Clinical Aspects in Sleep Disorders and Apnea
Sleep disorders are frequently reported complaints. Insomnia and hypersomnolence are symptoms often reported by patients and study participants. Sleep disorders with clinical consequences are not as common as complaints and symptoms might suggest. Sleep medicine is a new discipline which has developed its own curricula and physician specialization. Sleep medicine has developed a classification of sleep disorders with a manual with definitions and severity criteria. This classification will become part of the ICD-11 currently developed. The classification defines insomnia, sleep-related breathing disorders, central disorders of hypersomnolence, circadian rhythm sleep-wake disorders, parasomnias, sleep-related movement disorders, and other sleep disorders.
Diagnostic procedures include validated questionnaires; daytime testing of alertness and sleepiness; home recording of sleep-wake behavior, activity, and physiological signals; and finally a sleep laboratory investigation, cardiorespiratory polysomnography, with all signals recorded which change during normal and pathological sleep. Quantitative assessment of sleep, sleep stages, arousals from sleep, and vegetative functions during sleep is well-established, and normative values including age as modifier are well described.
Sleep disorders are recognized as risk factors for many other medical and mental disorders. Sleep disorders impair performance and may be perceived as early aging. Untreated sleep disorders cause costs at all levels of health care and need to be recognized and treated as appropriate.
Sleep disorders are a target to clinical pharmacology by being recognized and potentially excluded in any pharmacological trial. And sleep disorders are subject to drug discovery and development.
References and Further Reading
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