Normal sleep physiology, and the pathophysiology of various sleep disorders with emphasis on sleep-disordered breathing.

1.1 Health benefits of normal sleep 1.2 Physiology of normal sleep 1.3 Pathophysiology of SDB including anatomic and non-anatomic factors 1.4 Prevalence and Comorbidities of SDB 1.5 Risk factors of SDB including age and gender 1.6 Signs and symptoms of SDB 1.7 Impact of sleep disorders on the individual 1.8 Impact of sleep disorders on society 1.9 Prevalence, pathophysiology, and the clinical features of insomnia 1.10 Other respiratory sleep disorders 1.11 Other non-respiratory sleep disorders 1.12 The effects of pharmacotherapeutics on sleep

List all the sleep-wake disorders as identified by the American Academy of Sleep Medicine, International classification of sleep disorders 3rd ed 2014.

1. Insomnia

2. Hypersomnolence disorder

3. Narcolepsy

List all the breathing related sleep disorders as identified by the American Academy of Sleep Medicine, International classification of sleep disorders 3rd ed 2014.

1. Obstructive sleep apnoea hypopnea (OSA)

2. Central sleep apnoea

3. Sleep related hypoventilation

List all the parasomnias as identified by the American Academy of Sleep Medicine, International classification of sleep disorders 3rd ed 2014.

1. Non-REM sleep arousal disorders

2. Nightmare disorder

3. REM sleep behaviour disorder

4. Restless legs syndrome

What is the diagnostic criteria for insomnia as per the American Academy of Sleep Medicine, International classification of sleep disorders 3rd ed 2014?

• A predominant complaint of dissatisfaction with sleep quantity or quality, associated with one (or more) of the following symptoms:

  • Difficulty initiating/maintaining sleep

  • Inability to return to sleep

  • Sleep disturbance causing clinically significant distress/impairment. 

• The sleep difficulty occurs at least 3 nights per week, present for at least 3 months, despite adequate opportunity for sleep. 

What is the prevalence of insomnias?

• One-third of adults report insomnia symptoms,

• 10%–15% experience associated daytime impairments

• 6%–10% have symptoms

• More prevalent complaint among females than among males, with a gender ratio of about 1.44:1

• 40%–50% of individuals with insomnia also present with a comorbid mental disorder 

What is the development and course of insomnia?

• Onset of insomnia symptoms can occur at any time during life, but the first episode is more common in young adulthood.

• In women, new-onset insomnia may occur during menopause and persist even after other symptoms (e.g., hot flashes) have resolved. 

• The course of insomnia may be episodic, with recurrent episodes of sleep difficulties associated with the occurrence of stressful events

• Chronicity rates range from 45% to 75% for follow-ups of 1–7 years.

What is the diagnostic criteria for hypersomnolence disorder

• Self-reported excessive sleepiness (hypersomnolence) despite main sleep period lasting at least 7 hours, with at least one of the following symptoms:

  • Recurrent periods of sleep or lapses into sleep within the same day.

• A prolonged main sleep episode of more than 9 hours per day that is nonrestorative

(i.e., unrefreshing).

3. Difficulty being fully awake after abrupt awakening.

·                The hypersomnolence occurs at least three times per week, for at least 3 months.

·                Not explained by other sleep disorders