sleep disorder
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[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]
Etiology
- disturbances of the sleep-wake cycle
- travel across time zones
- shift work
- advanced sleep phase
- exposure to outdoor artificial light at night disrupts circadian rhythms[26]
- pharmaceutical agents
- insomnia (disorders of initiating or maintaining sleep)
- transient or short-term
- acute psychologic stress
- pharmaceutical agents*
- acute physical illness
- menopause & hot flashes in menopausal women[5][10]
- dyspepsia[6]
- long-term
- transient or short-term
- hypersomnia (excessive daytime somnolence)
- sleep apnea
- narcolepsy/cataplexy
- depression
- alcohol or drug-induced
- systemic illness
- head injury
- parasomnias (partial arousal with episodic movement)
- anorexic agents
- levodopa
- monoamine oxidase (MAO) inhibitors
- sympathomimetics
Epidemiology
- 1/7 of Americans are affected by a sleep disorder[4]
- difficulty falling asleep (37%)
- prevalence > women than men
- prevalence increases with age in men (65-85 years of age)
- nighttime awakening (29%)
- no sex difference
- prevalence increases with age (65-85 years of age)
- early morning awakening (19%)
- daytime sleepiness (19%)
- difficulty falling asleep (37%)
- common in patients with Parkinson's disease
Pathology
- sleep disturbance in middle-aged adults is associated with amyloid burden in at least 8 areas of the brain determined by 11C Pittsburgh compound B[16]
- excessive daytime sleepiness associated with accumulation of beta-amyloid in the cingulate gyrus & precuneus regions[18]
- 3 wake-promoting CNS nuclei, noradrenergic locus coeruleus, orexinergic lateral hypothalamic area & histaminergic tuberomammillary nucleus are associated with mt-tau pathology[25]
- both short & long sleep durations are associated with worse outcomes for older adults, including greater brain beta-amyloid burden, greater symptoms of depression, higher body mass index, & cognitive decline[23]
Diagnostic procedures
- see sleep study
- polysomnography with multiple sleep latency test (gold standard)
- bilateral anterior tibialis EMG for restless legs syndrome
- actigraphy may be useful for assessment of sleep disorders
- overnight pulse oximetry is useful for rule-out OSA in low-risk patients[1]
* has not been validated as a screening tool for OSA
Complications
- use of hypnotics in older individuals increases risk of falls & fractures
- insomnia & self-medication to improve sleep are associated with increased mortality
- sleep deprivation associated with hypertension & obesity
- sleep disturbance or poor quality of sleep associated with poor health-related quality of life, depression & increased mortality in the elderly[8]
- poor quality sleep associated with increased risk for suicide in the elderly[15]
- may play a role in restless legs syndrome
- sleep disturbance is common in patients with dementia[29]
- most likely associated with Lewy body dementia (49%)[29]
- less likely associated with Alzheimer's disease (24%)[16][29], frontotemporal dementia (32%), vascular dementia (35%)[29]
- sleep disruption is common in hospitalized patients & is a risk factor for delirium[20]
- impaired sleep is associated with a higher rate of future beta-amyloid accumulation[21]
- slow-wave activity & sleep efficiency both forecast an increase in beta-amyloid accumulation[21]
- sleep disorders associated with 3-fold increase in risk of stroke[28]
- obstructive sleep apnea specifically cited
- exposure to outdoor artificial light at night disrupts circadian rhythms & might be a risk factor for diabetes mellitus
- insufficient sleep associated with medical errors[22]
- sleep irregularity, especially sleep duration irregularity, is associated measures of subclinical atherosclerosis[27]
Management
- exposure to bright lights
- it is easier to lengthen a sleep cycle than to shorten it
- tasimelteon for sleep-wake disorder in the blind[7]
More general terms
More specific terms
- advanced sleep-phase syndrome; familial advanced sleep-phase syndrome (FASPS)
- asleep at the wheel (drowsy driving)
- fibromyalgia syndrome (fibromyositis, fibrositis)
- hypersomnia (hypersomnolence, excessive sleepiness)
- hypnic jerk; hypnagogic jerk; sleep start; sleep twitch; night start
- in-hospital sleep disruption
- insomnia
- irregular sleep/wake rhythm disorder
- narcolepsy
- parasomnia
- shift work sleep disorder
- sleep attack
