Disorders of sleep Sleep complaints

The starting point for the clinician is the patient's sleep complaint. They are of three basic types:

• not enough sleep or unrefreshing sleep (insomnia)

• sleeping too much (excessive daytime sleepiness)

• disturbed episodes during or otherwise related to sleep (parasomnias)

The detailed accounts later in this section are organized in relation to these main types of sleep complaint: insomnias ( Chapiei.4.14.,...2), excessive daytime sleepiness (Chapter.4.14.3), and parasomnias (Chapter 4.14.4). In recognition of the frequency with which sleep disturbance complicates physical and mental illness, additional accounts are then provided of sleep disturbance associated with psychiatric conditions ( ChapteL4.14.5) and with medical disorders (ChapteL4.14.§). Sleep problems in childhood and adolescence are discussed in Chap.teL,9...2...,9, with a separate account regarding preschool children in C.h§p.t.eL9.:..2..:.8.. The relationship between mental retardation and sleep disturbance are considered above, and common sleep problems in the elderly (which are common and troublesome (36>) are discussed in Chapter 8.6.

Whatever the clinical setting in which sleep complaints are investigated, the aim is to identify the specific sleep disorder from the many other conditions that can give rise to such complaints. Some sleep disorders may cause more than one type of complaint and a patient may have more than one sleep disorder. The question arises which scheme to use for the classification of sleep disorders.

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