Sleep disorder

File:2023 CDC recommendations for amount of sleep needed, by age.svg

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.{{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}}

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.{{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}} More research is needed to further understand the hereditary nature of sleep disorders.

A population susceptible to the development of sleep disorders includes people who have experienced a 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.{{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 }}

Neurodegenerative diseases are often associated with sleep disorders,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.Malkani, R., & Attarian, H. (2015). Sleep in Neurodegenerative Disorders. Current Sleep Medicine Reports, 1(2), 81-90. particularly when characterized by the abnormal accumulation of alpha-synuclein, as seen in multiple system atrophy (MSA), Parkinson's disease (PD),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.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. and Lewy body disease (LBD).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.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. 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. 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.

Neurodegenerative conditions are commonly related to structural brain impairments, which may disrupt sleep and wakefulness, circadian rhythm, and motor or non-motor functioning. Conversely, sleep disturbances are often linked to worsening patients' cognitive functioning, emotional state, and quality of life. Additionally, these abnormal behavioral symptoms can place a significant burden on their relatives and caregivers. 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.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.

Sleep disturbances have also been observed in Alzheimer's disease (AD), affecting about 45% of its population. When based on caregiver reports, this percentage increases to about 70%. 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 alteration. Additionally, changes in sleep architecture are observed in AD. 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. 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.

In Alzheimer's disease, in addition to cognitive decline and memory impairment, there are also significant sleep disturbances with modified sleep architecture.{{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}}{{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}} 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). More than 65% of people with Alzheimer's disease experience this type of sleep disturbance.

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

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

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

On the other hand, it is during sleep that beta-amyloid residues are degraded to prevent plaque formation. The glymphatic system is responsible for this through the phenomenon of glymphatic clearance. 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.

Glymphatic clearance occurs during NREM SWS sleep, a stage that decreases with normal aging, leading to reduced glymphatic clearance and increased beta-amyloid burden, which forms plaques. Therefore, sleep disturbances in individuals with Alzheimer's disease will amplify this phenomenon.

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

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

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

Recent studies have also linked sleep disturbances, neurogenesis, and AD. The subgranular zone and subventricular zone continue to produce new neurons in adult brains.{{cite journal |vauthors=Meerlo P, Mistlberger RE, Jacobs BL, Heller HC, McGinty D |date=June 2009 |title=New neurons in the adult brain: the role of sleep and consequences of sleep loss |journal=Sleep Medicine Reviews |volume=13 |issue=3 |pages=187–194 |doi=10.1016/j.smrv.2008.07.004 |pmc=2771197 |pmid=18848476}} These new cells are then incorporated into neuronal circuits in the subgranular zone, which is found in the hippocampus. These new cells contribute to learning and memory, playing an essential role in hippocampal-dependent memory.

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

Changes in sleep architecture in patients with AD occur during the preclinical phase of the disease. These changes could potentially be used to detect those most at risk of developing AD. 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.

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.{{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 }} Sleep disturbances - insomnia, hypersomnia and delayed sleep-phase disorder - are quite prevalent in severe mental illnesses such as psychotic disorders.{{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 }} 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.{{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 }} 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). 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. 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. Insomnias were the most frequently reported sleep disturbance across all three groups.

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. 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.{{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 }} The most common sleep-related symptom of bipolar disorder is insomnia, in addition to hypersomnia, nightmares, poor sleep quality, OSA, extreme daytime sleepiness, etc. 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.{{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 }}

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).{{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 }} 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.{{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 }} 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. Fatigue, as well as sleep disturbances such as irregular and excessive sleepiness, are linked to symptoms of depression. 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.{{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 }}

File:Room for sleep studies - NÄL hospital.jpg 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.{{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 }} 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.{{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}} 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.{{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}}

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.{{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 }}

Histamine plays a role in wakefulness in the brain. An allergic reaction over produces histamine, causing wakefulness and inhibiting sleep.{{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 }} 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.{{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 }}{{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}} Treatment of allergies has also been shown to help sleep apnea.{{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 }}

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.{{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 }} 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.{{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.

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

Hypnotherapy has been studied in the treatment of sleep disorders in both adults and children.{{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 }}

{{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 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. 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, it still provides evidence that music therapy can be an effective treatment for sleep disorders.{{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 }}

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.{{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 }} 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.{{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}}{{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}} Music is most effective before bed once the brain has been conditioned to it, helping to achieve sleep much faster.{{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}}

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{{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 }}{{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}} but had an insignificant and inconclusive impact on the quality of sleep compared to the placebo group.

{{Main|Sleep medicine}}

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

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:{{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.{{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}} }}

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.{{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 }} 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.{{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 }}

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.{{cite web|url= http://www.abdsm.org/|title= About the ADBSM |access-date= 2008-07-22 |publisher= American Board of Dental Sleep Medicine }} 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).{{cite web|year=2008|title=About AADSM|url=http://aadsm.org/|access-date=2008-07-22|publisher=Academy of Dental Sleep Medicine}}

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. Rest and sleep are described as restorative in order to support engagement in other occupational therapy occupations. In the OTPF, the occupation of rest and sleep is broken down into rest, sleep preparation, and sleep participation.{{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 }} 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.{{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 }}

In the UK, knowledge of sleep medicine and possibilities for diagnosis and treatment seem to lag. The Imperial College Healthcare{{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 }} 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.

