Chapter 10: Sleep Disturbances Part 1

Question 1

What is a sleep disturbance? Give some examples:

Answer 1

Any sleep-related problem that disrupts an individual’s normal sleep-wake cycle.
-May be temporary, occasional, or persistent
Eg. Problems with sleep onset, waking from sleep and abnormal behaviours

Question 2

When would a sleep disturbance be considered a sleep disorder?

Answer 2

If the disturbance is regular and causes distress or impairment in everyday life during normal waking hours.

Question 3

What is a primary sleep disorder? Give an example:

Answer 3

A sleep disorder that cannot be attributed to any other condition, such as another sleep disorder, medical problem, and substance use.
-It occurs in its own right and cannot be explained by another condition
Eg. Insomnia- regular waking during sleep.

Question 4

What is a secondary sleep disorder? Give an example:

Answer 4

Occurs as a by-product or result of another condition or use of substances.
-Usually improves with the underlying condition/cause being addressed
Eg. Insomnia due to excessive caffeine or stimulant use or insomnia due to physical illness or anxiety

Question 5

What are dyssomnias? Give some examples:

Answer 5

Sleep disorders that produce difficulty initiating, maintaining, and/or timing sleep.
-Results in problems falling asleep, staying asleep, and/or excessive sleep
Eg. Insomnia, circadian rhythm phase disorder

Question 6

How can a circadian rhythm phase disorder develop? Give some examples:

Answer 6

Can originate from external causes such as environment or lifestyle, but are primarily caused by changes to the mechanisms and processes that generate or time sleep.
Eg. Adolescence, shift-work, jetlag

Question 7

What is insomnia and what do people experience as a result?

Answer 7

A sleep disorder that typically involves persistent difficulty initiating or maintaining sleep.

• People experience dissatisfaction with quality or quantity of sleep and is perceived as insufficient or non-refreshing
• May result in distress or impairment when awake
• Either chronic or acute

Question 8

What is chronic insomnia?

Answer 8

Ongoing/longterm insomnia

Question 9

What is acute insomnia?

Answer 9

Short-term (situation/recurrent) insomnia

Question 10

What is situational insomnia?

Answer 10

Insomnia that lasts a few days or weeks and often is associated with life events or environment.
-Usually resolved when causal even passes

Question 11

What is recurrent insomnia?

Answer 11

Insomnia that occurs irregularly, interspersed with restful nights and often associated with stressful events.

Question 12

What is sleep-onset insomnia?

Answer 12

The sleep disorder involving persistent difficulty falling asleep at the usual sleep time.

Question 13

List the key symptoms of sleep-onset insomnia:

Answer 13

• Regular failure to fall asleep within 20-30 mins
• Complaint of poor quality sleep or reduced amount of sleep
• At least 3 nights per week
• Experienced for at least 3 months
• Occurs despite adequate opportunity to sleep
• Does not occur in the course of another disorder or due to another disorder or substance
• Causes impairment in functioning (school, work, social, recreational)

Question 14

List the effects of sleep-onset insomnia on the sleep-wake cycle:

Answer 14

• Disruption
• Changes in the amount, restfulness and timing of sleep
• Sleep onset tends to occur much later than desired and tends to be nonrestorative
• Total sleep time may be less than desired
• Excessive daytime sleepiness
• Difficulty waking up in the morning
• Frustration, anxiety or stress about not being able to fall asleep, which can make the problem worse
• Sleep-wake cycle may be out of sync causing other problems

Question 15

What are parasomnias, when may they occur, and what may they include? Give an example:

Answer 15

Sleep disorders characterised by the occurrence of inappropriate physiological and/or psychological activity during sleep or sleep-to-wake transitions.
-May occur while falling asleep, sleeping, between sleep stages or during arousal from sleep
-They are a specific event and may include abnormal motor activity, behaviours, emotions, perceptions, dreaming and autonomic NS functioning
Eg. Sleep walking

Question 16

What is sleep walking?

Answer 16

Involves getting up from bed and walking or performing other behaviours whilst asleep.

Question 17

Describe the level of activity and behaviour of individuals while sleep walking:

Answer 17

• Level of activity may vary. Some walkers may return to bed or behave as if they are agitated or frightened
• Most sleep walking involves routine activities of low complexity. The episode usually ends spontaneously.
• Eyes may be open and have a blank stare

Question 18

Describe the level of awareness individuals while sleep walking and its risk and treatment:

Answer 18

• Sleep walkers are typically unresponsive to communication
• Little awareness of experience and frequency underestimated as often episodes are unremembered or unobserved
• Major concern is the risk of injury
• Generally not treated unless an individual is at risk of harm

Question 19

What stage of sleep does sleep walking tend to occur, what age is it most common, and is there a cause?

Answer 19

• Generally occurs during stages 3-4 NREM (no sleep paralysis), therefore more likely to occur earlier in the night
• Common in childhood (10-30%) and typically ends by age 7
• Cause is unclear as it is difficult to study objectively

Question 20

List the effects of sleep walking on the sleep-wake cycle:

Answer 20

-Loss of deep sleep and sleep episode will be fragmented, leading to individuals not feeling as rested and more tired during the day

Question 21

What are circadian rhythm phase disorders?

Answer 21

Are a group of sleep disorders involving sleep disruption due to a mismatch between an individual’s sleep-wake pattern and that pattern that is desired or required.

• The individual cannot sleep when is desired, needed or expected.
• Sleep episodes may occur at least preferable or inappropriate times or wake times might be undesired.

Question 22

What may a circadian rhythm phase disorder be caused by?

Answer 22

• A naturally occurring change or malfunction in biological mechansims or processes regulating sleep-wake
• A mismatch between an individual’s sleep-wake cycle and the sleep-wake cycle required by their school, work or social schedule
• A mismatch between an individual’s sleep-wake cycle and the day-night cycle of their physical environment.

Question 23

What are circadian rhythm phase disorders classified as and what do they result in?

Answer 23

• Generally classified as dyssomnias

- Usually results in complaints of insomnia or excessive sleepiness.

Question 24

What is sleep deprivation?

Answer 24

A state caused by inadequate quantity or quality of sleep, either voluntarily or involuntarily.

• Voluntarily (Eg. When you are at a party)
• Involuntarily (Eg. Woken by a thunderstorm)

Question 25

What does sleep quantity refer to, what does it influence, and how can it be measured?

Answer 25

The amount of sleep

• Sleep quantity influences our perception of sleep quality
• Can be measured objectively using time

Question 26

What does sleep quality refer to and how can it be measured?

Answer 26

How well we feel we have slept.

-Primarily relies on subjective self-report measures.