Differentials
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Aanpak van slaapklachten en insomnie (slapeloosheid) bij volwassenen in de eerste lijnPublished by: Werkgroep Ontwikkeling Richtlijnen Eerste Lijn (Worel)Last published: 2018Prise en charge des problèmes de sommeil et de l’insomnie chez l’adulte en première lignePublished by: Groupe de Travail Développement de recommmandations de première ligneLast published: 2018Restless legs syndrome
SIGNS / SYMPTOMS
Difficulty sleeping may occur due to discomfort or irresistible movements of the legs.
INVESTIGATIONS
No differentiating tests. Diagnosis is based on clinical history. Iron studies may reveal low ferritin.
Periodic limb movement disorder (PLMD)
SIGNS / SYMPTOMS
PLMD is characterized by rhythmic movements of the limbs during sleep, which often disturbs sleep.
INVESTIGATIONS
Polysomnography and electromyogram results help confirm the presence of PLMD.
Obstructive sleep apnea (OSA)
SIGNS / SYMPTOMS
OSA is a sleep-related breathing disorder characterized by reductions in airflow during sleep.
INVESTIGATIONS
Polysomnography with measures of nasal/oral airflow, respiratory effort, oxygen saturation, body position, and snoring sounds.
Circadian rhythm disorders
SIGNS / SYMPTOMS
Circadian rhythm disorders are disorders of sleep timing, such as advanced sleep phase syndrome and delayed sleep phase syndrome.
INVESTIGATIONS
Sleep history. Sleep diary and actigraphy can help.
Short sleeper
SIGNS / SYMPTOMS
Habitual duration of sleep <5 hours nightly with normal sleep onset, continuity, and quality, and not associated with daytime impairment.
INVESTIGATIONS
Sleep history. Sleep diary, actigraphy, or serial polysomnography as confirmatory.
Narcolepsy and central disorder of hypersomnolence
SIGNS / SYMPTOMS
Hypersomnolence disorders may cause disrupted evening sleep.
INVESTIGATIONS
Multiple sleep latency tests.
Poor sleep hygiene
SIGNS / SYMPTOMS
Sleep disturbance due to behaviors that are not conducive to sleep (caffeine, alcohol use, or irregular sleep habits).
INVESTIGATIONS
Sleep history.
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