Sleep is an active, clinically important behavior, during which many physiologic processes of the organism change. These processes are temporally organized under cerebral influence. Sleep abnormality may represent a primary disorder of mechanisms regulating…

Associated With Mental Disorders. Disordered sleep is typical of most psychiatric disorders. Unipolar depression is characteristically associated with a disorder of initiating and maintaining sleep, most commonly early morning awakening. The patient…

“Menstrual-associated sleep disorder is a disorder of unknown cause, characterized by a complaint of either insomnia or excessive sleepiness, that is temporally related to the menses or menopause.” Premenstrual excessive sleepiness is a sometimes…

Substance-induced sleep disorder includes a prominent disturbance in sleep for which there is evidence from the history, physical examination, or laboratory findings of substance use, intoxication, or withdrawal. The diagnosis rests on temporal coincidence…

The high prevalence of sleep disorders and their effect on both longevity and quality of life have brought increased attention to the treatment of these conditions. Treatment guidelines and practice parameters are becoming…

The diagnosis of sleep disorders due to a general medical condition is used in cases in which a prominent disturbance in sleep is sufficiently severe to warrant independent clinical…

The essential feature of hypersomnia related to another mental disorder is a complaint of excessive sleepiness, with either prolonged nocturnal sleep or frequent daytime sleep episodes, that has lasted for at…

Insomnia related to another mental disorder should be diagnosed when a patient has a predominant complaint of insomnia for at least 1 month that causes daytime symptoms and impaired functioning. The…

The ICSD recognizes more than 20 additional parasomnias not listed in DSM-IV. One of these conditions that has drawn clinical and research interest is REM sleep behavior disorder. This disorder is characterized by…

Sleep terrors are characterized by a sudden awakening from Stage 3/4 sleep that is accompanied by a piercing scream, intense anxiety, and excessive autonomic arousal. These signs are significantly more intense…

Circadian rhythm sleep disorder is a persistent or recurrent pattern of sleep disruption characterized by excessive sleepiness or insomnia. These symptoms result from a mismatch between the individual’s sleep-wake schedule and endogenous circadian…

Parasomnias are disorders of arousal during sleep or dysfunctions associated with particular sleep stages. These disorders are manifestations of abnormal or excessive activation of the central nervous system. Parasomnias do not necessarily lead…

Breathing-related sleep disorder is characterized by a clinical complaint of excessive daytime sleepiness or insomnia or both. These symptoms result from periodic cessation of breathing (apnea), diminished amplitude of airflow (hypopnea), or increased work…

As noted above, both behavioral treatments and pharmacological treatments can be applied to the treatment of almost all sleep disorders. In this section, we describe how the general characteristics of these treatments,…

For most sleep disorders, behavioral/psychotherapeutic and pharmacological approaches are not incompatible and can be effectively combined to maximize therapeutic benefits. For example, hypnotic medications may improve sleep patterns more rapidly than some behavioral interventions…

Continuous positive airway pressure and bilevel positive airway pressure Continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) are used to treat breathing-related sleep disorder (Grunstein and Sullivan 2000; Strollo and Rogers…