J Korean Med Assoc.  2013 May;56(5):410-422.

Sleep disorders medicine

• Hong SB

Abstract

Sleep comprises one third of human life and is very important for maintaining healthy mental and physical states. Sleep disorders disturbing normal sleep are very common and may induce serious consequences. Sleep disorder medicine is based on the concept of two different states (waking and sleep) of the human brain. The problems of the waking conscious state affect sleep and problems during sleep also affect daytime mental and physical activities. The common symp-toms of patients with sleep disorders are excessive daytime sleepiness, a decrease in alertness, and fatigue. To detect sleep disorders, we should understand the physiology of normal sleep. Normal sleep consists of non-rapid eye movement (75% to 80%) and rapid eye movement (20% to 25%) sleep. The International Classification of Sleep Disorders second edition lists 77 different sleep disorders divided into 8 categories. Clinical approaches to sleep disorder patients should include detailed history taking including sleep history, a sleep questionnaire, sleep diary, physical examination including the nasal/oral cavities and airway, and neurological/psychological examination. The common sleep disorders are obstructive sleep apnea, insomnia, narcolepsy, restless legs syndrome, rapid eye movement sleep behavior disorder, and circadian rhythm sleep disorder. We should learn the characteristic clinical features of each sleep disorder and how to detect and treat them. We need a more active effort to educate physicians about sleep disorder medicine and should try large sample, long-term, and prospective studiesto reveal the pathophysiology and enhance the treatment of sleep disorders. Sleep disorders are common, serious, and treatable. However, most patients with sleep disorders are underdiagnosed and not treated appropriately due to lack of knowledge of sleep disorder medicine. The Ministry of Health and Welfare of South Korea should focus more attention on and provide more support for timely diagnosis and treatment of sleep disorders.

Keyword

Sleep disorder; Obstructive sleep apnea; Insomnia; Narcolepsy; Restless legs syndrome; REM sleep behavior disorder

MeSH Terms

Brain
Circadian Rhythm
Eye Movements
Fatigue
Humans
Motor Activity
Narcolepsy
Physical Examination
Surveys and Questionnaires
REM Sleep Behavior Disorder
Republic of Korea
Restless Legs Syndrome
Sleep Apnea, Obstructive
Sleep Initiation and Maintenance Disorders
Sleep Wake Disorders
Sleep, REM

Figure

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  Figure 1 Obstructive sleep apnea patient is wearing nasal continuous positive airway pressure (CPAP) mask. Informed consent was received from the patient.

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  Figure 2 Mandibular advancement device. (A) Monoblock and (B) two-block.

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