Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PSY301 Sleep Disorders > Assessment & Models of Insomnia > Flashcards

Assessment & Models of Insomnia Flashcards

1
Q

ICSD-3 insomnia criteria

A

A. Difficulty initiating sleep, difficulty maintainning sleep and/or early morning awakening

B. 1-item daytime impairment/dissatisfaction with sleep

C. Despite adequate opportunity for sleep

D. > 3x/week

E. > 3 months

F. Not better explained another sleep disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ways to assess insomnia

A

Clinical interview

Sleep diaries

Questionnaires

Actigraphy

Polysomnography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Clinical interview

A

1 on 1 interview

Ask questions to determine which criteria they fit

e.g. “what does your typical night look like?” will determine DIS, DMS and EMA, “When did your sleep problem start?”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Consensus sleep diary

A

Carney et al., 2012

Answer questions each day about their sleep that night to determine symptoms

Measures:

  • sleep onset latency
  • wake after sleep onset
  • early morning awakening
  • total sleep time
  • time in bed
  • sleep efficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Insomnia severity index

A

Morin, 1993

Questions about satisfaction, DIS, DMS, EMA…

0-4 likert scale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Sleep condition indicator

A

Espie et al., 2014

8 items asking about sleep over the past month

Answers score from 4 to 0

High scores indicate better sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dysfunctional beliefs about sleep scale

A

Morin, 1993

0-10 likert scale, strongly disagree - strongly agree

assesses persons beliefs about sleep e.g. how much sleep they need to function well, what they believe will happen if they don’t get enough sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Insomnia questionnaires

A

Insomnia severity index (Morin, 1993)

Sleep condition indicator (Espie et al., 2014)

Dysfunctional beliefs about sleep scale (Morin, 1993)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Actigraphy

A

Not commonly used but can help to exclude possibilities of other sleep disorders related to the body clock

Worn like a watch

Accelerometer measures and records movement (black spikes on output) - lack of spikes on output = less movement = sleep? Could just be laying still in bed –> not a true measure of sleep

Also records light (yellow spikes on output)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Polysomnography

A

Used to measure wakefulness, REM sleep and NREM sleep

EEG measures cortical activity

EOG measures eye activity

EMG measures muscle tone

Measure respiratory effort to rule out apnoea conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do we measure NREM sleep?

A

Electroencephalography (EEG)

Electrodes on scalp measure cortical activity

10-20 system –> electrodes placed at 10% and 20% distances between facial landmarks e.g. nose, ears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do we measure REM sleep?

A

EEG to measure cortical activity, EOG (electrooculography) to measure lateral eye movement and EMG (electromyography) to measure muscle tone

EOG electrodes placed above and right of right eye, below and left of left eye. Positive signal when eye looks toward the electrode so…

  • Left looking left = positive signal
  • Left looking right = negative signal
  • Right looking right = positive signal
  • Right looking left = negative signal

EMG electrodes placed on and under chin

  • chin EMG is relatively reduced during REM sleep
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Misperception of total sleep time and hypertension in insomniacs

A

Vgontzas et al., 2009

Measure sleep objectively with PSG

  • Insomniacs who underestimate TST have greater risk of hypertension
  • 5x higher risk if they also have short sleep time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Insomnia and depression

A

Insomnia is a common feature of major depression

Insomnia predicts development of depression (Riemann et al., 2003)

Treatment of insomnia enhances effects of treatment for comorbid depression (Fava et al., 2006)

CBT-I enhances depression outcome in patients with comorbid major depressive disorder and insomnia (Manber et al., 2008)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the 3-P model?

A

3-P model:

  • Spielman & Glovinsky, 1991
  • Based on stress-diathesis model
  • Predisposing factors (increase risk of insomnia)
  • Precipitating factors (push over insomnia threshold)
  • Perpetuating factors (behaviours that maintain insomnia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3-P model Evidence

A
  • Miller et al. (2014) - meta-analysis of 1344 studies
  • Stand-alone SRT effectively treats chronic insomnia
17
Q

3-P model limitations

A
  • Doesn’t address development of insomnia from acute to chronic
18
Q

Stimulus control model

A

Bootzin and Nicassion, 1978

  • Based on operant conditioning - behaviour is present when stimulus is present
  • Good sleepers: bedroom is condusive to sleep, don’t do other activities there - good stimulus control
  • Insomnia: bedroom is also condusive to many other activities e.g. work, watching TV, playing video games - poor stimulus control
19
Q

