Welcome to Everything Narcolepsy!

This website's 
goal is to reduce the misdiagnosis & mistreatment of narcoleptics though the promotion and sharing of narcolepsy information and resources found throughout the internet.

Hey early bird! This new website is still under construction.
Your Subtitle text

Diagnosing Narcolepsy


If despite your best efforts at maintaining good sleep hygiene, you still struggle with sleep problems you may have a sleep disorder that requires specialized professional treatment. Consider scheduling an appointment with a sleep doctor if your life is still negatively impacted by any of the following:


Persistent excessive daytime sleepiness or fatigue

Loud snoring accompanied by pauses in breathing

Difficulty falling asleep or staying asleep

Unrefreshing sleep

Frequent morning headaches

Unexplained frequent memory troubles or excessive absent mindedness

Crawling sensations in your legs or arms at night

Inability to move while falling asleep or waking up

Physically acting out dreams during sleep

Falling asleep at inappropriate times

Loss of muscle strength during strong emotions


There are more than 80 different types of sleep disorders and most of their sufferers are never accurately diagnosed. Before a sleep specialist considers whether you have a sleep disorders, he or she will first examine your medical history and current sleep hygiene. Most sleep specialists have their new patients fill out very long detailed questionnaires in advance of their 30-90 minute evaluation appointment.

Why See a Sleep Specialist?

Contrary to popular belief, most doctors never study sleep medicine in med school because the subject has not yet permeated into curriculum to any significant degree. The unusual demands of medical school, residency, shift work, and internships, force doctors self select to endure sleep deprivation thus causing them to be a population exceptionally free from difficulty in coping with sleep loss. Remember the Libby Zion malpractice case? The medical community responded by limiting resident's work week to a puny 80 hours a week! 80! The medical culture cultivates a macho type attitude towards sleep as something you can do without if you are determined and tough enough. It makes sense that this is a population that can be fairly characterized as a bit insensitive and disinterested when it comes to complaints of exhaustion.


One can understand why these doctor's don't often jump at the chance to study an area of medicine that they are forced to neglect in themselves. Few graduating physicians seek to become board certified in the field even though a huge portion of their patients may have sleep disorders. As a result there is a large discrepancy between the knowledge that exists about sleep medicine and what most physicians know about it.


Certainly there is a need for more doctors to seek a sleep science education. According to the National Institute of Neurological Disorders and Stroke more than 40 million Americans suffer from chronic, long-term sleep disorders each year, and an additional 20 million experience occasional sleep problems. They also account for an estimated $16 billion in medical costs each year, while the indirect costs due to lost productivity and other factors are probably much greater. There are more than 80 different types of sleep disorders, but most sufferers are never accurately diagnosed and never receive the right treatment. In fact most do not know they have a sleep disorder and their doctors' never refer them to a sleep specialist. In spite of that, the US represents the largest market for sleeping pills globally, accounting for a share of more than 48% and the number continues to grow with 57.25 million sleep medication prescriptions written in 2008 alone. That's an awful lot of medication prescribed primarily by physicians with little to no sleep medicine education.

 

This is why it's advisable that people not ask their general practioner for a long term prescription for a short term sleep problem. There is a reason why pharmaceutical companies advertise so heavily inside regular doctor's office waiting room and why you will never see a tissue box printed with the name of a sleep medication in a sleep clinic. Most people who ask their general practioner for a sleep medication end up receiving one.


Patients who could see into the future wouldn't want their body and mind becoming accustomed to depending on unnecessary medications for an undiagnosed problem they may or may not have. Every medicine that enters the body alters how the body works and how other medications a patient takes work. It's not easy to tell the difference between a symptom, a side effect, and drug interaction effect.  The doctor who conducts a patient's yearly physical should not prescribe contact lenses any more than he or she should prescribe medication for a sleep disorder. Sleep disorders are best diagnosed and treated by a sleep specialist. Very few internal medicine practitioners know how any of their prescriptions affect sleep architecture and few patients and doctors realize that the true amount of sleep someone gets is not calculated by when a person goes to bed at night and when they wake in the morning.

For an article on the lack of sleep science education in medical schools click here.


