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Symptoms of Sleep Disorders

Mark Dombeck, Ph.D.

Worried you may be suffering from a sleeping disorder? Check here for the symptoms you should look for before consulting a mental health professional.

Insomnia
Hypersomnia
Sleepwalking Disorder
Circadian Rhythm Sleep Disorder
Narcolepsy
Nightmare Disorder
Sleep Terror Disorder

Insomnia, Primary  (can't get to sleep)

The predominant complaint is difficulty initiating or maintaining sleep, or nonrestorative sleep, for at least 1 month.

The sleep disturbance (or associated daytime fatigue) causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The sleep disturbance does not occur exclusively during the course of Narcolepsy, Breathing-Related Sleep Disorder, Circadian Rhythm Sleep Disorder, or a Parasomnia.

The disturbance does not occur exclusively during the course of another mental disorder (e.g., Major Depressive Disorder, Generalized Anxiety Disorder, a delirium).

The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Hypersomnia, Primary  (Sleeping too much)

The predominant complaint is excessive sleepiness for at least 1 month (or less if recurrent) as evidenced by either prolonged sleep episodes or daytime sleep episodes that occur almost daily.

The excessive sleepiness causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The excessive sleepiness is not better accounted for by insomnia and does not occur exclusively during the course of another Sleep Disorder (e.g., Narcolepsy, Breathing-Related Sleep Disorder, Circadian Rhythm Sleep Disorder, or a Parasomnia) and cannot be accounted for by an inadequate amount of sleep.

The disturbance does not occur exclusively during the course of another mental disorder.

The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition

Sleepwalking Disorder

Repeated episodes of rising from bed during sleep and walking about, usually occurring during the first third of the major sleep episode.

While sleepwalking, the person has a blank, staring face, is relatively unresponsive to the efforts of others to communicate with him or her, and can be awakened only with great difficulty.

On awakening (either from the sleepwalking episode or the next morning), the person has amnesia for the episode.

Within several minutes after awakening from the sleepwalking episode, there is no impairment of mental activity or behavior (although there may initially be a short period of confusion or disorientation).
The sleepwalking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Circadian Rhythm Sleep Disorder

A persistent or recurrent pattern of sleep disruption leading to excessive sleepiness or insomnia that is due to a mismatch between the sleep-wake schedule required by a person's environment and his or her circadian sleep-wake pattern (e.g., jet-lag, night shift work, etc.)

The sleep disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The disturbance does not occur exclusively during the course of another Sleep Disorder or other mental disorder.

The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Narcolepsy

Irresistible attacks of refreshing sleep that occur daily over at least 3 months.

The presence of one or both of the following:

  • cataplexy (i.e., brief episodes of sudden bilateral loss of muscle tone, most often in association with intense emotion)
  • recurrent intrusions of elements of rapid eye movement (REM) sleep into the transition between sleep and wakefulness, as manifested by either hypnopompic or hypnagogic hallucinations or sleep paralysis at the beginning or end of sleep episodes

The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or another general medical condition.

Nightmare Disorder

Repeated awakenings from the major sleep period or naps with detailed recall of extended and extremely frightening dreams, usually involving threats to survival, security, or self-esteem. The awakenings generally occur during the second half of the sleep period.

On awakening from the frightening dreams, the person rapidly becomes oriented and alert (in contrast to the confusion and disorientation seen in Sleep Terror Disorder and some forms of epilepsy).

The dream experience, or the sleep disturbance resulting from the awakening, causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The nightmares do not occur exclusively during the course of another mental disorder (e.g., a delirium, Posttraumatic Stress Disorder) and are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Sleep Terror Disorder

Recurrent episodes of abrupt awakening from sleep, usually occurring during the first third of the major sleep episode and beginning with a panicky scream.

Intense fear and signs of autonomic arousal, such as tachycardia, rapid breathing, and sweating, during each episode.

Relative unresponsiveness to efforts of others to comfort the person during the episode.
No detailed dream is recalled and there is amnesia for the episode.

The episodes cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

References:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.