Sleep disorder: Difference between revisions

Latest revision as of 07:04, 18 November 2025

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A sleep disorder, or somnipathy, is a medical disorder that disrupts an individual's sleep patterns and quality. This can cause serious health issues and affect physical, mental, and emotional well-being.^[1] Polysomnography and actigraphy are tests commonly ordered for diagnosing sleep disorders.

Sleep disorders are broadly classified into dyssomnias, parasomnias, circadian rhythm sleep disorders, and other disorders (including those caused by medical or psychological conditions). When a person struggles to fall or stay asleep without an obvious cause, it is referred to as insomnia,^[2] which is the most common sleep disorder.^[3] Other sleep disorders include sleep apnea, narcolepsy, hypersomnia (excessive sleepiness at inappropriate times), sleeping sickness (disruption of the sleep cycle due to infection), sleepwalking, and night terrors.

Sleep disruptions can be caused by various issues, including teeth grinding (bruxism) and night terrors. Managing sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on addressing the underlying condition.^[4]

Sleep disorders are common in both children and adults. However, there is a significant lack of awareness about sleep disorders in children, with many cases remaining unidentified.^[5] Several common factors involved in the onset of a sleep disorder include increased medication use, age-related changes in circadian rhythms, environmental changes, lifestyle changes,^[6] existing physiological problems, and stress. Among the elderly, the risk of developing sleep-disordered breathing, periodic limb movements, restless legs syndrome, REM sleep behavior disorders, insomnia, and circadian rhythm disturbances is especially high.^[6]

Causes

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Centers for Disease Control and Prevention (CDC) recommendations for the amount of sleep needed decrease with age.^[7] While sleep quantity is important, good sleep quality is also essential to avoid sleep disorders.^[7]

A systematic review found that traumatic childhood experiences, such as family conflict or sexual trauma, significantly increase the risk of several sleep disorders in adulthood, including sleep apnea, narcolepsy, and insomnia.^[8]

An evidence-based synopsis suggests that idiopathic REM sleep behavior disorder may have a hereditary component. A total of 632 participants, half with idiopathic REM sleep behavior disorder and half without, completed self-report questionnaires. The study results suggest that people with the sleep disorder are more likely to report having a first-degree relative with the same sleep disorder than people of the same age and sex who do not have the disorder.^[9] More research is needed to further understand the hereditary basis of sleep disorders.

A population susceptible to the development of sleep disorders includes people who have experienced a traumatic brain injury. Due to the significant research focus on this issue, a systematic review was conducted to synthesize the findings. The results indicate that individuals who have experienced a traumatic brain injury are disproportionately at risk of developing narcolepsy, obstructive sleep apnea, excessive daytime sleepiness, and insomnia.^[10]

Obstructive sleep apnea is a common condition affecting 10-20% of middle-aged and older adults, characterized by repeated breathing pauses during sleep, leading to poor sleep quality, and excessive daytime somnolence and, sometimes insomnia.^[11] Common factors include obesity, narrow airways, and certain neuromuscular conditions that cause airway collapse during sleep.^[12]

Sleep disorders and neurodegenerative diseases

Neurodegenerative diseases are often associated with sleep disorders,^[13]^[14] particularly when characterized by the abnormal accumulation of alpha-synuclein, as seen in multiple system atrophy (MSA), Parkinson's disease (PD),^[15]^[16] and Lewy body disease (LBD).^[17]^[18] For example, individuals diagnosed with PD frequently experience various sleep issues, such as insomnia (affecting approximately 70% of the PD population), hypersomnia (over 50%), and REM sleep behavior disorder (RBD) (around 40%), which is linked to increased motor symptoms.^[15]^[14] Moreover, RBD has been identified as a significant precursor to the future development of these neurodegenerative diseases over several years, presenting a promising opportunity for improving treatments.^[13]^[14]

Neurodegenerative conditions are commonly related to structural brain impairments, which may disrupt sleep and wakefulness, circadian rhythm, and motor or non-motor functioning.^[13]^[14] Conversely, sleep disturbances are often linked to worsening of patients' cognitive functioning, emotional state, and quality of life.^[14]^[18] Additionally, these abnormal behavioral symptoms can place a significant burden on patients' relatives and caregivers.^[14]^[18] The limited research in this area, coupled with increasing life expectancy, highlights the need for a deeper understanding of the relationship between sleep disorders and neurodegenerative diseases.^[13]^[19]

Sleep disturbances and Alzheimer's disease

Sleep disturbances have also been observed in Alzheimer's disease (AD), affecting about 45% of the affected population.^[13]^[14] When based on caregiver reports, this percentage increases to about 70%.^[19] As in the PD population, insomnia and hypersomnia are frequently recognized in AD patients. These disturbances have been associated with the accumulation of beta-amyloid, circadian rhythm sleep disorders (CRSD), and melatonin alterations.^[13]^[14] Additionally, changes in sleep architecture are observed in AD.^[13]^[14]^[17] Although sleep architecture seems to naturally change with age, its development appears aggravated in AD patients. Slow-wave sleep (SWS) potentially decreases (and is sometimes absent), sleep spindles and the length of time spent in REM sleep are also reduced, while REM latency increases.^[19] Poor sleep onset in AD has been associated with dream-related hallucinations, increased restlessness, wandering, and agitation related to sundowning—a typical chronobiological phenomenon in the disease.^[14]^[19]

In Alzheimer's disease, in addition to cognitive decline and memory impairment, there are also significant sleep disturbances with modified sleep architecture.^[20]^[21] These disturbances may consist of sleep fragmentation, reduced sleep duration, insomnia, increased daytime napping, decreased quantity of some sleep stages, and a growing resemblance between some sleep stages (N1 and N2).^[21] More than 65% of people with Alzheimer's disease experience this type of sleep disturbance.^[21]

One factor that could explain this change in sleep architecture is a disruption in the circadian rhythm, which regulates sleep.^[21] This disruption can lead to sleep disturbances.^[21] Some studies show that people with Alzheimer's disease have a delayed circadian rhythm, whereas in normal aging, an advanced circadian rhythm is present.^[21]^[22]

In addition to these psychological symptoms, there are two main neurological features of Alzheimer's disease.^[20]^[21] The first is the accumulation of beta-amyloid waste, forming aggregate "plaques".^[21]^[20] The second is the accumulation of tau protein.^[21]^[20]

It has been shown that the sleep-wake cycle influences the beta-amyloid burden, a central component found in Alzheimer's disease (AD).^[21]^[20] As individuals awaken, the production of beta-amyloid protein becomes more consistent compared to its production during sleep.^[21]^[20]^[23] This phenomenon can be explained by two factors. First, metabolic activity is higher during waking hours, resulting in greater secretion of beta-amyloid protein.^[21]^[20] Second, oxidative stress increases during waking hours, which leads to greater beta-amyloid production.^[21]^[20]

On the other hand, it is during sleep that beta-amyloid residues are degraded to prevent plaque formation.^[21]^[20]^[23] The glymphatic system is responsible for this through the phenomenon of glymphatic clearance.^[21]^[20]^[23] Thus, during wakefulness, the beta-amyloid burden is greater because metabolic activity and oxidative stress are higher, and there is no protein degradation by glymphatic clearance. During sleep, the burden is reduced as there is less metabolic activity and oxidative stress, in addition to the glymphatic clearance that occurs.^[20]^[21]

Glymphatic clearance occurs during NREM SWS sleep,^[21]^[20]^[23] a stage that decreases with normal aging,^[20] leading to reduced glymphatic clearance and increased beta-amyloid burden, which forms plaques.^[23]^[21]^[20] Therefore, sleep disturbances in individuals with Alzheimer's disease may exacerbate this phenomenon.

The decrease in the quantity and quality of NREM SWS, along with sleep disturbances, will therefore increase the Aβ plaques.^[21]^[20] This initially occurs in the hippocampus, a brain structure integral to long-term memory formation.^[21]^[20] As hippocampal cell death occurs, it contributes to reduced memory performance and cognitive decline found in AD.^[21]

Although the causal relationship is unclear, the development of AD correlates with the onset of prominent sleep disorders.^[21] Similarly, sleep disorders exacerbate disease progression, forming a positive feedback loop.^[21] As a result, sleep disturbances are not only a symptom of AD; the relationship between sleep disturbances and AD is likely bidirectional.^[20]

At the same time, it has been shown that memory consolidation in long-term memory, which depends on the hippocampus, occurs during NREM sleep.^[21]^[24] This indicates that a decrease in NREM sleep will result in less consolidation, leading to poorer memory performance in hippocampal-dependent long-term memory.^[21]^[24] This drop in performance is one of the central symptoms of AD.^[21]

Recent studies have also linked sleep disturbances, neurogenesis, and AD.^[21] The subgranular zone and subventricular zone continue to produce new neurons in adult brains.^[21]^[25] These new cells are then incorporated into neuronal circuits in the subgranular zone, which is found in the hippocampus.^[21]^[25] These new cells contribute to learning and memory, playing an essential role in hippocampal-dependent memory.^[21]

However, recent studies have shown that several factors can interrupt neurogenesis,^[21] including stress and prolonged sleep deprivation (more than one day).^[21] The sleep disturbances encountered in AD could therefore suppress neurogenesis and impair hippocampal functions.^[21] This suppression would contribute to diminished memory performance and the progression of AD,^[21] while the progression of AD would further aggravate sleep disturbances.^[21]

Changes in sleep architecture in patients with AD occur during the preclinical phase of the disease.^[21] These changes could potentially be used to detect those most at risk of developing AD.^[21] However, this is still only theoretical.

While the exact mechanisms and causal relationship between sleep disturbances and AD remain unclear, these findings provide a better understanding and offer possibilities to improve the targeting of at-risk populations, as well as the implementation of treatments to curb the cognitive decline of AD patients.

Sleep disorder symptoms in psychiatric illnesses

Schizophrenia

In individuals with psychiatric illnesses sleep disorders may include a variety of clinical symptoms, including but not limited to: excessive daytime sleepiness, difficulty falling asleep, difficulty staying asleep, nightmares, sleep talking, sleepwalking, and poor sleep quality.^[26] Sleep disturbances - insomnia, hypersomnia, and delayed sleep-phase disorder - are quite prevalent in severe mental illnesses such as psychotic disorders.^[27] In those with schizophrenia, sleep disorders contribute to cognitive deficits in learning and memory. Sleep disturbances often occur before the onset of psychosis.

Sleep deprivation can also produce hallucinations, delusions and depression.^[28] A 2019 study investigated the three above-mentioned sleep disturbances in schizophrenia-spectrum (SCZ) and bipolar (BP) disorders in 617 SCZ individuals, 440 BP individuals, and 173 healthy controls (HC). Sleep disturbances were identified using the Inventory for Depressive Symptoms - Clinician-Rated Scale (IDS-C).^[27] Results suggested that at least one type of sleep disturbance was reported in 78% of the SCZ population, in 69% of individuals with BD, and in 39% of healthy controls.^[27] The SCZ group reported the highest number of sleep disturbances compared to the BD and HC groups; specifically, hypersomnia was more frequent among individuals with SCZ, and delayed sleep phase disorder was three times more common in the SCZ group compared to the BD group.^[27] Insomnias was the most frequently reported sleep disturbance across all three groups.^[27]

Bipolar disorder

One of the main behavioral symptoms of bipolar disorder is abnormal sleep. Studies have suggested that 23-78% of individuals with bipolar disorder consistently report symptoms of excessive time spent sleeping, or hypersomnia.^[26] The pathogenesis of bipolar disorder, including the higher risk of suicidal ideation, could possibly be linked to circadian rhythm variability, and sleep disturbances are a good predictor of mood swings.^[29] The most common sleep-related symptom of bipolar disorder is insomnia, in addition to hypersomnia, nightmares, poor sleep quality, obstructive sleep apnea, extreme daytime sleepiness, and other disturbances.^[29] Moreover, animal models have shown that sleep debt can induce episodes of bipolar mania in laboratory mice, but these models are still limited in their potential to explain bipolar disorder in humans with all its multifaceted symptoms, including those related to sleep disturbances.^[30]

Major depressive disorder (MDD)

Sleep disturbances (insomnia or hypersomnia)—though not a necessary diagnostic criterion—are among the most frequent symptoms in individuals with major depressive disorder (MDD).^[31] Among individuals with MDD, insomnia and hypersomnia have prevalence estimates of 88% and 27%, respectively, whereas individuals with insomnia have a threefold increased risk of developing MDD.^[32] Depressed mood and sleep efficiency strongly co-vary, and while sleep regulation problems may precede depressive episodes, such depressive episodes may also precipitate sleep deprivation.^[32] Fatigue, as well as sleep disturbances such as irregular and excessive sleepiness, are linked to symptoms of depression.^[32] Recent research has even pointed to sleep problems and fatigue as potential driving forces bridging MDD symptoms to those of co-occurring generalized anxiety disorder.^[33]

Treatment

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Sign with text: Sömnförsök pågår (Sleep study in progress), room for sleep studies in NÄL hospital, Sweden.

Treatments for sleep disorders generally can be grouped into four categories:

Behavioral and psychotherapeutic treatment
Rehabilitation and management
Medication
Other somatic treatment

None of these general approaches are sufficient for all patients with sleep disorders. Rather, the choice of a specific treatment depends on the patient's diagnosis, medical and psychiatric history, and preferences, as well as the expertise of the treating clinician. Often, behavioral/psychotherapeutic and pharmacological approaches may be compatible, and can effectively be combined to maximize therapeutic benefits.

Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.^[34] Medications and somatic treatments may provide the most rapid symptomatic relief from certain disorders, such as narcolepsy, which is best treated with prescription drugs like modafinil.^[35] Others, such as chronic and primary insomnia, may be more amenable to behavioral interventions—with more durable results.

Chronic sleep disorders in childhood, which affect some 70% of children with developmental or psychological disorders, are under-reported and under-treated. Sleep-phase disruption is also common among adolescents, whose school schedules are often incompatible with their natural circadian rhythm. Effective treatment begins with careful diagnosis using sleep diaries and perhaps sleep studies. Modifications in sleep hygiene may resolve the problem, but medical treatment is often warranted.^[36]

Special equipment may be required for treatment of several disorders such as obstructive apnea, circadian rhythm disorders, and bruxism. In severe cases, it may be necessary for individuals to accept living with the disorder, however well managed.

Some sleep disorders have been found to compromise glucose metabolism.^[37]

Allergy treatment

Histamine plays a role in wakefulness in the brain. An allergic reaction overproduces histamine, causing wakefulness and inhibiting sleep.^[38] Sleep problems are common in people with allergic rhinitis. A study from the N.I.H. found that sleep is dramatically impaired by allergic symptoms, and that the degree of impairment is related to the severity of those symptoms.^[39]^[40] Treatment of allergies has also been shown to help sleep apnea.^[41]

Acupuncture

A review of the evidence in 2012 concluded that current research is not rigorous enough to make recommendations regarding the use of acupuncture for insomnia.^[42] The pooled results of two trials on acupuncture showed a moderate likelihood that there may be some improvement in sleep quality for individuals with insomnia.^[42]Template:Rp This form of treatment for sleep disorders is generally studied in adults, rather than children. Further research would be needed to study the effects of acupuncture on sleep disorders in children.

Hypnosis

Research suggests that hypnosis may be helpful in alleviating some types and manifestations of sleep disorders in some patients.^[43] "Acute and chronic insomnia often respond to relaxation and hypnotherapy approaches, along with sleep hygiene instructions."^[44] Hypnotherapy has also helped with nightmares and sleep terrors. There are several reports of successful use of hypnotherapy for parasomnias,^[45]^[46] specifically for head and body rocking, bedwetting, and sleepwalking.^[47]

Hypnotherapy has been studied in the treatment of sleep disorders in both adults^[47] and children.^[48]

Music therapy

Script error: No such module "labelled list hatnote". Although more research should be done to increase the reliability of this method of treatment, research suggests that music therapy can improve sleep quality in acute and chronic sleep disorders. In one particular study, participants (18 years or older) who had experienced acute or chronic sleep disorders were put in a randomized controlled trial, and their sleep efficiency, in the form of overall time asleep, was observed. In order to assess sleep quality, researchers used subjective measures (i.e. questionnaires) and objective measures (i.e. polysomnography). The results of the study suggest that music therapy did improve sleep quality in subjects with acute or chronic sleep disorders, though only when tested subjectively. Although these results are not fully conclusive and more research should be conducted, they still provide evidence that music therapy can be an effective treatment for sleep disorders.^[49]

In another study specifically looking to help people with insomnia, similar results were seen. The participants who listened to music experienced better sleep quality than those who did not listen to music.^[50] Listening to slower-pace music before bed can help decrease the heart rate, making it easier to transition into sleep. Studies have indicated that music helps induce a state of relaxation that shifts an individual's internal clock towards the sleep cycle. This is said to have an effect on children and adults with various cases of sleep disorders.^[51]^[52] Music is most effective before bed once the brain has been conditioned to it, helping to achieve sleep much faster.^[53]

Melatonin

Research suggests that melatonin is useful in helping people fall asleep faster (decreased sleep latency), stay asleep longer, and experience improved sleep quality. To test this, a study was conducted that compared subjects who had taken melatonin to subjects with primary sleep disorders who had taken a placebo. Researchers assessed sleep onset latency, total minutes slept, and overall sleep quality in the melatonin and placebo groups to note the differences. In the end, researchers found that melatonin decreased sleep onset latency and increased total sleep time,^[54]^[55] but had an insignificant and inconclusive impact on the quality of sleep compared to the placebo group.

Sleep medicine

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Due to rapidly increasing knowledge and understanding of sleep in the 20th century, including the discovery of REM sleep in the 1950s and circadian rhythm disorders in the 70s and 80s, the medical importance of sleep was recognized. By the 1970s in the US, clinics and laboratories devoted to the study of sleep and sleep disorders had been founded, and a need for standards arose. The medical community began paying more attention to primary sleep disorders, such as sleep apnea, as well as the role and quality of sleep in other conditions.

File:To Sleep Forevermore.jpg

Sleep Medication.

Specialists in sleep medicine were originally and continue to be certified by the American Board of Sleep Medicine. Those passing the Sleep Medicine Specialty Exam received the designation "diplomate of the ABSM". Sleep medicine is now a recognized subspecialty within internal medicine, family medicine, pediatrics, otolaryngology, psychiatry and neurology in the United States. Certification in Sleep medicine shows that the specialist:<templatestyles src="Template:Blockquote/styles.css" />

has demonstrated expertise in the diagnosis and management of clinical conditions that occur during sleep, that disturb sleep, or that are affected by disturbances in the wake-sleep cycle. This specialist is skilled in the analysis and interpretation of comprehensive polysomnography, and well-versed in emerging research and management of a sleep laboratory.^[56]

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Competence in sleep medicine requires an understanding of a myriad of very diverse disorders. Many of which present with similar symptoms such as excessive daytime sleepiness, which, in the absence of volitional sleep deprivation, "is almost inevitably caused by an identifiable and treatable sleep disorder", such as sleep apnea, narcolepsy, idiopathic hypersomnia, Kleine–Levin syndrome, menstrual-related hypersomnia, idiopathic recurrent stupor, or circadian rhythm disturbances.^[57] Another common complaint is insomnia, a set of symptoms which can have a great many different causes, physical and mental. Management in the varying situations differs greatly and cannot be undertaken without a correct diagnosis.^[58]

Sleep dentistry (bruxism, snoring and sleep apnea), while not recognized as one of the nine dental specialties, qualifies for board-certification by the American Board of Dental Sleep Medicine (ABDSM). The qualified dentists collaborate with sleep physicians at accredited sleep centers, and can provide oral appliance therapy and upper airway surgery to treat or manage sleep-related breathing disorders.^[59] The resulting diplomate status is recognized by the American Academy of Sleep Medicine (AASM), and these dentists are organized in the Academy of Dental Sleep Medicine (USA).^[60]

Occupational therapy is an area of medicine that can also address a diagnosis of sleep disorder, as rest and sleep is listed in the Occupational Therapy Practice Framework (OTPF) as its own occupation of daily living.^[61] Rest and sleep are described as restorative in order to support engagement in other occupational therapy occupations.^[61] In the OTPF, the occupation of rest and sleep is broken down into rest, sleep preparation, and sleep participation.^[61] Occupational therapists have been shown to help improve restorative sleep through the use of assistive devices/equipment, cognitive behavioral therapy for Insomnia, therapeutic activities, and lifestyle interventions.^[62]

In the UK, knowledge of sleep medicine and possibilities for diagnosis and treatment seem to lag. The Imperial College Healthcare^[63] shows attention to obstructive sleep apnea syndrome and very few other sleep disorders. Some NHS trusts have specialist clinics for respiratory and neurological sleep medicine.