Stimulus control model limitations

A

Doesn’t take into account effects of classical conditioning - pairing of environment and behaviour. Bedroom is where person performs waking activities - automatic behaviour of arousal

Lack of evidence

20
Q

Cognitive model of insomnia

A

Harvey

  • Based on sympathetic responses
  • Negative beliefs about sleep trigger arousal (stress)
  • selectively attend info which supports their beliefs (e.g. mistakes at work)
  • safety behaviours (e.g. take on less intensive work)
  • feedback loop bc beliefs about sleep are affecting their life
21
Q

Cognitive model evidence

A

Morini, 1993 - insomnia patients hold dysfunctional beliefs about sleep

Edinger et al., 2001 - cognitive treatment reduces negative beliefs about sleep

Semler & Harvey, 2004 - Insomnia patients monitor and attend to sleep-related stimuli

Harvey, 2002 - insomnia patients engage in safety behaviours

  • interfering with regularity of sleep cycle e.g. naps, going to bed early
  • interference with getting to sleep e.g. drinking coffee, watching TV/reading in bed, planning the next day
  • paradoxical fuelling of thoughts e.g. telling self to stop worrying, telling self to go to sleep
  • exacerbation of daytime sleepingess e.g. skipping exercise, cancelling appointments
22
Q

Cognitive model limitations

A

Cause and effect - do the cognitions cause the insomnia or does the insomnia cause the cognitions?

23
Q

Interacting component approaches

A
  • Morin, 1993 – integrative model of insomnia
    • Dysfunctional cognitions
    • Maladaptive behaviour
    • Psychological arousal
    • Physical consequences
  • Espie et al., 1991 – interacting systems model
    • Arousal caused by psychological, cognitive and behavioural factors
  • CBT-I addresses behavioural and cognitive theories of insomnia
24
Q

Neurocognitive model of insomnia

A

Perlis et al., 1997

Adds on the 3-P model

  • Classical conditioning
    • Pairs bed to wakefulness – conditioned arousal
  • Cognitive alterations
    • Perception of time before sleep – attend to sensory processing
    • Increased STM and LTM
    • Perceived wakefulness
25
Q

Neurocognitive model evidence

A

Manconi, 2010 - sleep misperception common in insomnia

Perlis, 2001 - EEG shows less REM (deep sleep) and more NREM (lighter) sleep in insomniacs

Krystal, 2002 - increased beta and gamma EEG in those with sleep misperception (more activity)

26
Q

Strengths and limitations of neurocognitive model of insomnia

A

Strengths

  • addresses hyperarousal
  • explains how arousal disrupts sleep but also causes individual to be more aware of surroundings
  • Discusses roll of classical conditioning

Limitations

  • Doesn’t address transition from acute to chronic insomnia (development of insomnia)
  • doesn’t explain role of sleep homeostatis or body clock
27
Q

Attention-intention-effort model for insomnia

A

Normal sleepers:

Stressful life event → psych and phys arousal → attends this → prevents sleep à→ stress dissipates → sleep

Insomnia:

Stressful life event → arousal → inhibition of sleep-related de-arousal (not able to ‘shut off’ arousal from the day) → insomnia symptoms → shift attention toward sleep cues:

  1. implicit shift toward sleep cues (e.g. heart rate)
  2. explicit shift toward sleep cues (e.g. failed exam bc poor sleep)
  3. explicit intention
  4. sleep effort increase

→ chronic insomnia

28
Q

Evidence for the Attention-intention-effort model

A

Harris et al., 2015 - attentional bias in insomnia toward sleep cues (what item is disappearing from this image? Faster when sleep related item disappears)

29
Q

Cage Exchange model of insomnia

A

Cano et al., 2008

Tried to stimulate insomnia in rats by putting one rat in another rat’s cage

Stress → activity in ‘wake’ and ‘sleep’ areas of the brain during sleep

  • goes against sleep-wake switch idea - more complicated than we thought!?
  • sleep pressure → activity in sleep areas but stress → activity in wake areas

Explains why insomniacs often say they were awake when they were objectively asleep

PSY301 Sleep Disorders (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions