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Seiji Nishino, Center for Narcolepsy Stanford University School of Medicine 701B Welch Rd, RM 142 Palo Alto, CA 94304 USA,
Nobuhiro Fujiki, Center for Narcolepsy Stanford University School of Medicine 701B Welch Road Palo Alto, CA 93304 USA
We spend a significant part (about a third) of our lives sleeping, which is essential to our physical and psychological well-being. Sleep, however, is a fragile state that can easily be impaired by psychological stress or physical illness. For up to 10% of the general population, difficulty falling and/or maintaining sleep occurs several times a week (i.e., chronic insomnia). Some of these problems may be due to existences of obstructive sleep apnea syndrome, a condition that affects over 10% of the population, or due to restless leg syndrome (RLS)/periodic leg movement syndrome (PLMS), sleep-related involuntary leg movements often associated with an abnormal sensation in legs. Excessive daytime sleepiness (EDS), parasomnia, and sleep problems associated with medical/psychiatric conditions are also common. Narcolepsy is a primary EDS disorder affecting about 0.05% of the population. EDS is also often secondary to a severe insomnia associated with obstructive sleep apnea.
Many different pathophysiological/etiological mechanisms for these sleep disorders are considered, and the International Classification of Sleep Disorders (ICSD) lists over 84 different types of disorders (Table 29.1). These sleep-related problems are often chronic and negatively affect the subject's quality of life. In a 24-hr society that encourages sleep deprivation, daytime sleepiness is also an emerging issue even in healthy subjects. Accidents due to sleepiness are now well recognized as a major public hazard. The emergence of clinical sleep medicine has proceeded rapidly during the last 30 years with the awareness of these sleep problems.
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