Epidemiology

Children and adolescents

A systematic review reveals parasomnias to be the most common sleep disorder in childhood, affecting up to 50% of children. However, only 4% of these parasomnias persist past adolescence. These parasomnias and their prevalences in childhood are sleepwalking (17%), confusional arousals (17.3% in 3-13 year olds), sleep terrors (1-6.5%), and nightmares (10-50% in 3-5 year olds). Other common sleep disorders and their prevalences are behavioural insomnia of childhood (10-30%), delayed sleep phase disorder (7-16%), obstructive sleep apnea (1-5%), and restless legs syndrome (2-4%).^[64]

Sleepwalking was found to be more common in males, with no gender disparity noted in any of the other common childhood sleep disturbances. Obstructive sleep apnea was found to be more common in African Americans, individuals with craniofacial abnormalities, Down syndrome, neuromuscular diseases, and choanal atresia. A number of the sleep disorders listed were found to have a familial pattern, meaning the incidence in a child was more likely to occur if one or both parents had a history of that sleep disorder; these include sleepwalking, confusional arousals, delayed sleep phase disorder, and restless legs syndrome.^[64]

A different systematic review examining sleep bruxism in children found prevalence rates ranging from 5.9% to 49.6%. In preschool-aged children, between 15.29% and 38.6% grind their teeth in their sleep for at least one night per week. In all but one of the included studies, the prevalence of bruxism decreases as age increases.^[65]

Between 20 and 26% of adolescents report a sleep onset latency of greater than 30 minutes, and 7-36% have difficulty initiating sleep. Asian teens tend to have a higher prevalence of adverse sleep outcomes than their North American and European counterparts.^[66]

Insomnia

Insomnia is a prevalent form of sleep deprivation. Individuals with insomnia may have problems falling asleep, staying asleep, or a combination of both resulting in hyposomnia - i.e. insufficient quantity and poor quality of sleep.^[67]

Combining results from 17 studies on insomnia in China, a pooled prevalence of 15.0% is reported for the country.^[68] This result is consistent among other East Asian countries; however, this is considerably lower than a series of Western countries (50.5% in Poland, 37.2% in France and Italy, 27.1% in USA).^[68] Men and women residing in China experience insomnia at similar rates.^[68]

A separate meta-analysis focusing on this sleeping disorder in the elderly mentions that those with more than one physical or psychiatric malady experience it at a 60% higher rate than those with one condition or less. It also notes a higher prevalence of insomnia in women over the age of 50 than their male counterparts.^[69]

A study which resulted from a collaboration between Massachusetts General Hospital and Merck describes the development of an algorithm to identify patients with sleep disorders using electronic medical records. The algorithm that incorporated a combination of structured and unstructured variables identified more than 36,000 individuals with physician-documented insomnia.^[70]

Insomnia can start off at the basic level but about 40% of people who struggle with insomnia have worse symptoms.^[1] Treatments that can help with insomnia include medication, creating and following a sleep routine, limiting one's caffeine intake, and cognitive behavioral therapy for insomnia.^[1]

Obstructive sleep apnea

Obstructive sleep apnea affects around 4% of men and 2% of women in the United States.^[71] While the disorder is more prevalent among men, this difference tends to diminish with age. Obstructive sleep apnea is more prevalent among women during pregnancy,^[72] and women tend to report depression and insomnia in conjunction with obstructive sleep apnea.^[73]

In a meta-analysis of the various Asian countries, India and China present the highest prevalence of the disorder. Specifically, about 13.7% of the Indian population and 7% of Hong Kong's population is estimated to have obstructive sleep apnea. The two groups in the study experience daytime symptoms such as difficulties concentrating, mood swings, or high blood pressure,^[74] at similar rates (prevalence of 3.5% and 3.57%, respectively).^[71]

Obesity and sleep apnea

Script error: No such module "labelled list hatnote". In obese individuals, excess fat in the upper respiratory tract can lead to breathing difficulties during sleep and lead to obstructive sleep apnea.^[75] As obesity is a risk factor for obstructive sleep apnea, it is essential to screen obese individuals for obstructive sleep apnea and related disorders. Additionally, both obese and obstructive sleep apnea patients are at greater risk of developing a metabolic syndrome. Implementing dietary control in obese individuals can have a positive impact on sleep problems and help alleviate associated issues such as depression, anxiety, and insomnia.^[76] Excessive daytime sleepiness caused by obstructive sleep apnea may promote an inactive lifestyle, possibly contributing to obesity.^[2]

Sleep paralysis

In a systematic review, it was found that 7.6% of the general population had reported experiencing sleep paralysis at least once in their lifetime. Slightly more women (18.9%) reported experiencing sleep paralysis than men (15.9%). 28.3% of students reported experiencing sleep paralysis, with the highest incidence among students of Asian descent (39.9%) and lowest incidence among Caucasian students (30.8%) when compared to other ethnicities (Hispanic: 34.5%, African descent: 31.4%). 31.9% of psychiatric patients reported experiencing sleep paralysis, of which 34.6% had a panic disorder.^[77]

Restless legs syndrome

According to one meta-analysis, the average prevalence rate among North American and Western European populations is estimated to be 14.5±8.0%. Specifically in the United States, the prevalence of restless legs syndrome is estimated to be between 5% and 15.7% when using strict diagnostic criteria. Restless legs syndrome is over 35% more prevalent in American women than their male counterparts.^[78]

Classification (ICSD-3, 2023)

Insomnia

Insomnia is the most frequent sleep disorder.^[79] It may occur on its own or be associated with other conditions such as mental disorders (such as stress, anxiety, or depression). It can also be associated with medical conditions such as asthma, diabetes, heart disease, pregnancy, and neurological disorders^[80]

Central disorders of hypersomnolence

Central disorders of hypersomnolence are conditions that cause excessive daytime sleepiness. These disorders are not explained by sleep-related breathing problems, circadian rhythm disturbances, or other causes of nighttime sleep disruptions.

Narcolepsy

Narcolepsy is a rare and chronic sleep disorder. It is defined by four main symptoms: excessive daytime sleepiness with sudden sleep attacks, cataplexy (sudden loss of muscle tone and weakness), hypnagogic hallucinations and sleep paralysis.^[81]

There are two types of narcolepsy. Type 1 is marked by the presence of cataplexy and/or low cerebrospinal fluid hypocretin levels. Type 2 is characterized by the absence of both.^[82] Literature reviews suggest that narcolepsy is typically caused by genetic and environmental factors. The disorder is also linked to autoimmune damage of hypothalamic hypocretin-producing neurons.^[82]^[83]

Treatment of narcolepsy focuses on managing symptoms. There is no cure for narcolepsy. Given the disabling morbidity associated with narcolepsy, more research and drug trials are needed. Psychostimulants (methylphenidate, modafinil) and antidepressant (selective serotonin reuptake inhibitors and tricyclics) are used to manage narcolepsy symptoms. More recent targeted therapies such as pitolisant, solriamfetol, and sodium oxybate have been approved to improve wakefulness or reduce cataplexy.^[84]^[83]

Idiopathic hypersomnia (IH)

A chronic neurological disease often compared to narcolepsy type 2, characterized by excessive daytime sleepiness, even after normal or prolonged sleep time. Sleep time sometimes exceeds 10 hours in duration. There are two types of IH: with long nocturnal sleep time or without long nocturnal sleep time (marked by unintended and unrefreshing naps). The cause of idiopathic hypersomnia remains largely unclear, with no established pathophysiological mechanism.^[85]^[86] Patients dealing with idiopathic hypersomnia cannot obtain a healthy amount of sleep for a regular day of activities.

Treatment, as in narcolepsy, focuses primarily on symptom management. It is mainly based on stimulants to improve alertness and wakefulness.^[87]

Kleine-Levin Syndrome

Kleine–Levin syndrome is a very rare sleep disorder, mainly affecting adolescent males. It is classified among recurrent hypersomnias and is marked by episodes that last anywhere from days to weeks.^[88] Diagnosis requires the presence of at least one of the following signs during the episodes: cognitive dysfunction, altered perception, eating disorder and disinhibited behavior like hypersexuality. Between the episodes, patients typically return to baseline and do not show symptoms (ICSD-3-TR).

Post traumatic hypersomnia
Menstrual-related hypersomnia

Sleep disordered breathing disorders

Obstructive sleep apnea
Central sleep apneas
Central sleep apnea due to high-altitude periodic breathing
Primary central sleep apnea of infancy
Primary central sleep apnea of prematurity

Sleep-Related Hypoventilation Disorders

Congenital central alveolar hypoventilation syndrome
Sleep-related hypoxemia disorder

Circadian rhythm sleep disorder

Delayed sleep phase disorder
Advanced sleep phase disorder
Non-24-hour sleep–wake disorder
Jet lag disorder – Jet lag disorder is a type of circadian rhythm sleep disorder that results from rapid travel across multiple time zones. Individuals experiencing jet lag may encounter symptoms such as excessive sleepiness, fatigue, insomnia, irritability, and gastrointestinal disturbances upon reaching their destination. These symptoms arise due to the mismatch between the body's circadian rhythm, synchronized with the departure location, and the new sleep/wake cycle needed at the destination.^[89]

Parasomnia

A category of sleep disorders that involve abnormal and unnatural movements, behaviors, emotions, perceptions, and dreams in connection with sleep.

Bedwetting or sleep enuresis

Sleep-Related Movement Disorders

Sleep-related leg cramps
Nocturnal muscle cramps
Bruxism (teeth-grinding)
Catathrenia – nocturnal groaning
Exploding head syndrome – waking up in the night hearing loud noises.
Sleep terror (or pavor nocturnus) – Characterized by a sudden arousal from deep sleep with a scream or cry, accompanied by some behavioral manifestations of intense fear.^[90]
REM sleep behavior disorder
Sleepwalking (or somnambulism)
Sleep talking (or somniloquy)
Sleep sex (or sexsomnia)

References

Template:Reflist

External links

Template:Medical resources

Template:Commons category-inline
Sleep Problems – information leaflet from mental health charity The Royal College of Psychiatrists
WebMD Sleep Disorders Health Center

Template:SleepSeries2 Template:Autism spectrum Template:Authority control

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↑ ^a ^b Wang, P., Wing, Y.K., Xing, J. et al. Rapid eye movement sleep behavior disorder in patients with probable Alzheimer's disease. Aging Clin Exp Res (2016) 28: 951. https://doi.org/10.1007/s40520-015-0382-8.
↑ ^a ^b ^c McCarter, S., & Howell, J. (2017). REM Sleep Behavior Disorder and Other Sleep Disturbances in Non-Alzheimer Dementias. Current Sleep Medicine Reports, 3(3), 193-203.
↑ ^a ^b ^c ^d Dick-Muehlke, C. (2015). Psychosocial studies of the individual's changing perspectives in Alzheimer's disease (Premier Reference Source). Hershey, PA: Medical Information Science Reference.
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↑ Thorpy, Michael J. "Parasomniacs." The International Classification of Sleep Disorders: Diagnostic and Coding Manual. Rochester: American Sleep Disorders Association, 1990. Print.

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[Roepke,_S._K._2010-6] Roepke, S. K., & Ancoli-Israel, S. (2010). Sleep disorders in the elderly. The Indian Journal of Medical Research, 131, 302–310.

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[:7-13] ↑ ^a ^b ^c ^d ^e ^f ^g Zhong, Naismith, Rogers, & Lewis. (2011). Sleep–wake disturbances in common neurodegenerative diseases: A closer look at selected aspects of the neural circuitry. Journal of the Neurological Sciences, 307(1-2), 9-14.

[:9-14] ↑ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j Malkani, R., & Attarian, H. (2015). Sleep in Neurodegenerative Disorders. Current Sleep Medicine Reports, 1(2), 81-90.

[:8-15] Bjørnarå, Dietrichs, & Toft. (2013). REM sleep behavior disorder in Parkinson's disease – Is there a gender difference? Parkinsonism and Related Disorders, 19(1), 120-122.

[:10-16] Bjørnarå, K., Dietrichs, E., & Toft, M. (2015). Longitudinal assessment of probable rapid eye movement sleep behavior disorder in Parkinson's disease. European Journal of Neurology, 22(8), 1242-1244.

[:11-17] Wang, P., Wing, Y.K., Xing, J. et al. Rapid eye movement sleep behavior disorder in patients with probable Alzheimer's disease. Aging Clin Exp Res (2016) 28: 951. https://doi.org/10.1007/s40520-015-0382-8.

[:12-18] McCarter, S., & Howell, J. (2017). REM Sleep Behavior Disorder and Other Sleep Disturbances in Non-Alzheimer Dementias. Current Sleep Medicine Reports, 3(3), 193-203.

[:13-19] Dick-Muehlke, C. (2015). Psychosocial studies of the individual's changing perspectives in Alzheimer's disease (Premier Reference Source). Hershey, PA: Medical Information Science Reference.

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[90] Thorpy, Michael J. "Parasomniacs." The International Classification of Sleep Disorders: Diagnostic and Coding Manual. Rochester: American Sleep Disorders Association, 1990. Print.

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Sleep disorder: Difference between revisions

Latest revision as of 07:04, 18 November 2025

Contents

Causes

Sleep disorders and neurodegenerative diseases

Sleep disturbances and Alzheimer's disease

Sleep disorder symptoms in psychiatric illnesses

Schizophrenia

Bipolar disorder

Major depressive disorder (MDD)

Treatment

Allergy treatment

Acupuncture

Hypnosis

Music therapy

Melatonin

Sleep medicine

Epidemiology

Children and adolescents

Insomnia

Obstructive sleep apnea

Obesity and sleep apnea

Sleep paralysis

Restless legs syndrome

Classification (ICSD-3, 2023)

Insomnia

Central disorders of hypersomnolence

Narcolepsy

Idiopathic hypersomnia (IH)

