These include Other sleep disorders: Poor sleep hygiene, narcolepsy and other hypersomnolence disorders, restless legs syndrome, periodic limb movement disorder Drug and substance use: Alcohol, sedatives, numerous therapeutic and recreational drugs (see table) Medical disorders: Cardiovascular, respiratory, and metabolic disorders (eg, hypothyroidism) Depression (which often accompanies as well as contributes to disordered sleep) History and physical examination (including sleep history) should seek evidence of these conditions, including identification of clinical features of hypothyroidism and acromegaly.