How to Find a Sleep Specialist Experienced with Narcolepsy

Primary care physicians and neurologists are not all educated in the science of sleep medicine (it's an additional field of study one pursuits after becoming a doctor) therefore they have difficulty identifying and treating Narcolepsy. It's ideal to find a sleep medicine specialist who is board certified by the American Board of Sleep Medicine and already is treating a number of patients who have Narcolepsy (call around and ask.) Not all sleep centers have staff extensively educated and experienced with Narcolepsy. Many physicians neglect to remember to tell patients they should go off all medications safely possible for months prior to doing a first set of sleep studies for Narcolepsy. There are no definitive tests that clearly prove or disprove all suspected cases of Narcolepsy but sleep studies are heavily relied upon.


Organization of doctors and researchers dedicated to the advancement of sleep medicine and related research. Their website includes a list of accredited sleep centers and a listing of certified behavioral sleep medicine specialists that have expertise in using behavioral and cognitive methods to prevent and treat sleep problems.


The American Board of Sleep Medicine is the medical board that certifies doctors and researchers in sleep medicine. Their website includes listings of Board Certified Sleep Specialists by state or name. 


Dentists who treat sleep disorders with oral appliances are often members of the American Academy of Dental Sleep Medicine (previously the Sleep Disorders Dental Society). Their web site includes a searchable directory of dentists specialized in treating certain sleep problems.


National Sleep Foundation

The National Sleep Foundation is a charitable, educational and scientific not-for-profit organization dedicated to improving sleep health and safety through education, public awareness, and advocacy. Their website includes forums, and a searchable database of articles, polls, press releases, and sleep professionals.


Narcolepsy Narcolepsy Network Professional Members List
 
A list of sleep doctors who are members of the Narcolepsy network.



Typical undiagnosed Narcoleptic patient presentation
       at their primary care physician office appointment:


"Doctor, I don't know what's wrong with me. Even if I take a nap first, grocery shopping just exhausts me. Within a minute of walking in, I'm suddenly fuzzy brained and I forget to check my shopping list. I try and rush through to get home because I'm just exhausted beyond belief and I'm even dropping things. All I want to do is just get out of there and get home. Once, I barely make it to my car and had to nap right there in the parking lot in my car before I drove home. By the time I do get home I'm often furious to realize I've forgotten half the things I needed and I've picked up a bunch of things I don't need and don't remember putting in my cart. The next thing I know I'm laying on the couch and for all the money in the world I swear I cannot get up. Then my mother shows up and lectures me about laying on the couch being lazy when I'm supposed to be meeting her for dinner. And honestly, I have no memory of making plans with her but she swares she called me about it last week. Worst of all is sometimes as tired as I am all the time, I just can't sleep and I end up staying up too late. I just don't have enough energy to get through the day and I feel like losing my mind."


Narcolepsy's Common Misdiagnosises:

ADD or ADHD, Addiction, Adrenal Deficiency, Anemia, Allergies, Alzheimer Disease, Anemia, Bipolar Disorder, Borderline Personality Disorder, Chemical Sensitivities, Chronic Fatigue Syndrome, Circadian Rhythm Disorder, Conversion Disorder, Cytomegalovirus, Depression, Diabetes, Disassociative Identity Disorder, Dysnomia Disorder, Epilepsy, Epstein-Barr Virus, Hyper/Hypoglycemia, Idiopathic Hypersomnia, Insomnia, Learning Disabilities, Lyme Disease, Malingering, Medication side effects or interaction side effects, Mild Traumatic Brain Injury, Munchausen's Syndrome, Multiple Sclerosis, POTS, Pseudoseizures, Psychosis, Restless Leg Syndrome, Schizophrenia,Seasonal Affective Disorder, Sleep Apnea, Social Anxiety Disorder, Stroke

Syndascope, Thyroid Disease, Vasovagal Syncope, Vitamin Deficiencies

Why is Narcolepsy Easy to Misdiagnose?