Kleine-Levin Syndrome

Sleep disordered breathing disorders

Sleep-Related Hypoventilation Disorders

Circadian rhythm sleep disorder

Parasomnia

Sleep-Related Movement Disorders

See also

References

External links

Navigation menu

@@ Line 1: / Line 1: @@
 {{Short description|Medical disorder of a person's sleep patterns}}
-{{Infobox medical condition (new)
+{{Infobox medical condition
 | name            = Sleep disorder
 | synonyms        =
@@ Line 25: / Line 25: @@
 }}
-A '''sleep disorder''', or '''somnipathy''', is a [[medical disorder]] affecting an individual's [[sleep]] patterns, sometimes impacting physical, mental, social, and emotional functioning.<!-- Redundant phrasing? Both sentences state it affects patients’ lives.  --><ref name="Pavlova 292–299"/> [[Polysomnography]] and [[actigraphy]] are tests commonly ordered for diagnosing sleep disorders.
+A '''sleep disorder''', or '''somnipathy''', is a [[Disease|medical disorder]] that disrupts an individual's [[sleep]] patterns and quality. This can cause serious health issues and affect physical, mental, and emotional well-being.<!-- Redundant phrasing? Both sentences state it affects patients' lives.  --><ref name="Pavlova 292–299"/> [[Polysomnography]] and [[actigraphy]] are tests commonly ordered for diagnosing sleep disorders.
-Sleep disorders are broadly classified into [[dyssomnia]]s, [[parasomnia]]s, [[circadian rhythm sleep disorder]]s involving the timing of sleep, and other disorders, including those caused by medical or psychological conditions. When a person struggles to fall asleep or stay asleep without any obvious cause<!-- sentence could be interpreted as “with no obvious cause” describing “stay asleep” -->, it is referred to as [[insomnia]],<ref name=":24">{{Cite book |title=Essentials of neuropsychiatry and clinical neurosciences |vauthors=Hirshkowitz M |publisher=American Psychiatric Publishing |year=2004 |isbn=978-1-58562-005-0 |veditors=Yudofsky SC, Hales RE |edition=4 |location=Arlington, Virginia, USA |chapter=Chapter 10, Neuropsychiatric Aspects of Sleep and Sleep Disorders (pp 315-340) |quote=...insomnia is a symptom.  It is neither a disease nor a specific condition. (from p. 322). |chapter-url=https://books.google.com/books?id=XKhu7yb3QtsC&q=%22Max+Hirshkowitz%22&pg=PA315 |chapter-format=Google Books preview includes entire chapter 10}}</ref> which is the most common sleep disorder.<ref>{{cite web| url = https://www.psychiatry.org/patients-families/sleep-disorders/what-are-sleep-disorders| title = APA "What are sleep disorders?" |access-date=2019-06-25 |work=www.psychiatry.org}}</ref> Other sleep disorders include [[sleep apnea]], [[narcolepsy]], [[hypersomnia]] (excessive sleepiness at inappropriate times), [[sleeping sickness]] (disruption of the sleep cycle due to infection), [[sleepwalking]], and [[night terror]]s.
+Sleep disorders are broadly classified into [[dyssomnia]]s, [[parasomnia]]s, [[circadian rhythm sleep disorder]]s, and other disorders (including those caused by medical or psychological conditions). When a person struggles to fall or stay asleep without an obvious cause, it is referred to as [[insomnia]],<ref name=":24">{{Cite book |title=Essentials of neuropsychiatry and clinical neurosciences |vauthors=Hirshkowitz M |publisher=American Psychiatric Publishing |year=2004 |isbn=978-1-58562-005-0 |veditors=Yudofsky SC, Hales RE |edition=4 |location=Arlington, Virginia, USA |chapter=Chapter 10, Neuropsychiatric Aspects of Sleep and Sleep Disorders (pp 315-340) |quote=...insomnia is a symptom.  It is neither a disease nor a specific condition. (from p. 322). |chapter-url=https://books.google.com/books?id=XKhu7yb3QtsC&q=%22Max+Hirshkowitz%22&pg=PA315 |chapter-format=Google Books preview includes entire chapter 10}}</ref> which is the most common sleep disorder.<ref>{{cite web| url = https://www.psychiatry.org/patients-families/sleep-disorders/what-are-sleep-disorders| title = APA "What are sleep disorders?" |access-date=2019-06-25 |work=www.psychiatry.org}}</ref> Other sleep disorders include [[sleep apnea]], [[narcolepsy]], [[hypersomnia]] (excessive sleepiness at inappropriate times), [[sleeping sickness]] (disruption of the sleep cycle due to infection), [[sleepwalking]], and [[night terror]]s.
-Sleep disruptions can be caused by various issues, including teeth grinding ([[bruxism]]) and night terrors. Managing sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on addressing the underlying conditions.<ref>{{Cite web|title=Sleep Problems and Sleep Disorders|url=https://sleepify.co/sleep-statistics/|access-date=2021-08-24|website=Sleepify|date=26 June 2019 }}</ref>
+Sleep disruptions can be caused by various issues, including teeth grinding ([[bruxism]]) and night terrors. Managing sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on addressing the underlying condition.<ref>{{Cite web|title=Sleep Problems and Sleep Disorders|url=https://sleepify.co/sleep-statistics/|access-date=2021-08-24|website=Sleepify|date=26 June 2019 }}</ref>
-Sleep disorders are common in both children and adults.  <!-- what are “primary sleep disorders?” --> However, there is a significant lack of awareness about sleep disorders in children, with many cases remaining unidentified.<ref>{{cite journal | vauthors = Meltzer LJ, Johnson C, Crosette J, Ramos M, Mindell JA | title = Prevalence of diagnosed sleep disorders in pediatric primary care practices | journal = Pediatrics | volume = 125 | issue = 6 | pages = e1410–e1418 | date = June 2010 | pmid = 20457689 | pmc = 3089951 | doi = 10.1542/peds.2009-2725 }}</ref> Several common factors involved in the onset of a sleep disorder include increased medication use, age-related changes in circadian rhythms, environmental changes, lifestyle changes,<ref name="Roepke, S. K. 2010">Roepke, S. K., & Ancoli-Israel, S. (2010). Sleep disorders in the elderly. The Indian Journal of Medical Research, 131, 302–310.</ref> pre-diagnosed physiological problems, or stress. Among the elderly, the risk of developing sleep-disordered breathing, periodic limb movements, [[restless legs syndrome]], REM sleep behavior disorders, insomnia, and circadian rhythm disturbances is especially high.<ref name="Roepke, S. K. 2010" />
+Sleep disorders are common in both children and adults. However, there is a significant lack of awareness about sleep disorders in children, with many cases remaining unidentified.<ref>{{cite journal | vauthors = Meltzer LJ, Johnson C, Crosette J, Ramos M, Mindell JA | title = Prevalence of diagnosed sleep disorders in pediatric primary care practices | journal = Pediatrics | volume = 125 | issue = 6 | pages = e1410–e1418 | date = June 2010 | pmid = 20457689 | pmc = 3089951 | doi = 10.1542/peds.2009-2725 }}</ref> Several common factors involved in the onset of a sleep disorder include increased medication use, age-related changes in circadian rhythms, environmental changes, lifestyle changes,<ref name="Roepke, S. K. 2010">Roepke, S. K., & Ancoli-Israel, S. (2010). Sleep disorders in the elderly. The Indian Journal of Medical Research, 131, 302–310.</ref> existing physiological problems, and stress. Among the elderly, the risk of developing sleep-disordered breathing, periodic limb movements, [[restless legs syndrome]], REM sleep behavior disorders, insomnia, and circadian rhythm disturbances is especially high.<ref name="Roepke, S. K. 2010" />
 == Causes ==
-[[File:2023 CDC recommendations for amount of sleep needed, by age.svg |thumb |Centers for Disease Control and Prevention (CDC) recommendations for the amount of sleep needed decrease with age.<ref name="CDC_sleep" /> While sleep quantity is important, good sleep quality is also essential to avoid sleep disorders.<ref name="CDC_sleep">{{cite web |title=How Much Sleep Do I Need? |url=https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html |website=CDC.gov |date=14 September 2022 |publisher=Centers for Disease Control and Prevention (CDC) |archive-url=https://web.archive.org/web/20231102143914/https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html |archive-date=2 November 2023 |quote=Last Reviewed: September 14, 2022. Source: National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. |url-status=live }}</ref>]]
+[[File:2023 CDC recommendations for amount of sleep needed, by age.svg |thumb|Centers for Disease Control and Prevention (CDC) recommendations for the amount of sleep needed decrease with age.<ref name="CDC_sleep" /> While sleep quantity is important, good sleep quality is also essential to avoid sleep disorders.<ref name="CDC_sleep">{{cite web |title=How Much Sleep Do I Need? |url=https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html |website=CDC.gov |date=14 September 2022 |publisher=Centers for Disease Control and Prevention (CDC) |archive-url=https://web.archive.org/web/20231102143914/https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html |archive-date=2 November 2023 |quote=Last Reviewed: September 14, 2022. Source: National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. |url-status=live }}</ref>]]
 A systematic review found that traumatic childhood experiences, such as family conflict or sexual trauma, significantly increase the risk of several sleep disorders in adulthood, including [[sleep apnea]], [[narcolepsy]], and [[insomnia]].<ref>{{cite journal |vauthors=Kajeepeta S, Gelaye B, Jackson CL, Williams MA |date=March 2015 |title=Adverse childhood experiences are associated with adult sleep disorders: a systematic review |journal=Sleep Medicine |volume=16 |issue=3 |pages=320–330 |doi=10.1016/j.sleep.2014.12.013 |pmc=4635027 |pmid=25777485}}</ref>
-An evidence-based synopsis suggests that idiopathic REM sleep behavior disorder (iRBD) may have a hereditary component. A total of 632 participants, half with iRBD and half without, completed self-report questionnaires. The study results suggest that people with iRBD are more likely to report having a first-degree relative with the same sleep disorder than people of the same age and sex who do not have the disorder.<ref>{{cite journal |vauthors=Schenck CH |date=November 2013 |title=Family history of REM sleep behaviour disorder more common in individuals affected by the disorder than among unaffected individuals |journal=Evidence-Based Mental Health |volume=16 |issue=4 |pages=114 |doi=10.1136/eb-2013-101479 |pmid=23970760 |s2cid=2218369}}</ref> More research is needed to further understand the hereditary nature of sleep disorders.
+An evidence-based synopsis suggests that idiopathic REM sleep behavior disorder may have a hereditary component. A total of 632 participants, half with idiopathic REM sleep behavior disorder and half without, completed self-report questionnaires. The study results suggest that people with the sleep disorder are more likely to report having a first-degree relative with the same sleep disorder than people of the same age and sex who do not have the disorder.<ref>{{cite journal |vauthors=Schenck CH |date=November 2013 |title=Family history of REM sleep behaviour disorder more common in individuals affected by the disorder than among unaffected individuals |journal=Evidence-Based Mental Health |volume=16 |issue=4 |page=114 |doi=10.1136/eb-2013-101479 |pmid=23970760 |s2cid=2218369}}</ref> More research is needed to further understand the hereditary basis of sleep disorders.
-A population susceptible to the development of sleep disorders includes people who have experienced a [[Traumatic brain injury|traumatic brain injury (TBI)]]. Due to the significant research focus on this issue, a systematic review was conducted to synthesize the findings. The results indicate that individuals who have experienced a TBI are most disproportionately at risk for developing narcolepsy, obstructive sleep apnea, excessive daytime sleepiness, and insomnia.<ref>{{cite journal | vauthors = Mathias JL, Alvaro PK | title = Prevalence of sleep disturbances, disorders, and problems following traumatic brain injury: a meta-analysis | journal = Sleep Medicine | volume = 13 | issue = 7 | pages = 898–905 | date = August 2012 | pmid = 22705246 | doi = 10.1016/j.sleep.2012.04.006 }}</ref>
+A population susceptible to the development of sleep disorders includes people who have experienced a [[traumatic brain injury]]. Due to the significant research focus on this issue, a systematic review was conducted to synthesize the findings. The results indicate that individuals who have experienced a traumatic brain injury are disproportionately at risk of developing narcolepsy, obstructive sleep apnea, excessive daytime sleepiness, and insomnia.<ref>{{cite journal | vauthors = Mathias JL, Alvaro PK | title = Prevalence of sleep disturbances, disorders, and problems following traumatic brain injury: a meta-analysis | journal = Sleep Medicine | volume = 13 | issue = 7 | pages = 898–905 | date = August 2012 | pmid = 22705246 | doi = 10.1016/j.sleep.2012.04.006 }}</ref>
+[[Obstructive sleep apnea]] is a common condition affecting 10-20% of middle-aged and older adults, characterized by repeated breathing pauses during sleep, leading to poor sleep quality, and excessive daytime [[somnolence]] and, sometimes [[insomnia]].<ref>{{Cite journal |last1=Ong |first1=Jason C. |last2=Crawford |first2=Megan R. |last3=Wallace |first3=Douglas M. |date=May 2021 |title=Sleep Apnea and Insomnia |journal=Chest |language=en |volume=159 |issue=5 |pages=2020–2028 |doi=10.1016/j.chest.2020.12.002 |pmc=8129729 |pmid=33309524 }}</ref> Common factors include [[obesity]], narrow airways, and certain neuromuscular conditions that cause airway collapse during sleep.<ref>{{Cite journal |last1=Jordan |first1=Amy S. |last2=McSharry |first2=David G. |last3=Malhotra |first3=Atul |date=2014-02-22 |title=Adult obstructive sleep apnoea |journal=The Lancet |language=English |volume=383 |issue=9918 |pages=736–747 |doi=10.1016/S0140-6736(13)60734-5 |issn=0140-6736 |pmid=23910433 |pmc=3909558 }}</ref>
 == Sleep disorders and neurodegenerative diseases ==
-Neurodegenerative diseases are often associated with sleep disorders,<ref name=":7">Zhong, Naismith, Rogers, & Lewis. (2011). Sleep–wake disturbances in common neurodegenerative diseases: A closer look at selected aspects of the neural circuitry. Journal of the Neurological Sciences, 307(1-2), 9-14.</ref><ref name=":9">Malkani, R., & Attarian, H. (2015). Sleep in Neurodegenerative Disorders. Current Sleep Medicine Reports, 1(2), 81-90.</ref> particularly when characterized by the abnormal accumulation of [[alpha-synuclein]], as seen in [[multiple system atrophy]] (MSA), [[Parkinson's disease]] (PD),<ref name=":8">Bjørnarå, Dietrichs, & Toft. (2013). REM sleep behavior disorder in Parkinson's disease – Is there a gender difference? Parkinsonism and Related Disorders, 19(1), 120-122.</ref><ref name=":10">Bjørnarå, K., Dietrichs, E., & Toft, M. (2015). Longitudinal assessment of probable rapid eye movement sleep behavior disorder in Parkinson's disease. European Journal of Neurology, 22(8), 1242-1244.</ref> and [[Dementia with Lewy bodies|Lewy body disease]] (LBD).<ref name=":11">Wang, P., Wing, Y.K., Xing, J. et al. Rapid eye movement sleep behavior disorder in patients with probable Alzheimer’s disease. ''Aging Clin Exp Res'' (2016) 28: 951. https://doi.org/10.1007/s40520-015-0382-8.</ref><ref name=":12">McCarter, S., & Howell, J. (2017). REM Sleep Behavior Disorder and Other Sleep Disturbances in Non-Alzheimer Dementias. Current Sleep Medicine Reports, 3(3), 193-203.</ref> For example, individuals diagnosed with PD frequently experience various sleep issues, such as [[insomnia]] (affecting approximately 70% of the PD population), [[hypersomnia]] (over 50%), and [[Rapid eye movement sleep behavior disorder|REM sleep behavior disorder]] (RBD) (around 40%), which is linked to increased motor symptoms.<ref name=":8" /><ref name=":9" /> Moreover, RBD has been identified as a significant precursor for the future development of these neurodegenerative diseases over several years, presenting a promising opportunity for improving treatments.<ref name=":7" /><ref name=":9" />
+Neurodegenerative diseases are often associated with sleep disorders,<ref name=":7">Zhong, Naismith, Rogers, & Lewis. (2011). Sleep–wake disturbances in common neurodegenerative diseases: A closer look at selected aspects of the neural circuitry. Journal of the Neurological Sciences, 307(1-2), 9-14.</ref><ref name=":9">Malkani, R., & Attarian, H. (2015). Sleep in Neurodegenerative Disorders. Current Sleep Medicine Reports, 1(2), 81-90.</ref> particularly when characterized by the abnormal accumulation of [[alpha-synuclein]], as seen in [[multiple system atrophy]] (MSA), [[Parkinson's disease]] (PD),<ref name=":8">Bjørnarå, Dietrichs, & Toft. (2013). REM sleep behavior disorder in Parkinson's disease – Is there a gender difference? Parkinsonism and Related Disorders, 19(1), 120-122.</ref><ref name=":10">Bjørnarå, K., Dietrichs, E., & Toft, M. (2015). Longitudinal assessment of probable rapid eye movement sleep behavior disorder in Parkinson's disease. European Journal of Neurology, 22(8), 1242-1244.</ref> and [[Dementia with Lewy bodies|Lewy body disease]] (LBD).<ref name=":11">Wang, P., Wing, Y.K., Xing, J. et al. Rapid eye movement sleep behavior disorder in patients with probable Alzheimer's disease. ''Aging Clin Exp Res'' (2016) 28: 951. https://doi.org/10.1007/s40520-015-0382-8.</ref><ref name=":12">McCarter, S., & Howell, J. (2017). REM Sleep Behavior Disorder and Other Sleep Disturbances in Non-Alzheimer Dementias. Current Sleep Medicine Reports, 3(3), 193-203.</ref> For example, individuals diagnosed with PD frequently experience various sleep issues, such as [[insomnia]] (affecting approximately 70% of the PD population), [[hypersomnia]] (over 50%), and [[Rapid eye movement sleep behavior disorder|REM sleep behavior disorder]] (RBD) (around 40%), which is linked to increased motor symptoms.<ref name=":8" /><ref name=":9" /> Moreover, RBD has been identified as a significant precursor to the future development of these neurodegenerative diseases over several years, presenting a promising opportunity for improving treatments.<ref name=":7" /><ref name=":9" />
-Neurodegenerative conditions are commonly related to structural brain impairments, which may disrupt sleep and wakefulness, circadian rhythm, and motor or non-motor functioning.<ref name=":7" /><ref name=":9" /> Conversely, sleep disturbances are often linked to worsening patients' cognitive functioning, emotional state, and quality of life.<ref name=":9" /><ref name=":12" /> Additionally, these abnormal behavioral symptoms can place a significant burden on their relatives and caregivers.<ref name=":9" /><ref name=":12" /> The limited research in this area, coupled with increasing life expectancy, highlights the need for a deeper understanding of the relationship between sleep disorders and neurodegenerative diseases.<ref name=":7" /><ref name=":13">Dick-Muehlke, C. (2015). Psychosocial studies of the individual's changing perspectives in Alzheimer's disease (Premier Reference Source). Hershey, PA: Medical Information Science Reference.</ref>
+Neurodegenerative conditions are commonly related to structural brain impairments, which may disrupt sleep and wakefulness, circadian rhythm, and motor or non-motor functioning.<ref name=":7" /><ref name=":9" /> Conversely, sleep disturbances are often linked to worsening of patients' cognitive functioning, emotional state, and quality of life.<ref name=":9" /><ref name=":12" /> Additionally, these abnormal behavioral symptoms can place a significant burden on patients' relatives and caregivers.<ref name=":9" /><ref name=":12" /> The limited research in this area, coupled with increasing life expectancy, highlights the need for a deeper understanding of the relationship between sleep disorders and neurodegenerative diseases.<ref name=":7" /><ref name=":13">Dick-Muehlke, C. (2015). Psychosocial studies of the individual's changing perspectives in Alzheimer's disease (Premier Reference Source). Hershey, PA: Medical Information Science Reference.</ref>
 === Sleep disturbances and Alzheimer's disease ===
-Sleep disturbances have also been observed in [[Alzheimer's disease]] (AD), affecting about 45% of its population.<ref name=":7" /><ref name=":9" /> When based on caregiver reports, this percentage increases to about 70%.<ref name=":13" /> As in the PD population, insomnia and [[hypersomnia]] are frequently recognized in AD patients. These disturbances have been associated with the accumulation of [[Amyloid beta|beta-amyloid]], [[circadian rhythm sleep disorder]]s (CRSD), and [[melatonin]] alteration.<ref name=":7" /><ref name=":9" /> Additionally, changes in [[Sleep|sleep architecture]] are observed in AD.<ref name=":7" /><ref name=":9" /><ref name=":11" /> Although sleep architecture seems to naturally change with age, its development appears aggravated in AD patients. Slow-wave sleep (SWS) potentially decreases (and is sometimes absent), spindles and the length of time spent in REM sleep are also reduced, while its latency increases.<ref name=":13" /> Poor sleep onset in AD has been associated with dream-related hallucinations, increased restlessness, wandering, and agitation related to [[sundowning]]—a typical chronobiological phenomenon in the disease.<ref name=":9" /><ref name=":13" />
