Sleep Disorders and Systemic Disease

Normal sleep quality and quantity are necessary for optimal functioning and emotional and physical well being. Sleep problems associated with systemic disorders frequently disrupt initiation and maintenance of sleep, or cause symptoms of excessive daytime sleepiness or parasomnia behavior. Restless legs may result from iron deficiency, renal insufficiency, or pregnancy. Sleep-disordered breathing is frequently caused by cardiac and pulmonary disorders, and cancer and chronic pain disorders frequently disrupt sleep, resulting in insomnia and symptoms of fatigue and daytime sleepiness. This chapter reviews sleep-related symptoms and disorders associated with systemic disorders involving endocrine, pain, cardiac, pulmonary, renal, oncologic, and paraneoplastic, infectious, critical illness, and drug and toxin exposure, and discusses appropriate diagnostic evaluation and treatment approaches to sleep disorders in patients with systemic disease. Recognition of the frequency and morbidity of sleep disorders is growing, and comprehensive care of neurological patients requires that practitioners consider and address disordered sleep in their patients.