Dyssomnia

Dyssomnias are a broad classification of sleeping disorder that make it difficult to get to sleep, or to stay sleeping.

Dyssomnias are primary disorders of initiating or maintaining sleep or of excessive sleepiness and are characterized by a disturbance in the amount, quality, or timing of sleep.

Patients may complain of difficulty getting to sleep or staying asleep, intermittent wakefulness during the night, early morning awakening, or combinations of any of these. Transient episodes are usually of little significance. Stress, caffeine, physical discomfort, daytime napping, and early bedtimes are common factors.

There are over 30 recognized kinds of dyssomnias. Major groups of dyssomnias include:

• Intrinsic sleep disorders – 12 disorders recognized, including
  • hypersomnia,
  • narcolepsy,
  • periodic limb movement disorder,
  • restless legs syndrome,
  • sleep apnea.
• Extrinsic sleep disorders – 13 disorders recognized, including
  • alcohol-dependent sleep disorder,
  • food allergy insomnia,
  • inadequate sleep routine.
• Circadian rhythm sleep disorders – 6 disorders recognized, including
  • advanced sleep phase syndrome,
  • delayed sleep phase syndrome,
  • jet lag,
  • shift work sleep disorder.

In general, there are two broad classes of treatment, and the two may be combined: psychological (cognitive-behavioral) and pharmacologic. In situations of acute distress, such as a grief reaction, pharmacologic measures may be most appropriate. With primary insomnia, however, initial efforts should be psychologically based.

• Somnolence