+Sleep disturbances have also been observed in [[Alzheimer's disease]] (AD), affecting about 45% of the affected population.<ref name=":7" /><ref name=":9" /> When based on caregiver reports, this percentage increases to about 70%.<ref name=":13" /> As in the PD population, insomnia and [[hypersomnia]] are frequently recognized in AD patients. These disturbances have been associated with the accumulation of [[Amyloid beta|beta-amyloid]], [[circadian rhythm sleep disorder]]s (CRSD), and [[melatonin]] alterations.<ref name=":7" /><ref name=":9" /> Additionally, changes in [[Sleep|sleep architecture]] are observed in AD.<ref name=":7" /><ref name=":9" /><ref name=":11" /> Although sleep architecture seems to naturally change with age, its development appears aggravated in AD patients. Slow-wave sleep (SWS) potentially decreases (and is sometimes absent), sleep spindles and the length of time spent in REM sleep are also reduced, while REM latency increases.<ref name=":13" /> Poor sleep onset in AD has been associated with dream-related hallucinations, increased restlessness, wandering, and agitation related to [[sundowning]]—a typical chronobiological phenomenon in the disease.<ref name=":9" /><ref name=":13" />
 In Alzheimer's disease, in addition to cognitive decline and memory impairment, there are also significant sleep disturbances with modified sleep architecture.<ref name=":15">{{cite journal |vauthors=Mander BA, Winer JR, Jagust WJ, Walker MP |date=August 2016 |title=Sleep: A Novel Mechanistic Pathway, Biomarker, and Treatment Target in the Pathology of Alzheimer's Disease? |journal=Trends in Neurosciences |volume=39 |issue=8 |pages=552–566 |doi=10.1016/j.tins.2016.05.002 |pmc=4967375 |pmid=27325209}}</ref><ref name=":14">{{cite journal |vauthors=Kent BA, Mistlberger RE |date=April 2017 |title=Sleep and hippocampal neurogenesis: Implications for Alzheimer's disease |journal=Frontiers in Neuroendocrinology |volume=45 |pages=35–52 |doi=10.1016/j.yfrne.2017.02.004 |pmid=28249715 |s2cid=39928206}}</ref> These disturbances may consist of sleep fragmentation, reduced sleep duration, insomnia, increased daytime napping, decreased quantity of some sleep stages, and a growing resemblance between some sleep stages (N1 and N2).<ref name=":14" /> More than 65% of people with Alzheimer's disease experience this type of sleep disturbance.<ref name=":14" />
@@ Line 53: / Line 55: @@
 One factor that could explain this change in sleep architecture is a disruption in the circadian rhythm, which regulates sleep.<ref name=":14" /> This disruption can lead to sleep disturbances.<ref name=":14" /> Some studies show that people with Alzheimer's disease have a delayed circadian rhythm, whereas in normal aging, an advanced circadian rhythm is present.<ref name=":14" /><ref>{{cite journal | vauthors = Tranah GJ, Blackwell T, Stone KL, Ancoli-Israel S, Paudel ML, Ensrud KE, Cauley JA, Redline S, Hillier TA, Cummings SR, Yaffe K | display-authors = 6 | title = Circadian activity rhythms and risk of incident dementia and mild cognitive impairment in older women | journal = Annals of Neurology | volume = 70 | issue = 5 | pages = 722–732 | date = November 2011 | pmid = 22162057 | pmc = 3244839 | doi = 10.1002/ana.22468 }}</ref>
-In addition to these psychological symptoms, there are two main neurological symptoms of Alzheimer's disease.<ref name=":15" /><ref name=":14" /> The first is the accumulation of beta-amyloid waste, forming aggregate "plaques".<ref name=":14" /><ref name=":15" /> The second is the accumulation of tau protein.<ref name=":14" /><ref name=":15" />
+In addition to these psychological symptoms, there are two main neurological features of Alzheimer's disease.<ref name=":15" /><ref name=":14" /> The first is the accumulation of beta-amyloid waste, forming aggregate "plaques".<ref name=":14" /><ref name=":15" /> The second is the accumulation of tau protein.<ref name=":14" /><ref name=":15" />
 It has been shown that the sleep-wake cycle influences the beta-amyloid burden, a central component found in Alzheimer's disease (AD).<ref name=":14" /><ref name=":15" /> As individuals awaken, the production of beta-amyloid protein becomes more consistent compared to its production during sleep.<ref name=":14" /><ref name=":15" /><ref name=":16">{{cite journal |display-authors=6 |vauthors=Xie L, Kang H, Xu Q, Chen MJ, Liao Y, Thiyagarajan M, O'Donnell J, Christensen DJ, Nicholson C, Iliff JJ, Takano T, Deane R, Nedergaard M |date=October 2013 |title=Sleep drives metabolite clearance from the adult brain |journal=Science |volume=342 |issue=6156 |pages=373–377 |bibcode=2013Sci...342..373X |doi=10.1126/science.1241224 |pmc=3880190 |pmid=24136970}}</ref> This phenomenon can be explained by two factors. First, metabolic activity is higher during waking hours, resulting in greater secretion of beta-amyloid protein.<ref name=":14" /><ref name=":15" /> Second, oxidative stress increases during waking hours, which leads to greater beta-amyloid production.<ref name=":14" /><ref name=":15" />
@@ Line 59: / Line 61: @@
 On the other hand, it is during sleep that beta-amyloid residues are degraded to prevent plaque formation.<ref name=":14" /><ref name=":15" /><ref name=":16" /> The glymphatic system is responsible for this through the phenomenon of glymphatic clearance.<ref name=":14" /><ref name=":15" /><ref name=":16" /> Thus, during wakefulness, the beta-amyloid burden is greater because metabolic activity and oxidative stress are higher, and there is no protein degradation by glymphatic clearance. During sleep, the burden is reduced as there is less metabolic activity and oxidative stress, in addition to the glymphatic clearance that occurs.<ref name=":15" /><ref name=":14" />
-Glymphatic clearance occurs during NREM SWS sleep,<ref name=":14" /><ref name=":15" /><ref name=":16" /> a stage that decreases with normal aging,<ref name=":15" /> leading to reduced glymphatic clearance and increased beta-amyloid burden, which forms plaques.<ref name=":16" /><ref name=":14" /><ref name=":15" /> Therefore, sleep disturbances in individuals with Alzheimer's disease will amplify this phenomenon.
+Glymphatic clearance occurs during NREM SWS sleep,<ref name=":14" /><ref name=":15" /><ref name=":16" /> a stage that decreases with normal aging,<ref name=":15" /> leading to reduced glymphatic clearance and increased beta-amyloid burden, which forms plaques.<ref name=":16" /><ref name=":14" /><ref name=":15" /> Therefore, sleep disturbances in individuals with Alzheimer's disease may exacerbate this phenomenon.
-The decrease in the quantity and quality of NREM SWS, along with sleep disturbances, will therefore increase the AB plaques.<ref name=":14" /><ref name=":15" /> This initially occurs in the hippocampus, a brain structure integral to long-term memory formation.<ref name=":14" /><ref name=":15" /> As hippocampus cell death occurs, it contributes to the diminished memory performance and cognitive decline found in AD.<ref name=":14" />
+The decrease in the quantity and quality of NREM SWS, along with sleep disturbances, will therefore increase the [[Amyloid plaques|Aβ plaques]].<ref name=":14" /><ref name=":15" /> This initially occurs in the hippocampus, a brain structure integral to long-term memory formation.<ref name=":14" /><ref name=":15" /> As hippocampal cell death occurs, it contributes to reduced memory performance and cognitive decline found in AD.<ref name=":14" />
-Although the causal relationship is unclear, the development of AD correlates with the onset of prominent sleep disorders.<ref name=":14" /> Similarly, sleep disorders exacerbate disease progression, forming a positive feedback loop.<ref name=":14" /> As a result, sleep disturbances are not only a symptom of AD; the relationship between sleep disturbances and AD is bidirectional.<ref name=":15" />
+Although the causal relationship is unclear, the development of AD correlates with the onset of prominent sleep disorders.<ref name=":14" /> Similarly, sleep disorders exacerbate disease progression, forming a positive feedback loop.<ref name=":14" /> As a result, sleep disturbances are not only a symptom of AD; the relationship between sleep disturbances and AD is likely bidirectional.<ref name=":15" />
 At the same time, it has been shown that memory consolidation in long-term memory, which depends on the hippocampus, occurs during NREM sleep.<ref name=":14" /><ref name=":17">{{cite journal |vauthors=Diekelmann S, Born J |date=February 2010 |title=The memory function of sleep |journal=Nature Reviews. Neuroscience |volume=11 |issue=2 |pages=114–126 |doi=10.1038/nrn2762 |pmid=20046194 |s2cid=1851910}}</ref> This indicates that a decrease in NREM sleep will result in less consolidation, leading to poorer memory performance in hippocampal-dependent long-term memory.<ref name=":14" /><ref name=":17" /> This drop in performance is one of the central symptoms of AD.<ref name=":14" />
@@ Line 73: / Line 75: @@
 Changes in sleep architecture in patients with AD occur during the preclinical phase of the disease.<ref name=":14" /> These changes could potentially be used to detect those most at risk of developing AD.<ref name=":14" /> However, this is still only theoretical.
-While the exact mechanisms and causal relationship between sleep disturbances and AD remain unclear, these findings provide a better understanding and offer possibilities to improve targeting of at-risk populations, as well as the implementation of treatments to curb the cognitive decline of AD patients.
+While the exact mechanisms and causal relationship between sleep disturbances and AD remain unclear, these findings provide a better understanding and offer possibilities to improve the targeting of at-risk populations, as well as the implementation of treatments to curb the cognitive decline of AD patients.
 == Sleep disorder symptoms in psychiatric illnesses ==
 === Schizophrenia ===
-In individuals with psychiatric illnesses sleep disorders may include a variety of clinical symptoms, including but not limited to: excessive daytime sleepiness, difficulty falling asleep, difficulty staying asleep, nightmares, sleep talking, sleepwalking, and poor sleep quality.<ref name=":19">{{cite journal | vauthors = Hombali A, Seow E, Yuan Q, Chang SH, Satghare P, Kumar S, Verma SK, Mok YM, Chong SA, Subramaniam M | display-authors = 6 | title = Prevalence and correlates of sleep disorder symptoms in psychiatric disorders | journal = Psychiatry Research | volume = 279 | pages = 116–122 | date = September 2019 | pmid = 30072039 | doi = 10.1016/j.psychres.2018.07.009 | doi-access = free }}</ref> Sleep disturbances - insomnia, hypersomnia and delayed sleep-phase disorder - are quite prevalent in severe mental illnesses such as psychotic disorders.<ref name=":22">{{cite journal | vauthors = Laskemoen JF, Simonsen C, Büchmann C, Barrett EA, Bjella T, Lagerberg TV, Vedal TJ, Andreassen OA, Melle I, Aas M | display-authors = 6 | title = Sleep disturbances in schizophrenia spectrum and bipolar disorders - a transdiagnostic perspective | journal = Comprehensive Psychiatry | volume = 91 | pages = 6–12 | date = May 2019 | pmid = 30856497 | doi = 10.1016/j.comppsych.2019.02.006 | doi-access = free | hdl = 10852/76588 | hdl-access = free }}</ref> In those with [[schizophrenia]], sleep disorders contribute to cognitive deficits in learning and memory. Sleep disturbances often occur before the onset of psychosis.
+In individuals with psychiatric illnesses sleep disorders may include a variety of clinical symptoms, including but not limited to: excessive daytime sleepiness, difficulty falling asleep, difficulty staying asleep, nightmares, sleep talking, sleepwalking, and poor sleep quality.<ref name=":19">{{cite journal | vauthors = Hombali A, Seow E, Yuan Q, Chang SH, Satghare P, Kumar S, Verma SK, Mok YM, Chong SA, Subramaniam M | display-authors = 6 | title = Prevalence and correlates of sleep disorder symptoms in psychiatric disorders | journal = Psychiatry Research | volume = 279 | pages = 116–122 | date = September 2019 | pmid = 30072039 | doi = 10.1016/j.psychres.2018.07.009 | doi-access = free }}</ref> Sleep disturbances - insomnia, hypersomnia, and delayed sleep-phase disorder - are quite prevalent in severe mental illnesses such as psychotic disorders.<ref name=":22">{{cite journal | vauthors = Laskemoen JF, Simonsen C, Büchmann C, Barrett EA, Bjella T, Lagerberg TV, Vedal TJ, Andreassen OA, Melle I, Aas M | display-authors = 6 | title = Sleep disturbances in schizophrenia spectrum and bipolar disorders - a transdiagnostic perspective | journal = Comprehensive Psychiatry | volume = 91 | pages = 6–12 | date = May 2019 | pmid = 30856497 | doi = 10.1016/j.comppsych.2019.02.006 | doi-access = free | hdl = 10852/76588 | hdl-access = free }}</ref> In those with [[schizophrenia]], sleep disorders contribute to cognitive deficits in learning and memory. Sleep disturbances often occur before the onset of psychosis.
-Sleep deprivation can also produce hallucinations, delusions and depression.<ref name="Pocivavsek">{{cite journal | vauthors = Pocivavsek A, Rowland LM | title = Basic Neuroscience Illuminates Causal Relationship Between Sleep and Memory: Translating to Schizophrenia | journal = Schizophrenia Bulletin | volume = 44 | issue = 1 | pages = 7–14 | date = January 2018 | pmid = 29136236 | pmc = 5768044 | doi = 10.1093/schbul/sbx151 }}</ref> A 2019 study investigated the three above-mentioned sleep disturbances in schizophrenia-spectrum (SCZ) and bipolar (BP) disorders in 617 SCZ individuals, 440 BP individuals, and 173 healthy controls (HC). Sleep disturbances were identified using the Inventory for Depressive Symptoms - clinician rated scale (IDS-C).<ref name=":22" /> Results suggested that at least one type of sleep disturbance was reported in 78% of the SCZ population, in 69% individuals with BD, and in 39% of healthy controls.<ref name=":22" /> The SCZ group reported the most number of sleep disturbances compared to the BD and HC groups; specifically, hypersomnia was more frequent among individuals with SCZ, and delayed sleep phase disorder was three times more common in the SCZ group compared to the BD group.<ref name=":22" /> Insomnias were the most frequently reported sleep disturbance across all three groups.<ref name=":22" />
+Sleep deprivation can also produce hallucinations, delusions and depression.<ref name="Pocivavsek">{{cite journal | vauthors = Pocivavsek A, Rowland LM | title = Basic Neuroscience Illuminates Causal Relationship Between Sleep and Memory: Translating to Schizophrenia | journal = Schizophrenia Bulletin | volume = 44 | issue = 1 | pages = 7–14 | date = January 2018 | pmid = 29136236 | pmc = 5768044 | doi = 10.1093/schbul/sbx151 }}</ref> A 2019 study investigated the three above-mentioned sleep disturbances in schizophrenia-spectrum (SCZ) and bipolar (BP) disorders in 617 SCZ individuals, 440 BP individuals, and 173 healthy controls (HC). Sleep disturbances were identified using the Inventory for Depressive Symptoms - Clinician-Rated Scale (IDS-C).<ref name=":22" /> Results suggested that at least one type of sleep disturbance was reported in 78% of the SCZ population, in 69% of individuals with BD, and in 39% of healthy controls.<ref name=":22" /> The SCZ group reported the highest number of sleep disturbances compared to the BD and HC groups; specifically, hypersomnia was more frequent among individuals with SCZ, and delayed sleep phase disorder was three times more common in the SCZ group compared to the BD group.<ref name=":22" /> Insomnias was the most frequently reported sleep disturbance across all three groups.<ref name=":22" />
 === Bipolar disorder ===
-One of the main behavioral symptoms of [[bipolar disorder]] is abnormal sleep. Studies have suggested that 23-78% of individuals with bipolar disorders consistently report symptoms of excessive time spent sleeping, or hypersomnia.<ref name=":19" /> The pathogenesis of bipolar disorder, including the higher risk of suicidal ideation, could possibly be linked to circadian rhythm variability, and sleep disturbances are a good predictor of mood swings.<ref name=":20">{{cite journal | vauthors = Steardo L, de Filippis R, Carbone EA, Segura-Garcia C, Verkhratsky A, De Fazio P | title = Sleep Disturbance in Bipolar Disorder: Neuroglia and Circadian Rhythms | journal = Frontiers in Psychiatry | volume = 10 | pages = 501 | date = 2019-07-18 | pmid = 31379620 | pmc = 6656854 | doi = 10.3389/fpsyt.2019.00501 | doi-access = free | author-link5 = Alexei Verkhratsky }}</ref> The most common sleep-related symptom of bipolar disorder is insomnia, in addition to hypersomnia, nightmares, poor sleep quality, OSA, extreme daytime sleepiness, etc.<ref name=":20" /> Moreover, animal models have shown that sleep debt can induce episodes of bipolar mania in laboratory mice, but these models are still limited in their potential to explain bipolar disease in humans with all its multifaceted symptoms, including those related to sleep disturbances.<ref>{{cite journal | vauthors = Logan RW, McClung CA | title = Animal models of bipolar mania: The past, present and future | journal = Neuroscience | volume = 321 | pages = 163–188 | date = May 2016 | pmid = 26314632 | pmc = 4766066 | doi = 10.1016/j.neuroscience.2015.08.041 }}</ref>
+One of the main behavioral symptoms of [[bipolar disorder]] is abnormal sleep. Studies have suggested that 23-78% of individuals with bipolar disorder consistently report symptoms of excessive time spent sleeping, or hypersomnia.<ref name=":19" /> The pathogenesis of bipolar disorder, including the higher risk of suicidal ideation, could possibly be linked to circadian rhythm variability, and sleep disturbances are a good predictor of mood swings.<ref name=":20">{{cite journal | vauthors = Steardo L, de Filippis R, Carbone EA, Segura-Garcia C, Verkhratsky A, De Fazio P | title = Sleep Disturbance in Bipolar Disorder: Neuroglia and Circadian Rhythms | journal = Frontiers in Psychiatry | volume = 10 | article-number = 501 | date = 2019-07-18 | pmid = 31379620 | pmc = 6656854 | doi = 10.3389/fpsyt.2019.00501 | doi-access = free | author-link5 = Alexei Verkhratsky }}</ref> The most common sleep-related symptom of bipolar disorder is insomnia, in addition to hypersomnia, nightmares, poor sleep quality, obstructive sleep apnea, extreme daytime sleepiness, and other disturbances.<ref name=":20" /> Moreover, animal models have shown that sleep debt can induce episodes of bipolar mania in laboratory mice, but these models are still limited in their potential to explain bipolar disorder in humans with all its multifaceted symptoms, including those related to sleep disturbances.<ref>{{cite journal | vauthors = Logan RW, McClung CA | title = Animal models of bipolar mania: The past, present and future | journal = Neuroscience | volume = 321 | pages = 163–188 | date = May 2016 | pmid = 26314632 | pmc = 4766066 | doi = 10.1016/j.neuroscience.2015.08.041 }}</ref>
 === Major depressive disorder (MDD) ===
-Sleep disturbances (insomnia or hypersomnia) - though not a necessary diagnostic criterion - are one of the most frequent symptoms of individuals with major depressive disorder (MDD).<ref>{{cite journal | vauthors = Liu X, Buysse DJ, Gentzler AL, Kiss E, Mayer L, Kapornai K, Vetró A, Kovacs M | display-authors = 6 | title = Insomnia and hypersomnia associated with depressive phenomenology and comorbidity in childhood depression | journal = Sleep | volume = 30 | issue = 1 | pages = 83–90 | date = January 2007 | pmid = 17310868 | doi = 10.1093/sleep/30.1.83 | doi-access = free }}</ref> Among individuals with MDD, insomnia and hypersomnia have prevalence estimates of 88% and 27%, respectively, whereas individuals with insomnia have a threefold increased risk of developing MDD.<ref name=":21">{{cite journal | vauthors = Murphy MJ, Peterson MJ | title = Sleep Disturbances in Depression | journal = Sleep Medicine Clinics | volume = 10 | issue = 1 | pages = 17–23 | date = March 2015 | pmid = 26055669 | pmc = 5678925 | doi = 10.1016/j.jsmc.2014.11.009 }}</ref> Depressed mood and sleep efficiency strongly co-vary, and while sleep regulation problems may precede depressive episodes, such depressive episodes may also precipitate sleep deprivation.<ref name=":21" /> Fatigue, as well as sleep disturbances such as irregular and excessive sleepiness, are linked to symptoms of depression.<ref name=":21" /> Recent research has even pointed to sleep problems and fatigues as potential driving forces bridging MDD symptoms to those of co-occurring generalized anxiety disorder.<ref name="Coussement & Heeren-2022">{{cite journal | vauthors = Coussement C, Heeren A | title = Sleep problems as a transdiagnostic hub bridging impaired attention control, generalized anxiety, and depression | journal = Journal of Affective Disorders | volume = 296 | pages = 305–308 | date = January 2022 | pmid = 34606807 | doi = 10.1016/j.jad.2021.09.092 | s2cid = 238357084 | hdl = 2078.1/251649 | hdl-access = free }}</ref>
