Psychiatric And Medical Conditions

For the majority of students, problems with sleep are due to lifestyle factors and may be corrected by the consistent practice of good sleep hygiene. For some students, however, sleep disturbances are associated with an underlying psychiatric or medical condition. Therefore, if the problems with sleep persist despite the practice of good sleep hygiene, a medical consultation is recommended. The clinician may recommend investigations that include a thorough history, physical examination and laboratory work. Further investigation may include a sleep study, which usually consists of one or two nights’ sleep at a sleep laboratory. The sleep study consists of the monitoring of a wide range of physiological functions using a polysomnograph.

A polysomnogram reflects functions such as the patient’s EEG, EKG, muscle tone, limb movement, eye movement and breathing throughout the night. The resulting data may be of great assistance to the clinician when determining the cause of the insomnia or excessive daytime sleepiness.

Psychiatric Conditions

Problems with sleep can be associated with psychiatric conditions including mood disorders such as depression and mania, anxiety disorders such as generalized anxiety disorder, panic disorder, obsessive compulsive disorder and post-traumatic stress disorder, psychosis such as schizophrenia; and substance abuse. If the problems with sleep are associated with a psychiatric condition then the underlying condition needs to be treated before the problems with sleep can be resolved.

Medical Conditions

Sleep disturbances can also be associated with a number of medical conditions including: cardiovascular diseases such as ischemic heart disease and cardiac arrhythmias; respiratory disorders such as chronic obstructive pulmonary disease and asthma; gastrointestinal disease such as peptic ulcer disease and reflux esophagitis; endocrine diseases such as thyroid disorders; renal disorders such as chronic renal failure; haematological disorders such as sickle cell anaemia; and rheumatic diseases such as fibromyalgia syndrome. If the problems with sleep are due to a medical condition, then a medical intervention is required.