CHAPTER © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 2NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FORSleep SALE OR DISTRIBUTION Disorders NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Agsandrew/Shutterstock © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION CHAPTER OUTLINE EEG arousal alveolar hypoventilation paradoxical breathing idiopathic central alveolar History of Sleep Disorders© Jones & Bartlett Learning, LLCmicrognathia © Joneshypoventilation & Bartlett Learning, LLC Classification of Sleep DisordersNOT FOR SALE OR DISTRIBUTIONretrognathia NOTsnoring FOR SALE OR DISTRIBUTION Insomnia apnea–hypopnea primary snoring Sleep-Related Breathing Disorders index (AHI) sleep-related groaning Central Disorders of Hypersomnolence respiratory disturbance catathrenia Circadian Rhythm Sleep–Wake Disorders index (RDI) CPAP therapy Parasomnias respiratory effort–related positional therapy Sleep-Related© Jones Movement & Bartlett Disorders Learning, LLC arousal (RERA)© Jones & Bartletttonsillectomy Learning, LLC OtherNOT Sleep FOR Disorders SALE OR DISTRIBUTION upper-airwayNOT resistance FOR SALEadenoidectomy OR DISTRIBUTION Chapter Summary syndrome bi-level therapy excessive daytime multiple sleep latency LEARNING OBJECTIVES sleepiness (EDS) test (MSLT) sudden infant death maintenance of 1. Discuss a brief history of sleep disorders. syndrome wakefulness test © Jones & Bartlett2. Learn theLearning, classification LLC of sleep disorders as outlined by © Jonescentral & sleep Bartlett apnea (CSA) Learning,narcolepsy LLC the AASM. central apnea cataplexy NOT FOR SALE3. Desc ORribe DISTRIBUTION the features and symptoms of each disorder. NOTcontinuous FOR SALE positive OR airway DISTRIBUTION sleep paralysis 4. Discuss the social and personal impact of specific pressure (CPAP) hypnagogic hallucinations disorders. hypercapnia narcolepsy tetrad hypocapnia automatic behavior KEY TERMS Cheyne–Stokes breathing microsleep © Jones & Bartlett Learning, LLChigh-altitude periodic ©narcolepsy Jones type& Bartlett I Learning, LLC Pickwickian syndrome behavioral insomnia breathing hypnagogic Association of Sleep NOT FORof SALE childhood OR DISTRIBUTIONprimary central NOThypnopompic FOR SALE OR DISTRIBUTION Disorders Centers short-term insomnia sleep apnea sleep-onset REM (ASDC) disorder primary sleep apnea period (SOREMP) International Classification group therapy of infancy narcolepsy type II of Sleep Disorders (ICSD) light therapy treatment-emergent idiopathic hypersomnia insomnia sleep restriction central sleep apnea recurrent hypersomnia chronic© Jones insomnia & disorder Bartlett Learning,self-control techniques LLC complex sleep© apneaJones & Bartlettperiodic Learning, hypersomnolence LLC psychophysiologicalNOT FOR SALE OR DISTRIBUTIONbiofeedback obesity hypoventilationNOT FOR SALEKleine-Levin OR DISTRIBUTION syndrome insomnia sleep-related breathing syndrome (OHS) hypersomnia idiopathic insomnia disorders congenital central insufficient sleep paradoxical insomnia obstructive sleep alveolar hypoventilation syndrome sleep diary apnea (OSA) syndrome (CCHS) circadian rhythm sleep log obstructive apnea late-onset central circadian rhythm sleep– © Jones & sleepBartlett hygiene Learning, LLChypopnea © Joneshypoventilation & Bartlett with Learning, wake LLC disorder (CRSWD) NOT FOR SALElimit-setting OR disorder DISTRIBUTIONoxygen desaturation NOT FORhypothalamic SALE dysfunction OR DISTRIBUTIONactigraphy 13 © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. 9781284189490_CH02_Endee.indd 13 17/12/19 10:11 PM 14 CHAPTER 2 Sleep Disorders delayed sleep–wake somniloquy which defined scoring techniques for sleep studies for © Jones & Bartlettphase disorder Learning, LLCsleep-related movement © Jones & Bartlett Learning, LLC the next 40 years. NOT FOR SALEadvanced OR sleep–wake DISTRIBUTION disorders NOT FOR SALE OR DISTRIBUTION phase disorder restless legs In 1970, Dement started the first sleep-disorders irregular sleep–wake syndrome (RLS) lab, which provided all-night evaluations of patients rhythm disorder periodic limb movement with sleep complaints; within 5 years there were free-running circadian disorder (PLMD) four more sleep centers in business. In 1975, the rhythm periodic limb movements Association of Sleep Disorders Centers (ASDC) non–24-hour sleep–wake© Jones &in Bartlettsleep Learning, LLC © Jones & Bartlett was Learning, LLC rhythm disorder NOT FORPLM SALE index OR DISTRIBUTIONdeveloped, which is now knownNOT as theFOR American SALE OR DISTRIBUTION shift work disorder sleep-related leg cramps Academy of Sleep Medicine (AASM). Its sleep center jet lag