Failure rates among physicians for diagnosing Narcolepsy are high:

45% of neurologists

76.5% of internists

78.1% of general practitioners

88.9% of psychiatrists

100% of pediatricians

(According to "Narcolepsy Presenting as Pseudoseizures" by Charles K. Dunham MD 


Unfortunately, Narcoleptics are likely one of the most misdiagnosed populations. 75% of them never learn the real cause of their symptoms and it takes an average of 11 years after symptom onset for 25% of Narcoleptics to ever be accurately diagnosed. Unless a patient and specialist specifically look to confirm or rule out Narcolepsy, the diagnosis is rarely ever made for a number of reasons:


Most doctor's don't know what Narcolepsy looks likeThey never knowingly come across a single case of Narcolepsy, though statistically most doctors have a few Narcoleptic patients because about 1 in 2,000 people have the condition in the USA. In fact, majority of sleep disorder medications are prescribed by physicians who don't know how to recognize, diagnose, and treat sleep disorders because the sleep medicine field is not included in most general medical school educations. Few doctors seek to study and become board certified in sleep medicine even though sleep disorders are incredibly common and can negatively effect any patient's auto immune system, nervous system, cognitive function, and more.


Patient's don't recognize all of their symptoms as symptoms. For most patients, Narcolepsy begins between the ages of 15 and 30 years. Undiagnosed Narcoleptics often mistake some of their embarrassing and confusing symptoms as character flaws or emotional problems that they see no reason to disclose to a doctor. Many of Narcolepsy's symptoms are realized only in retrospect or by highly specific tests. And believe it or not, a patient who complains that they are "sleepy" verses a patient who says they are "tired" tend to have their complaint valued very differently.


The symptoms undiagnosed Narcoleptics describe often point to other medical conditions. The symptoms don't clearly stand out as being sleep related. "Tired, forgetful and weak" are common patient complaints in every area of medicine. Medication sensitivity and paradoxical reactions to certain types of medications is not often realized to be a symptoms unto itself.


Narcolepsy is rare and misunderstood. Most people know what Cystic Fibrosis is even though CF is less common than Narcolepsy. Most people understand how debilitating Multiple Sclerosis yet most people don't understand that Narcolepsy is just as debilitating a disability as MS and just as common.


There is no single test that can prove or disprove every case of possible Narcolepsy. Even if there were a perfect test, it would be hard for a doctor to know who to test because the symptoms a patient describes very often point to other medical conditions. Even when a diagnosis of Narcolepsy is suspected, it's not easy to rule out all other possibilities and solidly confirm a diagnosis.

Many Narcolepsy tests are expensive and inaccessible. Tests that can help with diagnosing Narcolepsy are often very expensive and may not be covered by insurance at all, or only after courses of treatment with certain medications are unsuccessful. Some tests are not easily accessible due to long waitlists or geographic location.


Many Narcoleptics have medical histories that contain multiple red flags.

Narcoleptics tend to have medical histories with elaborate medical workups by general practitioners, cardiologist, endocrinologists, neurologists, ENTs, nutritionists, and psychiatrists. (To add to the confusion some antidepressants coincidentally alter sleep stages enough to provide some partial relief to Narcoleptics.) Misdiagnosed Narcoleptics spend years or their whole adult life held back and held down by misunderstood symptoms that don't improve, expensive medical tests for conditions they don't have, and unnecessary medication and their many direct and interactive side effects. Frustrated patients look for a new doctor, and another, and another trying to find the one who will finally figure out what is wrong and give them a treatment option that works. When nothing works people become suspicious and patients are commonly blamed for their symptoms by their friends, family, themselves, and even their doctors. Exam notes often include information many medical care providers interpret as red flags signaling that perhaps a patient suffers from emotional and behavioral problems instead of a physical problem.

 

Undiagnosed sleep disorder patients often have medical histories filled with red flags. The more doctors a patient seeks out, the more red flags in the file. The more red flags in the patient's file, the faster the patient's requests for medical help are answered with referrals to social workers and other psychological professionals for their "doctor shopping", "drug seeking", and/or "frequent flyer" behavior. Not surprisingly these accusations often become self-fulfilling prophecies when patients give up on the medical establishment that has let them down. People with sleep disorders have an understandably high rate of accidental injury, unidentified drug interaction side effects, isolation and depression, behavioral problems, self medication, relationship problems, and financial hardship.

