Overview of Sleep Disorders

The sleep disorders fall into four main categories (1) insomnia, (2) hypersomnia, (3) parasomnias, and (4) sleep schedule disorders. Insomnia is the most common sleep problem. It is simply defined as poor sleep and can be manifested by difficulty falling asleep, difficulty staying asleep, waking up too early, or waking up in the morning without feeling refreshed. 

Hypersomnia is the opposite of insomnia it is excessive sleepiness. This can be dangerous when driving or operating heavy equipment. It can be a hindrance in school or at work and additionally can be a source of great embarrassment. In reality, it can be difficult to distinguish a patient who is suffering from hypersomnia from one who is suffering from insomnia. This may seem odd, but in fact the most 

The final category is termed the sleep-wake schedule disorders. These are seen in people who get their days and nights turned around. The most common examples are shift workers and travelers with jet lag. Additionally, in the elderly, especially those with dementia, a malfunction in the circadian biological rhythm that regulates sleep can leave them awake and alert at night but drowsy and sleeping during the day. 

Although we are focusing on the primary sleep disorders, sleep disturbance quite often occurs as a symptom of another illness. Depression, anxiety, and substance abuse can impair the quality of sleep, though in the setting of chronic insomnia, other psychiatric disorders account for less than 50% of cases. Nightmares are a frequent complication of post-traumatic stress disorder (PTSD), and pain, endocrine conditions, and a host of medical illnesses can produce sleep problems. Thus, when discussing insomnia or hypersomnia, we are well advised to remember that these can be either a symptom of a psychiatric syndrome, a medical illness, or a sleep disorder. 

In this chapter, we will not attempt to provide an exhaustive description of every sleep disorder. Medication therapy plays a minimal role in the treatment of many sleep disorders. In fact, we contend that medication, apart from being an integral component of a comprehensive multimodal treatment program, is seldom an effective treatment for any sleep problem with the possible exception of acute insomnia due to an identifiable and short-lived stressor. Nevertheless, medications do play a part in the treatment of some sleep disorders. 

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Overview of Sleep Disorders. Talk About Sleep. Available online at http //www.talkaboutsleep.com/sleep-disorders. 

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