- sleep deprivation; insufficient sleep syndrome
- sleep disordered breathing (SDB)
- sleep paralysis
- sleep-related hypoventilation syndrome
- sleep-related movement disorder
Additional terms
- age-associated changes in sleep
- bruxism
- enuresis
- International classification of sleep disorders
- Kleine-Levin syndrome
- nightmare
References
- ↑ 1.0 1.1 Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1038-40
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 829-39
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ 4.0 4.1 Alessi C In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 29-Oct 2, 2004
- ↑ 5.0 5.1 Freedman RR, Roehrs TA. Sleep disturbance in menopause. Menopause. 2007 Sep-Oct;14(5):826-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17486023
- ↑ 6.0 6.1 Lacy BE et al. Functional dyspepsia is associated with sleep disorders. Clin Gastroenterol Hepatol 2011 May; 9:410. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21334461
- ↑ 7.0 7.1 FDA News Release: Jan. 31, 2014 FDA approves Hetlioz: first treatment for non-24 hour sleep-wake disorder in blind individuals. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm384092.htm
- ↑ 8.0 8.1 Fung CH, Martin JL, Chung C et al Sleep disturbance among older adults in assisted living facilities. Am J Geriatr Psychiatry. 2012 Jun;20(6):485-93 PMID:22531104
Martin JL, Fiorentino L, Jouldjian S et al Poor self-reported sleep quality predicts mortality within one year of inpatient post-acute rehabilitation among older adults. Sleep. 2011 Dec 1;34(12):1715-21. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22131610
Marrin JL, Fiorentino L, Jouldjian S et al Sleep quality in residents of assisted living facilities: effect on quality of life, functional status, and depression. J Am Geriatr Soc. 2010 May;58(5):829-36. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20722819 - ↑ Bloom HG, Ahmed I, Alessi CA et al Evidence-based recommendations for the assessment and management of sleep disorders in older persons. J Am Geriatr Soc. 2009 May;57(5):761-89 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19484833
- ↑ 10.0 10.1 Athappilly G and Joffe H Sleep Disturbances During the Menopausal Transition. NEJM Journal Watch. Women's Health. March 11, 2014 Massachusetts Medical Society http://www.jwatch.org/na33784/2014/03/11/sleep-disturbances-during-menopausal-transition (subscription may be needed) http://www.jwatch.org
- ↑ Neikrug AB, Ancoli-Israel S. Sleep disorders in the older adult - a mini-review. Gerontology. 2010;56(2):181-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19738366
- ↑ Barion A, Zee PC. A clinical approach to circadian rhythm sleep disorders. Sleep Med. 2007 Sep;8(6):566-77 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17395535
- ↑ Morgenthaler TI, Lee-Chiong T, Alessi C et al Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. An American Academy of Sleep Medicine report. Sleep. 2007 Nov;30(11):1445-59. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18041479
- ↑ Sack RL, Auckley D, Auger RR et al Circadian rhythm sleep disorders: part I, basic principles, shift work and jet lag disorders. An American Academy of Sleep Medicine review. Sleep. 2007 Nov;30(11):1460-83. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18041480
Sack RL, Auckley D, Auger RR et al Circadian rhythm sleep disorders: part II, advanced sleep phase disorder, delayed sleep phase disorder, free-running disorder, and irregular sleep-wake rhythm. An American Academy of Sleep Medicine review. Sleep. 2007 Nov;30(11):1484-501. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18041481 - ↑ 15.0 15.1 Bernert RA et al Association of Poor Subjective Sleep Quality With Risk for Death by Suicide During a 10-Year PeriodA Longitudinal, Population-Based Study of Late Life. JAMA Psychiatry. Published online August 13, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25133759 <Internet> http://archpsyc.jamanetwork.com/article.aspx?articleid=1895670
- ↑ 16.0 16.1 16.2 Sprecher KE, Bendlin BB, Racine AM et al Amyloid burden is associated with self-reported sleep in nondemented late middle-aged adults. Neurobiol Aging. 2015 Sep;36(9):2568-76. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26059712
- ↑ McCleery J, Cohen DA, Sharpley AL. Pharmacotherapies for sleep disturbances in Alzheimer's disease. Cochrane Database Syst Rev. 2014 Mar 21;(3):CD009178. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24659320
