Chapter 8: Eating and Sleeping Disorders Flashcards
Anorexia Nervosa
a result from a major fear of gaining weight
restricting energy intake leading to significantly low body weight in relation to age, sex, developmental trajectory, and physical health
Must have low weight (below 15% expected weight)
Often begins with dieting
Most deadly mental disorder (starve to death)
2 subtypes:
1) restricting type: no food, excessive exercise
2) binge-eating/purging type: excessive exercise, puking. Won’t eat all day, then binge once and purge food. The difference here from bulimia is they are skinny
commonly begins in adolescence
tends to be chronic unless starts treatment within the first year or two
Treatment: multidisciplinary team. Psychotherapy/counseling and medical and nutritional intervention.
Not common in North American Black women
Bulimia Nervosa
Recurrent episodes of binge eating
Fear of gaining weight
Recurrent inappropriate compensatory behavior with the intent to prevent weight gain (purging, laxative abuse, excessive exercise, fasting)
1.5 and 5% lifetime prevalence
average onset is late adolescence/ early adulthood
They are most often with in 10% of normal body weight. They aren’t skinny like anorexia.
Treatment: Cognitive behavioral therapy CBT. Antidepressants.
Binge-Eating Disorder
binge-eating without compensatory behaviors (not because they are afraid of weight gain, more emotional eating)
tend to be obese
These episodes are associated with 3 or more of the following:
- eating much more rapidly than normal
- eating until feeling uncomfortably full
- eating large amounts of food when not hungry
- eating alone because of feeling embarrassed by how much one is eating
- feeling disgusted with oneself, depressed, or guilty afterward
on average, binge eating occurs at least once a week for three months
This is the most occurring eating disorder in America
Treatment: CBT, interpersonal psychotherapy, and self-help techniques. All effective.
What are the two major types of eating disorders?
anorexia and bulimia
What do anorexia and bulimia have in common?
Both have fear of weight gain. Strong sociocultural origins (westernized views).
Insomnia disorder
one of the most common sleep disorders
Problems initiating sleep/maintaining sleep
Only diagnosed as a sleep disorder if it is not better explained by a different condition (e.g. GAD)
Treatment: benzodiazepines, sleep meds. Best as short-term solution. CBT–education on sleep, monitor sleep, practice better sleep habits (reduce stress, improve sleep hygiene i.e. bedroom only for sleeping nothing else, condition yourself)
Hypersomnolence Disorder
too much sleep
treatment: stimulants
Narcolepsy
falling asleep randomly
Cataplexy: jump into sleep state due to startle response
onset adolescence
typically improves over time
Treatment: stimulants (Ritalin), cataplexy usually treated with antidepressants
Breathing related sleep disorders
Obstructive Apnea: respiratory system works, airflow stops
Central Apnea: respiratory systems stops for brief periods
Sleep-related hypoventilation: decreased breathing during sleep
cause can be overweight
treatment: meds, weight loss, or mechanical devices (CPAP)
Circadian Rhythm Sleep-Wake Disorder
disturbed sleep leading to distress and/or functional impairment
due to brain’s inability to synchronize day and night
Treatment: phase delays (move bedtime later–best approach), phase advance, use bright light to trick biological clock
Parasomnias
problem is not with sleep itself, problem is abnormal events during sleep, or shortly after waking. Can be during REM and not during REM.
Sleep terrors
parasomnia
recurrent episodes of panic-like symptoms during non-REM sleep
no memory of this happening
can’t be woken up
treatment: wait and see, usually it will fade away as the kid grows up. Severe cases use antidepressants or benzodiazepines
Sleep walking
parasomnia
occurs during non-REM sleep
person must leave bed
runs in families
accompanied by nocturnal eating
treatment: usually go away on its own
Nightmare disorder
parasomnia
repeated episodes of extended, extremely dysphoric dreams leading to distress and/or impairment in daily life
treatment: antidepressants and/or relaxation training
REM Sleep Behavior Disorder
repeated episodes of arousal during sleep associated with vocalization and/or complex motor behaviors
often major problem is injury to self or sleeping partner