disorder bruxism accreditation went into effect 2 years later in 1977. By parasomnia sleep-related bruxism the early 1990s, several professional sleep societies had confusional arousal rhythmic masticatory sleepwalking muscle activity developed, including the ASDC, Clinical Sleep Society, somnambulism© Jones & Bartlett Learning,sleep-related LLCrhythmic Association© of JonesProfessional & Bartlett Sleep Societies, Learning, American LLC sleepNOT terror FOR SALE OR DISTRIBUTIONmovement disorder Board of SleepNOT Medicine, FOR SALEand National OR DISTRIBUTIONSleep Founda- night terror body rocking tion. The American Academy of Sleep Medicine was sleep-related eating disorder head banging known as the Clinical Sleep Society from 1984 to 1986 REM-related parasomnias myoclonus REM sleep behavior benign sleep myoclonus and the American Sleep Disorders Association from disorder (RBD) of infancy 1987 to 1998; in 1999 it became the American Academy © Jones & isomorphismBartlett Learning, LLCpropriospinal myoclonus © Jonesof Sleep & Medicine.Bartlett Learning, LLC recurrent isolated at sleep onset NOT FOR SALE OR DISTRIBUTION NOT FORIn 1990, SALE the AASM OR DISTRIBUTION developed the first edition of the sleep paralysis excessive fragmentary International Classification of Sleep Disorders (ICSD), nightmare myoclonus (EFM) posttraumatic stress hypnagogic foot tremor which categorized and described all known sleep dis- disorder (PTSD) alternating leg muscle orders. A second edition of the ICSD was published in exploding head syndrome activation 2005 (ICSD-2), and the third edition was published in sleep-related hallucinations© Jonessleep & Bartlettstart Learning, LLC2014 (ICSD-3). The information© Jones in this chapter& Bartlett reflects Learning, LLC nocturnal enuresis hypnic jerk the updated definitions and classifications of sleep dis- bedwetting NOT FORenvironmental SALE OR sleep DISTRIBUTION NOT FOR SALE OR DISTRIBUTION sleep enuresis disorder orders found in the third edition. sleep talking Classification of Sleep Disorders History of Sleep Disorders © Jones & Bartlett Learning, LLC The following© Jonespages categorize & Bartlett sleep Learning,disorders as out-LLC 3 SinceNOT the beginningFOR SALE of time, OR humans DISTRIBUTION have been fasci- lined in theNOT third editionFOR ofSALE the ICSD OR: DISTRIBUTION nated with sleep. Many early writings discuss sleep and 1. Insomnia sleep disorders in a variety of ways. In 1836, Charles a. Chronic insomnia disorder Dickens published a series of papers called the “Posthu- b. Short-term insomnia disorder mous Papers of the Pickwick Club.”1 In these writings, c. Other insomnia disorders he describes a boy named Joe who was overweight and © Jones & Bartlett Learning, LLC © Jones &d. Bartlett Isolated symptomsLearning, and LLC normal variants extremely tired, and who snored heavily. A drawing of 2. NOT FOR SALEthe boy ORshows DISTRIBUTION an obese young man with a short, fat NOT FOR Sleep-reSALE latedOR breathingDISTRIBUTION disorders a. neck. From this, the term Pickwickian syndrome was Obstructive sleep apnea disorders i. coined; although it is not used today, the symptoms Obstructive sleep apnea, adult ii. have many similarities with the sleep disorder called Obstructive sleep apnea, pediatric b. obesity hypoventilation© Jonessyndrome &. Bartlett Learning, LLC Central sleep apnea© syndromeJones & Bartlett Learning, LLC Pioneering sleep researchers in the 1950s and 1960s i. Central sleep apnea with Cheyne– such as Nathaniel Kleitman,NOT FOR William SALE Dement, OR and DISTRIBUTION oth- Stokes breathingNOT FOR SALE OR DISTRIBUTION ers identified different stages of sleep and were able to ii. Central sleep apnea due to a medical recognize specific patterns of these stages throughout disorder without Cheyne–Stokes the night. Along with the development of new tech- breathing iii. nologies© Jones designed & Bartlett to read and Learning, record physiological LLC © JonesCentral &slee Bartlettp apnea due Learning, to high-altitude LLC activities,NOT FOR this gave SALE way to OR the DISTRIBUTIONdevelopment of the field NOTperiodic FOR breathingSALE OR DISTRIBUTION of sleep disorders. In 1961, the Sleep Research Society iv. Central sleep apnea due to a medication began informally with such sleep pioneers as Doctors or substance William Dement, Allan Rechtschaffen, Nathaniel v. Primary central sleep apnea Kleitman, Michel Jouvet, and Eugene Aserinsky. In vi. Primary central sleep apnea of infancy vii. © Jones & 1968,Bartlett Rechtschaffen Learning, and LLCDr. Anthony Kales produced © Jones & BartlettPrimary Learning, central sleep LLC apnea of