14.7 - sleep disorders Flashcards
what are the three major categories of sleep disorders
- insomnia - all disorders of falling and staying asleep
- hypersonic - all disorders of excessive sleep or sleepiness
- All those disorders that are specifically related to REM sleep dysfunction
what are disorders are commonly associated with insomnia and hyper Sonia
depression and bipolar
what percentage of respondents report sleep related problems
- are most of these clinically significant?
- give an example
around 30
- no, most of these people have sleep that is normal in sleep labs
- many people sleep 6 hours or less and function properly, but people tell them to get more sleep so they spend more time in bed than they should and have difficulty falling asleep/
what tends to hinder, and what tends to help people with minor sleep problems?
- anxiety associated with inability to sleep makes it even harder for them to sleep
- counselling that persuades them to goto bed only when they are sleepy
- doesn’t work on everyone!!
define iatrogenic and relate it to insomnia
means physician created, and in terms of insomnia many cases are iatrogenic bc the prescription of benzos are a major cause
- tend to function well at first, but soon become. trapped in a spiral of drug use as tolerance develops and more and more is required, too eventually they have withdrawals a symptom of which is insomnia
what is the different between the reported and actual time it takes insomniacs to fall asleep and how much sleep they get?
reported - 1 hr to fall asleep, 4.5 hr of sleep
actual - average sleep latency of 15 mints, sleep an average of 6.5 hours
what did we used to call people who said they were insomniacs but slept more than 6.5 hours?
- why dont we say this anymore?
neurotics!
- because some of those with neurotic pseudo insomnia were found to have sleep apnea, nocturnal myoclonus or other sleep disturbing problems - so they had enough sleep but not enough undisturbed sleep
describe sleep apnea
- why are they so often misdiagnosed (2)
patients stop breathing several times each night, when the patient will awaken and breathe again, then fall back asleep
- leads to a sense of sleeping poorly, often misdiagnosed as insomnia
- often unaware of their awakenings and instead companion of excess sleepiness, and get diagnosed with hypersonic
what are the two types of sleep apnea?
- obstructive sleep apnea - obstruction of the respiratory passages by muscle spasms or atone and often occurs in vigorous snorers
- central sleep apnea - failure of the CNS to stimulate respiration
what are the risk factors for sleep apnea
- male
- overweight folks
- the elderly
what is periodic limb movement disorder?
- what do patients with this disorder complain of?
characterized by periodic, involuntary movements of the labs often involving twitches of the legs during sleep.
- complain of poor sleep and daytime sleepiness, unaware of the nature of their problem
what is restless leg syndrome?
tension or uneasiness in heir legs keeping ppl from falling asleep
are there any treatments for the two leg induced sleep disroders
no, they are both chronic once they start, however l-dopa can sometimes help
what is sleep restriction therapy
one of the most effective treatments for insomnia
- ammt of time an insomniac is allowed to spend in bed is reduced
- after a period of sleep restriction, the amount of time spent in bed is increased in small increments as long as sleep latency remains normal
- helps even servers insomniacs
explain narcolepsy
- prevalence
- symptoms
1/200
two prominent symptoms:
1. severe daytime sleepiness, repeated, brief (10-15 minute) sleep episodes at inappropriate times, even tho they only sleep an extra hour or so per day
2. cataplexy - recurring loses of muscle tone during wakefulness, often due to emotional experience.
- when mild, can force patients to sit down
- when sever - patients become totally mobile but fully conscious for a few minutes
