Triazolam
Hypnotics and Sedatives
GABA Modulators
Anti-Anxiety Agents
Benzodiazepines
Manifest Anxiety Scale
Midazolam
Flunitrazepam
Sleep Disorders, Circadian Rhythm
Jet Lag Syndrome
Encyclopedias as Topic
Phototherapy
Comparing single and cumulative dosing procedures in human triazolam discriminators. (1/115)
This study evaluated a cumulative dosing procedure for drug discrimination with human participants. Four participants learned to discriminate triazolam (0.35 mg/70 kg) from placebo. A crossover design was used to compare the results under a single dosing procedure with results obtained under a cumulative dosing procedure. Under the single dosing procedure, a dose of triazolam (0, 0.05, 0.15, or 0.35 mg/70 kg) or secobarbital (0, 25, 75, or 175 mg/70 kg) was administered 45 min before assessment. Determining each dose-effect curve thus required four sessions. Under the cumulative dosing procedure, four doses of triazolam (0, 0.05, 0.10, and 0.20 mg/70 kg) or secobarbital (0, 25, 50, and 100 mg/70 kg) were administered approximately 55 min apart, producing a complete dose-effect curve in one four-trial session. Regardless of procedure, triazolam and secobarbital produced discriminative stimulus and self-reported effects similar to previous single dosing studies in humans. Shifts to the right in cumulative dose-effect curves compared to single dose-effect curves occurred on several self-report measures. When qualitative stimulus functions rather than quantitative functions are of interest, application of cumulative dosing may increase efficiency in human drug discrimination. (+info)Dental anesthetic management of a patient with ventricular arrhythmias. (2/115)
During routine deep sedation for endodontic therapy, a dentist-anesthesiologist observed premature ventricular contractions (PVCs) on a 62-yr-old woman's electrocardiogram (EKG) tracing. The dentist was able to complete the root canal procedure under intravenous (i.v.) sedation without any problems. The dentist-anesthesiologist referred the patient for medical evaluation. She was found to be free from ischemic cardiac disease with normal ventricular function. The patient was cleared to continue her dental treatment with deep sedation. She subsequently continued to undergo dental treatment with deep intravenous sedation without incident, although her EKG exhibited frequent PVCs, up to 20 per minute, including couplets and episodes of trigeminy. This article will review indications for medical intervention, antiarrhythmic medications, and anesthetic interventions for perioperative PVCs. (+info)Flumazenil discrimination by humans under a two-response and a novel-response procedure. (3/115)
In this study we assessed the discriminative stimulus, self-reported, and performance effects of flumazenil in humans. The first group (n = 6) was trained to discriminate flumazenil (0.56 mg/70 kg i.v.) from saline and tested with flumazenil (0.10, 0.32, 0.56, and 1.0 mg/70 kg) under a two-response drug discrimination procedure. The second group (n = 8) was trained to discriminate flumazenil (0.56 mg/70 kg i.v.) from saline and tested with flumazenil (0.32, 0.56, and 1.0 mg/70 kg), midazolam (0.10, 0.56, and 1.0 mg/70 kg), and caffeine (75 mg/70 kg) under a novel-response drug discrimination procedure. In both groups, flumazenil was acquired and maintained as a discriminative stimulus. Flumazenil dose-dependently increased flumazenil-appropriate responding and ratings of strength of drug effect and sedation, and decreased ratings of stimulant effects and psychomotor performance. Under the novel-response procedure, midazolam produced dose-dependent increases in flumazenil-appropriate responding. However, midazolam produced 43 and 25% novel responding at the intermediate and highest test doses, respectively. Midazolam dose-dependently increased ratings of strength of drug effect and sedation, and decreased ratings of stimulant effects and psychomotor performance. The magnitude of effects on ratings of strength of drug effect and sedation were comparable after flumazenil and midazolam, but psychomotor performance effects were greater after midazolam than after flumazenil. Caffeine produced mostly saline-appropriate responding. The results indicate that flumazenil has agonist effects similar to those of midazolam; however, novel responding after midazolam, and the greater performance decrement after midazolam, suggest that flumazenil does not act as a traditional benzodiazepine agonist. (+info)Response-rate suppression in operant paradigm as predictor of soporific potency in rats and identification of three novel sedative-hypnotic neuroactive steroids. (4/115)