Most people don't take misdiagnosed and mistreated sleep disorders seriously even though they are not uncommon and can even be deadly. Examples of this are not hard to come by. Arguably the world's most famous entertainer, Michael Jackson was a sleep disorder patient without a clear diagnosis or effective treatment plan, but he had significant resources and influence and went looking for his own creative solution to his sleep problem and the end result was fatal. To this day people tend to have strong feelings about who was more at fault, the patient or his cardiologist. Ask any group of recently diagnosed sleep disorder patients what they used to fantasize doing if they ever won the lottery, a fair portion of them will describe fantasies of finding a doctor who could give them anesthesia at night so they could finally wake up with enough energy to get through the day.


The only indisputable thing we can take away from Mr. Jackson's tragic death is that it gives us proof that even with substantial money and influence, getting an uncommon sleep disorder properly diagnosed, respected, and properly treated is still incredibly difficult and uncommon. The urge to cast blame on a person (doctor or patient) instead of a sleep disorder is hard to deny.


Common "red flags" found in a Narcoleptics medical history file:

many different doctors/doctor shopping - (psych problems, drug seeker?)

multiple conflicting symptoms and diagnosis's - (psych problems, drug seeker?)

high amount doctor visits/frequent flyer - (psych problems, drug seeker?)

injuries of unknown origin - (psych problems, addict, abused?)

patient asking about specific medical conditions - (psych problems, drug seeker?)

asking to try specific nontraditional medications - (drug seeker?)

no friends or family at ER visits - (psych problems, abused?)

overweight, poor, and isolated - (psych problems, lifestyle issues, financial motives?)

admits history of self medication - (psych problems, drug seeker?)

claims opiates and synthetic opiates provide little pain relief - (drug seeker?)

claims traditional treatments offer no relief of symptoms - (psych problems, drug seeker?)

symptoms not present at time of exam - (psych problems, drug seeker?)

conflicting recollections, stressed, emotional (psych problems, dishonest?)

patient takes many different medications - (psych problems, compliance issues, drug seeker?)

 

The presence of Narcolepsy's symptoms does not necessarily indicate a likely diagnosis because first, other more likely causes and conditions must be ruled out. When there is any suspicion of Narcolepsy, patients are urged to improve their sleep hygiene and start keeping a sleep diary (sample diary 1 and sleep diary 2) and bring that sleep diary and their documented medical history with them to their evaluation appointment with a board certified sleep specialist experienced in diagnosing and treating Narcolepsy.


Video: Talking with your doctor about sleep 

Stanford Sleep Inventory Sleep Inventory Questionnaire.


At the appointment the doctor will look over the patients Medical Records, do a brief physical exam, and ask the patient to fill out an Epworth Sleepiness Scale worksheet. The Epworth Scale asks patients to rate how likely they are to fall asleep in various situations. People with Narcolepsy usually score over 10 in the 0-24 scale.


If there is an indication that the patient may indeed have Narcolepsy, the patient is often weaned off certain types of medications and spend about two months as medication-free as safely possible while maintaining an accurate sleep log and practicing good sleep hygiene in preparation for one or two sleep studies at a sleep clinic, a PSG (Overnight Polysomnograph Test) and an MSLT (Multi Sleep Latency Test otherwise known as a nap study.) These tests may be conducted just once, but it's not uncommon for them to need to be repeated. Patients are usually also asked to fill out detailed sleep habit and cataplexy questionnaires while at the sleep clinic.

(Medical article article on validating cataplexy and Video: How to Prepare for a Sleep Study)

The PSG is most often used to identify and measure sleep apnea, but for people with Narcolepsy, the test helps rule out non-narcolepsy caused reasons for excessive daytime sleepiness as well as measure sleep latency (how long it takes to fall asleep), SOREMs (sleep onset REM), unusual transitions between sleep stages, and overall sleep efficiency. During sleep studies EEG-like monitors are glued to the patients scalp to measure brain activity. More that 10% of people with Narcolepsy have normal PSG results.

