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Sleep Disorder: Problems Associated With Other Disorders: Differential Diagnoses & Workup

Author: Dennis A Nutter, Jr, MD, Consulting Staff, Department of Psychiatry, Northeast Georgia Medical Center
Coauthor(s): Guy K Palmes, MD, Program Director, Assistant Professor, Department of Psychiatry, Section of Child and Adolescent Psychiatry, Wake Forest University; Benyam Tegene, MD, Fellow, Department of Psychiatry, Wake Forest University Baptist Medical Center
Contributor Information and Disclosures

Updated: Apr 4, 2007

Differential Diagnoses

Anxiety Disorder: Generalized Anxiety
Learning Disorder: Written Expression
Anxiety Disorder: Panic Disorder
Obesity
Anxiety Disorder: Separation Anxiety and School Refusal
Obesity-Hypoventilation Syndrome and Pulmonary Consequences of Obesity
Anxiety Disorder: Social Phobia and Selective Mutism
Obstructive Sleep Apnea Syndrome
Anxiety Disorder: Specific Phobia
Oppositional Defiant Disorder
Anxiety Disorder: Trichotillomania
Pervasive Developmental Disorder
Asthma
Pervasive Developmental Disorder: Asperger Syndrome
Bladder Anomalies
Pervasive Developmental Disorder: Autism
Child Abuse & Neglect: Physical Abuse
Pervasive Developmental Disorder: Rett Syndrome
Child Abuse & Neglect: Posttraumatic Stress Disorder
Posterior Urethral Valves
Child Abuse & Neglect: Sexual Abuse
Prader-Willi Syndrome
Chronic Fatigue Syndrome
Pulmonary Hypertension, Idiopathic
Cognitive Deficits
Sarcoidosis
Conduct Disorder
Sleep Apnea
Down Syndrome
Sleep Disorder: Night Terrors
Eating Disorder: Anorexia
Sleep Disorder: Nightmares
Eating Disorder: Bulimia
Somatoform Disorder: Conversion
Eating Disorder: Pica
Somatoform Disorder: Pain
Eating Disorder: Rumination
Somatoform Disorder: Somatization
Fibromyalgia
Substance Abuse: Cocaine
Fragile X Syndrome
Substance Abuse: Nicotine
Gastroesophageal Reflux
Tuberous Sclerosis
Hyperthyroidism
Urinary Tract Infection
Hypothyroidism
Velocardiofacial Syndrome
Juvenile Rheumatoid Arthritis
Williams Syndrome
Lactose Intolerance
Wilson Disease
Learning Disorder: Mathematics
Learning Disorder: Reading

Workup

Other Tests

  • Sleep laboratory studies are very helpful when indicated, but most common pediatric sleep problems do not require formal sleep laboratory testing. Most sleep problems resolve with behavioral treatments. A detailed sleep history, thorough physical examination, and sleep logs provide the foundation for accurate diagnosis, treatment, and possible referral for polysomnography. Atypical presentations, snoring associated with daytime somnolence, behavioral-emotional problems, apneic or hypopneic episodes, suspicion of narcolepsy, abnormal and disruptive movements in sleep, unexplained or recalcitrant sleep difficulties, or daytime sleepiness indicate a need for sleep studies.
  • Overnight polysomnography and next-day multiple sleep latency testings represent the most commonly used sleep studies. Clinical suspicion of any of the following disorders should prompt referral for sleep studies:
    • Sleep-related seizurelike activity
    • Sleep-related gastroesophageal reflux
    • Nighttime asthma or persistent cough
    • ADHD or Tourette syndrome associated with restless sleep and disrupted daytime functioning
    • RLS and PLMS - Relatively common in these patients
    • Recurrent REM sleep behaviors
    • Severe bruxism
    • Snoring and hypopnea or apnea
    • Recalcitrant or unexplained and daytime somnolence
    • Suspected narcolepsy
  • Multiple sleep latency tests aid in clarifying unexplained excessive daytime sleepiness and narcolepsy symptoms.

More on Sleep Disorder: Problems Associated With Other Disorders

Overview: Sleep Disorder: Problems Associated With Other Disorders
Differential Diagnoses & Workup: Sleep Disorder: Problems Associated With Other Disorders
Treatment & Medication: Sleep Disorder: Problems Associated With Other Disorders
Follow-up: Sleep Disorder: Problems Associated With Other Disorders
References

References

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Further Reading

Keywords

associated problems in select sleep disturbances, dyssomnias, parasomnias, medical-psychiatric disorders, hypersomnia, insomnia, narcolepsy, obstructive sleep apnea syndrome, OSAS, periodic limb movements in sleep, PLMS, sleepwalking, somnambulism, bruxism, teeth grinding, grinding teeth, nightmares, night mares, sleep terrors, primary nocturnal enuresis, rhythmic movement disorders, confusional arousals, delayed sleep phase syndrome, DSPS, sleep disorders, sleep problems, rapid eye movement, REM, nonrapid eye movement, non-REM, NREM, circadian sleep-wake cycle, circadian rhythm

Contributor Information and Disclosures

Author

Dennis A Nutter, Jr, MD, Consulting Staff, Department of Psychiatry, Northeast Georgia Medical Center
Dennis A Nutter, Jr, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry and American Psychiatric Association
Disclosure: Nothing to disclose.

Coauthor(s)

Guy K Palmes, MD, Program Director, Assistant Professor, Department of Psychiatry, Section of Child and Adolescent Psychiatry, Wake Forest University
Disclosure: Nothing to disclose.

Benyam Tegene, MD, Fellow, Department of Psychiatry, Wake Forest University Baptist Medical Center
Benyam Tegene, MD is a member of the following medical societies: American Medical Association and American Psychiatric Association
Disclosure: Nothing to disclose.

Medical Editor

Chet Johnson, MD, Medical Director, Child Development Unit, Department of Pediatrics, Professor, University of Kansas Medical Center
Chet Johnson, MD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc
Disclosure: Nothing to disclose.

Managing Editor

Caroly Pataki, MD, Associate Program Director, Clinical Associate Professor, Department of Psychiatry and Biobehavioral Sciences, Division of Child and Adolescent Psychiatry, Neuropsychiatric Institute and Hospital, UCLA
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry
Disclosure: Nothing to disclose.

CME Editor

Carrie Sylvester, MD, MPH, Director of Education in Child and Adolescent Psychiatry, Professor, Departments of Psychiatry and Pediatrics, Northwestern University Medical School
Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Medical Women's Association, American Psychiatric Association, and American Society for Adolescent Psychiatry
Disclosure: Nothing to disclose.

Chief Editor

Murray M Kappelman, MD, Professor, Departments of Pediatrics and Psychiatry, University of Maryland School of Medicine
Murray M Kappelman, MD is a member of the following medical societies: Ambulatory Pediatric Association and American Academy of Child and Adolescent Psychiatry
Disclosure: Nothing to disclose.

 
 
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