Novel neuroactive steroids were evaluated for their effects on operant responding, rotorod motor performance, and electroencephalogram recording in rats. Co 134444, Co 177843, and Co 127501 were compared with the prototypical gamma-aminobutyric acid(A)-positive allosteric modulators triazolam, zolpidem, pentobarbital, pregnanolone, and CCD 3693. Each of the compounds produced a dose-related decrease in response rates under a variable-interval 2-min schedule of positive reinforcement in an operant paradigm. In addition, all compounds produced a dose-related increase in ataxia and significant increases in nonrapid eye movement sleep in this experiment or have been previously reported to do so. Co 134444, Co 177843, and Co 127501 increased nonrapid eye movement sleep at doses that had no effect on rapid eye movement sleep. All of the compounds were more potent at decreasing operant responding than they were at increasing ataxia. Furthermore, the potency of compounds to produce response-rate suppression in an operant paradigm appeared to be a better predictor of soporific potency than did potency in the rotorod assay. The screening for sedative-hypnotic activity resulted in the identification of the novel orally active neuroactive steroids Co 134444, Co 177843, and Co 127501. (+info)The hamster circadian rhythm system includes nuclei of the subcortical visual shell. (5/115)
The clock regulating mammalian circadian rhythmicity resides in the suprachiasmatic nucleus. The intergeniculate leaflet, a major component of the subcortical visual system, has been shown to be essential for certain aspects of circadian rhythm regulation. We now report that midbrain visual nuclei afferent to the intergeniculate leaflet are also components of the hamster circadian rhythm system. Loss of connections between the intergeniculate leaflet and visual midbrain or neurotoxic lesions of pretectum or deep superior colliculus (but not of the superficial superior colliculus) blocked phase shifts of the circadian activity rhythm in response to a benzodiazepine injection during the subjective day. Such damage did not disturb phase response to a novel wheel stimulus. The amount of wheel running or open field locomotion were equivalent in lesioned and control groups after benzodiazepine treatment. Electrical stimulation of the deep superior colliculus, without its own effect on circadian rhythm phase, greatly attenuated light-induced phase shifts. Such stimulation was associated with increased FOS protein immunoreactivity in the suprachiasmatic nucleus. The results show that the circadian rhythm system includes the visual midbrain and distinguishes between mechanisms necessary for phase response to benzodiazepine and those for phase response to locomotion in a novel wheel. The results also refute the idea that benzodiazepine-induced phase shifts are the consequence of induced locomotion. Finally, the data provide the first indication that the visual midbrain can modulate circadian rhythm response to light. A variety of environmental stimuli may gain access to the circadian clock mechanism through subcortical nuclei projecting to the intergeniculate leaflet and, via the final common path of the geniculohypothalamic tract, from the leaflet to the suprachiasmatic nucleus. (+info)Midazolam and triazolam biotransformation in mouse and human liver microsomes: relative contribution of CYP3A and CYP2C isoforms. (6/115)
Midazolam (MDZ) and triazolam (TRZ) hydroxylation, reactions considered to be cytochrome P-4503A (CYP3A)-mediated in humans, were examined in mouse and human liver microsomes. In both species, alpha- and 4-hydroxy metabolites were the principal products. Western blotting with anti-CYP3A1 antibody detected a single band of immunoreactive protein in both human and mouse samples: 0.45 +/- 0. 12 and 2.02 +/- 0.24 pmol/mg protein (mean +/- S.E., n = 3), respectively. Ketoconazole potently inhibited MDZ and TRZ metabolite formation in human liver microsomes (IC(50) range, 0.038-0.049 microM). Ketoconazole also inhibited the formation of both TRZ metabolites and of 4-OH-MDZ formation in mouse liver microsomes (IC(50) range, 0.0076-0.025 microM). However, ketoconazole (10 microM) did not produce 50% inhibition of alpha-OH-MDZ formation in mouse liver microsomes. Anti-CYP3A1 antibodies produced concentration-dependent inhibition of MDZ and TRZ metabolite formation in human liver microsomes and of TRZ metabolite and 4-OH-MDZ formation in mouse liver microsomes to less than 20% of control values but reduced alpha-OH-MDZ formation to only 66% of control values in mouse liver microsomes. Anti-CYP2C11 antibodies inhibited alpha-OH-MDZ metabolite formation in a concentration-dependent manner to 58% of control values in mouse liver microsomes but did not inhibit 4-OH-MDZ formation. Thus, TRZ hydroxylation appears to be CYP3A specific in mice and humans. alpha-Hydroxylation of MDZ has a major CYP2C component in addition to CYP3A in mice, demonstrating that metabolic profiles of drugs in animals cannot be assumed to reflect human metabolic patterns, even with closely related substrates. (+info)Comparative kinetics and response to the benzodiazepine agonists triazolam and zolpidem: evaluation of sex-dependent differences. (7/115)
