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Chapter 56. Sleep Disorders

Karl Doghramji, M.D.; Anna Ivanenko, M.D., Ph.D.
DOI: 10.1176/appi.books.9781585622986.264175

Sections

Excerpt

This chapter includes disorders subsumed under the broad category of sleep disorders in DSM-IV-TR (American Psychiatric Association 2000). The category is organized into four sections. The first section, that of the dyssomnias, includes disorders of the amount, quality, or timing of sleep, such as primary insomnia, primary hypersomnia, narcolepsy, breathing-related sleep disorder, dyssomnia not otherwise specified, and circadian rhythm sleep disorder. Treatment principles for the excessive sleepiness of primary hypersomnia are similar to those for narcolepsy; therefore, primary hypersomnia will not be discussed separately in this chapter. The second section is comprised of the parasomnias, disorders involving abnormal behavioral or physiological events occurring in association with sleep, specific sleep stages, or sleep–wake transitions. The final two DSM-IV-TR sleep disorder sections pertain to sleep disorders related to another mental disorder and to a general medical condition, respectively. Disorders falling within these latter two sections are not addressed in our review, because they comprise a heterogeneous group of disorders involving sleep-related symptoms secondary to other conditions that are more thoroughly reviewed in other sections of this volume. This chapter covers disorders encountered during both childhood and adulthood.

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Table Reference Number
Table 56–1. Sleep hygiene education
Table Reference Number
Table 56–2. Hypnotic agents used in the treatment of primary insomnia
Table Reference Number
Table 56–3. Pharmacological treatment of narcolepsy
Table Reference Number
Table 56–4. Management of restless legs syndrome 

References

Agostini JV, Leo-Summers LS, Inouye SK: Cognitive and other adverse effects of diphenhydramine use in hospitalized older patients. Arch Intern Med 161:2091–2097, 2001
[PubMed]
 
Allen RP, Picchietti D, Hening WA, et al: Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology: a report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Restless Legs Syndrome Diagnosis and Epidemiology Workshop at the National Institutes of Health; International Restless Legs Syndrome Study Group. Sleep Med 4:101–119, 2003
[PubMed]
 
American Academy of Pediatrics: Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. Section of Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome. Pediatrics 109:704–712, 2002
 
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000
 
Arendt J, Stone B, Skene DJ: Sleep disruption in jet lag and other circadian rhythm-related disorders, in Principles and Practice of Sleep Medicine, 4th Edition. Edited by Kryger MH, Roth T, Dement WC. Philadelphia, PA, Elsevier Saunders, 2005, pp 659–672
 
Baker AM, Johnson DG, Levisky JA, et al: Fatal diphenylhydramine intoxication in infants. J Forens Sci 48:425–428, 2003
[PubMed]
 
Boulos Z, Campbell SS, Lewy AJ, et al: Light treatment for sleep disorders: consensus report, VII: jet lag. J Biol Rhythms 10:167–176, 1995
[PubMed]
 
Brouillette RT, Manoukian JJ, Ducharme FM, et al: Efficacy of fluticasone nasal spray for pediatric obstructive sleep apnea. J Pediatr 138:838–844, 2001
[PubMed]
 
Burg FD, Ingelfinger JR, Polin R, et al. (eds): Gellis and Kagan's Current Pediatric Therapy, 17th Edition. Philadelphia, PA, WB Saunders, 2002
 
Chesson AL Jr, Littner M, Davila D, et al: Practice parameters for the use of light therapy in the treatment of sleep disorders. Standards of Practice Committee, American Academy of Sleep Medicine. Sleep 22:641–660, 1999
[PubMed]
 
Claustrat B, Brun I, David M, et al: Melatonin and jet-lag: confirmatory result using a simplified protocol. Biol Psychiatry 32:703–711, 1992
 
Cohen SR, Simms C, Burstein FD, et al: Alternatives to tracheostomy in infants and children with obstructive sleep apnea. J Pediatr Surg 34:182–186, 1999
[PubMed]
 
Czeisler CA, Johnson MP, Duffy JF, et al: Exposure to bright light and darkness to treat physiological maladaptation to night work. N Engl J Med 322:1253–1259, 1990
[PubMed]
 