+Sleep disturbances (insomnia or hypersomnia)—though not a necessary diagnostic criterion—are among the most frequent symptoms in individuals with major depressive disorder (MDD).<ref>{{cite journal | vauthors = Liu X, Buysse DJ, Gentzler AL, Kiss E, Mayer L, Kapornai K, Vetró A, Kovacs M | display-authors = 6 | title = Insomnia and hypersomnia associated with depressive phenomenology and comorbidity in childhood depression | journal = Sleep | volume = 30 | issue = 1 | pages = 83–90 | date = January 2007 | pmid = 17310868 | doi = 10.1093/sleep/30.1.83 | doi-access = free }}</ref> Among individuals with MDD, insomnia and hypersomnia have prevalence estimates of 88% and 27%, respectively, whereas individuals with insomnia have a threefold increased risk of developing MDD.<ref name=":21">{{cite journal | vauthors = Murphy MJ, Peterson MJ | title = Sleep Disturbances in Depression | journal = Sleep Medicine Clinics | volume = 10 | issue = 1 | pages = 17–23 | date = March 2015 | pmid = 26055669 | pmc = 5678925 | doi = 10.1016/j.jsmc.2014.11.009 }}</ref> Depressed mood and sleep efficiency strongly co-vary, and while sleep regulation problems may precede depressive episodes, such depressive episodes may also precipitate sleep deprivation.<ref name=":21" /> Fatigue, as well as sleep disturbances such as irregular and excessive sleepiness, are linked to symptoms of depression.<ref name=":21" /> Recent research has even pointed to sleep problems and fatigue as potential driving forces bridging MDD symptoms to those of co-occurring generalized anxiety disorder.<ref name="Coussement & Heeren-2022">{{cite journal | vauthors = Coussement C, Heeren A | title = Sleep problems as a transdiagnostic hub bridging impaired attention control, generalized anxiety, and depression | journal = Journal of Affective Disorders | volume = 296 | pages = 305–308 | date = January 2022 | pmid = 34606807 | doi = 10.1016/j.jad.2021.09.092 | s2cid = 238357084 | hdl = 2078.1/251649 | hdl-access = free }}</ref>
 == Treatment ==
@@ Line 98: / Line 100: @@
 None of these general approaches are sufficient for all patients with sleep disorders. Rather, the choice of a specific treatment depends on the patient's diagnosis, medical and psychiatric history, and preferences, as well as the expertise of the treating clinician. Often, behavioral/psychotherapeutic and pharmacological approaches may be compatible, and can effectively be combined to maximize therapeutic benefits.
-Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.<ref>{{cite journal | vauthors = Ramar K, Olson EJ | title = Management of common sleep disorders | journal = American Family Physician | volume = 88 | issue = 4 | pages = 231–238 | date = August 2013 | pmid = 23944726 | url = https://www.aafp.org/afp/2013/0815/p231.html }}</ref> Medications and somatic treatments may provide the most rapid symptomatic relief from certain disorders, such as narcolepsy, which is best treated with prescription drugs such as [[modafinil]].<ref name="pmid22608642">{{cite book |title=Neurobiology of Psychiatric Disorders |vauthors=Voderholzer U, Guilleminault C |year=2012 |isbn=978-0-444-52002-9 |series=Handbook of Clinical Neurology |volume=106 |pages=527–40 |chapter=Sleep disorders |doi=10.1016/B978-0-444-52002-9.00031-0 |pmid=22608642}}</ref> Others, such as chronic and primary insomnia, may be more amenable to behavioral interventions—with more durable results.
+Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.<ref>{{cite journal | vauthors = Ramar K, Olson EJ | title = Management of common sleep disorders | journal = American Family Physician | volume = 88 | issue = 4 | pages = 231–238 | date = August 2013 | pmid = 23944726 | url = https://www.aafp.org/afp/2013/0815/p231.html }}</ref> Medications and somatic treatments may provide the most rapid symptomatic relief from certain disorders, such as narcolepsy, which is best treated with prescription drugs like [[modafinil]].<ref name="pmid22608642">{{cite book |title=Neurobiology of Psychiatric Disorders |vauthors=Voderholzer U, Guilleminault C |year=2012 |isbn=978-0-444-52002-9 |series=Handbook of Clinical Neurology |volume=106 |pages=527–40 |chapter=Sleep disorders |doi=10.1016/B978-0-444-52002-9.00031-0 |pmid=22608642}}</ref> Others, such as chronic and primary insomnia, may be more amenable to behavioral interventions—with more durable results.
 Chronic sleep disorders in childhood, which affect some 70% of children with developmental or psychological disorders, are under-reported and under-treated. Sleep-phase disruption is also common among adolescents, whose school schedules are often incompatible with their natural circadian rhythm. Effective treatment begins with careful diagnosis using sleep diaries and perhaps sleep studies. Modifications in [[sleep hygiene]] may resolve the problem, but medical treatment is often warranted.<ref>{{cite journal |vauthors=Ivanenko A, Massey C|title=Assessment and Management of Sleep Disorders in Children  |journal=Psychiatric Times |volume=23 |issue=11 |date=October 1, 2006 |url=http://www.psychiatrictimes.com/articles/assessment-and-management-sleep-disorders-children}}</ref>
-Special equipment may be required for treatment of several disorders such as obstructive apnea, circadian rhythm disorders and bruxism. In severe cases, it may be necessary for individuals to accept living with the disorder, however well managed.
+Special equipment may be required for treatment of several disorders such as obstructive apnea, circadian rhythm disorders, and bruxism. In severe cases, it may be necessary for individuals to accept living with the disorder, however well managed.
-Some sleep disorders have been found to compromise glucose metabolism.<ref name="Keckeis">{{cite journal | vauthors = Keckeis M, Lattova Z, Maurovich-Horvat E, Beitinger PA, Birkmann S, Lauer CJ, Wetter TC, Wilde-Frenz J, Pollmächer T | display-authors = 6 | title = Impaired glucose tolerance in sleep disorders | journal = PLOS ONE | volume = 5 | issue = 3 | pages = e9444 | date = March 2010 | pmid = 20209158 | pmc = 2830474 | doi = 10.1371/journal.pone.0009444 | veditors = Finkelstein D | doi-access = free | bibcode = 2010PLoSO...5.9444K }}</ref>
+Some sleep disorders have been found to compromise glucose metabolism.<ref name="Keckeis">{{cite journal | vauthors = Keckeis M, Lattova Z, Maurovich-Horvat E, Beitinger PA, Birkmann S, Lauer CJ, Wetter TC, Wilde-Frenz J, Pollmächer T | display-authors = 6 | title = Impaired glucose tolerance in sleep disorders | journal = PLOS ONE | volume = 5 | issue = 3 | article-number = e9444 | date = March 2010 | pmid = 20209158 | pmc = 2830474 | doi = 10.1371/journal.pone.0009444 | veditors = Finkelstein D | doi-access = free | bibcode = 2010PLoSO...5.9444K }}</ref>
 === Allergy treatment ===
-Histamine plays a role in wakefulness in the brain. An allergic reaction over produces histamine, causing wakefulness and inhibiting sleep.<ref>{{cite journal | vauthors = Thakkar MM | title = Histamine in the regulation of wakefulness | journal = Sleep Medicine Reviews | volume = 15 | issue = 1 | pages = 65–74 | date = February 2011 | pmid = 20851648 | pmc = 3016451 | doi = 10.1016/j.smrv.2010.06.004 }}</ref> Sleep problems are common in people with [[allergic rhinitis]]. A study from the [[N.I.H.]] found that sleep is dramatically impaired by allergic symptoms, and that the degree of impairment is related to the severity of those symptoms.<ref>{{cite journal | vauthors = Léger D, Annesi-Maesano I, Carat F, Rugina M, Chanal I, Pribil C, El Hasnaoui A, Bousquet J | display-authors = 6 | title = Allergic rhinitis and its consequences on quality of sleep: An unexplored area | journal = Archives of Internal Medicine | volume = 166 | issue = 16 | pages = 1744–1748 | date = September 2006 | pmid = 16983053 | doi = 10.1001/archinte.166.16.1744 | doi-access = free }}</ref><ref>{{Cite web|url=https://sleepfoundation.org/sleep-topics/sleep-related-problems/allergic-rhinitis-and-sleep|title=Allergies and Sleep|website=sleepfoundation.org|access-date=2017-06-08}}</ref> Treatment of allergies has also been shown to help sleep apnea.<ref>{{cite journal | vauthors = Staevska MT, Mandajieva MA, Dimitrov VD | title = Rhinitis and sleep apnea | journal = Current Allergy and Asthma Reports | volume = 4 | issue = 3 | pages = 193–199 | date = May 2004 | pmid = 15056401 | doi = 10.1007/s11882-004-0026-0 | s2cid = 42447055 }}</ref>
+Histamine plays a role in wakefulness in the brain. An allergic reaction overproduces histamine, causing wakefulness and inhibiting sleep.<ref>{{cite journal | vauthors = Thakkar MM | title = Histamine in the regulation of wakefulness | journal = Sleep Medicine Reviews | volume = 15 | issue = 1 | pages = 65–74 | date = February 2011 | pmid = 20851648 | pmc = 3016451 | doi = 10.1016/j.smrv.2010.06.004 }}</ref> Sleep problems are common in people with [[allergic rhinitis]]. A study from the [[N.I.H.]] found that sleep is dramatically impaired by allergic symptoms, and that the degree of impairment is related to the severity of those symptoms.<ref>{{cite journal | vauthors = Léger D, Annesi-Maesano I, Carat F, Rugina M, Chanal I, Pribil C, El Hasnaoui A, Bousquet J | display-authors = 6 | title = Allergic rhinitis and its consequences on quality of sleep: An unexplored area | journal = Archives of Internal Medicine | volume = 166 | issue = 16 | pages = 1744–1748 | date = September 2006 | pmid = 16983053 | doi = 10.1001/archinte.166.16.1744 | doi-access = free }}</ref><ref>{{Cite web|url=https://sleepfoundation.org/sleep-topics/sleep-related-problems/allergic-rhinitis-and-sleep|title=Allergies and Sleep|website=sleepfoundation.org|access-date=2017-06-08}}</ref> Treatment of allergies has also been shown to help sleep apnea.<ref>{{cite journal | vauthors = Staevska MT, Mandajieva MA, Dimitrov VD | title = Rhinitis and sleep apnea | journal = Current Allergy and Asthma Reports | volume = 4 | issue = 3 | pages = 193–199 | date = May 2004 | pmid = 15056401 | doi = 10.1007/s11882-004-0026-0 | s2cid = 42447055 }}</ref>
 === Acupuncture ===
-A review of the evidence in 2012 concluded that current research is not rigorous enough to make recommendations around the use of [[acupuncture]] for [[insomnia]].<ref name="CheukEtalAcupuncture">{{cite journal | vauthors = Cheuk DK, Yeung WF, Chung KF, Wong V | title = Acupuncture for insomnia | journal = The Cochrane Database of Systematic Reviews | volume = 9 | issue = 9 | pages = CD005472 | date = September 2012 | pmid = 22972087 | doi = 10.1002/14651858.cd005472.pub3 | pmc = 11262418 }}</ref> The pooled results of two trials on acupuncture showed a moderate likelihood that there may be some improvement to sleep quality for individuals with insomnia.<ref name="CheukEtalAcupuncture" />{{rp|15}} This form of treatment for sleep disorders is generally studied in adults, rather than children. Further research would be needed to study the effects of acupuncture on sleep disorders in children.
+A review of the evidence in 2012 concluded that current research is not rigorous enough to make recommendations regarding the use of [[acupuncture]] for [[insomnia]].<ref name="CheukEtalAcupuncture">{{cite journal | vauthors = Cheuk DK, Yeung WF, Chung KF, Wong V | title = Acupuncture for insomnia | journal = The Cochrane Database of Systematic Reviews | volume = 2012 | issue = 9 | article-number = CD005472 | date = September 2012 | pmid = 22972087 | doi = 10.1002/14651858.cd005472.pub3 | pmc = 11262418 }}</ref> The pooled results of two trials on acupuncture showed a moderate likelihood that there may be some improvement in sleep quality for individuals with insomnia.<ref name="CheukEtalAcupuncture" />{{rp|15}} This form of treatment for sleep disorders is generally studied in adults, rather than children. Further research would be needed to study the effects of acupuncture on sleep disorders in children.
 === Hypnosis ===
-Research suggests that [[hypnosis]] may be helpful in alleviating some types and manifestations of sleep disorders in some patients.<ref name="Stradling">{{cite journal | vauthors = Stradling J, Roberts D, Wilson A, Lovelock F | title = Controlled trial of hypnotherapy for weight loss in patients with obstructive sleep apnoea | journal = International Journal of Obesity and Related Metabolic Disorders | volume = 22 | issue = 3 | pages = 278–281 | date = March 1998 | pmid = 9539198 | doi = 10.1038/sj.ijo.0800578 | doi-access = free }}</ref> "Acute and chronic insomnia often respond to relaxation and hypnotherapy approaches, along with sleep hygiene instructions."<ref name="Ng">{{cite journal | vauthors = Ng BY, Lee TS | title = Hypnotherapy for sleep disorders | journal = Annals of the Academy of Medicine, Singapore | volume = 37 | issue = 8 | pages = 683–688 | date = August 2008 | pmid = 18797562 | doi = 10.47102/annals-acadmedsg.V37N8p683 | s2cid = 18511973 | doi-access = free }}</ref> [[Hypnotherapy]] has also helped with nightmares and sleep terrors. There are several reports of successful use of hypnotherapy for parasomnias<ref name="Graci">{{cite journal | vauthors = Graci GM, Hardie JC | title = Evidenced-based hypnotherapy for the management of sleep disorders | journal = The International Journal of Clinical and Experimental Hypnosis | volume = 55 | issue = 3 | pages = 288–302 | date = July 2007 | pmid = 17558719 | doi = 10.1080/00207140701338662 | s2cid = 21598789 }}</ref><ref name="Hauri">{{cite journal | vauthors = Hauri PJ, Silber MH, Boeve BF | title = The treatment of parasomnias with hypnosis: a 5-year follow-up study | journal = Journal of Clinical Sleep Medicine | volume = 3 | issue = 4 | pages = 369–373 | date = June 2007 | pmid = 17694725 | pmc = 1978312 | doi = 10.5664/jcsm.26858 }}</ref> specifically for head and body rocking, bedwetting and sleepwalking.<ref name="Hurwitz">{{cite journal | vauthors = Hurwitz TD, Mahowald MW, Schenck CH, Schluter JL, Bundlie SR | title = A retrospective outcome study and review of hypnosis as treatment of adults with sleepwalking and sleep terror | journal = The Journal of Nervous and Mental Disease | volume = 179 | issue = 4 | pages = 228–233 | date = April 1991 | pmid = 2007894 | doi = 10.1097/00005053-199104000-00009 | s2cid = 10018843 }}</ref>
+Research suggests that [[hypnosis]] may be helpful in alleviating some types and manifestations of sleep disorders in some patients.<ref name="Stradling">{{cite journal | vauthors = Stradling J, Roberts D, Wilson A, Lovelock F | title = Controlled trial of hypnotherapy for weight loss in patients with obstructive sleep apnoea | journal = International Journal of Obesity and Related Metabolic Disorders | volume = 22 | issue = 3 | pages = 278–281 | date = March 1998 | pmid = 9539198 | doi = 10.1038/sj.ijo.0800578 | doi-access = free }}</ref> "Acute and chronic insomnia often respond to relaxation and hypnotherapy approaches, along with sleep hygiene instructions."<ref name="Ng">{{cite journal | vauthors = Ng BY, Lee TS | title = Hypnotherapy for sleep disorders | journal = Annals of the Academy of Medicine, Singapore | volume = 37 | issue = 8 | pages = 683–688 | date = August 2008 | pmid = 18797562 | doi = 10.47102/annals-acadmedsg.V37N8p683 | s2cid = 18511973 | doi-access = free }}</ref> [[Hypnotherapy]] has also helped with nightmares and sleep terrors. There are several reports of successful use of hypnotherapy for parasomnias,<ref name="Graci">{{cite journal | vauthors = Graci GM, Hardie JC | title = Evidenced-based hypnotherapy for the management of sleep disorders | journal = The International Journal of Clinical and Experimental Hypnosis | volume = 55 | issue = 3 | pages = 288–302 | date = July 2007 | pmid = 17558719 | doi = 10.1080/00207140701338662 | s2cid = 21598789 }}</ref><ref name="Hauri">{{cite journal | vauthors = Hauri PJ, Silber MH, Boeve BF | title = The treatment of parasomnias with hypnosis: a 5-year follow-up study | journal = Journal of Clinical Sleep Medicine | volume = 3 | issue = 4 | pages = 369–373 | date = June 2007 | pmid = 17694725 | pmc = 1978312 | doi = 10.5664/jcsm.26858 }}</ref> specifically for head and body rocking, bedwetting, and sleepwalking.<ref name="Hurwitz">{{cite journal | vauthors = Hurwitz TD, Mahowald MW, Schenck CH, Schluter JL, Bundlie SR | title = A retrospective outcome study and review of hypnosis as treatment of adults with sleepwalking and sleep terror | journal = The Journal of Nervous and Mental Disease | volume = 179 | issue = 4 | pages = 228–233 | date = April 1991 | pmid = 2007894 | doi = 10.1097/00005053-199104000-00009 | s2cid = 10018843 }}</ref>
 Hypnotherapy has been studied in the treatment of sleep disorders in both adults<ref name="Hurwitz" /> and children.<ref name="Owensa">{{cite journal | vauthors = Owens LJ, France KG, Wiggs L | title = REVIEW ARTICLE: Behavioural and cognitive-behavioural interventions for sleep disorders in infants and children: A review | journal = Sleep Medicine Reviews | volume = 3 | issue = 4 | pages = 281–302 | date = December 1999 | pmid = 12531150 | doi = 10.1053/smrv.1999.0082 }}</ref>
@@ Line 119: / Line 121: @@
 === Music therapy ===
 {{Further|Music and sleep}}
-Although more research should be done to increase the reliability of this method of treatment, research suggests that [[music therapy]] can improve sleep quality in [[Insomnia|acute]] and chronic sleep disorders. In one particular study, participants (18 years or older) who had experienced acute or chronic sleep disorders were put in a randomly controlled trial, and their sleep efficiency, in the form of overall time asleep, was observed. In order to assess sleep quality, researchers used subjective measures (i.e. [[questionnaire]]s) and objective measures (i.e. [[polysomnography]]). The results of the study suggest that music therapy did improve sleep quality in subjects with acute or chronic sleep disorders, though only when tested subjectively. Although these results are not fully conclusive and more research should be conducted, it still provides evidence that music therapy can be an effective treatment for sleep disorders.<ref>{{cite journal | vauthors = Wang CF, Sun YL, Zang HX | title = Music therapy improves sleep quality in acute and chronic sleep disorders: a meta-analysis of 10 randomized studies | journal = International Journal of Nursing Studies | volume = 51 | issue = 1 | pages = 51–62 | date = January 2014 | pmid = 23582682 | doi = 10.1016/j.ijnurstu.2013.03.008 }}</ref>
+Although more research should be done to increase the reliability of this method of treatment, research suggests that [[music therapy]] can improve sleep quality in [[Insomnia|acute]] and chronic sleep disorders. In one particular study, participants (18 years or older) who had experienced acute or chronic sleep disorders were put in a randomized controlled trial, and their sleep efficiency, in the form of overall time asleep, was observed. In order to assess sleep quality, researchers used subjective measures (i.e. [[questionnaire]]s) and objective measures (i.e. [[polysomnography]]). The results of the study suggest that music therapy did improve sleep quality in subjects with acute or chronic sleep disorders, though only when tested subjectively. Although these results are not fully conclusive and more research should be conducted, they still provide evidence that music therapy can be an effective treatment for sleep disorders.<ref>{{cite journal | vauthors = Wang CF, Sun YL, Zang HX | title = Music therapy improves sleep quality in acute and chronic sleep disorders: a meta-analysis of 10 randomized studies | journal = International Journal of Nursing Studies | volume = 51 | issue = 1 | pages = 51–62 | date = January 2014 | pmid = 23582682 | doi = 10.1016/j.ijnurstu.2013.03.008 }}</ref>
-In another study specifically looking to help people with insomnia, similar results were seen. The participants that listened to music experienced better sleep quality than those who did not listen to music.<ref>{{cite journal | vauthors = Jespersen KV, Pando-Naude V, Koenig J, Jennum P, Vuust P | title = Listening to music for insomnia in adults | journal = The Cochrane Database of Systematic Reviews | volume = 2022 | issue = 8 | pages = CD010459 | date = August 2022 | pmid = 36000763 | pmc = 9400393 | doi = 10.1002/14651858.CD010459.pub3 }}</ref> Listening to slower pace music before bed can help decrease the heart rate, making it easier to transition into sleep. Studies have indicated that music helps induce a state of relaxation that shifts an individual's [[Circadian rhythm|internal clock]] towards the sleep cycle. This is said to have an effect on children and adults with various cases of sleep disorders.<ref>{{Cite web|url=https://www.webmd.com/sleep-disorders/features/can-music-help-me-sleep|title=Can Music Help Me Sleep?|website=WebMD|language=en|access-date=2019-09-29}}</ref><ref>{{Cite web|url=https://medium.com/taking-note/can-music-make-you-a-productivity-powerhouse-9161721fced6|title=Can Music Make You a Productivity Powerhouse?|last=Evernote|date=2018-07-26|website=Medium|language=en|access-date=2019-09-29}}</ref> Music is most effective before bed once the brain has been conditioned to it, helping to achieve sleep much faster.<ref>{{Cite web|url=https://www.psychologytoday.com/blog/sleep-newzzz/201812/the-many-health-and-sleep-benefits-music|title=The Many Health and Sleep Benefits Of Music|website=Psychology Today|language=en-US|access-date=2019-09-30}}</ref>
