8. Sleep-Wake Disorders Flashcards
DF: An essential and naturally recurring state of mind and body, characterised by altered reduced consciousness, relatively inhibited sensory activity, and reduced muscle activity
Sleep
Stages of sleep
Stage 1: Light sleep, drowsiness and sleep begin
Stage 2: Stable Sleep, brain chemicals block senses
Stage 3: Deep sleep, growth hormone released
Stage 4: REM sleep, revitalises memory, high activity and intense dreaming likely to occur
Each cycle of stages of sleep lasts ___-___ minutes
90-120
Measurement technologies for sleep
Polysomnography (PSG), Actigraphy, EEG
Patterns of change in sleep cycles with age
Longer time to fall asleep,
Less total sleep time
Less time in regular/slow wave/REM sleep
Sleep disorders classified by unusual behaviours during sleep
Parasomnias
Sleep disorders classified by sleep quantity, quality and timing
Dyssomnias
Nightmare Disorder, REM Behaviour Disorder, and NREM Arousal Disorders are classified as:
Parasomnias
3 Types of Parasomnias:
- Nightmare Disorder
- REM Behaviour Disorder
- NREM Arousal Disorders
Insomnia disorder, Hypersomnolence disorders, Breathing-related sleep disorders, and Circadian rhythm disorders are examples of:
Dyssomnias
4 Types of Dyssomnias
- Insomnia disorder
- Hypersomnolence disorders
- Breathing-related sleep disorders
- Circadian rhythm disorders
Parasomnia:
1. Incomplete awakenings from deep sleep that involve motor movements
2. Most often in first third of the night
3. Often triggered by external stimulus which elicits partial awakening
NREM Arousal disorders
Recurring episodes of sleepwalking, talking, eating, sex etc. With no/vague memory of episode in the morning are symptoms of:
NREM Parasomnias
DF: Frightening experiences during sleep, may be accompanied by screaming, walking, sitting up, only a vague memory of the dream, and amnesia for the event next morning
Sleep terrors
Treatments for NREM Arousal Disorders (5 Points)
- Psycho education
- Medications (Melatonin, Benzodiazepines)
- Good sleep Hygiene
- Stress management
- Scheduled awakenings (esp. for adolescents)
2 Types of REM Parasomnias
- Nightmare disorder
- REM-Sleep behaviour disorder
Characteristics of REM-Sleep Behaviour Disorder
- Movement/Vocalisation occurs during REM/dreaming (Typically 2nd half of night)
- Movements are uncoordinated and aimless (thrashing, unintelligible speech/Vocalisation)
- Mechanism of muscle atonia (paralysis) in REM sleep dysfunctional
Characteristics of Nightmare disorder
- Disturbing, vivid dreams that awaken the sleeper, 3+ times a week with stress and impairment
- Typically 2nd half of sleep (REM)
- Awakening following nightmare can be lengthy
Imagery Rehearsal Therapy (IRT) treatment for chronic nightmares is based on the notion that:
Nightmares can become habitual
- Build relaxation/imagery/coping skills
- Select nightmare to work on
- Write description of the start fo nightmare
- Select a way to change the nightmare
- Write the nightmare with the change
- Rehearsed the dream with change plus relaxation
- Rehearsal before bed
Steps for Imagery Rehearsal Treatment (IRT)
Dyssomnias: 2 Disorders of excessive daytime sleepiness
Narcolepsy and Hypersomnolence disorder
Dyssomnia: Breathing-related sleep disorder
Obstructive Sleep Apnea
Neurological disorder characterised by excessive daytime sleepiness, recurrent episodes of irrepressible need to sleep, and episodes of sleep and cataplexy triggered by strong emotion
Narcolepsy
Treatments for narcolepsy
Stimulant medications
Psychological/behavioural interventions
