreshing good night sleep on regular basis due to various causes including psychiatric and non-psychiatric problems
Clinical: Can cause increase in daytime fatigue and poor vigilance resulting in social and job dysfunction
Diagnosis: Clinical evaluation
Treatment: Cognitive behavioral therapy, sleep hygiene, rarely medications

Nocturnal Seizures
Definition: Seizure activity during sleep
Diagnosis: Extended polysomnogram
Treatment by neurologist

What are the indications for a sleep apnea study/polysomnography?

  • Excessive snoring associated with the following: excessive daytime sleepiness, restless sleep, mental confusion and morning headaches, hypertension, strokes, congestive heart failure, cardiac arrhythmias, chronic fatigue, or obesity
  • Breath holding and choking during sleep
  • Parasomnia
  • Insomnia (with excessive daytime sleepiness)
  • Excessive daytime sleepiness/fatigue
  • Excessive leg movements during sleep/restless legs
  • In children, symptoms of upper airway obstruction, drop in school grades/Attention Deficit Disorder/restless sleep
  • Narcolepsy evaluation
  • Abnormal sleep behaviors