+In another study specifically looking to help people with insomnia, similar results were seen. The participants who listened to music experienced better sleep quality than those who did not listen to music.<ref>{{cite journal | vauthors = Jespersen KV, Pando-Naude V, Koenig J, Jennum P, Vuust P | title = Listening to music for insomnia in adults | journal = The Cochrane Database of Systematic Reviews | volume = 2022 | issue = 8 | article-number = CD010459 | date = August 2022 | pmid = 36000763 | pmc = 9400393 | doi = 10.1002/14651858.CD010459.pub3 }}</ref> Listening to slower-pace music before bed can help decrease the heart rate, making it easier to transition into sleep. Studies have indicated that music helps induce a state of relaxation that shifts an individual's [[Circadian rhythm|internal clock]] towards the sleep cycle. This is said to have an effect on children and adults with various cases of sleep disorders.<ref>{{Cite web|url=https://www.webmd.com/sleep-disorders/features/can-music-help-me-sleep|title=Can Music Help Me Sleep?|website=WebMD|language=en|access-date=2019-09-29}}</ref><ref>{{Cite web|url=https://medium.com/taking-note/can-music-make-you-a-productivity-powerhouse-9161721fced6|title=Can Music Make You a Productivity Powerhouse?|last=Evernote|date=2018-07-26|website=Medium|language=en|access-date=2019-09-29}}</ref> Music is most effective before bed once the brain has been conditioned to it, helping to achieve sleep much faster.<ref>{{Cite web|url=https://www.psychologytoday.com/blog/sleep-newzzz/201812/the-many-health-and-sleep-benefits-music|title=The Many Health and Sleep Benefits Of Music|website=Psychology Today|language=en-US|access-date=2019-09-30}}</ref>
 === Melatonin ===
-Research suggests that [[melatonin (medication)|melatonin]] is useful in helping people fall asleep faster (decreased [[sleep onset latency|sleep latency]]), stay asleep longer, and experience improved sleep quality. To test this, a study was conducted that compared subjects who had taken melatonin to subjects with primary sleep disorders who had taken a placebo. Researchers assessed sleep onset latency, total minutes slept, and overall sleep quality in the melatonin and placebo groups to note the differences. In the end, researchers found that melatonin decreased sleep onset latency and increased total sleep time<ref>{{cite journal | vauthors = Ferracioli-Oda E, Qawasmi A, Bloch MH | title = Meta-analysis: melatonin for the treatment of primary sleep disorders | journal = PLOS ONE | volume = 8 | issue = 5 | pages = e63773 | date = 2013-06-06 | pmid = 23691095 | pmc = 3656905 | doi = 10.1371/journal.pone.0063773 | doi-access = free | bibcode = 2013PLoSO...863773F }}</ref><ref>{{cite web|url=http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?ID=12013029090|title=Meta-analysis: melatonin for the treatment of primary sleep disorders|website=www.crd.york.ac.uk|access-date=2016-03-08}}</ref> but had an insignificant and inconclusive impact on the quality of sleep compared to the placebo group.
+Research suggests that [[melatonin (medication)|melatonin]] is useful in helping people fall asleep faster (decreased [[sleep onset latency|sleep latency]]), stay asleep longer, and experience improved sleep quality. To test this, a study was conducted that compared subjects who had taken melatonin to subjects with primary sleep disorders who had taken a placebo. <!-- what are "primary sleep disorders?" -->Researchers assessed sleep onset latency, total minutes slept, and overall sleep quality in the melatonin and placebo groups to note the differences. In the end, researchers found that melatonin decreased sleep onset latency and increased total sleep time,<ref>{{cite journal | vauthors = Ferracioli-Oda E, Qawasmi A, Bloch MH | title = Meta-analysis: melatonin for the treatment of primary sleep disorders | journal = PLOS ONE | volume = 8 | issue = 5 | article-number = e63773 | date = 2013-06-06 | pmid = 23691095 | pmc = 3656905 | doi = 10.1371/journal.pone.0063773 | doi-access = free | bibcode = 2013PLoSO...863773F }}</ref><ref>{{cite web|url=http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?ID=12013029090|title=Meta-analysis: melatonin for the treatment of primary sleep disorders|website=www.crd.york.ac.uk|access-date=2016-03-08}}</ref> but had an insignificant and inconclusive impact on the quality of sleep compared to the placebo group.
 == Sleep medicine ==
@@ Line 132: / Line 134: @@
 [[File:To_Sleep_Forevermore.jpg|thumb|Sleep Medication.]]
-Specialists in sleep medicine were originally and continue to be certified by the [[American Board of Sleep Medicine]]. Those passing the Sleep Medicine Specialty Exam received the designation "diplomate of the [[American Board of Sleep Medicine|ABSM]]". Sleep medicine is now a recognized subspecialty within [[internal medicine]], [[family medicine]], [[pediatrics]], [[otolaryngology]], [[psychiatry]] and [[neurology]] in the [[United States]]. Certification in Sleep medicine shows that the specialist:{{blockquote|has demonstrated expertise in the diagnosis and management of clinical conditions that occur during sleep, that disturb sleep, or that are affected by disturbances in the wake-sleep cycle. This specialist is skilled in the analysis and interpretation of comprehensive polysomnography, and well-versed in emerging research and management of a sleep laboratory.<ref>{{cite web|url=http://www.abms.org/Who_We_Help/Physicians/specialties.aspx|title=American Board of Medical Specialties : Recognized Physician Specialty and Subspecialty Certificates|access-date=2008-07-21|url-status=dead|archive-url=https://web.archive.org/web/20120508025259/http://www.abms.org/who_we_help/physicians/specialties.aspx|archive-date=2012-05-08}}</ref> }}
+Specialists in sleep medicine were originally and continue to be certified by the [[American Board of Sleep Medicine]]. Those passing the Sleep Medicine Specialty Exam received the designation "diplomate of the [[American Board of Sleep Medicine|ABSM]]". Sleep medicine is now a recognized subspecialty within [[internal medicine]], [[family medicine]], [[pediatrics]], [[otolaryngology]], [[psychiatry]] and [[neurology]] in the [[United States]]. Certification in Sleep medicine shows that the specialist:{{blockquote|has demonstrated expertise in the diagnosis and management of clinical conditions that occur during sleep, that disturb sleep, or that are affected by disturbances in the wake-sleep cycle. This specialist is skilled in the analysis and interpretation of comprehensive polysomnography, and well-versed in emerging research and management of a sleep laboratory.<ref>{{cite web|url=http://www.abms.org/Who_We_Help/Physicians/specialties.aspx|title=American Board of Medical Specialties: Recognized Physician Specialty and Subspecialty Certificates|access-date=2008-07-21|archive-url=https://web.archive.org/web/20120508025259/http://www.abms.org/who_we_help/physicians/specialties.aspx|archive-date=2012-05-08}}</ref> }}
 Competence in sleep medicine requires an understanding of a myriad of very diverse disorders. Many of which present with similar [[symptom]]s such as excessive daytime sleepiness, which, in the absence of volitional [[sleep deprivation]], "is almost inevitably caused by an identifiable and treatable sleep disorder", such as sleep apnea, [[narcolepsy]], [[idiopathic hypersomnia]], [[Kleine–Levin syndrome]], menstrual-related hypersomnia, [[idiopathic]] recurrent stupor, or [[circadian rhythm sleep disorders|circadian rhythm disturbances]].<ref>{{cite journal | vauthors = Mahowald MW | title = What is causing excessive daytime sleepiness? Evaluation to distinguish sleep deprivation from sleep disorders | journal = Postgraduate Medicine | volume = 107 | issue = 3 | pages = 108–10, 115–8, 123 | date = March 2000 | pmid = 10728139 | doi = 10.3810/pgm.2000.03.932 | s2cid = 42939232 }}</ref> Another common complaint is insomnia, a set of symptoms which can have a great many different causes, physical and mental. Management in the varying situations differs greatly and cannot be undertaken without a correct diagnosis.<ref>{{cite journal | vauthors = Araújo T, Jarrin DC, Leanza Y, Vallières A, Morin CM | title = Qualitative studies of insomnia: Current state of knowledge in the field | journal = Sleep Medicine Reviews | volume = 31 | pages = 58–69 | date = February 2017 | pmid = 27090821 | pmc = 4945477 | doi = 10.1016/j.smrv.2016.01.003 }}</ref>
@@ Line 138: / Line 140: @@
 Sleep dentistry ([[bruxism]], [[snoring]] and [[sleep apnea]]), while not recognized as one of the nine [[dentistry|dental specialties]], qualifies for board-certification by the American Board of Dental Sleep Medicine (ABDSM). The qualified dentists collaborate with sleep physicians at accredited sleep centers, and can provide oral appliance therapy and upper airway surgery to treat or manage sleep-related breathing disorders.<ref>{{cite web|url= http://www.abdsm.org/|title= About the ADBSM |access-date= 2008-07-22 |publisher= American Board of Dental Sleep Medicine }}</ref> The resulting diplomate status is recognized by the [[American Academy of Sleep Medicine]] (AASM), and these dentists are organized in the Academy of Dental Sleep Medicine (USA).<ref>{{cite web|year=2008|title=About AADSM|url=http://aadsm.org/|access-date=2008-07-22|publisher=Academy of Dental Sleep Medicine}}</ref>
-[[Occupational therapy]] is an area of medicine that can also address a diagnosis of sleep disorder, as rest and sleep is listed in the Occupational Therapy Practice Framework (OTPF) as its own occupation of daily living.<ref name=":23" />  Rest and sleep are described as restorative in order to support engagement in other occupational therapy occupations.<ref name=":23" /> In the OTPF, the occupation of rest and sleep is broken down into rest, sleep preparation, and sleep participation.<ref name=":23">{{cite journal | vauthors =  | title = Occupational Therapy Practice Framework: Domain and Process-Fourth Edition | journal = The American Journal of Occupational Therapy | volume = 74 | issue = Supplement_2 | pages = 7412410010p1–7412410010p87 | date = August 2020 | pmid = 34780625 | doi = 10.5014/ajot.2020.74S2001 | s2cid = 204057541 }}</ref> Occupational therapists have been shown to help improve restorative sleep through the use of assistive devices/equipment, [[Cognitive behavioral therapy for insomnia|cognitive behavioral therapy for Insomnia]], therapeutic activities, and lifestyle interventions.<ref>{{cite journal | vauthors = Ho EC, Siu AM | title = Occupational Therapy Practice in Sleep Management: A Review of Conceptual Models and Research Evidence | journal = Occupational Therapy International | volume = 2018 | pages = 8637498 | date = 2018-07-29 | pmid = 30150906 | pmc = 6087566 | doi = 10.1155/2018/8637498 | doi-access = free }}</ref>
+[[Occupational therapy]] is an area of medicine that can also address a diagnosis of sleep disorder, as rest and sleep is listed in the Occupational Therapy Practice Framework (OTPF) as its own occupation of daily living.<ref name=":23" />  Rest and sleep are described as restorative in order to support engagement in other occupational therapy occupations.<ref name=":23" /> In the OTPF, the occupation of rest and sleep is broken down into rest, sleep preparation, and sleep participation.<ref name=":23">{{cite journal | vauthors =  | title = Occupational Therapy Practice Framework: Domain and Process-Fourth Edition | journal = The American Journal of Occupational Therapy | volume = 74 | issue = Supplement_2 | pages = 7412410010p1–7412410010p87 | date = August 2020 | pmid = 34780625 | doi = 10.5014/ajot.2020.74S2001 | s2cid = 204057541 }}</ref> Occupational therapists have been shown to help improve restorative sleep through the use of assistive devices/equipment, [[Cognitive behavioral therapy for insomnia|cognitive behavioral therapy for Insomnia]], therapeutic activities, and lifestyle interventions.<ref>{{cite journal | vauthors = Ho EC, Siu AM | title = Occupational Therapy Practice in Sleep Management: A Review of Conceptual Models and Research Evidence | journal = Occupational Therapy International | volume = 2018 | article-number = 8637498 | date = 2018-07-29 | pmid = 30150906 | pmc = 6087566 | doi = 10.1155/2018/8637498 | doi-access = free }}</ref>
-In the UK, knowledge of sleep medicine and possibilities for diagnosis and treatment seem to lag. The Imperial College Healthcare<ref>{{cite web |url= http://www.imperial.nhs.uk/services/sleepservices/index.htm |title= Sleep services |access-date= 2008-08-02 |year= 2008 |publisher= Imperial College Healthcare NHS Trust |url-status= dead |archive-url= https://web.archive.org/web/20081004181017/http://www.imperial.nhs.uk/services/sleepservices/index.htm |archive-date= 2008-10-04 }}</ref> shows attention to obstructive sleep apnea syndrome (OSA) and very few other sleep disorders. Some NHS trusts have specialist clinics for respiratory and neurological sleep medicine.
+In the UK, knowledge of sleep medicine and possibilities for diagnosis and treatment seem to lag. The Imperial College Healthcare<ref>{{cite web |url= http://www.imperial.nhs.uk/services/sleepservices/index.htm |title= Sleep services |access-date= 2008-08-02 |year= 2008 |publisher= Imperial College Healthcare NHS Trust |archive-url= https://web.archive.org/web/20081004181017/http://www.imperial.nhs.uk/services/sleepservices/index.htm |archive-date= 2008-10-04 }}</ref> shows attention to obstructive sleep apnea syndrome and very few other sleep disorders. Some NHS trusts have specialist clinics for respiratory and neurological sleep medicine.
 == Epidemiology ==
-=== Children and young adults ===
+=== Children and adolescents ===
-According to one meta-analysis of sleep disorders in children, [[confusional arousals]] and [[sleepwalking]] are the two most common sleep disorders among children.<ref name=":1">{{cite journal | vauthors = Carter KA, Hathaway NE, Lettieri CF | title = Common sleep disorders in children | journal = American Family Physician | volume = 89 | issue = 5 | pages = 368–377 | date = March 2014 | pmid = 24695508 | url = http://www.aafp.org/afp/2014/0301/p368.html }}</ref> An estimated 17.3% of kids between 3 and 13 years old experience confusional arousals.<ref name=":1" /> About 17% of children sleepwalk, with the disorder being more common among boys than girls,<ref name=":1" /> the peak ages of sleepwalking are from 8 to 12 years old.<ref name=":1" />
+A systematic review reveals parasomnias to be the most common sleep disorder in childhood, affecting up to 50% of children. However, only 4% of these parasomnias persist past adolescence. These parasomnias and their prevalences in childhood are [[sleepwalking]] (17%), [[confusional arousal]]s (17.3% in 3-13 year olds), [[Night terror|sleep terrors]] (1-6.5%), and [[nightmare]]s (10-50% in 3-5 year olds). Other common sleep disorders and their prevalences are behavioural insomnia of childhood (10-30%), [[delayed sleep phase disorder]] (7-16%), [[obstructive sleep apnea]] (1-5%), and [[restless legs syndrome]] (2-4%).<ref name=":1">{{cite journal |vauthors=Carter KA, Hathaway NE, Lettieri CF |date=March 2014 |title=Common sleep disorders in children |url=http://www.aafp.org/afp/2014/0301/p368.html |journal=American Family Physician |volume=89 |issue=5 |pages=368–377 |pmid=24695508}}</ref>
-A different systematic review offers a high range of prevalence rates of [[Bruxism|sleep bruxism]] for children. Parasomnias like sleepwalking and talking typically occur during the first part of an individual's sleep cycle, the first slow wave of sleep <ref>{{cite journal | vauthors = Carter KA, Hathaway NE, Lettieri CF | title = Common sleep disorders in children | journal = American Family Physician | volume = 89 | issue = 5 | pages = 368–377 | date = March 2014 | pmid = 24695508 | url = https://pubmed.ncbi.nlm.nih.gov/24695508/ }}</ref> During the first slow wave of sleep period of the sleep cycle the mind and body slow down causing one to feel drowsy and relaxed. At this stage it is the easiest to wake up, therefore many children do not remember what happened during this time.
-Nightmares are also considered a parasomnia among children, who typically remember what took place during the nightmare. However, nightmares only occur during the last stage of sleep - [[Rapid eye movement sleep|Rapid Eye Movement (REM)]] sleep. REM is the deepest stage of sleep, it is named for the host of neurological and physiological responses an individual can display during this period of the sleep cycle which are similar to being awake'''.<ref>{{cite book| vauthors = Patel AK, Reddy V, Shumway KR, Araujo AF | chapter = Physiology, Sleep Stages |date=2021| chapter-url = http://www.ncbi.nlm.nih.gov/books/NBK526132/| title = StatPearls|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=30252388|access-date=2021-09-19}}</ref>'''
-Between 15.29% and 38.6% of preschoolers grind their teeth at least one night a week. All but one of the included studies reports decreasing [[Bruxism|bruxist]] prevalence as age increased, as well as a higher prevalence among boys than girls.<ref>{{cite journal | vauthors = Machado E, Dal-Fabbro C, Cunali PA, Kaizer OB | title = Prevalence of sleep bruxism in children: a systematic review | journal = Dental Press Journal of Orthodontics | volume = 19 | issue = 6 | pages = 54–61 | date = 2014 | pmid = 25628080 | pmc = 4347411 | doi = 10.1590/2176-9451.19.6.054-061.oar }}</ref>
-Another systematic review noted 7-16% of young adults have [[delayed sleep phase disorder]]. This disorder reaches peak prevalence when people are in their 20s.<ref name=":1" />  Between 20 and 26% of adolescents report a [[sleep onset latency]] of greater than 30 minutes. Also, 7-36% have difficulty initiating sleep.<ref name=":4">{{cite journal | vauthors = Gradisar M, Gardner G, Dohnt H | title = Recent worldwide sleep patterns and problems during adolescence: a review and meta-analysis of age, region, and sleep | journal = Sleep Medicine | volume = 12 | issue = 2 | pages = 110–118 | date = February 2011 | pmid = 21257344 | doi = 10.1016/j.sleep.2010.11.008 }}</ref>  Asian teens tend to have a higher prevalence of all of these adverse sleep outcomes—than their North American and European counterparts.<ref name=":4" />
+Sleepwalking was found to be more common in males, with no gender disparity noted in any of the other common childhood sleep disturbances. Obstructive sleep apnea was found to be more common in African Americans, individuals with [[Craniofacial abnormality|craniofacial abnormalities]], [[Down syndrome]], [[neuromuscular disease]]s, and [[choanal atresia]]. A number of the sleep disorders listed were found to have a familial pattern, meaning the incidence in a child was more likely to occur if one or both parents had a history of that sleep disorder; these include sleepwalking, confusional arousals, delayed sleep phase disorder, and restless legs syndrome.<ref name=":1" />
-By adulthood, parasomnias can normally be resolved due to a person's growth; however, 4% of people have recurring symptoms.
+A different systematic review examining [[Bruxism|sleep bruxism]] in children found prevalence rates ranging from 5.9% to 49.6%. In preschool-aged children, between 15.29% and 38.6% grind their teeth in their sleep for at least one night per week. In all but one of the included studies, the prevalence of bruxism decreases as age increases.<ref>{{cite journal | vauthors = Machado E, Dal-Fabbro C, Cunali PA, Kaizer OB | title = Prevalence of sleep bruxism in children: a systematic review | journal = Dental Press Journal of Orthodontics | volume = 19 | issue = 6 | pages = 54–61 | date = 2014 | pmid = 25628080 | pmc = 4347411 | doi = 10.1590/2176-9451.19.6.054-061.oar }}</ref>
-=== Effects of Untreated Sleep Disorders ===
+Between 20 and 26% of adolescents report a [[sleep onset latency]] of greater than 30 minutes, and 7-36% have difficulty initiating sleep. Asian teens tend to have a higher prevalence of adverse sleep outcomes than their North American and European counterparts.<ref name=":4">{{cite journal |vauthors=Gradisar M, Gardner G, Dohnt H |date=February 2011 |title=Recent worldwide sleep patterns and problems during adolescence: a review and meta-analysis of age, region, and sleep |journal=Sleep Medicine |volume=12 |issue=2 |pages=110–118 |doi=10.1016/j.sleep.2010.11.008 |pmid=21257344}}</ref>