Video: The Sleep Study: Measuring How Well You Sleep at Night

Video: Introduction To The Sleep Lab:


The MSLT clearly identifies Narcolepsy in 85% of people who indeed have Narcolepsy, but without a PSG the night before, the results are usually considered invalid. The MSLT is similar to a PSG, but it measures how quickly a patient falls asleep when repeatedly given the opportunity to nap in a dark quiet room and it measures whether or not they experience REM during nap opportunities. Sleep deprivation can mimic Narcolepsy on a Multiple Sleep Latency Test which is why the MSLT alone can not confirm a diagnosis. While some people may have Nacolepsy symptoms that presents itself so clearly on an MSLT that the diagnosis in undeniable, many people with possible Narcolepsy are asked to undergo further tests.                              (How to Decipher Your Sleep Study Results)


In addition to sleep studies, the Epworth Sleep Scale, examining a medical history and sleep log, and a physical exam, many doctor's also order several blood tests, including a one measuring HLA (HumanLeukocyte Antigens.) Over 90% of patients with Narcolepsy-Cataplexy carry HLA-DQB1. But HLA testing is not used to diagnose Narcolepsy because 20% of the general population carry the exact same HLA subtypes.


Some neurologists also ask for an EEG and a CAT scan to rule out other neurological problems and occasionally a CSF (cerebrospinal fluid) test is sought in order to measure hypocretin (orexin) levels. This requires a lumbar puncture (lumbar puncture/spinal tap) and in the US the sample fluid is only examined by one lab, the one at the Stanford University Center for Narcolepsy. Their recent studies have shown that the hypocretin-containing brain cells are diminished in the spinal fluid tests of 93% of patients with Narcolepsy with Cataplexy, 56% of patients with only Narcolepsy, 52% of patients with Hypersomnia, and 17% of patients with no known sleep disorder. In Narcolepsy these cells are thought to be destroyed by an autoimmune attack, but not all people with a reduced hypocretin levels have Narcolepsy. Stanford warns people from thinking that their hypocretin test can confirm whether or not anyone has Narcolepsy.


Sometimes patients suspected of having Narcolepsy are asked to wear an actigraph. Actigraphy is the measurement of activity with the use of a small device worn on the wrist that looks like a watch. It monitors movement and can be used to assess sleep-wake cycles over an extended period of time. They may be worn for weeks or months and help identify sleep-wake cycle patterns, as may occur in circadian rhythm disorders such as Advanced Sleep Phase Syndrome, Delayed Sleep Phase Syndrome, Narcolepsy, or even with Insomnia. These results are often correlated with a sleep diary.


As you likely may have realized by now, the unfortunate truth is no single test is 100% specific for Narcolepsy. This is why there are many patients whose treatment is based on their "likely having" Narcolepsy. There are many patients who say their doctor diagnosed them with "Idiopathic Hypersomnia with a strong indication of Narcolepsy with Cataplexy." Some patients find that after keeping a detailed sleep diary, improving their sleep hygiene, collecting all documentation of their entire medical history, filling out dozens of Epworth Sleep Scales, repeated PSGs, repeated MSLTs, an HLA blood test, enduring a CSF measuring hypocretins, EEGsCAT scans, and wearing an actigraph for weeks or months, their doctors still keep changing their mind between a diagnosis of Idiopathic Hypersomnia and Narcolepsy. Since neither are curable and the symptoms of both conditions are treatable by similar means, these patients live without a firm diagnosis, but with an experienced physician their treatment options are not reduced from the options available to those who do have a firm diagnosis.


The following is the Diagnostic Criteria for Narcolepsy from the ICSD-2 (International Classification of Sleep Disorders, 2nd edition):


Narcolepsy with Cataplexy


A. Has a complaint of excessive daytime sleepiness occurring almost daily for at least three months.


B. A definite history of cataplexy, defined as sudden and transient episodes of loss of muscle tone triggered by emotions, is present.

 Note: To be labeled as cataplexy, these episodes must be triggered by strong emotions-most reliably laughing or joking-and must be generally bilateral and brief (less than two minutes). Consciousness is preserved, at least at the beginning of the episode. Observed cataplexy with transient reversible loss of deep tendon reflexes is a very strong, but rare, diagnostic finding.


