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Advanced Neurology The rising impact of sleep disorders in the post-pandemic era

Table 2. An overview of sleep disorders and their characteristics
Condition References
Insomnia Diagnostic Sleep disturbances: Schreck et al., Pavlova et al.,
criteria 1. Difficulty initiating sleep Holder et al., Sateia 2,5-7
2. Difficulty maintaining sleep
3. Waking up earlier than desired
4. Reluctance to adhere to an appropriate bedtime schedule
Associated daytime symptoms:
1. Fatigue/malaise
2.Attention, concentration, or memory impairment
3.Mood disturbance/irritability
4.Behavioral problems
5.Susceptibility to errors/accidents
6.Concerns about or dissatisfaction with sleep (>3 times/week and >3 months)
Etiology • Idiopathic
• Inadequate sleep hygiene
• Improper sleep training
• Secondary or concurrent psychiatric or medical condition
• Drug or substance use
Treatment • Hypnotics
• Antidepressants
• Melatonin agonists
• Orexin antagonists
Circadian rhythm Diagnostic 1. Delayed sleep–wake phase disorder: Schreck et al., Pavlova et al.,
sleep–wake criteria The patient’s sleep pattern is consistently delayed beyond what is considered necessary Holder et al., Sateia 2,5-7
disorders 2. Advanced sleep–wake phase disorders:
The patient’s sleep consistently commences earlier than deemed necessary.
3. Symptoms present for at least 3 months
4. Sleep log and actigraphy monitoring for a minimum of 7 days, demonstrating a
shift in sleep schedule, either shifting later or earlier than usual.
Etiology • Polymorphism in the hPer3 gene
• Increased or decreased exposure to light
• Behavioral, social, and occupational activities
• Psychiatric disorders
Treatment • Melatonin−combined with morning blue light
Sleep-disordered Diagnostic 1. The patient complains of sleepiness, non-restorative sleep, fatigue, or Schreck et al., Pavlova et al.,
breathing: criteria insomnia symptoms Holder et al., Sateia 2,5-7
obstructive and 2. The patient wakes up with breath-holding, gasping, or choking
central sleep apnea 3. Habitual snoring, breathing interruptions, or both during the patient’s sleep
4. The patient was diagnosed with hypertension, a mood disorder, cognitive
dysfunction, coronary artery disease, stroke, congestive heart failure, atrial
fibrillation, or type 2 diabetes mellitus.
Etiology • Obesity
• Upper airway obstruction
• Structural abnormalities of the head and neck
• Endocrine disorders
• Alcohol consumption
• Use of sedatives
• Genetic predisposition
Treatment • Continuous or bilevel positive airway pressure
• Dental or oral appliances
• Surgery for specific indications
• Weight loss
• Avoiding triggers
Narcolepsy Diagnostic Type 1: Schreck et al., Pavlova et al.,
criteria 1. The patient experiences daily episodes of an uncontrollable urge to sleep or Holder et al., Sateia 2,5-7
daytime sleep lapses, lasting for a minimum of 3 months
2. Cataplexy and a mean sleep latency of ≤8 min and two or more SOREMPs*
3. CSF hypocretin-1 concentration ≤110 pg/mL
Type 2:
1. Narcolepsy without cataplexy
2. Hypersomnolence is not explained by other causes such as insufficient
sleep, obstructive sleep apnea, and medication or substance use
(Cont’d...)

Volume 4 Issue 1 (2025) 14 doi: 10.36922/an.4006