Sleep Disorder

Sleeping Disorder

The brain and its infinite complexity will surely puzzle us for centuries to come. But, as with any other organ in the body, things can go wrong with the brain (and the behavior it controls). Whether it is Alzheimer's or Parkinson's disease, anxiety, depression, or schizophrenia, there is no shortage of possible diseases and disorders of the brain. And sleep, which the brain closely controls and monitors, is also susceptible to going out of whack. In recent decades, with the advancement of sleep research and improved knowledge about sleep, scientists and medical doctors have come to realize that sleep disorders are much more common than anyone previously imagined. Sleep disorders can be classified as primary or secondary, depending on the presumed cause of the disorder. Primary sleep disorders are those that arise in the absence of other medical or psychiatric conditions, while secondary sleep disorders are likely caused by some other condition (Kabat-Zinn, 1990).

Symptoms/Diagnostic Criteria

Many things cause sleep disorder, it turns out, which is perhaps why it is so common. The number one cause of insomnia is stress, whether over an exam, school activity, personal relationship, or family and work issues. Insomnia can also be caused by anxiety or depression, illnesses such as arthritis or other forms of chronic pain, travel across time zones (jet lag), and poor sleep habits (such as drinking caffeine or alcohol, or exercising too close to bedtime). Finally, some medications, such as those used to treat Attention Deficit/Hyperactivity Disorder (ADHD), high blood pressure, or nasal congestion, also interfere with the ability to fall asleep.

Diagnosis of sleep disorders usually requires a psychological history as well as a medical history. With the exception of sleep apnea syndromes, physical examinations are not usually revealing. The patient's sex and age are useful starting points in assessing the problem. The doctor may also talk to other family members in order to obtain information about the patient's symptoms. The family's observations are particularly important to evaluate sleepwalking, kicking in bed, snoring loudly, or other behaviors that the patient cannot remember (Goldson, 1997).

History of the disorder

Sleep disorders were poorly described at the turn of the century, and, other than narcolepsy and sleeping sickness, few specific sleep disorders were recognized. In addition to general medical illness, environmental effects and anxiety were viewed as the main causes of sleep disturbance. However, a gradual recognition of the multiplicity of sleep diagnoses began to parallel progress in psychiatry. Freud's book The Interpretation of Dreams led to the development of psychoanalysis, which was applied to the treatment of insomnia until the evolution of a more "organic" or "biological" psychiatric approach (Hartmann, 1988).

Psychoactive medications became widely used with the introduction of the phenothiazines in the 1950s, but hypnotic medications, particularly the barbiturates, had been in common usage since barbital was introduced in 1903. The 1960s saw the introduction of the benzodiazepine hypnotics, which largely replaced the barbiturates in the late 1970s. However, the 1980s saw a decline in the use of hypnotics with increased physician and public ...