Eighteen healthy volunteers (10 men and 8 women) participated in a single-dose, double-blind, three-way crossover pharmacokinetic and pharmacodynamic study. Treatment conditions were 0.25 mg of triazolam, a full-agonist benzodiazepine ligand; 10 mg of zolpidem, an imidazopyridine having relative selectivity for the type 1 benzodiazepine receptor subtype; and placebo. Weight-normalized clearance of triazolam was higher in women than in men (8.7 versus 5. 5 ml/min/kg), but the difference was not significant. In contrast, zolpidem clearance was lower in women than in men (3.5 versus 6.7 ml/min/kg, P <.06). Compared to placebo, both active medications produced significant benzodiazepine agonist-like pharmacodynamic effects: sedation, impaired psychomotor performance, impaired information recall, and increased electroencephalographic beta-amplitude. Effects of triazolam and zolpidem in general were comparable and less than 8 h in duration. There was no evidence of a substantial or consistent sex difference in pharmacodynamic effects or in the kinetic-dynamic relationship, although subtle differences could not be ruled out due to low statistical power. The complete dependence of triazolam clearance on CYP3A activity, as opposed to the mixed CYP participation in zolpidem clearance, may explain the differing sex effects on clearance of the two compounds. (+info)Detection of triazolam and its hydroxy metabolites in rat hair by reversed-phase liquid chromatography with electrospray ionization mass spectrometry. (8/115)
A sensitive method using reversed-phase liquid chromatography coupled with electrospray ionization mass spectrometry (LC-ESI-MS) for simultaneous determination of triazolam (TZ) and its hydroxy metabolites in hair has been developed. After the addition of deuterium-labeled 1 -hydroxymethyltriazolam (1-HT-d4) as an internal standard, analytes in hair shaft and hair root samples were extracted with a basic medium, CH2Cl2/MeOH/28% NH4OH (20:80:2), at room temperature overnight. The chromatographic separation of the analytes was achieved using a 3-microm micro HPLC column (100 x 2.0-mm i.d.) with a gradient of acetonitrile in water containing 1% acetic acid as the mobile phase at a flow rate of 0.15 mL/min. The mass spectrometer was operated in selected-ion monitoring mode at quasi molecular ions [M+H]+ of TZ and its metabolites. Under the proposed conditions, the ranges of quantitation of TZ, 1-HT, and 4-HT were 0.1-10 ng/0.2 mL. The method has been applied to determine the hair shaft and hair root incorporation of TZ and its metabolites into Dark Agouti rats administered with 3 mg/kg or 6 mg/kg intraperitoneally twice a day for five days. Judging from the retention behavior by the chromatography and the mass spectra of the peaks detected, TZ, 1-HT, and 4-HT were incorporated in the hair shaft and the hair root. The concentration of 4-HT was the highest of all compounds detected. An unknown substance thought to be 1,4-diHT also appeared in both hair shaft and hair root samples. This substance was obtained from in vitro metabolic studies of TZ using rat liver microsome fraction and was accompanied by the other two metabolites, 1-HT and 4-HT. Structural elucidation was performed with online high-performance liquid chromatography-MS after acetylation of the substance with acetic anhydride and pyridine. This is the first report of the detection of the hydroxy metabolites of TZ in hair. The method has been found to be useful as a screening procedure of TZ intake in humans. (+info)Triazolam is a short-acting benzodiazepine drug, which is primarily used for the treatment of insomnia. It works by increasing the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits the activity of neurons in the brain, thereby producing a calming effect. Triazolam has a rapid onset of action and its effects typically last for 1-2 hours, making it useful for inducing sleep. However, due to its short duration of action and potential for dependence and tolerance, triazolam is generally recommended for short-term use only.
Like all benzodiazepines, triazolam carries a risk of serious side effects, including respiratory depression, physical dependence, and cognitive impairment. It should be used with caution and under the close supervision of a healthcare provider.