-Children and young adults who do not get enough sleep due to sleep disorders also have many other health problems such as obesity and physical problems where it could interfere with everyday life.<ref>{{cite journal | vauthors = Wheaton AG, Jones SE, Cooper AC, Croft JB | title = Short Sleep Duration Among Middle School and High School Students - United States, 2015 | language = en-us | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 67 | issue = 3 | pages = 85–90 | date = January 2018 | pmid = 29370154 | pmc = 5812312 | doi = 10.15585/mmwr.mm6703a1 }}</ref> It is recommended that children and young adults stick to the hours of sleep recommended by the CDC, as it helps increase mental health, physical health, and more.<ref>{{cite journal | vauthors = Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS | display-authors = 6 | title = Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion | journal = Journal of Clinical Sleep Medicine | volume = 12 | issue = 11 | pages = 1549–1561 | date = November 2016 | pmid = 27707447 | pmc = 5078711 | doi = 10.5664/jcsm.6288 }}</ref>
 === Insomnia ===
 [[Insomnia]] is a prevalent form of sleep deprivation. Individuals with insomnia may have problems falling asleep, staying asleep, or a combination of both resulting in hyposomnia - i.e. insufficient quantity and poor quality of sleep.<ref name="Zeitlhofer et al. 1993">{{cite journal | vauthors = Zeitlhofer J, Tribl G, Saletu B | title = [Sleep disorders in neurology: hyposomnia] | journal = Wiener Klinische Wochenschrift | volume = 105 | issue = 2 | pages = 37–41 | year = 1993 | pmid = 8442353 }}</ref>
-Combining results from 17 studies on insomnia in China, a pooled prevalence of 15.0% is reported for the country.<ref name=":5">{{cite journal | vauthors = Cao XL, Wang SB, Zhong BL, Zhang L, Ungvari GS, Ng CH, Li L, Chiu HF, Lok GK, Lu JP, Jia FJ, Xiang YT | display-authors = 6 | title = The prevalence of insomnia in the general population in China: A meta-analysis | journal = PLOS ONE | volume = 12 | issue = 2 | pages = e0170772 | date = 2017-02-24 | pmid = 28234940 | pmc = 5325204 | doi = 10.1371/journal.pone.0170772 | doi-access = free | bibcode = 2017PLoSO..1270772C }}</ref>  This result is consistent among other [[East Asia]]n countries; however, this is considerably lower than a series of [[Western world|Western countries]] (50.5% in Poland, 37.2% in France and Italy, 27.1% in USA).<ref name=":5" /> Men and women residing in China experience insomnia at similar rates.<ref name=":5" />
+Combining results from 17 studies on insomnia in China, a pooled prevalence of 15.0% is reported for the country.<ref name=":5">{{cite journal | vauthors = Cao XL, Wang SB, Zhong BL, Zhang L, Ungvari GS, Ng CH, Li L, Chiu HF, Lok GK, Lu JP, Jia FJ, Xiang YT | display-authors = 6 | title = The prevalence of insomnia in the general population in China: A meta-analysis | journal = PLOS ONE | volume = 12 | issue = 2 | article-number = e0170772 | date = 2017-02-24 | pmid = 28234940 | pmc = 5325204 | doi = 10.1371/journal.pone.0170772 | doi-access = free | bibcode = 2017PLoSO..1270772C }}</ref>  This result is consistent among other [[East Asia]]n countries; however, this is considerably lower than a series of [[Western world|Western countries]] (50.5% in Poland, 37.2% in France and Italy, 27.1% in USA).<ref name=":5" /> Men and women residing in China experience insomnia at similar rates.<ref name=":5" />
 A separate meta-analysis focusing on this sleeping disorder in the elderly mentions that those with more than one physical or psychiatric malady experience it at a 60% higher rate than those with one condition or less. It also notes a higher prevalence of insomnia in women over the age of 50 than their male counterparts.<ref>{{cite journal | vauthors = Rodriguez JC, Dzierzewski JM, Alessi CA | title = Sleep problems in the elderly | journal = The Medical Clinics of North America | volume = 99 | issue = 2 | pages = 431–439 | date = March 2015 | pmid = 25700593 | pmc = 4406253 | doi = 10.1016/j.mcna.2014.11.013 }}</ref>
-A study that was resulted from a collaboration between [[Massachusetts General Hospital]] and [[Merck & Co.|Merck]] describes the development of an [[algorithm]] to identify patients with sleep disorders using electronic medical records. The algorithm that incorporated a combination of structured and unstructured variables identified more than 36,000 individuals with physician-documented insomnia.<ref>{{cite journal | vauthors = Kartoun U, Aggarwal R, Beam AL, Pai JK, Chatterjee AK, Fitzgerald TP, Kohane IS, Shaw SY | display-authors = 6 | title = Development of an Algorithm to Identify Patients with Physician-Documented Insomnia | journal = Scientific Reports | volume = 8 | issue = 1 | pages = 7862 | date = May 2018 | pmid = 29777125 | pmc = 5959894 | doi = 10.1038/s41598-018-25312-z | bibcode = 2018NatSR...8.7862K }}</ref>
+A study which resulted from a collaboration between [[Massachusetts General Hospital]] and [[Merck & Co.|Merck]] describes the development of an [[algorithm]] to identify patients with sleep disorders using electronic medical records. The algorithm that incorporated a combination of structured and unstructured variables identified more than 36,000 individuals with physician-documented insomnia.<ref>{{cite journal | vauthors = Kartoun U, Aggarwal R, Beam AL, Pai JK, Chatterjee AK, Fitzgerald TP, Kohane IS, Shaw SY | display-authors = 6 | title = Development of an Algorithm to Identify Patients with Physician-Documented Insomnia | journal = Scientific Reports | volume = 8 | issue = 1 | article-number = 7862 | date = May 2018 | pmid = 29777125 | pmc = 5959894 | doi = 10.1038/s41598-018-25312-z | bibcode = 2018NatSR...8.7862K }}</ref>
-Insomnia can start off at the basic level but about 40% of people who struggle with insomnia have worse symptoms.<ref name="Pavlova 292–299">{{cite journal | vauthors = K Pavlova M, Latreille V | title = Sleep Disorders | language = English | journal = The American Journal of Medicine | volume = 132 | issue = 3 | pages = 292–299 | date = March 2019 | pmid = 30292731 | doi = 10.1016/j.amjmed.2018.09.021 | s2cid = 52935007 }}</ref> There are treatments that can help with insomnia and that includes medication, planning out a sleep schedule, limiting oneself from caffeine intake, and cognitive behavioral therapy.<ref name="Pavlova 292–299" />
+Insomnia can start off at the basic level but about 40% of people who struggle with insomnia have worse symptoms.<ref name="Pavlova 292–299">{{cite journal | vauthors = K Pavlova M, Latreille V | title = Sleep Disorders | language = English | journal = The American Journal of Medicine | volume = 132 | issue = 3 | pages = 292–299 | date = March 2019 | pmid = 30292731 | doi = 10.1016/j.amjmed.2018.09.021 | s2cid = 52935007 }}</ref> Treatments that can help with insomnia include medication, creating and following a sleep routine, limiting one's caffeine intake, and [[cognitive behavioral therapy for insomnia]].<ref name="Pavlova 292–299" />
 === Obstructive sleep apnea ===
-[[Obstructive sleep apnea]] (OSA) affects around 4% of men and 2% of women in the United States.<ref name=":2">{{cite journal | vauthors = Mirrakhimov AE, Sooronbaev T, Mirrakhimov EM | title = Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature | journal = BMC Pulmonary Medicine | volume = 13 | pages = 10 | date = February 2013 | pmid = 23433391 | pmc = 3585751 | doi = 10.1186/1471-2466-13-10 | doi-access = free }}</ref> In general, this disorder is more prevalent among men. However, this difference tends to diminish with age. Women experience the highest risk for OSA during pregnancy,<ref name=":0">{{cite journal | vauthors = Wimms A, Woehrle H, Ketheeswaran S, Ramanan D, Armitstead J | title = Obstructive Sleep Apnea in Women: Specific Issues and Interventions | journal = BioMed Research International | volume = 2016 | pages = 1764837 | date = 2016 | pmid = 27699167 | pmc = 5028797 | doi = 10.1155/2016/1764837 | doi-access = free }}</ref> and tend to report experiencing [[Depression (mood)|depression]] and [[insomnia]] in conjunction with obstructive sleep apnea.<ref name=":3">{{cite journal | vauthors = Valipour A | title = Gender-related differences in the obstructive sleep apnea syndrome | journal = Pneumologie | volume = 66 | issue = 10 | pages = 584–588 | date = October 2012 | pmid = 22987326 | doi = 10.1055/s-0032-1325664 | doi-access = free }}</ref>
+[[Obstructive sleep apnea]] affects around 4% of men and 2% of women in the United States.<ref name=":2">{{cite journal |vauthors=Mirrakhimov AE, Sooronbaev T, Mirrakhimov EM |date=February 2013 |title=Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature |journal=BMC Pulmonary Medicine |volume=13 |doi=10.1186/1471-2466-13-10 |pmc=3585751 |pmid=23433391 |doi-access=free |article-number=10}}</ref> While the disorder is more prevalent among men, this difference tends to diminish with age. Obstructive sleep apnea is more prevalent among women during pregnancy,<ref name=":0">{{cite journal | vauthors = Wimms A, Woehrle H, Ketheeswaran S, Ramanan D, Armitstead J | title = Obstructive Sleep Apnea in Women: Specific Issues and Interventions | journal = BioMed Research International | volume = 2016 | article-number = 1764837 | date = 2016 | pmid = 27699167 | pmc = 5028797 | doi = 10.1155/2016/1764837 | doi-access = free }}</ref> and women tend to report [[Depression (mood)|depression]] and [[insomnia]] in conjunction with obstructive sleep apnea.<ref name=":3">{{cite journal | vauthors = Valipour A | title = Gender-related differences in the obstructive sleep apnea syndrome | journal = Pneumologie | volume = 66 | issue = 10 | pages = 584–588 | date = October 2012 | pmid = 22987326 | doi = 10.1055/s-0032-1325664 | doi-access = free }}</ref>
-In a meta-analysis of the various Asian countries, India and China present the highest prevalence of the disorder. Specifically, about 13.7% of the Indian population and 7% of Hong Kong's population is estimated to have OSA. The two groups in the study experience daytime OSA symptoms such as difficulties concentrating, mood swings, or high blood pressure,<ref>{{Cite web|url=https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090|title=Obstructive sleep apnea – Symptoms and causes – Mayo Clinic|website=www.mayoclinic.org|access-date=2017-11-27}}</ref> at similar rates (prevalence of 3.5% and 3.57%, respectively).<ref name=":2" />
+In a meta-analysis of the various Asian countries, India and China present the highest prevalence of the disorder. Specifically, about 13.7% of the Indian population and 7% of Hong Kong's population is estimated to have obstructive sleep apnea. The two groups in the study experience daytime symptoms such as difficulties concentrating, mood swings, or high blood pressure,<ref>{{Cite web|url=https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090|title=Obstructive sleep apnea – Symptoms and causes – Mayo Clinic|website=www.mayoclinic.org|access-date=2017-11-27}}</ref> at similar rates (prevalence of 3.5% and 3.57%, respectively).<ref name=":2" />
-=== Obesity and Sleep Apnea ===
+=== Obesity and sleep apnea ===
-The worldwide incidence of obstructive sleep apnea (OSA) is on the rise, largely due to the increasing prevalence of obesity in society. In individuals who are obese, excess fat deposits in the upper respiratory tract can lead to breathing difficulties during sleep, giving rise to OSA. There is a strong connection between obesity and OSA, making it essential to screen obese individuals for OSA and related disorders. Moreover, both obesity and OSA patients are at higher risk of developing metabolic syndrome. Implementing dietary control in obese individuals can have a positive impact on sleep problems and can help alleviate associated issues such as depression, anxiety, and insomnia.<ref>{{Cite journal |last=Owen |first=Lauren |last2=Corfe |first2=Bernard |date=November 2017 |title=The role of diet and nutrition on mental health and wellbeing |url=https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/role-of-diet-and-nutrition-on-mental-health-and-wellbeing/372284768DB78DB02EB199E277AABF79 |journal=Proceedings of the Nutrition Society |language=en |volume=76 |issue=4 |pages=425–426 |doi=10.1017/S0029665117001057 |issn=0029-6651}}</ref> [[Sleep and weight|Obesity]] can influence the disturbance in sleep patterns resulting in OSA. <ref>{{cite journal | vauthors = Lee JH, Cho J | title = Sleep and Obesity | journal = Sleep Medicine Clinics | volume = 17 | issue = 1 | pages = 111–116 | date = March 2022 | pmid = 35216758 | doi = 10.1016/j.jsmc.2021.10.009 | s2cid = 245696606 }}</ref> Obesity is a risk factor for OSA because it can affect the upper respiratory system by accumulating fat deposition around the muscles surrounding the lungs. Additionally, OSA can irritate the obesity by prolonging sleepiness throughout the day leading to reduces physical activity and an inactive lifestyle.<ref name=":24" />
+{{Further|Sleep and weight}}
+In obese individuals, excess fat in the upper respiratory tract can lead to breathing difficulties during sleep and lead to obstructive sleep apnea.<ref>{{cite journal |vauthors=Lee JH, Cho J |date=March 2022 |title=Sleep and Obesity |journal=Sleep Medicine Clinics |volume=17 |issue=1 |pages=111–116 |doi=10.1016/j.jsmc.2021.10.009 |pmid=35216758 |s2cid=245696606}}</ref> As obesity is a risk factor for obstructive sleep apnea, it is essential to screen obese individuals for obstructive sleep apnea and related disorders. Additionally, both obese and obstructive sleep apnea patients are at greater risk of developing a [[metabolic syndrome]]. Implementing dietary control in obese individuals can have a positive impact on sleep problems and help alleviate associated issues such as depression, anxiety, and insomnia.<ref>{{Cite journal |last1=Owen |first1=Lauren |last2=Corfe |first2=Bernard |date=November 2017 |title=The role of diet and nutrition on mental health and wellbeing |url=https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/role-of-diet-and-nutrition-on-mental-health-and-wellbeing/372284768DB78DB02EB199E277AABF79 |journal=Proceedings of the Nutrition Society |language=en |volume=76 |issue=4 |pages=425–426 |doi=10.1017/S0029665117001057 |pmid=28707609 |issn=0029-6651}}</ref> [[Excessive daytime sleepiness]] caused by obstructive sleep apnea may promote an inactive lifestyle, possibly contributing to obesity.<ref name=":24" />
 === Sleep paralysis ===
-A [[systematic review]] states 7.6% of the general population experiences [[sleep paralysis]] at least once in their lifetime. Its prevalence among men is 15.9%, while 18.9% of women experience it.
+In a systematic review, it was found that 7.6% of the general population had reported experiencing [[sleep paralysis]] at least once in their lifetime. Slightly more women (18.9%) reported experiencing sleep paralysis than men (15.9%). 28.3% of students reported experiencing sleep paralysis, with the highest incidence among students of Asian descent (39.9%) and lowest incidence among Caucasian students (30.8%) when compared to other ethnicities (Hispanic: 34.5%, African descent: 31.4%). 31.9% of psychiatric patients reported experiencing sleep paralysis, of which 34.6% had a [[panic disorder]].<ref>{{cite journal | vauthors = Sharpless BA, Barber JP | title = Lifetime prevalence rates of sleep paralysis: a systematic review | journal = Sleep Medicine Reviews | volume = 15 | issue = 5 | pages = 311–315 | date = October 2011 | pmid = 21571556 | pmc = 3156892 | doi = 10.1016/j.smrv.2011.01.007 }}</ref>
-When considering specific populations, 28.3% of students and 31.9% of psychiatric patients have experienced this phenomenon at least once in their lifetime. Of those psychiatric patients, 34.6% have [[panic disorder]]. Sleep paralysis in students is slightly more prevalent for those of Asian descent (39.9%) than other ethnicities (Hispanic: 34.5%, African descent: 31.4%, Caucasian 30.8%).<ref>{{cite journal | vauthors = Sharpless BA, Barber JP | title = Lifetime prevalence rates of sleep paralysis: a systematic review | journal = Sleep Medicine Reviews | volume = 15 | issue = 5 | pages = 311–315 | date = October 2011 | pmid = 21571556 | pmc = 3156892 | doi = 10.1016/j.smrv.2011.01.007 }}</ref>
+=== Restless legs syndrome ===
+According to one meta-analysis, the average prevalence rate among North American and Western European populations is estimated to be 14.5±8.0%. Specifically in the United States, the prevalence of [[restless legs syndrome]] is estimated to be between 5% and 15.7% when using strict diagnostic criteria. Restless legs syndrome is over 35% more prevalent in American women than their male counterparts.<ref>{{cite journal | vauthors = Innes KE, Selfe TK, Agarwal P | title = Prevalence of restless legs syndrome in North American and Western European populations: a systematic review | journal = Sleep Medicine | volume = 12 | issue = 7 | pages = 623–634 | date = August 2011 | pmid = 21752711 | pmc = 4634567 | doi = 10.1016/j.sleep.2010.12.018 }}</ref>
-=== Restless legs syndrome ===
+==Classification (ICSD-3, 2023)==
-According to one meta-analysis, the average prevalence rate for North America,             and Western Europe is estimated to be 14.5±8.0%. Specifically in the United States, the prevalence of [[restless legs syndrome]] is estimated to be between 5% and 15.7% when using strict diagnostic criteria. RLS is over 35% more prevalent in American women than their male counterparts.<ref>{{cite journal | vauthors = Innes KE, Selfe TK, Agarwal P | title = Prevalence of restless legs syndrome in North American and Western European populations: a systematic review | journal = Sleep Medicine | volume = 12 | issue = 7 | pages = 623–634 | date = August 2011 | pmid = 21752711 | pmc = 4634567 | doi = 10.1016/j.sleep.2010.12.018 }}</ref> Restless Leg Syndrome (RLS) is a sensorimotor disorder characterized by discomfort in the lower limbs. Typically, symptoms worsen in the evening, improve with movement, and exacerbate when at rest.<ref>{{Cite journal |last1=Kocabicak |first1=Ersoy |last2=Terzi |first2=Murat |last3=Akpinar |first3=Kursad |last4=Paksoy |first4=Kemal |last5=Cebeci |first5=Ibrahim |last6=Iyigun |first6=Omer |date=2014 |title=Restless Leg Syndrome and Sleep Quality in Lumbar Radiculopathy Patients |journal=Behavioural Neurology |language=en |volume=2014 |pages=1–5 |doi=10.1155/2014/245358 |doi-access=free |pmid=25110396 |pmc=4109372 |issn=0953-4180}}</ref>
+=== Insomnia ===
+Insomnia is the most frequent sleep disorder.<ref>{{Cite journal |last=Buysse |first=Daniel J. |date=2013-02-20 |title=Insomnia |journal=JAMA |volume=309 |issue=7 |pages=706–716 |doi=10.1001/jama.2013.193 |issn=1538-3598 |pmc=3632369 |pmid=23423416}}</ref> It may occur on its own or be associated with other conditions such as mental disorders (such as stress, anxiety, or depression). It can also be associated with medical conditions such as asthma, diabetes, heart disease, pregnancy, and neurological disorders<ref>{{cite web |date=September 2011 |title=Sleep Disorders and Sleeping Problems |url=http://helpguide.org/life/sleep_disorders.htm |archive-url=https://web.archive.org/web/20111205131737/http://helpguide.org/life/sleep_disorders.htm |archive-date=2011-12-05 |website=helpguide.org |vauthors=Smith MA, Robinson L, Boose G, Segal R}}</ref>
+=== Central disorders of hypersomnolence ===
+Central disorders of hypersomnolence are conditions that cause excessive daytime sleepiness. These disorders are not explained by sleep-related breathing problems, circadian rhythm disturbances, or other causes of nighttime sleep disruptions.
+==== Narcolepsy ====
+[[Narcolepsy]] is a rare and chronic sleep disorder. It is defined by four main symptoms: excessive daytime sleepiness with sudden sleep attacks, [[cataplexy]] (sudden loss of muscle tone and weakness), [[Hypnagogia|hypnagogic]] [[hallucination]]s and [[sleep paralysis]].<ref>{{Cite journal |last1=Akintomide |first1=Gbolagade Sunmaila |last2=Rickards |first2=Hugh |date=2011 |title=Narcolepsy: a review |journal=Neuropsychiatric Disease and Treatment |volume=7 |pages=507–518 |doi=10.2147/NDT.S23624 |doi-access=free |issn=1178-2021 |pmc=3173034 |pmid=21931493}}</ref>
+There are two types of narcolepsy. Type 1 is marked by the presence of cataplexy and/or low [[cerebrospinal fluid]] [[Hypocretin (orexin) receptor 2|hypocretin]] levels. Type 2 is characterized by the absence of both.<ref name=ch>{{Cite journal |last1=Hanin |first1=Cyril |last2=Arnulf |first2=Isabelle |last3=Maranci |first3=Jean-Baptiste |last4=Lecendreux |first4=Michel |last5=Levinson |first5=Douglas F. |last6=Cohen |first6=David |last7=Laurent-Levinson |first7=Claudine |date=July 2021 |title=Narcolepsy and psychosis: A systematic review |journal=Acta Psychiatrica Scandinavica |language=en |volume=144 |issue=1 |pages=28–41 |doi=10.1111/acps.13300 |pmid=33779983 |pmc=8360149 |issn=0001-690X}}</ref> Literature reviews suggest that narcolepsy is typically caused by genetic and environmental factors. The disorder is also linked to autoimmune damage of [[Hypothalamus|hypothalamic]] hypocretin-producing neurons.<ref name=ch/><ref name="Narcolepsy: a review">{{Cite journal |last1=Akintomide |first1=Gbolagade Sunmaila |last2=Rickards |first2=Hugh |date=2011-09-08 |title=Narcolepsy: a review |journal=Neuropsychiatric Disease and Treatment |language=English |volume=7 |issue=1 |pages=507–518 |doi=10.2147/NDT.S23624 |pmid=21931493 |pmc=3173034 |doi-access=free }}</ref>