- ↑ 18.0 18.1 Carvalho DZ, St Louis EK, Knopman DS et al Association of Excessive Daytime Sleepiness With Longitudinal beta-Amyloid Accumulation in Elderly Persons Without Dementia. JAMA Neurol. Published online March 12, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29532057 https://jamanetwork.com/journals/jamaneurology/fullarticle/2674279
- ↑ The Treatment of Sleep Disorders of Older People. NIH Consensus Statement Online 1990 Mar 26-28;8(3):1-22 http://consensus.nih.gov/cons/078/078_statement.htm
Facts About Problem Sleepiness http://www.nhlbi.nih.gov/health/public/sleep/pslp_fs.htm - ↑ 20.0 20.1 Wesselius HM, van den Ende ES, Alsma J et al. Quality and quantity of sleep and factors associated with sleep disturbance in hospitalized patients. JAMA Intern Med 2018 Jul 16; PMID: https://www.ncbi.nlm.nih.gov/pubmed/30014139 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2687528
Growdon ME, Inouye SK. Minimizing sleep disruption for hospitalized patients: A wake-up call. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30014149 JAMA Intern Med 2018 Jul 16; https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2687522 - ↑ 21.0 21.1 21.2 Winer JR, Mander BA, Kumar S et al Sleep Disturbance Forecast beta-Amyloid Accumulation across Subsequent Years. Current Biology. September 03, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32888482 https://www.cell.com/current-biology/fulltext/S0960-9822(20)31171-4
- ↑ 22.0 22.1 Trockel MT, Menon NK, Rowe SG et al Assessment of Physician Sleep and Wellness, Burnout, and Clinically Significant Medical Errors. JAMA Netw Open. 2020;3(12):e2028111 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33284339 Free article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2773777
- ↑ 23.0 23.1 George J Amyloid-Sleep Link Emerges in Alzheimer's Trial Screening Data. Both short and long sleepers self-reported worse cognitive function. MedPage Today August 30, 2021 https://www.medpagetoday.com/neurology/alzheimersdisease/94275
Winer JR, Deters KD, Kennedy G et al Association of short and long sleep duration with amyloid-beta burden and cognition in aging. JAMA Neurol 2021. August 30 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34459862 https://jamanetwork.com/journals/jamaneurology/article-abstract/2783664 - ↑ 24.0 24.1 Mason IC, Grimaldi D, Reid KJ et al Light exposure during sleep impairs cardiometabolic function. Proc Natl Acad Sci U S A. 2022. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35286195 https://www.pnas.org/doi/10.1073/pnas.2113290119
- ↑ 25.0 25.1 25.2 25.3 Oh JY, Walsh CM, Ranasinghe K et al Subcortical Neuronal Correlates of Sleep in Neurodegenerative Diseases. JAMA Neurol. Published online April 4, 2022. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35377391 https://jamanetwork.com/journals/jamaneurology/fullarticle/2790494
- ↑ 26.0 26.1 Zheng R, Xin Z, Li M et al Outdoor light at night in relation to glucose homoeostasis and diabetes in Chinese adults: a national and cross-sectional study of 98,658 participants from 162 study sites. Diabetologia. 2022. Nov 14. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36372821 https://link.springer.com/article/10.1007/s00125-022-05819-x
- ↑ 27.0 27.1 Full KM, Huang T, Shah NA et al Sleep Irregularity and Subclinical Markers of Cardiovascular Disease: The Multi- Ethnic Study of Atherosclerosis. J Am Heart Assoc. 2023. Feb 15 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36789869 Free article https://www.ahajournals.org/doi/10.1161/JAHA.122.027361
- ↑ 28.0 28.1 Whitlock Burton K Disordered Sleep Tied to a Marked Increase in Stroke Risk. Medscape. April 10, 2023 https://www.medscape.com/viewarticle/990611
Mc Carthy CE, Yusuf S, Judge S et al Sleep Patterns and the Risk of Acute Stroke: Results from the INTERSTROKE International Case-Control Study. Neurology. 2023. April 5 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37019662 https://n.neurology.org/content/early/2023/04/05/WNL.0000000000207249 - ↑ 29.0 29.1 29.2 29.3 29.4 Koren T, Fisher E, Webster L, Livingston G, Rapaport P. Prevalence of sleep disturbances in people with dementia living in the community: A systematic review and meta-analysis. Ageing Res Rev. 2023 Jan;83:101782. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36356799 Free article. Review.
- ↑ National Center for Complementary and Inegrative Health Sleep Disorders: In Depth https://www.nccih.nih.gov/health/sleep-disorders-in-depth