Hypnotics and sedatives are classes of medications that have depressant effects on the central nervous system, leading to sedation (calming or inducing sleep), reduction in anxiety, and in some cases, decreased awareness or memory. These agents work by affecting the neurotransmitter GABA (gamma-aminobutyric acid) in the brain, which results in inhibitory effects on neuronal activity.
Hypnotics are primarily used for the treatment of insomnia and other sleep disorders, while sedatives are often prescribed to manage anxiety or to produce a calming effect before medical procedures. Some medications can function as both hypnotics and sedatives, depending on the dosage and specific formulation. Common examples of these medications include benzodiazepines (such as diazepam and lorazepam), non-benzodiazepine hypnotics (such as zolpidem and eszopiclone), barbiturates, and certain antihistamines.
It is essential to use these medications under the guidance of a healthcare professional, as they can have potential side effects, such as drowsiness, dizziness, confusion, and impaired coordination. Additionally, long-term use or high doses may lead to tolerance, dependence, and withdrawal symptoms upon discontinuation.
GABA (gamma-aminobutyric acid) modulators are substances that affect the function of GABA, which is the primary inhibitory neurotransmitter in the central nervous system. GABA plays a crucial role in regulating neuronal excitability and reducing the activity of overactive nerve cells.
GABA modulators can either enhance or decrease the activity of GABA receptors, depending on their specific mechanism of action. These substances can be classified into two main categories:
1. Positive allosteric modulators (PAMs): These compounds bind to a site on the GABA receptor that is distinct from the neurotransmitter binding site and enhance the activity of GABA at the receptor, leading to increased inhibitory signaling in the brain. Examples of positive allosteric modulators include benzodiazepines, barbiturates, and certain non-benzodiazepine drugs used for anxiolysis, sedation, and muscle relaxation.
2. Negative allosteric modulators (NAMs): These compounds bind to a site on the GABA receptor that reduces the activity of GABA at the receptor, leading to decreased inhibitory signaling in the brain. Examples of negative allosteric modulators include certain antiepileptic drugs and alcohol, which can reduce the effectiveness of GABA-mediated inhibition and contribute to their proconvulsant effects.
It is important to note that while GABA modulators can have therapeutic benefits in treating various neurological and psychiatric conditions, they can also carry risks for abuse, dependence, and adverse side effects, particularly when used at high doses or over extended periods.
Anti-anxiety agents, also known as anxiolytics, are a class of medications used to manage symptoms of anxiety disorders. These drugs work by reducing the abnormal excitement in the brain and promoting relaxation and calmness. They include several types of medications such as benzodiazepines, azapirone, antihistamines, and beta-blockers.
Benzodiazepines are the most commonly prescribed anti-anxiety agents. They work by enhancing the inhibitory effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which results in sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant properties. Examples of benzodiazepines include diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin).
Azapirones are a newer class of anti-anxiety agents that act on serotonin receptors in the brain. Buspirone (Buspar) is an example of this type of medication, which has fewer side effects and less potential for abuse compared to benzodiazepines.
Antihistamines are medications that are primarily used to treat allergies but can also have anti-anxiety effects due to their sedative properties. Examples include hydroxyzine (Vistaril, Atarax) and diphenhydramine (Benadryl).
Beta-blockers are mainly used to treat high blood pressure and heart conditions but can also help manage symptoms of anxiety such as rapid heartbeat, tremors, and sweating. Propranolol (Inderal) is an example of a beta-blocker used for this purpose.
It's important to note that anti-anxiety agents should be used under the guidance of a healthcare professional, as they can have side effects and potential for dependence or addiction. Additionally, these medications are often used in combination with psychotherapy and lifestyle modifications to manage anxiety disorders effectively.
Benzodiazepines are a class of psychoactive drugs that have been widely used for their sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant properties. They act by enhancing the inhibitory effects of gamma-aminobutyric acid (GABA), the major inhibitory neurotransmitter in the central nervous system.
Benzodiazepines are commonly prescribed for the treatment of anxiety disorders, insomnia, seizures, and muscle spasms. They can also be used as premedication before medical procedures to produce sedation, amnesia, and anxiolysis. Some examples of benzodiazepines include diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), and temazepam (Restoril).
While benzodiazepines are effective in treating various medical conditions, they can also cause physical dependence and withdrawal symptoms. Long-term use of benzodiazepines can lead to tolerance, meaning that higher doses are needed to achieve the same effect. Abrupt discontinuation of benzodiazepines can result in severe withdrawal symptoms, including seizures, hallucinations, and anxiety. Therefore, it is important to taper off benzodiazepines gradually under medical supervision.