C. The diagnosis of narcolepsy with cataplexy should, whenever possible, be confirmed by nocturnal polysomnography followed by an MSLT; the mean sleep latency on MSLT is less than or equal to eight minutes and two or more SOREMPs are observed following sufficient nocturnal sleep (minimum six hours) during the night prior to the test. Alternatively, hypocretin-l levels in the CSF are less than or equal to 110 pg/mL or one third of mean normal control values.

 Note: The presence of two or more SOREMPs during the MSLT is a very specific finding, whereas a mean sleep latency of less than eight minutes can be found in up to 30% of the normal population. Low CSF hypocretin-l levels (less than or equal to 110 pglmL or one third of mean normal control values) are found in more than 90% of patients with narcolepsy with cataplexy and almost never in controls or in other patients with other pathologies.


D. The hypersomnia is not better explained by another sleep disorder, medical or neurological disorder, mental disorder, medication use, or substance use disorder.



Narcolepsy without Cataplexy


A. The patient has a complaint of excessive daytime sleepiness occurring almost daily for at least three months.


B. Typical cataplexy is not present, although doubtful or atypical cataplexy-like episodes may be reported.


C. The diagnosis of narcolepsy without cataplexy must be confirmed by nocturnal polysomnography followed by an MSLT. In narcolepsy without cataplexy, the mean sleep latency on MSLT is less than or equal to eight minutes and two or more SOREMPs are observed following sufficient nocturnal sleep (minimum six hours) during the night prior to the test.

Note: The presence of two or more SGREMPs during the MSLT is a specific finding, whereas a mean steep latency of less than eight minutes can be found in up to 30% of the normal population.


D. The hypersomnia is not better explained by another sleep disorder, medical or neurological disorder, mental disorder, medication use, or substance use disorder.



Narcolepsy Due to Medical Condition


A. The patient has a complaint of excessive daytime sleepiness occurring almost daily for at least three months.


B. One of the following is observed:


i. A definite history of cataplexy, defined as sudden and transient episodes of loss of muscle tone (muscle weakness) triggered by emotions, is present.

Note: To be cataplexy, these episodes must be triggered by strong emotions, most reliably by laughing or joking, and must be generally bilateral and brief (less than two minutes). Consciousness is preserved at least at the beginning of the episode. In narcolepsy (with cataplexy) due to a medical condition, the diagnosis should, whenever possible, be confirmed by nocturnal polysomnography followed by an MSLT (see MSLT criteria below).


ii. If cataplexy is not present or is very atypical, polysomnographic monitoring performed over the patient's habitual sleep period followed by an MSLT must demonstrate a mean sleep latency on the MSLT of less than eight minutes with two or more SOREMPs, despite sufficient nocturnal sleep prior to the test (minimum six hours)

Note: The presence of two or more SOREMPs during the MSLT is a very specific finding, whereas a mean sleep latency of less than eight minutes can be found in up to 30% of the general population.


iii. Hypocretin-l levels in the CSF are less than 110 pg/mL (or 30% of normal control values), provided the patient is not comatose

Note: In patients with severe medical or neurological illness, nocturnal polysomnography or the MSLT may be impossible to conduct or to interpret. Similarly, the value of measuring hypocretin-l levels in the CSF in critically ill patients is uncertain. Abnormal polysomnography and low CSF hypocretin-l levels should be interpreted within the clinical context.


C. A significant underlying medical or neurological disorder accounts for the daytime sleepiness


D. The hypersomnia is not better explained by another sleep disorder, mental disorder, medication use, or substance use disorder.

The Science Behind Narcolepsy Video 

Types of Sleep Disorders


Video: Overview of sleep disorders


Narcoleptics often have more then one type of sleep disorder. There are more than eighty different sleeping disorders. There are two main types of sleep disorder: dyssomnias and parasomnias (and a third tangential category that relates to other conditions, such as depression and addiction.) Dyssomnias produce either excessive sleepiness or difficulty initiating or maintaining sleep. Dyssomnias are divided into three subcategories: Intrinsic Sleep Disorders, Extrinsic Sleep Disorders, and Circadian Rhythm Sleep Disorders.