+Treatment of narcolepsy focuses on managing symptoms. There is no cure for narcolepsy. Given the disabling morbidity associated with narcolepsy, more research and drug trials are needed. Psychostimulants ([[methylphenidate]], [[modafinil]]) and [[antidepressant]] ([[selective serotonin reuptake inhibitor]]s and [[Tricyclic antidepressant|tricyclics]]) are used to manage narcolepsy symptoms. More recent targeted therapies such as [[pitolisant]], [[solriamfetol]], and [[sodium oxybate]] have been approved to improve wakefulness or reduce cataplexy.<ref>{{Cite journal |last1=Chue |first1=P. |last2=Chue |first2=J. |last3=Tate |first3=M. |last4=Andreiev |first4=A. |last5=Abba-Aji |first5=A. |date=April 2024 |title=A Review of Current and Future Pharmacologic Treatments for Narcolepsy |journal=European Psychiatry |language=en |volume=67 |issue=S1 |pages=S777 |doi=10.1192/j.eurpsy.2024.1618 |issn=0924-9338|pmc=11862624 }}</ref><ref name="Narcolepsy: a review"/>
+==== [[Idiopathic hypersomnia]] (IH) ====
+A [[Chronic condition|chronic]] neurological disease often compared to [[narcolepsy]] type 2, characterized by  excessive daytime sleepiness, even after normal or prolonged sleep time. Sleep time sometimes exceeds 10 hours in duration. There are two types of IH: with long nocturnal sleep time or without long nocturnal sleep time (marked by unintended and unrefreshing naps). The cause of idiopathic hypersomnia remains largely unclear, with no established pathophysiological mechanism.<ref>{{Cite journal |last1=Trotti |first1=Lynn M. |last2=Becker |first2=Lorne A. |last3=Friederich Murray |first3=Catherine |last4=Hoque |first4=Romy |date=2021-05-25 |title=Medications for daytime sleepiness in individuals with idiopathic hypersomnia |journal=The Cochrane Database of Systematic Reviews |volume=2021 |issue=5 |article-number=CD012714 |doi=10.1002/14651858.CD012714.pub2 |issn=1469-493X |pmc=8144933 |pmid=34031871}}</ref><ref>{{Cite journal |last=Thorpy |first=Michael J. |date=2012-10-01 |title=Classification of Sleep Disorders |url=https://www.neurotherapeuticsjournal.org/article/S1878-7479(23)01711-7/fulltext |journal=Neurotherapeutics |language=English |volume=9 |issue=4 |pages=687–701 |doi=10.1007/s13311-012-0145-6 |pmid=22976557 |pmc=3480567 |issn=1878-7479}}</ref> Patients dealing with idiopathic hypersomnia cannot obtain a healthy amount of sleep for a regular day of activities.
+Treatment, as in narcolepsy, focuses primarily on symptom management. It is mainly based on stimulants to improve alertness and wakefulness.<ref>{{Cite journal |last1=Boulanger |first1=Talia |last2=Pigeon |first2=Pascale |last3=Crawford |first3=Stephen |date=2024 |title=Diagnostic challenges and burden of idiopathic hypersomnia: a systematic literature review |journal=Sleep Advances: A Journal of the Sleep Research Society |volume=5 |issue=1 |article-number=zpae059 |doi=10.1093/sleepadvances/zpae059 |issn=2632-5012 |pmc=11359170 |pmid=39211350}}</ref>
+==== Kleine-Levin Syndrome ====
+Kleine–Levin syndrome is a very rare sleep disorder, mainly affecting adolescent males. It is classified among recurrent [[hypersomnia]]s and is marked by episodes that last anywhere from days to weeks.<ref>{{Cite journal |last1=Arnulf |first1=I. |last2=Zeitzer |first2=J. M. |last3=File |first3=J. |last4=Farber |first4=N. |last5=Mignot |first5=E. |date=December 2005 |title=Kleine-Levin syndrome: a systematic review of 186 cases in the literature |journal=Brain: A Journal of Neurology |volume=128 |issue=Pt 12 |pages=2763–2776 |doi=10.1093/brain/awh620 |issn=1460-2156 |pmid=16230322}}</ref> Diagnosis requires the presence of at least one of the following signs during the episodes: [[Neurocognitive disorder|cognitive dysfunction]], altered perception, [[eating disorder]] and [[Disinhibition|disinhibited]] behavior like [[hypersexuality]]. Between the episodes, patients typically return to baseline and do not show symptoms (ICSD-3-TR).
+* Post traumatic hypersomnia
+* Menstrual-related hypersomnia
+=== Sleep disordered breathing disorders ===
+* Obstructive sleep apnea
+* Central sleep apneas
+* Central sleep apnea due to high-altitude periodic breathing
+* Primary central sleep apnea of infancy
+* Primary central sleep apnea of prematurity
+=== Sleep-Related Hypoventilation Disorders ===
+* Congenital central alveolar hypoventilation syndrome
+* Sleep-related hypoxemia disorder
+=== Circadian rhythm sleep disorder ===
+* [[Delayed sleep phase disorder]]
+* [[Advanced sleep phase disorder]]
+* [[Non-24-hour sleep–wake disorder]]
+* [[Jet lag|Jet lag disorder]] – Jet lag disorder is a type of circadian rhythm sleep disorder that results from rapid travel across multiple time zones. Individuals experiencing jet lag may encounter symptoms such as excessive sleepiness, fatigue, insomnia, irritability, and gastrointestinal disturbances upon reaching their destination. These symptoms arise due to the mismatch between the body's circadian rhythm, synchronized with the departure location, and the new sleep/wake cycle needed at the destination.<ref>{{Cite journal |last1=Burgess |first1=Helen J. |last2=Crowley |first2=Stephanie J. |last3=Gazda |first3=Clifford J. |last4=Fogg |first4=Louis F. |last5=Eastman |first5=Charmane I. |date=August 2003 |title=Preflight Adjustment to Eastward Travel:3 Days of Advancing Sleep with and without Morning Bright Light |journal=Journal of Biological Rhythms |language=en |volume=18 |issue=4 |pages=318–328 |doi=10.1177/0748730403253585 |issn=0748-7304 |pmc=1262683 |pmid=12932084}}</ref>
-==List of conditions==
+=== Parasomnia ===
-There are a numerous sleep disorders. The following list includes some of them:
+A category of sleep disorders that involve abnormal and unnatural movements, behaviors, emotions, perceptions, and dreams in connection with sleep.
-* [[Bruxism]], involuntary grinding or clenching of the teeth while sleeping.
+* [[Bedwetting]] or sleep enuresis
-* [[Catathrenia]], nocturnal groaning during prolonged exhalation.
-* [[Delayed sleep phase disorder]] (DSPD), inability to awaken and fall asleep at socially acceptable times but no problem with sleep maintenance, a disorder of [[circadian rhythm]]s. Other such disorders are [[advanced sleep phase disorder]] (ASPD), [[non-24-hour sleep–wake disorder]] (non-24) in the sighted or in the blind, and [[irregular sleep wake rhythm]], all much less common than DSPD, as well as the situational [[shift work sleep disorder]].<ref>{{cite book |author=American Academy of Sleep Medicine |url=http://www.esst.org/adds/ICSD.pdf |title=The International Classification of Sleep Disorders, Revised (ICSD-R) |publisher=American Sleep Disorders Association |year=2001 |isbn=978-0-9657220-1-8 |archive-url=https://web.archive.org/web/20110726034931/http://www.esst.org/adds/ICSD.pdf |archive-date=2011-07-26 |url-status=dead}}</ref>
-* [[Fatal familial insomnia]], an extremely rare  and universally-fatal prion disease that causes a complete cessation of sleep.
-* [[Hypopnea|Hypopnea syndrome]], abnormally shallow breathing or slow respiratory rate while sleeping.
-* [[Idiopathic hypersomnia]], a primary, neurologic cause of long-sleeping, sharing many similarities with narcolepsy.<ref>{{Cite web |title=Idiopathic hypersomnia &#124; Genetic and Rare Diseases Information Center (GARD) – an NCATS Program |url=https://rarediseases.info.nih.gov/diseases/8737/idiopathic-hypersomnia |access-date=2023-09-09 |work=rarediseases.info.nih.gov}}</ref>
-* [[Insomnia]] disorder (primary insomnia), chronic difficulty in falling asleep or maintaining sleep when no other cause is found for these symptoms. Insomnia can also be comorbid with or secondary to other disorders.
-* [[Kleine–Levin syndrome]], a rare disorder characterized by persistent episodic hypersomnia and cognitive or mood changes.<ref>{{cite journal |vauthors=Arnulf I, Rico TJ, Mignot E |date=October 2012 |title=Diagnosis, disease course, and management of patients with Kleine-Levin syndrome |journal=The Lancet. Neurology |volume=11 |issue=10 |pages=918–928 |doi=10.1016/S1474-4422(12)70187-4 |pmid=22995695 |s2cid=7636103}}</ref>
-* [[Narcolepsy]], characterized by [[excessive daytime sleepiness]] (EDS) and so-called "sleep attacks", relatively sudden-onset, irresistible urges to sleep, which may interfere with occupational and social commitments. About 70% of those who have narcolepsy also have [[cataplexy]], a sudden weakness in the motor muscles that can result in collapse to the floor while retaining full conscious awareness.<ref>{{Cite web |title=Narcolepsy Fact Sheet |url=http://www.ninds.nih.gov/disorders/narcolepsy/detail_narcolepsy.htm |access-date=2011-06-23 |work=www.ninds.nih.gov |archive-date=2016-07-27 |archive-url=https://web.archive.org/web/20160727232102/http://www.ninds.nih.gov/disorders/narcolepsy/detail_narcolepsy.htm |url-status=dead }}</ref>
-* [[Night terror]], ''Pavor nocturnus'', sleep terror disorder, an abrupt awakening from sleep with behavior consistent with [[fear|terror]].<ref>{{cite book |title=Discovering psychology |vauthors=Hockenbury DH, Hockenbury SE |publisher=Worth Publishers |year=2010 |isbn=978-1-4292-1650-0 |edition=5th |location=New York, NY |pages=157}}</ref>
-* [[Nocturia]], a frequent need to get up and urinate at night. It differs from [[enuresis]], or bed-wetting, in which the person does not arouse from sleep, but the bladder nevertheless empties.<ref>{{Cite web |date=November 21, 2018 |title=Nocturia or Frequent Urination at Night |url=https://www.sleepfoundation.org/physical-health/nocturia-or-frequent-unrination-night |website=Sleep Foundation}}</ref>
-* [[Parasomnia]]s, disruptive sleep-related events involving inappropriate actions during sleep, for example sleepwalking, night-terrors and catathrenia.
-* [[Periodic limb movements in sleep]] (PLMS), sudden involuntary movement of the arms or legs during sleep. In the absence of other sleep disorders, PLMS may cause sleep disruption and impair sleep quality, leading to [[periodic limb movement disorder]] (PLMD).
-* Other limb movements in sleep, including [[Hypnic jerk|hypneic jerks]] and [[nocturnal myoclonus]].
-* [[Rapid eye movement sleep behavior disorder]] (RBD), acting out violent or dramatic dreams while in REM sleep, sometimes injuring bed partner or self (REM sleep disorder or RSD).<ref>{{cite web |title=REM Sleep Behavior Disorder |url=http://www.mayoclinic.org/rem-sleep-behavior-disorder/ |access-date=27 July 2016 |publisher=[[Mayo Clinic]]}}</ref>
-* [[Restless legs syndrome]] (RLS), an irresistible urge to move legs.
-* [[Shift work sleep disorder]] (SWSD), a situational [[circadian rhythm sleep disorder]]. ([[Jet lag]] was previously included as a situational circadian rhythm sleep disorder, but it does not appear in [[DSM-5]], see [[Diagnostic and Statistical Manual of Mental Disorders]] for more).
-* [[Sleep apnea]], [[obstructive sleep apnea]], obstruction of the airway during sleep, causing lack of sufficient deep sleep, often accompanied by snoring. Other forms of sleep apnea are less common.<ref>{{cite web |title=Snoring: A Precursor to Medical Issues |url=https://www.snorerx.com/Snoring-Precursor-to-Medical-Issues.pdf |access-date=27 July 2016 |website=Stop Snoring Device |vauthors=Mandell R |archive-date=8 October 2016 |archive-url=https://web.archive.org/web/20161008054536/https://www.snorerx.com/Snoring-Precursor-to-Medical-Issues.pdf |url-status=dead }}</ref> Obstructive sleep apnea (OSA) is a medical disorder that is caused by repetitive collapse of the upper airway (back of the throat) during sleep. For the purposes of sleep studies, episodes of full upper airway collapse for at least ten seconds are called apneas.<ref>{{cite web |title=Sleep Apnea Diagnosis |url=https://singularsleep.com/pages/sleep-apnea-test-home-study/#sleep-apnea |access-date=27 April 2018 |publisher=SingularSleep}}</ref>
-* [[Sleep paralysis]], characterized by temporary [[paralysis]] of the body shortly before or after sleep. Sleep paralysis may be accompanied by [[visual]], [[sound|auditory]] or [[Touch|tactile]] [[hallucination]]s. It is not a disorder unless severe, and is often seen as part of narcolepsy.
-* [[Sleepwalking]] or ''somnambulism'', engaging in activities normally associated with wakefulness (such as [[eating]] or [[clothing|dressing]]), which may include walking, without the conscious knowledge of the subject.
-* [[Somniphobia]], one cause of sleep deprivation, a dread/ fear of falling asleep or going to bed. Signs of the illness include anxiety and panic attacks before and during attempts to sleep.
-== Types ==
+=== Sleep-Related Movement Disorders ===
-* [[Dyssomnia]]s – A broad category of sleep disorders characterized by either [[hypersomnia]] 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.<ref>{{Cite MeSH|uid=68020920|name=Dyssomnias|MeSH Unique ID=D020920}}</ref>
+* Sleep-related leg cramps
-** [[Insomnia]]: Insomnia may be primary or it may be comorbid with or secondary to another disorder such as a mood disorder (i.e., emotional stress, anxiety, depression)<ref>{{Cite web |title=Insomnia treatment |url=https://hiburimnamal.co.il/טיפול-בחרדות/אינסומניה/ |website=hiburimnamal.co.il |vauthors=Levin NS}}</ref> or underlying health condition (i.e., asthma, diabetes, heart disease, pregnancy or neurological conditions).<ref>{{cite web |date=September 2011 |title=Sleep Disorders and Sleeping Problems |url=http://helpguide.org/life/sleep_disorders.htm |url-status=dead |archive-url=https://web.archive.org/web/20111205131737/http://helpguide.org/life/sleep_disorders.htm |archive-date=2011-12-05 |website=helpguide.org |vauthors=Smith MA, Robinson L, Boose G, Segal R}}</ref>
+* Nocturnal muscle cramps
-** Primary [[hypersomnia]]: Hypersomnia of central or brain origin
+* [[Bruxism]] (teeth-grinding)
-*** [[Narcolepsy]]: A chronic neurological disorder (or dyssomnia), which is caused by the brain's inability to control sleep and wakefulness.<ref>{{cite web |date=June 27, 2011 |title=NINDS Narcolepsy |url=http://www.ninds.nih.gov/disorders/narcolepsy/narcolepsy.htm |url-status=dead |archive-url=https://web.archive.org/web/20140221134209/http://www.ninds.nih.gov/disorders/narcolepsy/narcolepsy.htm |archive-date=February 21, 2014 |website=National Institute of Neurological Disorders and Stroke}}</ref>
+* [[Catathrenia]] – nocturnal groaning
-*** [[Idiopathic hypersomnia]]: A chronic neurological disease similar to narcolepsy, in which there is an increased amount of fatigue and sleep during the day. Patients who have idiopathic hypersomnia cannot obtain a healthy amount of sleep for a regular day of activities. This hinders the patients' ability to perform well, and patients have to deal with this for the rest of their lives.<ref name="pmid22608642" />
+* [[Exploding head syndrome]] – waking up in the night hearing loud noises.
-*** Recurrent hypersomnia, including [[Kleine–Levin syndrome]]
+* [[Night terror|Sleep terror]] (or pavor nocturnus) – Characterized by a sudden arousal from deep sleep with a scream or cry, accompanied by some behavioral manifestations of intense fear.<ref>Thorpy, Michael J. "Parasomniacs." The International Classification of Sleep Disorders: Diagnostic and Coding Manual. Rochester: American Sleep Disorders Association, 1990. Print.</ref>
-*** Post traumatic hypersomnia
+* [[Rapid eye movement behavior disorder|REM sleep behavior disorder]]
-*** Menstrual-related hypersomnia
+* [[Sleepwalking]] (or somnambulism)
-** [[Sleep disordered breathing]] (SDB), including (non-exhaustive):
+* [[Sleep talking]] (or somniloquy)
-*** Several types of [[sleep apnea]]
+* [[Sleep sex]] (or sexsomnia)
-*** [[Snoring]]
-*** [[Upper airway resistance syndrome]]
-** [[Restless leg syndrome]]
-** [[Periodic limb movement disorder]]
-* [[Circadian rhythm sleep disorders]]
-** [[Delayed sleep phase disorder]]
-** [[Advanced sleep phase disorder]]
-** [[Non-24-hour sleep–wake disorder]]
-* [[Parasomnia]]s – A category of sleep disorders that involve abnormal and unnatural movements, behaviors, emotions, perceptions, and dreams in connection with sleep.
-** [[Bedwetting]] or sleep enuresis
-** [[Bruxism]] (Tooth-grinding)
-** [[Catathrenia]] – nocturnal groaning
-** [[Exploding head syndrome]] – Waking up in the night hearing loud noises.
-** [[Night terror|Sleep terror]] (or Pavor nocturnus) – Characterized by a sudden arousal from deep sleep with a scream or cry, accompanied by some behavioral manifestations of intense fear.<ref>Thorpy, Michael J. "Parasomniacs." The International Classification of Sleep Disorders: Diagnostic and Coding Manual. Rochester: American Sleep Disorders Association, 1990. Print.</ref>
-** [[Rapid eye movement behavior disorder|REM sleep behavior disorder]]
-** [[Sleepwalking]] (or somnambulism)
-** [[Sleep talking]] (or somniloquy)
-** [[Sleep sex]] (or sexsomnia)
-* Medical or psychiatric conditions that may produce sleep disorders
-** [[22q11.2 deletion syndrome]]
-** [[Alcoholism]]
-** [[Mood disorders]]
-*** [[clinical depression|Depression]]
-** [[Anxiety disorder]]
-** [[Nightmare disorder]]
-** [[Panic]]
-** [[Dissociative identity disorder]]
-** [[Psychosis]] (such as [[Schizophrenia]])
-* [[African trypanosomiasis|Sleeping sickness]] – a parasitic disease which can be transmitted by the [[Tsetse fly]].
-* [[Jet lag|Jet lag disorder]] – Jet lag disorder is a type of circadian rhythm sleep disorder that results from rapid travel across multiple time zones. Individuals experiencing jet lag may encounter symptoms such as excessive sleepiness, fatigue, insomnia, irritability, and gastrointestinal disturbances upon reaching their destination. These symptoms arise due to the mismatch between the body's circadian rhythm, synchronized with the departure location, and the new sleep/wake cycle needed at the destination.<ref>{{Cite journal |last1=Rosenberg |first1=Russell P. |last2=Bogan |first2=Richard K. |last3=Tiller |first3=Jane M. |last4=Yang |first4=Ronghua |last5=Youakim |first5=James M. |last6=Earl |first6=Craig Q. |last7=Roth |first7=Thomas |date=July 2010 |title=A Phase 3, Double-Blind, Randomized, Placebo-Controlled Study of Armodafinil for Excessive Sleepiness Associated With Jet Lag Disorder |journal=Mayo Clinic Proceedings |language=en |volume=85 |issue=7 |pages=630–638 |doi=10.4065/mcp.2009.0778 |pmc=2894718 |pmid=20530317}}</ref><ref>{{Cite journal |last1=Burgess |first1=Helen J. |last2=Crowley |first2=Stephanie J. |last3=Gazda |first3=Clifford J. |last4=Fogg |first4=Louis F. |last5=Eastman |first5=Charmane I. |date=August 2003 |title=Preflight Adjustment to Eastward Travel:3 Days of Advancing Sleep with and without Morning Bright Light |journal=Journal of Biological Rhythms |language=en |volume=18 |issue=4 |pages=318–328 |doi=10.1177/0748730403253585 |issn=0748-7304 |pmc=1262683 |pmid=12932084}}</ref>
 == See also ==
-{{columns-list|colwidth=22em|
+{{columns-list|colwidth=22em|* [[Chronotype]]s
-* [[Chronotype]]s
-* [[Health effects from noise]]
 * [[International Classification of Sleep Disorders]]
-* [[Mouth breathing]]
+* [[Sleep study]]
-* [[Neuropeptide S receptor#Clinical significance|NPSR mutations]]
-* [[Polysomnographic technologist]]
 * [[Sleep hygiene]]
-* [[Sleep problems in women]]
+* [[Sleep diary]]
-* [[Sleep study]]
+* [[Sleep problems in women]]}}
-* [[Sundowning]]
-* [[Vegetative symptoms]]
-* [[White noise machine]]
-}}
 == References ==
@@ Line 288: / Line 265: @@
 {{SleepSeries2}}
+{{Autism spectrum}}
 {{Authority control}}
 [[Category:Sleep disorders| ]]

Sleep disorder: Difference between revisions

Latest revision as of 07:04, 18 November 2025

Causes

Sleep disorders and neurodegenerative diseases

Sleep disturbances and Alzheimer's disease

Sleep disorder symptoms in psychiatric illnesses

Schizophrenia

Bipolar disorder

Major depressive disorder (MDD)

Treatment

Allergy treatment

Acupuncture

Hypnosis

Music therapy

Melatonin

Sleep medicine

Epidemiology

Children and adolescents

Insomnia

Obstructive sleep apnea

Obesity and sleep apnea

Sleep paralysis

Restless legs syndrome

Classification (ICSD-3, 2023)

Insomnia

Central disorders of hypersomnolence

Narcolepsy

Idiopathic hypersomnia (IH)

Kleine-Levin Syndrome

Sleep disordered breathing disorders

Sleep-Related Hypoventilation Disorders

Circadian rhythm sleep disorder

Parasomnia

Sleep-Related Movement Disorders

See also

References

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