A sleep disorder (somnipathy) is a disorder in the sleep patterns of a person or animal. Some sleep disorders can interfere with mental and emotional function.

Common sleep disorders

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The most common sleep disorders include:

• Bruxism: The sufferer involuntarily grinds his or her teeth while sleeping
• Delayed sleep phase syndrome (DSPS): a sleep disorder of circadian rhythm
• Hypopnea syndrome
• Insomnia: While not considered a sleep disorder in its own right, Insomnia is characterized by the inability to fall asleep and/or remain asleep for a reasonable amount of time.
• Jet lag or desynchronosis: Temporary condition resulting in out of sync sleep patterns as a result of rapidly travelling across multiple time zones
• Narcolepsy: The condition of falling asleep spontaneously and unwillingly
• Night terror or Pavor nocturnus or sleep terror disorder: abrupt awakening from sleep with behavior consistent with terror
• Parasomnias: Include a variety of disruptive sleep-related events
• Periodic limb movement disorder (PLMD): Involuntary movement of arms and/or legs during sleep. See also Hypnic jerk, which is not a disorder.
• Rapid eye movement behavior disorder (RBD): Acting out violent or dramatic dreams while in REM sleep
• Restless legs syndrome (RLS): An irresistible urge to move legs while sleeping. Often accompanies PLMD.
• Shift work sleep disorder (SWSD)
• Sleep apnea: The obstruction of the airway during sleep
• Sleep paralysis: Conscious paralysis upon waking or falling asleep
• Sleepwalking or somnambulism: Engaging in activities that are normally associated with wakefulness (such as eating or dressing), which may include walking, without the conscious knowledge of the subject
• Snoring: Loud breathing patterns while sleeping, sometimes accompanying sleep apnea

Broad classifications of sleep disorders

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• Dysomnias - A broad category of sleep disorders characterized by either hypersomnolence or insomnia. The three major subcategories include intrinsic (i.e., arising from within the body), extrinsic (secondary to environmental conditions or various pathologic conditions), and disturbances of circadian rhythm. MeSH
  • Insomnia
  • Narcolepsy
  • Obstructive Sleep Apnea
  • Restless Leg Syndrome
  • Periodic limb movement disorder
  • Hypersomnia
    • Recurrent Hypersomnia - including Kleine-Levin Syndrome
    • Posttraumatic Hypersomnia
    • "Healthy" Hypersomnia
  • Circadian rhythm sleep disorders
    • Delayed sleep phase syndrome
    • Advanced sleep phase syndrome
    • Non-24-hour sleep-wake syndrome
• Parasomnias
  • REM Sleep Behaviour Disorder
  • Sleep Terror
  • Sleepwalking (or Somnambulism)
  • Tooth-grinding
  • Bedwetting or sleep enuresis.
  • Sudden infant death syndrome (or SIDS)
  • Sleep talking (or Somniloquy)

More on [ Sleep disorder ]

UPHS - Penn Sleep Centers Newsletter

Asleep at the Wheel?
Truck drivers who routinely get too little sleep or suffer from sleep apnea show signs of fatigue and impaired performance that can make them a hazard on the road, according to a major new study by Penn Sleep Centers researchers. The study results, entitled “Impaired Performance in Commercial Drivers: Role of Sleep Apnea and Short Sleep Duration,” were published in the August 15th issue of the American Journal of Respiratory and Critical Care Medicine.
Sleep Apnea and Heart Disease
Along with the epidemic of obesity, the incidence of sleep apnea has risen at an alarming rate. The most common form, known as obstructive sleep apnea (OSA), is caused by extra tissue in the upper airway that collapses and literally blocks the airflow to the lungs. The risk factors for OSA include male sex (women’s risk increases after menopause), obesity, and neck size greater than 17 inches. The symptoms of sleep apnea include fatigue, early morning headaches, snoring, falling asleep during the daytime, depression and witnessed episodes of irregular breathing while sleeping.
Cognitive-Behavioral Treatment of Insomnia
Insomnia is the most prevalent sleep disorder, representing one of the most common complaints reported to doctors by their patients. In an effort to provide non-pharmacologic treatment options for insomnia, research and clinical practice have focused on developing cognitive- behavior treatments as an alternative.
Do Flies and Worms Sleep?
Can you tell if a fly is asleep? This is precisely the question asked seven years ago by Dr. Joan Hendricks, who is now the Dean of the School of Veterinary Medicine at the University of Pennsylvania. In collaboration with Dr. Amita Sehgal and Dr. Allan Pack of the Penn Center for Sleep and Respiratory Neurobiology (CSRN), Dr. Hendricks wanted to determine if the fruit fly Drosophila melanogaster, an animal used since the early 1900s for genetic studies in biology, has a sleeplike state much as we do. But unlike human studies, where one can measure brain electrical activity to distinguish sleep from the waking state, one cannot easily measure fly brain waves. Instead, Dr. Hendricks used behavioral measures.
Advice for Sleepy Students
Each fall, Grace Pien, MD in the University of Pennsylvania Division of Sleep Medicine sees teenagers being brought into her office by parents. The teens complain about difficulty falling asleep at night. After several follow-up questions, Pien often determines that these patients suffer from a sleep disorder called delayed sleep phase syndrome (DSPS) - when the body's circadian rhythm delays the urge to sleep until much later than what is considered to be a normal bedtime.
New Headquarters for Penn Sleep
In April of this year, the practices and sleep laboratory facilities of the Penn Sleep Centers at the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center were merged into a single new site at 3624 Market St. which serves as headquarters for the Penn Sleep Centers. This newly renovated facility provides pleasant and spacious areas for both patients and staff.

