Association of Sleep Disorders

Nieto FJ, Young TB, Link BK, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. JAMA 2000 283 1829-1836. 

Baldwin CM, Griffith KA, Nieto FJ, O Connor GT, Walsleben JA, Redline S. The association of sleep-disordered breathing and sleep symptoms with quality of life in the Sleep Heart Health Study. Sleep 2001 24(1) 96-105. 

The association of sleep disorders with other clinical fields such as cardiology, neurology, mood and attention disorders, and pneumology is well recognized. Sleep deprivation is a medical issue, but also a social one. As a consequence, we have seen a number of societal and regulatory changes to ensure that appropriate sleep time is available. 

In 1968, Allan Rechtschaffen and Anthony Kales standardized the criteria for the different stages of sleep in their Rechtschaffen and Kales (R K) system. In 1975, Dement founded the Association of Sleep Disorders Centers, which later became the American Academy of Sleep Medicine. The association developed a diagnostic nomenclature of sleep disorders in 1979, which was revised in 1990. In 2007, the association published The AASM Manual for the Scoring of Sleep and Associated Events Rules, Terminology, and Technical Specifications, a revision of the R K system. 

Peppard P, Young T, Palta M, et al. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000 342 1378-1384. 

International Classification of Sleep Disorders Diagnostic and Coding Manual (1990). Rochester, MN American Sleep Disorders Association. 

Sleep disorders are common, and are generally underdiagnosed. The two major complaints related to sleep are insomnia ( I can t sleep ) and excessive daytime sleepiness (EDS, I can t stay awake ). EDS is a relatively nonspecific symptom. It can be the end result of any factor that causes sleep disruption, and it can be caused by primary or intrinsic sleep disorders. Insomnia of any cause can result in sleep deprivation and subsequent EDS. The most common cause of EDS in the general population is self-imposed sleep deprivation, or insufficient sleep syndrome. By contrast, the most common causes of EDS seen in a sleep center are primary (intrinsic) disorders of EDS. The American Academy of Sleep Medicine (AASM, formerly the American Sleep Disorders Association) classification of sleep disorders includes over 80 diagnoses that are associated with EDS, but the majority of patients evaluated at sleep centers have sleep apnea, narcolepsy, idiopathic hypersomnia, or periodic limb movements of sleep. 

Undoubtedly, there is growing evidence for an association between disturbed sleep and impaired adolescent functioning however, more attention needs to be directed toward identifying possible causal paths and possible strategies for intervention. Furthermore, clinicians need to become more aware of the potential role of sleep disorders when evaluating children with neurobehavioral deficits. 

Zammit, G.K. Delayed sleep phase syndrome and related conditions. In Pressman MR, Orr WC, eds. Understanding Sleep The Evaluation and Treatment of Sleep Disorders. Washington, DC American Psychological Association (APA), 1997. 

The question arises whether the association of sleep duration with mortality hazard could be an artifact of comorbidities, since so many diseases, disorders, and discomforts are associated with disturbed sleep. In our prior analysis of CPSII, we controlled as far as possible for the major risk factor data available from the CPSII questionnaires, to see if such extensive control for comorbidities would eliminate the significant associations of mortality hazard with sleep duration. 

Diagnostic Classification Steering Committee (1990) International classification of sleep disorders. Diagnostic and coding manual. American Sleep Disorders Association, Rochester... 

Melatonin [73-31-4] C 2H N202 (31) has marked effects on circadian rhythm (11). Novel ligands for melatonin receptors such as (32) (12), C2yH2gN202, have affinities in the range of 10 Af, and have potential use as therapeutic agents in the treatment of the sleep disorders associated with jet lag. Such agents may also be usehil in the treatment of seasonal affective disorder (SAD), the depression associated with the winter months. Histamine (see Histamine and histamine antagonists), adenosine (see Nucleic acids), and neuropeptides such as corticotropin-like intermediate lobe peptide (CLIP) and vasoactive intestinal polypeptide (VIP) have also been reported to have sedative—hypnotic activities (7). 

The adverse reactions most often associated with the administration of the COMT inhibitors include disorientation, confusion, light-headedness, dizziness, dyskinesias, hyperkinesias, nausea, vomiting, hallucinations, and fever. Other adverse reactions are orthostatic hypotension, sleep disorders, excessive dreaming, somnolence, and muscle cramps. A serious and possibly fatal adverse reaction that can occur with the administration of tolcapone is liver failure... 

Associate Professor University of Iowa College of Pharmacy Iowa City, Iowa Chapter 38 Sleep Disorders... 

---