Czeisler CA, Walsh JK, Roth T, et al: Modafinil for excessive sleepiness associated with shift-work sleep disorder. US Modafinil in Shift Work Sleep Disorder Study Group. N Engl J Med 353:476–486, 2005
[PubMed]
 
Fletcher EC, Munafo DA: Role of nocturnal oxygen therapy in obstructive sleep apneas: when should it be used? Chest 98:1497–1504, 1990
[PubMed]
 
Gengo F, Gabos C, Miller JK: The pharmacodynamics of diphenhydramine-induced drowsiness and changes in mental performance. Clin Pharmacol Ther 45:15–21, 1989
[PubMed]
 
Greenblatt DJ, Divoll M, Harmatz JS, et al: Kinetics and clinical effects of flurazepam in young and elderly noninsomniacs. Clin Pharmacol Therapeutics 30:475–486, 1981
[PubMed]
 
Hajak G, Rodenbeck A, Voderholzer U, et al: Doxepin in the treatment of primary insomnia: a placebo-controlled, double-blind, polysomnographic study. J Clin Psychiatry 62:453–463, 2001
[PubMed]
 
Harding JG, Limbard LE (eds): Goodman and Gilman's The Pharmacological Basis of Therapeutics. New York, McGraw Hill, 1996
 
Hening W, Allen R, Earley C, et al: The treatment of restless legs syndrome and periodic limb movement disorder. Sleep 22:970–999, 1999
[PubMed]
 
Hirai K, Kita M, Ohta H, et al: Ramelteon (TAK-375) accelerates reentrainment of circadian rhythm after a phase advance of the light-dark cycle in rats. J Biol Rhythms 20:27–37, 2005
[PubMed]
 
Hoffstein V, Viner S, Mateika S, et al: Treatment of obstructive sleep apnea with nasal continuous positive airway pressure: patient compliance, perception of benefits, and side effects. Am Rev Respir Dis 145(4 Pt 1):841–845, 1992
 
Ivanenko A, Crabtree VM, Tauman R, et al: Melatonin in children and adolescents with insomnia: a retrospective study. Clin Pediatr 42:210–212, 2003a
 
Ivanenko A, Tauman R, Gozal D: Modafinil in the treatment of excessive daytime sleepiness in children. Sleep Medicine 4:579–582, 2003b
 
Kallepalli BR, Bharata VS, Fogas BS, et al: Trazodone is only slightly faster than fluoxetine in relieving insomnia in adolescents with depressive disorders. J Child Adolesc Psychopharmacol 7:97–107, 1997
[PubMed]
 
Kato K, Hirai K, Nishiyama K, et al: Neurochemical properties of Ramelteon (TAK-375), a selective MT1/MT2 receptor agonist. Neuropharmacology 48:301–310, 2005
[PubMed]
 
Krakow B, Kellner R, Pathak D, et al: Imagery rehearsal treatment for chronic nightmares. Behav Res Ther 33:837–843, 1995
[PubMed]
 
Kribbs NB, Pack AI, Kline LR, et al: Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis 147:887–895, 1993
[PubMed]
 
Kryger MH, Roth T, Dement WC (eds): Principles and Practice of Sleep Medicine, 4th Edition. Philadelphia, PA, Elsevier Saunders, 2005
 
Krystal AD, Walsh JK, Laska E, et al: Sustained efficacy of eszopiclone over 6 months of nightly treatment: results of a randomized, double-blind, placebo-controlled study in adults with chronic insomnia. Sleep 26:793–799, 2003
[PubMed]
 
Kuhn BR, Elliot AJ: Treatment efficacy in behavioral pediatric sleep medicine. J Psychosomatic Res 54:587–597, 2003
[PubMed]
 
Kupfer DJ, Coble P, Kane J, et al: Imipramine and EEG sleep in children with depressive symptoms. Psychopharmacology (Berl) 60:117–123, 1979
[PubMed]
 
Kushida CA, Littner MR, Morgenthaler T, et al: Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep 28:499–521, 2005
[PubMed]
 
Labbate LA, Lafer B, Thibault A, et al: Side effects induced by bright light treatment for seasonal affective disorder. J Clin Psych 55:189–191, 1994
[PubMed]
 
Lipton AJ, Gozal D: Treatment of obstructive sleep apnea in children: do we really know how? Sleep Med Rev 7:61–80, 2003
[PubMed]
 
