Dyssomnias

Dyssomnia

Dyssomnia covers a range of specific sleep disorders, the Inability to Sleep, Insomnia, Sleeplessness, Wakefulness. Chronic and persistent difficulty in either; falling asleep, remaining asleep through the night, or waking up too early. All types of insomnia can lead to daytime drowsiness, poor concentration, and the inability to feel refreshed and rested in the morning.

Dyssomnias are disorders of the amount, quality, or timing of sleep.

Patients with dyssomnias present with difficulty initiating or maintaining sleep or with excessive daytime somnolence. The DSM-IV defines dyssomnias as primary disturbances in the quantity, quality, or timing of sleep. These disorders are believed to be a consequence of central nervous system abnormalities that alter the sleep process.

A dyssomnia is a disruption of the body's natural resting and waking patterns. Dyssomnias may be extrinsic (having an external cause), or intrinsic (having their cause in the body). A dyssomnia may also be caused by problems with a person's circadian rhythm, or internal clock.

Common Causes of Dyssomnia

• jet lag
• shift work
• wake-sleep pattern disturbances
• grief
• depression or major depression
• worry
• anxiety or stress
• exhilaration or excitement
• bed or bedroom not conducive to sleep
• nicotine, alcohol, caffeine, food, or stimulants at bedtime
• aging
• excessive sleep during the day
• excessive physical or intellectual stimulation at bedtime
• overactive thyroid (hyperthyroidism)
• taking a new drug (medication side-effect).
• alcoholism or abrupt cessation of alcohol after long-term use
• inadequate bright-light exposure during waking hours
• abruptly stopping a medication (such as sleeping pills).
• medications or illicit "street drugs" (for example, excessive thyroid replacement hormone, amphetamines, caffeine-containing beverages, cocaine, ephedrine, phenylpropanolamine, theophylline derivatives)
• withdrawal of medications (such as sedatives or hypnotics)
• interference with sleep by various diseases, including an enlarged prostate (men), cystitis (women), COPD, pain of arthritis, heartburn, and heart or lung problems
• restless leg syndrome

Associated Features of Dyssomnias

1. Psycho-Physiologic Insomnia
2. Idiopathic
3. Narcolepsy
4. Recurrent Hypersomnia
5. Obstructive Apnea Syndrome
6. Mixed Apnea Syndrome
7. Central Apnea Syndrome
8. Alveolar Hypoventilation
9. Periodic Leg Movements and Leg-Related Syndrome

Dyssomnia NOS

Dyssomnia NOS (not otherwise specified) refers to any insomnia, hypersomnia, or circadian rhythm disturbance that does not meet the full criteria for a specific dyssomnia.

Treatment of Dyssomnia

Medical disorders, psychiatric disorders, and stress may precipitate or aggravate parasomnias. A careful history of psychosocial stresses, alcohol or drug use, and symptoms of depression should be obtained. Also, a detailed Mental Status Examination should be performed. Patients found to have an underlying psychological or psychiatric disorder should be seen by a psychologist or psychiatrist, and appropriate therapy should be offered.

Drug treatment should only be resorted to a as a last option. Practice good sleep hygiene: avoid using alcohol in the evening and to avoid caffeine before bedtime.

Counseling may be helpful for psychological disorders that lead to insomnia and the practice of relaxation techniques may also be helpful.

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Site last updated: March 4, 2008