Journal SLEEP Articles

Melantonin for the Treatment of Advanced Sleep Phase Disorder
LETTER TO THE EDITOR - Melantonin for the Treatment of Advanced Sleep Phase Disorder
Response to Zee, P., Melantonin for the Treatment of Advanced Sleep Phase Disorder. SLEEP 2008;31:923.
LETTER TO THE EDITOR - RESPONSE - Response to Zee, P., Melantonin for the Treatment of Advanced Sleep Phase Disorder. SLEEP 2008;31:923.
Sleep Deprivation of Rats: The Hyperphagic Response Is Real
Study Objectives: Chronic sleep deprivation of rats causes hyperphagia without body weight gain. Sleep deprivation hyperphagia is prompted by changes in pathways governing food intake; hyperphagia may be adaptive to sleep deprivation hypermetabolism. A recent paper suggested that sleep deprivation might inhibit ability of rats to increase food intake and that hyperphagia may be an artifact of uncorrected chow spillage. To resolve this, a palatable liquid diet (Ensure) was used where spillage is insignificant. Design: Sleep deprivation of male Sprague Dawley rats was enforced for 10 days by the flowerpot/platform paradigm. Daily food intake and body weight were measured. On day 10, rats were transcardially perfused for analysis of hypothalamic mRNA expression of the orexigen, neuropeptide Y (NPY). Setting: Morgan State University, sleep deprivation and transcardial perfusion; University of Maryland, NPY in situ hybridization and analysis. Measurements and Results: Using a liquid diet for accurate daily measurements, there was no change in food intake in the first 5 days of sleep deprivation. Importantly, from days 6-10 it increased significantly, peaking at 29% above baseline. Control rats steadily gained weight but sleep-deprived rats did not. Hypothalamic NPY mRNA levels were positively correlated to stimulation of food intake and negatively correlated with changes in body weight. Conclusion: Sleep deprivation hyperphagia may not be apparent over the short term (i.e., ≤5 days), but when extended beyond 6 days, it is readily observed. The timing of changes in body weight and food intake suggests that the negative energy balance induced by sleep deprivation prompts the neural changes that evoke hyperphagia.
Entropy-based Measures of EEG Arousals as Biomarkers for Sleep Dynamics: Applications to Hypertension
Study Objectives: We propose a generation of PSG-derived measures that using entropy can quantify temporal patterns of sleep, and investigate the role of these measures as predictors of hypertension. We also investigate the influence of age on these entropy-based measures as compared to traditional indices. Design and Setting: Cross-sectional analyses of the association between hypertension status with traditional PSG and novel measures using adjusted and unadjusted logistic regression models. The novel measures were developed to quantify variability of the arousal event process. Patients or Participants: Analyses were based on a subsample of subjects from the Cleveland Family Study with clearly disparate hypertension status. Measurements and Results: Among traditional PSG indices, the apnea hypopnea index (AHI) has the highest Odds Ratio (unadjusted and adjusted for age, gender, race, BMI: OR = 2.36 (95% CI: 1.48, 3.75, P = 0.0003) and 1.18, (95% CI: 0.76, 1.84, P = 0.46), respectively). The best predictor among the entropy-based measures is derived from analysis of the temporal patterns of arousal duration with unadjusted and adjusted ORs of 1.36 (95% CI: 1.08, 1.71, P = 0.0085) and 2.08 (95% CI: 1.19, 3.64, P = 0.01), respectively. Conclusions: Our findings suggest that when adjusted for common confounders such as age, gender, race, and BMI, the entropy-based features that quantify the variability of the arousal event process are more strongly associated with hypertension as compared to traditional PSG indices; they are not as strongly influenced by age as are the traditional indices. The result implies that the regularity of arousals may be an important feature associated with hypertension. These measures may provide a powerful tool for discriminating individuals at risk for comorbidities, such as hypertension, associated with sleep disturbances.
