371 Ch 370. Sleep Disorders

Normal sleep: NREM (stages N1, N2, N3 slow wave) + REM cycles ~ 90 min；adults need 7-9 hr；ICSD-3 categories: (1) Insomnia (chronic difficulty falling/staying asleep), (2) Sleep-disordered breathing (OSA, CSA), (3) Hypersomnias (narcolepsy types 1 + 2, idiopathic), (4) Circadian rhythm disorders (delayed/advanced sleep phase, shift work, jet lag, irregular, non-24), (5) Parasomnias (NREM — sleepwalking, sleep terrors, confusional arousal; REM — RBD), (6) Sleep-related movement disorders (RLS, PLMD, bruxism)；OSA epidemic — ~ 10-30% adults; AHI ≥ 5 with symptoms or AHI ≥ 15 = diagnosis; PAP therapy mainstay; narcolepsy = orexin/hypocretin deficiency (type 1 with cataplexy), HLA-DQB1*06:02；REM behavior disorder (RBD) = prodrome of synucleinopathy (PD, DLB, MSA) — 80% develop within 15 years！emerging therapies 2023-2024: DARE (daridorexant) dual orexin antagonist for insomnia; TAK-994 + others orexin receptor 2 agonists for narcolepsy trials。