According to one meta-analysis of sleep disorders in children, confusional arousals and sleepwalking are the two most common sleep disorders among children.{{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 }} An estimated 17.3% of kids between 3 and 13 years old experience confusional arousals. About 17% of children sleepwalk, with the disorder being more common among boys than girls, the peak ages of sleepwalking are from 8 to 12 years old.

A different systematic review offers a high range of prevalence rates of 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 {{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/ }} 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 (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.{{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}}

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 bruxist prevalence as age increased, as well as a higher prevalence among boys than girls.{{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 }}

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. Between 20 and 26% of adolescents report a sleep onset latency of greater than 30 minutes. Also, 7-36% have difficulty initiating sleep.{{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 }} Asian teens tend to have a higher prevalence of all of these adverse sleep outcomes—than their North American and European counterparts.

By adulthood, parasomnias can normally be resolved due to a person's growth; however, 4% of people have recurring symptoms.

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.{{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 }} 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.{{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 }}

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.{{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 }}

Combining results from 17 studies on insomnia in China, a pooled prevalence of 15.0% is reported for the country.{{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 }} 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). Men and women residing in China experience insomnia at similar rates.

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.{{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 }}

A study that was 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.{{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 }}

Insomnia can start off at the basic level but about 40% of people who struggle with insomnia have worse symptoms.{{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 }} 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.

Obstructive sleep apnea (OSA) affects around 4% of men and 2% of women in the United States.{{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 }} 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,{{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 }} and tend to report experiencing depression and insomnia in conjunction with obstructive sleep apnea.{{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 }}

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,{{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}} at similar rates (prevalence of 3.5% and 3.57%, respectively).

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.{{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}} Obesity can influence the disturbance in sleep patterns resulting in OSA. {{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 }} 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.

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.

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%).{{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 }}

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.{{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 }} 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.{{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}}

There are a numerous sleep disorders. The following list includes some of them:

• Bruxism, involuntary grinding or clenching of the teeth while sleeping.
• 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 rhythms. 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.{{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}}
• Fatal familial insomnia, an extremely rare and universally-fatal prion disease that causes a complete cessation of sleep.
• 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.{{Cite web |title=Idiopathic hypersomnia | 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}}
• 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.{{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}}
• 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.{{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 }}
• Night terror, Pavor nocturnus, sleep terror disorder, an abrupt awakening from sleep with behavior consistent with terror.{{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}}
• 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.{{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}}
• Parasomnias, 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 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).{{cite web |title=REM Sleep Behavior Disorder |url=http://www.mayoclinic.org/rem-sleep-behavior-disorder/ |access-date=27 July 2016 |publisher=Mayo Clinic}}
• 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.{{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 }} 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.{{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}}
• Sleep paralysis, characterized by temporary paralysis of the body shortly before or after sleep. Sleep paralysis may be accompanied by visual, auditory or tactile hallucinations. 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 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.

• Dyssomnias – 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.{{Cite MeSH|uid=68020920|name=Dyssomnias|MeSH Unique ID=D020920}}
• 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){{Cite web |title=Insomnia treatment |url=https://hiburimnamal.co.il/טיפול-בחרדות/אינסומניה/ |website=hiburimnamal.co.il |vauthors=Levin NS}} or underlying health condition (i.e., asthma, diabetes, heart disease, pregnancy or neurological conditions).{{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}}
• Primary hypersomnia: Hypersomnia of central or brain origin
• Narcolepsy: A chronic neurological disorder (or dyssomnia), which is caused by the brain's inability to control sleep and wakefulness.{{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}}
• 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.
• Recurrent hypersomnia, including Kleine–Levin syndrome
• Post traumatic hypersomnia
• Menstrual-related hypersomnia
• Sleep disordered breathing (SDB), including (non-exhaustive):
• Several types of sleep apnea
• 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
• Parasomnias – 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.
• 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.Thorpy, Michael J. "Parasomniacs." The International Classification of Sleep Disorders: Diagnostic and Coding Manual. Rochester: American Sleep Disorders Association, 1990. Print.
• 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
• Depression
• Anxiety disorder
• Nightmare disorder
• Panic
• Dissociative identity disorder
• Psychosis (such as Schizophrenia)
• Sleeping sickness – a parasitic disease which can be transmitted by the Tsetse fly.
• 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.{{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}}{{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}}

{{columns-list|colwidth=22em|

• Chronotypes
• Health effects from noise
• International Classification of Sleep Disorders
• Mouth breathing
• NPSR mutations
• Polysomnographic technologist
• Sleep hygiene
• Sleep problems in women
• Sleep study
• Sundowning
• Vegetative symptoms
• White noise machine

}}

{{Reflist}}

{{Medical resources

| DiseasesDB = 26877

| ICD10 = {{ICD10|F|51||f|50}}, {{ICD10|G|47||g|40}}

| ICD9 = {{ICD9|307.4}}, {{ICD9|327}}, {{ICD9|780.5}}

| ICDO =

| OMIM =

| MedlinePlus = 000800

| eMedicineSubj = med

| eMedicineTopic = 609

| MeshID = D012893

}}

• {{commons category-inline}}
• [http://www.rcpsych.ac.uk/mentalhealthinfoforall/problems/sleepproblems/sleepingwell.aspx Sleep Problems] – information leaflet from mental health charity The Royal College of Psychiatrists
• [http://www.webmd.com/sleep-disorders/guide/insomnia-symptoms-and-causes WebMD] Sleep Disorders Health Center

{{SleepSeries2}}

{{Authority control}}