Multicenter Case-Control Study on Restless Legs Syndrome in Multiple Sclerosis: the REMS Study
Study objectives: To verify the existence of a symptomatic form of restless legs syndrome (RLS) secondary to multiple sclerosis (MS) and to identify possible associated risk factors. Design: Prospective, multicenter, case-control epidemiologic survey. Settings: Twenty sleep centers certified by the Italian Association of Sleep Medicine. Patients: Eight hundred and sixty-one patients affected by MS and 649 control subjects. Interventions: N/A. Measures and results: Data regarding demographic and clinical factors, presence and severity of RLS, the results of hematologic tests, and visual analysis of cerebrospinal magnetic resonance imaging studies were collected. The prevalence of RLS was 19% in MS and 4.2% in control subjects, with a risk to be affected by RLS of 5.4 (95%confidence interval: 3.56-8.26) times greater for patients with MS than for control subjects. In patients with MS, the following risk factors for RLS were significant: older age; longer MS duration; the primary progressive MS form; higher global, pyramidal, and sensory disability; and the presence of leg jerks before sleep onset. Patients with MS and RLS more often had sleep complaints and a higher intake of hypnotic medications than patients with MS without RLS. RLS associated with MS was more severe than that of control subjects. Conclusions: RLS is significantly associated with MS, especially in patients with severe pyramidal and sensory disability. These results strengthen the idea that the inflammatory damage correlated with MS may induce a secondary form of RLS. As it does in idiopathic cases, RLS has a significant impact on sleep quality in patients with MS; therefore, it should be always searched for, particularly in the presence of insomnia unresponsive to treatment with common hypnotic drugs.
Orthodontic Expansion Treatment and Adenotonsillectomy in the Treatment of Obstructive Sleep Apnea in Prepubertal Children
Study objective: Rapid maxillary expansion and adenotonsillectomy are proven treatments of obstructive sleep apnea (OSA) in children. Our goal was to investigate whether rapid maxillary expansion should be offered as an alternative to surgery in select patients. In addition, if both therapies are required, the order in which to perform these interventions needs to be determined. Design: Prepubertal children with moderate OSA clinically judged to require both adenotonsillectomy and orthodontic treatment were randomized into 2 treatment groups. Group 1 underwent adenotonsillectomy followed by orthodontic expansion. Group 2 underwent therapies in the reverse sequence. Subjects: Thirty-two children (16 girls) in an academic sleep clinic. Method: Clinical evaluation and polysomnography were performed after each stage to assess efficacy of each treatment modality. Results: The 2 groups were similar in age, symptoms, apnea-hypopnea index, and lowest oxygen saturation. Two children with orthodontic treatment first did not require subsequent adenotonsillectomy. Thirty children underwent both treatments. Two of them were still symptomatic and presented with abnormal polysomogram results following both therapies. In the remaining 28 children, all results were significantly different from those at entry (P = 0.001) and from single therapy (P = 0.01), regardless of the order of treatment. Both therapies were necessary to obtain complete resolution of OSA. Conclusion: In our study, 87.5% of the children with sleep-disordered breathing had both treatments. In terms of treatment order, 2 of 16 children underwent orthodontic treatment alone, whereas no children underwent surgery alone to resolve OSA. Two children who underwent both treatments continued to have OSA.

