Sleep Disorders
| Disorder | Symptoms and signs | Most effective treatment |
|---|---|---|
| Delayed sleep phase syndrome | Late sleep onset and wake-up time | Bright light therapy in the morning low-dose melatonin in the evening |
| Insomnia | Difficulty initiating or maintaining sleep, daytime sleepiness with inability to nap, daytime impairment (e.g., difficulty with memory, concentration, attention; worry about sleep; mood disturbance; irritability) | Cognitive behavior therapy benzodiazepine receptor agonists |
| Narcolepsy | Excessive daytime sleepiness, cataplexy, hallucinations upon falling asleep or awakening | Modafinil (Provigil) or stimulants gamma hydroxybutyric acid (sodium oxybate [Xyrem]) selective serotonin reuptake inhibitors |
| Obstructive sleep apnea | Snoring, witnessed apneas, gasping or choking, excessive daytime sleepiness | Continuous positive airway pressure |
| Rapid eye movement sleep behavior disorder | Motor activity during sleep, acting out of dreams, polysomnography showing increased muscle tone | Clonazepam (Klonopin) Melatonin |
| Restless legs syndrome | Uncomfortable sensation (e.g., “creepy crawly,” aching) in both legs, symptoms are worse in the evening, improve with movement such as walking or stretching | Dopaminergic agonists |
Common Indications for Sleep Study
- Diagnosis of a sleep disorder
- Narcolepsy
- Parasomnias
- Periodic limb movement disorder
- Rapid eye movement sleep behavior disorder
- Sleep-related breathing disorders, such as obstructive and central sleep apnea
- Sleep-related seizure disorders
- Evaluation of sleep-related symptoms
- Sleep maintenance insomnia Snoring
- Unexplained daytime fatigue or sleepiness
- Treatment of sleep-related breathing disorders (i.e., using positive airway pressure titration)