Explanations of Insomnia Flashcards
AO1 Short-Term Insomnia
Difficulties in sleeping for short periods of time, e.g. days/weeks - caused by immediate worries e.g. death in family, exams or temp. medical condition
AO1 Long-Term (chronic) Insomnia
DSM definition - sleep difficulties lasting more than four weeks, diagnosis not based on no. hours sleep but on how person feels + operates next day, distinction between primary + secondary - sec more common
AO1 Primary Insomnia
Not directly associated with any other health condition or physical cause e.g. may be bad sleeping habits but insomnia is only problem, may have once had identifiable cause but has since gone yet insomnia persists
AO1 Secondary Insomnia EXPLANATION
Sleep issues BECAUSE of something else - single underlying medical, psychiatric or environmental cause + IS SYMPTOM of main disorder
AO1 Secondary Insomnia EXAMPLES
Med condition first - Insomnia characteristic of depression/heart disease, typical of shift work/circadian rhythm disorders e.g. phase delay, Older people more likely as discomfort when sleeping but also because less SWS so more easily awoken, Env factors - caffeine or alcohol, parasomnias e.g. sleep apnoea + sleep walking + teeth grinding
AO2 Support - Important to distinguish between insomnia types = implications for treatment
E: Treat disorder rather than insomnia, if distinction not made treatment being hindered, E: e.g. if result of chronic depression, not helpful to just treat symptom as not alleviating root of problem + allowing to resurface, L: O’Hayon + Roth 2003 15,000 cases insomnia preceded cases of mood disorders therefore helpful to treat insomnia regardless of primary or secondary
AO2 Support - Important to understand insomnia + be able to effectively treat as has serious consequences
E: Zammit et al. 1999 patients with insomnia scored lower on MOCS than controls, issues with concentration, memory, reasoning + problem solving, E: found keeping awake three hours longer than usual led to impairments equivalent to modest levels of alcohol, L: Support - Zammit et al. 1500 deaths annually result of car accidents related to sleepiness or fatigue
RWA - Distinction between causes of P+S leads to effective treatment
E: e.g. bad habits that cause primary insomnia; going to sleep later and later, artificial/blue light etc. E: Sleep hygiene is having good sleep practice - if going to sleep in warm room, this can be changed L: Therefore, distinction gives primary insomniac more choice to help them sleep
AO2 - 3P Model of Insomnia - distinguish between predisposing, precipitating + perpetuating factors
E: Predisposing = genetic factors, Watson et al. 2006 50% risk could be attributed to genetics, E: Insomniacs likely to experience hyperarousal both when awake + asleep - may predispose, L: Therefore people who have insomnia already experience hyperarousal in response to jet lag or stress SO only some can develop it
? What does the 3P model distinguish between ?
Predisposing, precipitating + perpetuating factors
AO2 - 3P Model of Insomnia - Precipitating factors are events that trigger disorder in vulnerable individuals
E: Can include stress from e.g. school, exams or shift work, E: explains why only some people develop insomnia when exposed to same conditions as do not have same genetic predisposition L: Includes being tense before bed as aware of past sleep problems so becomes issue rather than insomnia, Espie 2002 perpetuating factors key to chronic insomnia
DIFFERENT APPROACH - Cognitive Approach - Attribution Theory been used to help treat primary insomnia in real world
E: When insomniacs hold belief going to have difficulty sleeping, expectation becomes reality as person is tense when trying to sleep - learned to attribute sleep difficulties to insomnia E: Storms + Nisbett have insomniacs placebo and told would either stimulate or act as sedative, those told it was stimulant actually fell asleep quicker as attributed arousal to pill so relaxed, L: Attribution theory helps insomniac as if can learn sleep difficulty lies elsewhere will end dysfunctional attribution
AO2 Limitation of research - chronic highly complex + unlikely to be explained by single factor
E: e.g. chronic insomnia can have many causes: stress, bad sleeping habits, mental, psychiatric or environmental, E: as are so many different types of insomnia attributed to so many different causes, difficult to make generalisations applying to all (Dement 1999), L: limits research, understanding + treatment because research tends to find only small effects - means research unlikely to uncover clear solutions
