Sleep Disorders :Dual Diagnosis

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A sleep disorder, or somnipathy, is a medical disorder of the sleep patterns of a person or animal. Some sleep disorders are serious enough to interfere with normal physical, mental, social and emotional functioning. Polysomnography and actigraphy are tests commonly ordered for some sleep disorders.

Disruptions in sleep can be caused by a variety of issues, including teeth grinding (bruxism) and night terrors. When a person suffers from difficulty falling asleep and/or staying asleep with no obvious cause, it is referred to as insomnia.

Sleep disorders are broadly classified into dyssomnias, parasomnias, circadian rhythm sleep disorders involving the timing of sleep, and other disorders including ones caused by medical or psychological conditions.

The most common sleep disorder is insomnia.Others are sleep apnea, narcolepsy and hypersomnia (excessive sleepiness at inappropriate times), sleeping sickness (disruption of sleep cycle due to infection), sleepwalking, and night terrors. Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.

Common disorders:

• Bruxism, involuntarily 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.
• 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.

Types: Dyssomnias – A broad category of sleep disorders characterized by either hypersomnia or insomnia. 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) or underlying health condition (i.e., asthma, diabetes, heart disease, pregnancy or neurological conditions).

Causes:

traumatic childhood experiences (such as family conflict or sexual trauma) significantly increases the risk for a number of sleep disorders in adulthood, including sleep apnea, narcolepsy, and insomnia. It is currently unclear whether or not moderate alcohol consumption increases the risk of obstructive sleep apnea.

Sleep disorders and neurodegenerative diseases: Neurodegenerative diseases have been often associated with sleep disorders, mainly when they are characterized by abnormal accumulation of alpha-synuclein, such as multiple system atrophy (MSA), Parkinson's disease (PD) and Lewy body disease (LBD) The neurodegenerative conditions are commonly related to brain structures impairment, which might disrupt the states of sleep and wakefulness, circadian rhythm, motor or non-motor functioning.

Sleep disorder symptoms in psychiatric illnesses: Schizophrenia, mood and anxiety disorders: psychiatric illnesses, sleep disorders may include a variety of clinical symptoms such as excessive daytime sleepiness, difficulty falling asleep, difficulty staying asleep, nightmares, sleep talking, sleep walking, and poor quality sleep, among various others.

Bipolar disorder: The pathogenesis of bipolar disorder, including the higher risk of suicidal ideation, can be directly linked to circadian rhythm variability, and sleep disturbances are a good predictor of mood swings.

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Regards,
Nancy Ella
Journal Editor
Dual Diagnosis: Open Access
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