Sleep and Breathing

American Academy of Dental Sleep Medicine Continuing Education Offerings
Fri, 11 Jul 2008 07:20:01 -0000
American Academy of Dental Sleep Medicine Continuing Education Offerings Content Type Journal ArticleCategory CMEDOI 10.1007/s11325-008-0204-8 Journal Sleep and BreathingOnline ISSN 1522-1709Print ISSN 1520-9512 Journal Volume Volume 12 Journal Issue Volume 12, Number 3 / August, 2008
European Academy of Dental Sleep Medicine EADSM
Fri, 11 Jul 2008 07:19:49 -0000
European Academy of Dental Sleep Medicine EADSM Content Type Journal ArticleCategory Society NewsDOI 10.1007/s11325-008-0203-9 Journal Sleep and BreathingOnline ISSN 1522-1709Print ISSN 1520-9512 Journal Volume Volume 12 Journal Issue Volume 12, Number 3 / August, 2008
Lower extremity edema and pulmonary hypertension in morbidly obese patients with obstructive sleep apnea
Thu, 10 Jul 2008 07:25:02 -0000
Abstract Introduction  In 70 consecutive male patients with obstructive sleep apnea (OSA) diagnosed at the Northport VA Medical Center Sleep Disorders Center, we have characterized the association between obesity, OSA, and pulmonary hypertension (PH). Materials and methods  By including anthropometric, pulmonary function, and sleep study parameters in a multivariate logistic regression model, we found that a BMI of >40 kg/m2 and the minimum oxygen saturation in non-rapid eye movement (NREM) sleep predicted the presence of pretibial edema in this sleep apnea population. We then characterized the hemodynamics of those OSA patients that had lower extremity edema. Twenty-nine of the 70 consecutive patients with sleep apnea (41%) had pretibial edema, and right heart catheterization data was obtained for 28 (97%) of these patients. Results and discussion  Ninety-three percent (26/28) of the patients had right heart failure (mean RAP > 5 mm Hg; RAP range = 0–32 mmHg) and PH (PA mean ≥ 20 mm Hg) was present in 86% (24/28.) The OSA patients with lower extremity edema had an increased cardiac output (7.0 + 1.4 l/min) with a normal cardiac index (2.9 + 0.5 l/min/m2) in the setting of an elevated pulmonary capillary wedge pressure (PCWP 17 ± 7 mmHg) and a normal pulmonary vascular resistance (122 + 70 dynes s cm−5). While PCWP, FEV1% predicted, and the minimum oxygen saturation in NREM sleep all independently predicted PH, PCWP was the most important predictor of PH. Conclusion  We conclude that pulmonary hypertension is commonly seen in patients with OSA with pretibial edema and that pretibial edema is a highly specific sign of PH in OSA patients. Pulmonary hypertension appears to result from an elevated back pressure and diastolic dysfunction with contributions from lung function and nocturnal oxygen saturation. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11325-008-0200-zAuthors Daniel J. O’Hearn, Oregon Health & Science University Department of Medicine, Portland VA Medical Center P3-PULM P.O. Box 1034 Portland OR 97239 USAAvram R. Gold, Northport VA Medical Center (NY) Department of Medicine Northport NY USAMorris S. Gold, Novartis Consumer Health Summit NJ USAPaul Diggs, Northport VA Medical Center (NY) Department of Medicine Northport NY USASteven M. Scharf, University of Maryland Department of Medicine Baltimore MD USA Journal Sleep and BreathingOnline ISSN 1522-1709Print ISSN 1520-9512

PubMed: 1389-9457

Adaptive servo-ventilation in patients with coexisting obstructive sleep apnoea/hypopnoea and Cheyne-Stokes respiration.
Randerath WJ, Galetke W, Stieglitz S, Laumanns C, Schäfer T Related Articles Adaptive servo-ventilation in patients with coexisting obstructive sleep apnoea/hypopnoea and Cheyne-Stokes respiration. Sleep Med. 2008 Jul 18; Authors: Randerath WJ, Galetke W, Stieglitz S, Laumanns C, Schäfer T OBJECTIVE: The coexistence of obstructive (OSAS) and central sleep apnoea (CSA) and Cheyne-Stokes respiration (CSR) is common in patients with and without underlying heart diseases. CPAP has been shown to improve CSA/CSR by about 50%, but recent data suggest maximal suppression of CSA is important in improving clinical outcomes in heart failure patients. Adaptive servo-ventilation (ASV) effectively suppresses CSA/CSR in heart failure, but only few trials have considered patients with coexisting OSAS and CSA/CSR. METHODS: Prospective, observational pilot study to evaluate the efficacy of a new ASV device, the BiPAP AutoSV, in 10 male consecutive patients with coexisting OSAS and CSA/CSR with and without heart failure over eight weeks. Six had stable heart failure. MEASUREMENTS AND RESULTS: The total AHI improved from 48.9+/-20.6/h to 8.7+/-7.4, the obstructive AHI from 15.8+/-16.2/h to 2.6+/-2.5/h and the central AHI from 33.1+/-10.8/h to 6.1+/-5.9/h (all p<0.01). Furthermore, there was a significant improvement in sleep profile and respiratory related arousals. The six patients with cardiovascular disease, including three with congestive heart failure, showed similar improvements in all parameters. CONCLUSIONS: BiPAP AutoSV was effective in reducing all types of respiratory disturbances in coexisting OSAS and CSA/CSR with and without heart failure. Further studies comparing the long-term clinical efficacy of this device against CPAP are warranted. PMID: 18640873 [PubMed - as supplied by publisher]
Excessive daytime sleepiness in sleep apnea: It is not just apnea hypopnea index.
Vgontzas AN Related Articles Excessive daytime sleepiness in sleep apnea: It is not just apnea hypopnea index. Sleep Med. 2008 Jul 18; Authors: Vgontzas AN PMID: 18640872 [PubMed - as supplied by publisher]

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