Learning Objectives

  • Describe symptoms and treatments of insomnia
  • Recognize symptoms of parasomnias
  • Describe symptoms and treatments for sleep apnea
  • Recognize risk factors for sudden infant death syndrome (SIDS) and preventive measures
  • Describe symptoms and treatments for narcolepsy

Insomnia

  • Most common sleep disorder; difficulty falling/staying asleep.
  • Symptoms: Long delays in sleep onset, frequent awakenings, anxiety about sleep.
  • Criteria: Symptoms present at least three nights/week for one month.
  • Contributing factors: Age, drug use, exercise, mental status, bedtime routines.
  • Treatments: Limit stimulants, increase exercise, cognitive-behavioral therapy (CBT), medication with caution.

Parasomnias

  • Disruptive motor activities or experiences during sleep.
  • Examples: Sleepwalking, restless leg syndrome, night terrors.

Sleepwalking

  • Engaging in complex behaviors while asleep (e.g., walking, driving).
  • Often occurs during slow-wave sleep; treatment success varies with pharmacotherapy.

REM Sleep Behavior Disorder (RBD)

  • Lack of muscle paralysis in REM, leading to physical activity during dreams.
  • Associated with Parkinson's disease; treated with clonazepam or melatonin.

Other Parasomnias

Restless Leg Syndrome
  • Uncomfortable sensations in legs during inactivity; relieved by movement.
  • Associated with conditions like chronic kidney disease; treated with various drugs.
Night Terrors
  • Panic episodes, little memory afterward.
  • Occur during NREM sleep; treatment typically unnecessary unless another condition exists.

Sleep Apnea

  • Breathing stops during sleep; episodes can last 10-20 seconds.
  • Symptoms: Loud snoring, fatigue, possible cardiovascular disease.
  • Types: Obstructive (airway blockage) and central (brain signal disruption).
  • Treatments: CPAP device; alternatives are being explored (e.g., EPAP).

Sudden Infant Death Syndrome (SIDS)

  • Infant stops breathing during sleep.
  • Highest risk: Infants under 12 months, especially boys.
  • Risk factors: Premature birth, smoking, hyperthermia.
  • Recommendations: Sleep on back, avoid suffocation hazards, no head coverings to prevent overheating.

Narcolepsy

  • Inability to resist sleep; episodes linked with cataplexy (muscle weakness).
  • Symptoms can mimic REM sleep features; episodes last from minutes to half an hour.
  • Triggered by stress; treated with stimulants, ongoing research into hypocretin-targeted medications.