Benzodiazepines are classified as Schedule IV controlled substances in the United States due to their potential for abuse and dependence. It is essential to use them only as directed by a healthcare provider and to be aware of their potential risks and benefits.
Oxazepam is a benzodiazepine medication that is primarily used to treat anxiety disorders and symptoms such as sleeplessness and irritability. It works by enhancing the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits the activity of certain neurons in the brain, producing a calming effect.
In medical terms, oxazepam can be defined as follows:
Oxazepam is a Schedule IV controlled substance, indicating that it has a potential for abuse and dependence. It is available in tablet form and is typically taken two to four times per day. Common side effects of oxazepam include drowsiness, dizziness, and weakness. More serious side effects can include memory problems, confusion, and difficulty breathing.
It's important to note that oxazepam should only be used under the supervision of a healthcare provider, as it can have significant risks and interactions with other medications. It is not recommended for use in pregnant women or those with a history of substance abuse.
Nitrazepam is a benzodiazepine drug primarily used for the treatment of severe insomnia and sometimes for managing certain types of epilepsy. It works by increasing the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits central nervous system activity, thereby producing calming effects.
According to the World Health Organization's (WHO) Anatomical Therapeutic Chemical (ATC) classification system, Nitrazepam falls under the category of "N05CD - Benzodiazepine derivatives" and has the ATC code "N05CD02".
It is essential to note that Nitrazepam should only be used under medical supervision due to its potential for dependence, addiction, and other side effects. It is also not recommended for long-term use or in pregnant or breastfeeding women without consulting a healthcare professional first.
The Manifest Anxiety Scale (MAS) is a psychological self-reporting measurement tool used to assess the level of anxiety in individuals. It was developed by psychologist Charles D. Spielberger and his colleagues in the 1950s as part of their research on anxiety and stress. The MAS measures the subjective experience of anxiety or feelings of tension, worry, and nervousness that an individual may be experiencing.
The MAS consists of a series of statements or items that describe various symptoms or manifestations of anxiety. Respondents are asked to rate how well each statement describes their own experiences on a scale, typically ranging from "not at all" to "very much." The total score is calculated by summing up the ratings for all the items, with higher scores indicating greater levels of anxiety.
It's important to note that while the MAS can provide useful information about an individual's subjective experience of anxiety, it should not be used as a standalone diagnostic tool. A comprehensive assessment by a qualified mental health professional is necessary for a proper diagnosis and treatment plan.
Midazolam is a medication from the class of drugs known as benzodiazepines. It works by enhancing the effect of a neurotransmitter called gamma-aminobutyric acid (GABA), which has a calming effect on the brain and nervous system. Midazolam is often used for its sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant properties.
Medically, midazolam is used for various purposes, including:
1. Preoperative medication (sedation before surgery)
2. Procedural sedation (for minor surgical or diagnostic procedures)
3. Treatment of seizures (status epilepticus)
4. Sedation in critically ill patients
5. As an adjunct to anesthesia during surgeries
6. Treatment of alcohol withdrawal symptoms
7. To induce amnesia for certain medical or dental procedures
Midazolam is available in various forms, such as tablets, intravenous (IV) solutions, and intranasal sprays. It has a rapid onset of action and a short duration, making it suitable for brief, intermittent procedures. However, midazolam can cause side effects like drowsiness, confusion, respiratory depression, and memory impairment. Therefore, its use should be carefully monitored by healthcare professionals.
Flunitrazepam is a benzodiazepine drug, which has sedative, hypnotic, muscle relaxant, and anticonvulsant properties. Its primary use is for the treatment of severe insomnia and occasionally for managing anxiety disorders. It works by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain that inhibits the activity of nerve cells and produces a calming effect.
Flunitrazepam is also known by its brand name, Rohypnol, and has gained notoriety for its use as a date-rape drug due to its ability to cause sedation, amnesia, and muscle relaxation at high doses. It is important to note that flunitrazepam is a controlled substance in many countries and its use without a prescription is illegal.
A Circadian Rhythm Sleep Disorder (CRSD) is a condition in which a person's sleep-wake cycle is out of sync with the typical 24-hour day. This means that their internal "body clock" that regulates sleep and wakefulness does not align with the external environment, leading to difficulties sleeping, staying awake, or functioning at appropriate times.