Marcus CL: Nasal steroids as treatment for obstructive sleep apnea: don't throw away the scalpel yet. J Pediatr 138:795–797, 2001
[PubMed]
 
Marcus CL, Ward SL, Mallory GB, et al: Use of nasal continuous positive airway pressure as treatment of childhood obstructive sleep apnea. J Pediatr 127:88–94, 1995
[PubMed]
 
Micromedex Healthcare Series: Thomson Micromedex, Greenwood Village, CO, 2006
 
Mignot E: Narcolepsy: pharmacology, pathophysiology, and genetics, in Principles and Practice of Sleep Medicine, 4th Edition. Edited by Kryger MH, Roth T, Dement WC. Philadelphia, PA, Elsevier Saunders, 2005, pp 761–790
 
Mindell JA: Empirically supported treatments in pediatric psychology: bedtime refusal and night wakenings in young children. J Pediatr Psychol 24:465–481, 1999
[PubMed]
 
Mitler MM, Aldrich MS, Koob GF, et al: Narcolepsy and its treatment with stimulants. ASDA Standards of Practice. Sleep 17:351–371, 1994
 
Möhler H, Fritschy JM, Rudolph U: A new benzodiazepine pharmacology. J Pharmacol Exp Ther 300:2–8, 2002
[PubMed]
 
Montplaisir J, Allen R, Walters A, et al: Restless legs syndrome and periodic limb movements in sleep, in Principles and Practice of Sleep Medicine, 4th Edition. Edited by Kryger MH, Roth T, Dement WC. Philadelphia, PA, Elsevier Saunders, 2005, pp 839–852
 
Morin CM, Colecchi C, Stone J, et al: Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial. JAMA 281:991–999, 1999
[PubMed]
 
Nagtegaal JE, Kerkhof GA, Smits MG, et al: Delayed sleep phase syndrome: a placebo-controlled crossover study on the effects of melatonin administered 5 hours before the individual dim light melatonin onset. J Sleep Res 7:135–143, 1998
[PubMed]
 
National Institutes of Health State of the Science Conference Statement: Manifestations and Management of Chronic Insomnia in Adults June 13–15, 2005. Sleep 28:1049–1057, 2005
 
Owens JA, Babcock D, Blumer J, et al: The use of pharmacotherapy in the treatment of pediatric insomnia in primary care: rational approaches: a consensus meeting summary. Journal of Clinical Sleep Medicine 1:49–59, 2005
[PubMed]
 
Palm L, Blennow G, Wetterberg L: Long-term melatonin treatment in blind children and young adults with circadian sleep-wake disturbances. Dev Med Child Neurol 39:319–325, 1997
[PubMed]
 
Pelayo R, Chen W, Monzon S, et al: Pediatric sleep pharmacology: you want to give my kid sleeping pills? Pediatr Clin North Am 51:117–134, 2004
[PubMed]
 
Prince JB, Wilens TE, Biederman J, et al: Clonidine for sleep disturbances associated with attention-deficit hyperactivity disorder: a systematic chart review of 62 cases. J Am Acad Child Adolesc Psychiatry 35:599–605, 1996
[PubMed]
 
Redline S, Tishler PV, Schluchter M, et al: Risk factors for sleep-disordered breathing in children: association with obesity, race, and respiratory problems. Am J Respir Crit Care Med 159:1527–1532, 1999
[PubMed]
 
Reed MD, Findling RL: Overview of current management of sleep disturbances in children, I: pharmacotherapy. Curr Ther Res Clin Exp 63 (suppl B):18–37, 2002
 
Riley RW, Powell NB, Guilleminault C: Obstructive sleep apnea syndrome: a review of 306 consecutively treated surgical patients. Otolaryngol Head Neck Surg 108:117–125, 1993
[PubMed]
 
Ringdahl EN, Pereira SL, Delzell JE Jr: Treatment of primary insomnia. J Am Board Fam Pract 17:212–219, 2004
[PubMed]
 
Rogers AE, Aldrich MA, Lin X: A comparison of three different sleep schedules for reducing daytime sleepiness in narcolepsy. Sleep 24:385–391, 2001
[PubMed]
 
Rosekind MR: Managing work schedules: an alertness and safety perspective, in Principles and Practice of Sleep Medicine, 4th Edition. Edited by Kryger M, Roth T, Dement W. Philadelphia, PA, Elsevier Saunders, 2005, pp 680–690
 
