Diagnostic Considerations

Many abnormalities of the sleep-wake cycle manifest as sleep-wake disorders. These conditions include the following:

Jet lag: a study performed on airline pilots operating on transmeridian routes found that the older the pilot, the greater the cumulative sleep loss
Acute and chronic shift-work insomnia
Delayed-sleep-phase syndromes
Advanced-sleep-phase syndromes
Non–24-hour circadian rhythms
Disorganized circadian rhythms

Psychophysiologic insomnia is associated with acute emotional conflicts or reactions and is transient in nature. If it is associated with frustration to fall asleep, thereby resulting in arousal, it can be persistent in nature.

Differential Diagnoses

Workup

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Author

Glen L Xiong, MD Associate Clinical Professor, Department of Psychiatry and Behavioral Sciences, Department of Internal Medicine, University of California, Davis, School of Medicine; Medical Director, Sacramento County Mental Health Treatment Center

Glen L Xiong, MD is a member of the following medical societies: AMDA - The Society for Post-Acute and Long-Term Care Medicine, American College of Physicians, American Psychiatric Association, Central California Psychiatric Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: SafelyYou, Blue Cross Blue Shield<br/>book co-editor for: Wolter Kluwer, American Psychiatric Publishing Inc.

Coauthor(s)

Ariel B Neikrug, PhD Assistant Professor, Department of Psychiatry and Human Behavior, Director, Behavioral Sleep Medicine Program, University of California, Irvine

Ariel B Neikrug, PhD is a member of the following medical societies: Sleep Research Society

Disclosure: Nothing to disclose.

Olivia Vukcevich, BS Junior Specialist,Department of Psychiatry and Behavioral Sciences, UC Davis Medical Center

Disclosure: Nothing to disclose.

Chief Editor

Ana Hategan, MD, FRCPC Associate Clinical Professor, Department of Psychiatry and Behavioral Neurosciences, Division of Geriatric Psychiatry, McMaster University School of Medicine; Geriatric Psychiatrist, St Joseph's Health Care Hamilton, Canada

Ana Hategan, MD, FRCPC is a member of the following medical societies: Canadian Academy of Geriatric Psychiatry, Canadian Coalition for Seniors' Mental Health, Canadian Psychiatric Association, International Psychogeriatric Association, Ontario Medical Association, Royal College of Physicians and Surgeons of Canada

Disclosure: Book royalties and/or honoraria for articles from American Psychiatric Publishing, Springer, and Current Psychiatry.

Additional Contributors

Angela Gentili, MD Director of Geriatric Medicine Fellowship Program, Professor of Internal Medicine, Division of Geriatric Medicine, Virginia Commonwealth University Health System and McGuire Veterans Affairs Medical Center, Richmond, VA

Angela Gentili, MD is a member of the following medical societies: Virginia Geriatrics Society, American Geriatrics Society

Disclosure: Nothing to disclose.

Guy E Brannon, MD Associate Clinical Professor of Psychiatry, Louisiana State University Health Sciences Center; Director, Adult Psychiatry Unit, Chemical Dependency Unit, Clinical Research, Brentwood Behavior Health Company

Disclosure: Received income in an amount equal to or greater than $250 from: Sunovion; Forest.

Acknowledgements

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Geriatric Sleep Disorder Differential Diagnoses

Diagnostic Considerations

Differential Diagnoses

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