Sleep and medical disorders

Marcel Hungs MD PhD (Dr. Hungs, sleep medicine practitioner in St. Paul, Minnesota, received honorariums from Pfizer and Cephalon for speaking engagements.)
Antonio Culebras MD, editor. (Dr. Culebras of SUNY Upstate Medical University has no relevant financial relationships to disclose.)
Originally released November 4, 1993; last updated November 16, 2012; expires November 16, 2015
Notice: This article has expired and is therefore not available for CME credit.


The understanding of sleep has received revitalized attention in recent years due to increasing recognition of the involvement of sleep disorders in numerous medical conditions. The author discusses the recent advances in this rapidly growing field and summarizes the interactions of sleep disorders and medical illnesses, such as renal disease, rheumatologic and endocrinological disorders, and malignancies, as well as discusses diagnostic approaches and new treatment options.

Key points


• Sleep disturbances are common in medical conditions.


• Numerous medical disorders cause or are associated with sleep disorders such as poor sleep quality, insomnia, obstructive sleep apnea, and restless legs syndrome.


• Moreover, sleep disorders such as sleep apnea can worsen a medical disorder, such as arterial hypertension or diabetes mellitus.


• The management of sleep disorders associated with medical conditions requires a multimodal approach with a tailored treatment plan addressing sleep hygiene, medication usage, and pain management.

Historical note and terminology

The interaction of sleep disorders and medical conditions has been recognized since at least the 19th century. In 1896, acromegaly was the first endocrine disorder recognized to be associated with heavy snoring and excessive daytime sleepiness (Roxburgh and Collis 1896). For decades, disturbed nocturnal sleep and daytime sleepiness have been observed with chronic renal failure (Karacan et al 1973).

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