SLEEP DISORDERS
DEFINITION |
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Sleep disorders are a group of syndromes
characterized by disturbance in the patient's amount of sleep,
quality or timing of sleep, or in behaviors or physiological
conditions associated with sleep. There are about 70 different sleep
disorders. To qualify for the diagnosis of sleep disorder, the
condition must be a persistent problem, cause the patient
significant emotional distress, and interfere with his or her social
or occupational functioning. The fourth edition (1994) of the
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
specifically excludes temporary disruptions of sleeping patterns
caused by travel or other short-term stresses.
Although sleep is a basic behavior in animals as well as humans,
researchers still do not completely understand all of its functions
in maintaining health. In the past 30 years, however, laboratory
studies on human volunteers have yielded new information about the
different types of sleep. Researchers have learned about the
cyclical patterns of different types of sleep and their
relationships to breathing, heart rate, brain waves, and other
physical functions. These measurements are obtained by a technique
called polysomnography.
There are five stages of human sleep. Four stages have non-rapid eye
movement (NREM) sleep, with unique brain wave patterns and physical
changes occurring. Dreaming occurs in the fifth stage, during rapid
eye movement (REM) sleep.
Stage 1 NREM sleep. This stage occurs while a person is falling
asleep. It represents about 5% of a normal adult's sleep time.
Stage 2 NREM sleep. In this stage, (the beginning of "true" sleep),
the person's electroencephalogram (EEG) will show distinctive wave
forms called sleep spindles and K complexes. About 50% of sleep time
is stage 2 REM sleep.
Stages 3 and 4 NREM sleep. Also called delta or slow wave sleep,
these are the deepest levels of human sleep and represent 10-20% of
sleep time. They usually occur during the first 30-50% of the
sleeping period.
REM sleep. REM sleep accounts for 20-25% of total sleep time. It
usually begins about 90 minutes after the person falls asleep, an
important measure called REM latency. It alternates with NREM sleep
about every hour and a half throughout the night. REM periods
increase in length over the course of the night.
Sleep cycles vary with a person's age. Children and adolescents have
longer periods of stage 3 and stage 4 NREM sleep than do middle aged
or elderly adults. Because of this difference, the doctor will need
to take a patient's age into account when evaluating a sleep
disorder. Total REM sleep also declines with age.
The average length of nighttime sleep varies among people. Most
people sleep between seven and nine hours a night. This population
average appears to be constant throughout the world. In temperate
climates, however, people often notice that sleep time varies with
the seasons. It is not unusual for people in North America and
Europe to sleep about 40 minutes longer per night during the winter. |
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| SLEEP DISORDERS RELATED ITEMS |
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