Rosenthal NE, Joseph-Vanderpool JR, Levendosky AA, et al: Phase-shifting effects of bright morning light as treatment for delayed sleep phase syndrome. Sleep 13:354–361, 1990
[PubMed]
 
Rozerem [package insert]. Osaka, Japan, Takeda Pharmaceutical Company Limited, 2005
 
Salva P, Costa J: Clinical pharmacokinetics and pharmacodynamics of zolpidem: therapeutic implications. Clin Pharmacokinet 29:142–153, 1995
[PubMed]
 
Schechter MS, American Academy of Pediatrics, Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome: Technical report: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 109:e69, 2002
 
Schenck CH, Mahowald MW: Polysomnographic, neurologic, psychiatric, and clinical outcome report on 70 consecutive cases with REM sleep behavior disorder (RBD): sustained clonazepam efficacy in 89.5% of 57 treated patients. Cleve Clin J Med 57 (suppl):S9–S23, 1990
 
Schenck CH, Bundlie SR, Patterson AL, et al: Rapid eye movement sleep behavior disorder. A treatable parasomnia affecting older adults. JAMA 257:1786–1789, 1987
[PubMed]
 
Schmidt-Nowara W, Lowe A, Wiegand L, et al: Oral appliances for the treatment of snoring and obstructive sleep apnea: a review. Sleep 18:501–510, 1995
[PubMed]
 
Shain BN, Naylor M, Shipley JE, et al: Imipramine effects on sleep in depressed adolescents: preliminary report. Biol Psychiatry 28:459–462, 1990
[PubMed]
 
Sheldon SH: Insomnia in children. Curr Treat Options Neurol 3:37–50, 2001
[PubMed]
 
Sheldon SH, Jacobsen J: REM-sleep motor disorder in children. J Child Neurol 13:257–260, 1998
[PubMed]
 
Simakajornboon N, Gozal D, Vlasic V, et al: Periodic limb movements in sleep and iron status in children. Sleep 26:735–738, 2003
[PubMed]
 
Smits MG, Nagtegaal EE, van der Heijden J, et al: Melatonin for chronic sleep onset insomnia in children: a randomized placebo-controlled trial. J Child Neurol 16:86–92, 2001
[PubMed]
 
Spielman AJ: A behavioral perspective on insomnia treatment. Psychiatr Clin North Am 10:541–553, 1987
[PubMed]
 
Standards of Practice Committee: Practice parameters for the treatment of narcolepsy: an update for 2000. American Sleep Disorders Association. Sleep 24:451–466, 2001
 
Sullivan CE, Issa FG, Berthon-Jones M, et al: Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet 1(8225):862–865, 1981
[PubMed]
 
Terman M, Terman JS: Bright light therapy: side effects and benefits across the symptom spectrum. J Clin Psychiatry 60:799–808, 1999
[PubMed]
 
Thorpy M, Chesson A, Derderian, S, et al: Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances. Sleep 18:511–513, 1995
 
Touitou Y: Human aging and melatonin: clinical relevance. Exp Gerontol 36:1083–1100, 2001
[PubMed]
 
Walsh JK, Erman M, Erwin CW, et al: Subjective hypnotic efficacy of trazodone and zolpidem in DSM-III-R primary insomnia. Human Psychopharmacology: Clinical and Experimental 13:191–198, 1998
 
Walters AS, Mandelbaum DE, Lewin DS, et al: Dopaminergic therapy in children with restless legs/periodic limb movements in sleep and ADHD: dopaminergic therapy study group. Pediatr Neurol 22:182–186, 2000
[PubMed]
 
Waters KA, Everett FM, Bruderer JW, et al: Obstructive sleep apnea: the use of nasal CPAP in 80 children. Am J Respir Crit Care Med 152:780–785, 1995
[PubMed]
 
Weitzman ED, Czeisler CA, Coleman RM, et al: Delayed sleep phase syndrome: a chronobiological disorder with sleep-onset insomnia. Arch Gen Psychiatry 38:737–746, 1981
[PubMed]
 
White DP: Central sleep apnea, in Principles and Practice of Sleep Medicine, 4th Edition. Edited by Kryger MH, Roth T, Dement WC. Philadelphia, PA, Elsevier Saunders, 2005, pp 969–982
 
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