Sleep 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 faliure, heart attacks, depressive symptoms.
Diagnosis: Polysomnogram
Upper Airway Resistance Syndrome
Signs and Symptoms: Heavy snoring and frequent brain arousals
Clinical: Increase daytime sleepiness, fatigue, and auto accidents
Diagnosis: Polysomnogram
Excessive Snoring
Signs and Symptoms: Heavy snoring
Clinical: Socially disruptive snoring resulting in poor sleep of bedfellows
Diagnosis: Polysomnogram to exclude sleep apnea
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 disfunctions
Diagnosis: Polysomnogram and Multiple Sleep Latency Test
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 disfunctions
Diagnosis: Polysomnogram and Multiple Sleep Latency Test
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 disfunctions
Diagnosis: Polysomnogram
Parasomnia
NREM
Definition: Intrusion of wakefulness behavior during non-REM (non-dream) sleep. (e.g. sleepwalking)
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
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 disfunction
Diagnosis: Sleep Diary
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 disfunction
Diagnosis: Clinical evaluation
Nocturnal Seizures
Definition: Seizure activity during sleep
Diagnosis: Extended polysomnogram
What are the indications for a sleep apnea study/polysomnography?
Excessive snoring associated with the following: 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
