Nihon rinsho. Japanese journal of clinical medicine
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The American Academy of Sleep Medicine Board of Directors published the International Classification of Sleep Disorders, 3rd edition (ICSD -3) in 2014. In the 3rd edition, the most drastic change in the content was the unity of secondary insomnia categories into single "chronic insomnia" category. ⋯ In the sleep related breathing disorder section, several new diagnostic categories were added, and diagnosis of a sleep related hypoventilation disorder was set to require the confirmation of elevated PaCO2. This manuscript overviews the differences and the similarities in the content between the ICSD-3 and the former edition.
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Orexin A and orexin B are hypothalamic neuropeptides that were discovered in 1998. Several studies suggested that orexin deficiency causes narcolepsy in humans and other mammalian species, highlighting roles of this hypothalamic neuropeptide in the regulation of sleep and wakefulness. ⋯ Recent findings have brought about the possibility of novel therapies targeting orexin system for sleep disorder including insomnia and narcolepsy-cataplexy. In this review, I will discuss the current understanding of the integrative physiology and clinical perspectives of the orexin system.
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Insomnia is very common in older adults, but is generally related to medical and psychiatric illness, medication, circadian rhythm change. Cognitive-behavioral therapy for insomnia(CBT-I) is a brief, sleep-focused, multimodal intervention by psychological and behavioral procedures. ⋯ CBT-I has proved successful for older adults with primary and comorbid insomnia and for those with dependency on hypnotics. Proper treatment of insomnia is effective and can improve overall physical and mental health and quality of life in the elderly patient.
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Sleep related movement disorders (SRMD) are characterized by simple, stereotyped movements occur during sleep, with the exception of restless legs syndrome (RLS). RLS has the following essential features; an urge to move the legs usually accompanied by uncomfortable sensation in the legs, improvement of symptoms after movement (non-stereotypical movements, such as walking and stretching, to reduce symptoms), and symptoms occur or worsen during periods of rest and in the evening and night. ⋯ In the International Classification of Sleep Disorders, 3rd edition, sleep disturbances or daytime symptoms are prerequiste for a diagnosis of SRMD. We here review diagnosis and treatment of SRMD.