CRSDs can be caused by a variety of factors, including genetic predisposition, environmental influences, and medical conditions. Some common types of CRSDs include Delayed Sleep Phase Syndrome (DSPS), Advanced Sleep Phase Syndrome (ASPS), Non-24-Hour Sleep-Wake Rhythm Disorder, and Shift Work Disorder.
Symptoms of CRSDs may include difficulty falling asleep or staying asleep at the desired time, excessive sleepiness during the day, difficulty concentrating or functioning at work or school, and mood disturbances. Treatment for CRSDs may involve lifestyle changes, such as adjusting sleep schedules or exposure to light at certain times of day, as well as medications or other therapies.
Jet Lag Syndrome, also known as Desynchronosis, is a temporary sleep disorder that causes disruption of the body's circadian rhythms (internal biological clock) due to rapid travel across different time zones. The symptoms may include difficulty sleeping or staying asleep, daytime fatigue, decreased alertness, reduced cognitive performance, digestive issues, and general malaise. These symptoms typically resolve within a few days as the body adjusts to the new time zone. Preventative measures and treatments can include gradually adjusting sleep schedules prior to travel, maintaining hydration, exposure to natural light in the destination time zone, and in some cases, melatonin supplements may be recommended.
An encyclopedia is a comprehensive reference work containing articles on various topics, usually arranged in alphabetical order. In the context of medicine, a medical encyclopedia is a collection of articles that provide information about a wide range of medical topics, including diseases and conditions, treatments, tests, procedures, and anatomy and physiology. Medical encyclopedias may be published in print or electronic formats and are often used as a starting point for researching medical topics. They can provide reliable and accurate information on medical subjects, making them useful resources for healthcare professionals, students, and patients alike. Some well-known examples of medical encyclopedias include the Merck Manual and the Stedman's Medical Dictionary.
Phototherapy is a medical treatment that involves the use of light to manage or improve certain conditions. It can be delivered in various forms, such as natural light exposure or artificial light sources, including lasers, light-emitting diodes (LEDs), or fluorescent lamps. The wavelength and intensity of light are carefully controlled to achieve specific therapeutic effects.
Phototherapy is most commonly used for newborns with jaundice to help break down bilirubin in the skin, reducing its levels in the bloodstream. This type of phototherapy is called bilirubin lights or bili lights.
In dermatology, phototherapy can be applied to treat various skin conditions like psoriasis, eczema, vitiligo, and acne. Narrowband ultraviolet B (UVB) therapy, PUVA (psoralen plus UVA), and blue or red light therapies are some examples of dermatological phototherapies.
Phototherapy can also be used to alleviate symptoms of seasonal affective disorder (SAD) and other mood disorders by exposing patients to bright artificial light, which helps regulate their circadian rhythms and improve their mood. This form of phototherapy is called light therapy or bright light therapy.
It's essential to consult a healthcare professional before starting any phototherapy treatment, as inappropriate use can lead to adverse effects.
Sleep initiation and maintenance disorders are a category of sleep disorders that involve difficulty falling asleep and staying asleep throughout the night. This category includes:
1. Insomnia disorder: A persistent difficulty in initiating or maintaining sleep, or early morning awakening, despite adequate opportunity and circumstances for sleep, which causes clinically significant distress or impairment.
2. Narcolepsy: A chronic neurological disorder characterized by excessive daytime sleepiness, cataplexy (sudden loss of muscle tone triggered by strong emotions), hypnagogic hallucinations (vivid, dream-like experiences that occur while falling asleep) and sleep paralysis (temporary inability to move or speak while falling asleep or waking up).
3. Breathing-related sleep disorders: A group of disorders that involve abnormal breathing patterns during sleep, such as obstructive sleep apnea and central sleep apnea, which can lead to difficulty initiating and maintaining sleep.
4. Circadian rhythm sleep-wake disorders: A group of disorders that involve a misalignment between the individual's internal circadian rhythm and the external environment, leading to difficulty falling asleep and staying asleep at desired times.
5. Parasomnias: A group of disorders that involve abnormal behaviors or experiences during sleep, such as sleepwalking, night terrors, and REM sleep behavior disorder, which can disrupt sleep initiation and maintenance.
These disorders can have significant impacts on an individual's quality of life, daytime functioning, and overall health, and should be evaluated and managed by a healthcare professional with expertise in sleep medicine.