Intrinsic Sleep Disorders:

Psychophysiological Insomnia

Sleep State Misperception

Idiopathic Insomnia

Narcolepsy

Recurrent Hypersomnia

Idiopathic Hypersomnia

Posttraumatic Hypersomnia

Obstructive Sleep Apnea Syndrome

Central Sleep Apnea Syndrome

Central Alveolar Hypoventilation Syndrom

Periodic Limb Movement Disorder

Restless Legs Syndrome

Extrinsic Sleep Disorders:

Inadequate Sleep Hygiene

Environmental Sleep Disorder

Altitude Insomnia

Adjustment Sleep Disorder

Insufficient Sleep Disorder

Limit-Setting Sleep Disorder

Food Allergy Insomnia

Nocturnal Eating (Drinking) Syndrome

Hypnotic-Dependent Sleep Disorder

Stimulant-Dependent Sleep Disorder

Alcohol-Dependent Sleep Disorder

Toxin-Induced Sleep Disorder


Circadian Rhythm Sleep Disorders

Time Zone Change (Jet Lag) Syndrome

Shift Work Sleep Disorder

Irregular Sleep-Wake Pattern

Delayed Sleep Phase Syndrome

Advanced Sleep Phase Syndrome

Non-24-Hour Sleep-Wake Disorder


Parasomnias

Parasomnias consist mainly of inappropriate physical behaviors that intrude predominantly during sleep. This group includes: Arousal Disorders, Sleep-Wake Transition Disorders, and other Parasomnias Usually Associated With REM Sleep


Arousal Disorders

Confusional Arousals

Sleepwalking

Sleep Terrors


Sleep-Wake Transition Disorders

Rhythmic Movement Disorder

Sleep Starts

Sleep Talking

Nocturnal Leg Cramps


Parasomnias Usually Associated With REM Sleep

Nightmares

Sleep Paralysis

Impaired Sleep-Related Penile Erections

Sleep-Related Painful Erections

REM Sleep-Related Sinus Arrest

REM Sleep Behavior Disorder


Other Parasomnias

Sleep Bruxism- Tooth grinding

Sleep Enuresis

Sleep-Related Abnormal Swallowing Syndrome- A disorder in which inadequate swallowing of saliva results in aspiration (inhalation) of excess saliva, with coughing, choking, and brief arousals or full awakenings from sleep.

Nocturnal Paroxysmal Dystonia

Sudden Unexplained Nocturnal Death Syndrome

Primary Snoring

 

Infant Sleep Apnea

Congenital Central Hypoventilation Syndrome

Sudden Infant Death Syndrome

Benign Neonatal Sleep Myoclonus


Sleep Disorders Associated With Medical/Psychiatric Disorders

Majority of mental/ mood disorders can cause sleep disturbances. These includes various psychoses, mood disorders, anxiety disorders, panic disorders, alcoholism, etc.


Associated with Mental Disorders

Psychoses

Mood Disorders

Anxiety Disorders

Panic Disorders

Alcoholism


Associated with Neurological Disorders

Cerebral Degenerative Disorders

Dementia

Parkinsonism

Fatal Familial Insomnia

Sleep-Related Epilepsy

Electrical Status Epilepticus of Sleep

Sleep-Related Headaches


Associated with Other Medical Disorders

Sleeping Sickness

Nocturnal Cardiac Ischemia

Chronic Obstructive Pulmonary Disease (COPD)

Sleep-Related Asthma

Sleep-Related Gastroesophageal Reflux

Peptic Ulcer Disease

Fibromyalgia

Related Videos:

Health Science Channel Narcolepsy video 

Thrillers of the Night - A video overview of various sleep disorders & events

Understanding Restless Legs Syndrome 

What Causes Sleep Apnea 

Pediatric sleep disorders 

Circadian Rhythms 

Delayed Sleep Phase Syndrome 

Stanford's Most Wanted - A Parody About Sleep Debt

Night Terrors

Idiopathic Hypersomnia Org 

Periodic Limb Movement Disorder 

REM Behavior Disorder

Bruxism brochure - More Than Just A Headache In The Morning?

"Do I Have Insomnia?"

Why You Shouldn't Sleep with Your Pets

Web Hosting Companies