Insomnia (1) Flashcards
Define dyssomnia
Sleep disorder characterized by problems in timing, quality, or amount of sleep
Define parasomnia
sleep disorder characterized by abnormalities in physiology or behavior associated with sleep
How does the DSM 5 define insomia?
Complaint of dissatisfaction with sleep quantity or quality associated with at least one of the followoing symptoms:
1- difficulty initiating sleep
2- difficulty maintaining sleep
3- early morning awakening w/ inability to return to sleep
How long/ how frequently must sleep disturbances occur to be considered insomnia?
3 nights per week and present for 3 months
T/F: If a sleep disturbance is attributable to the physiological effects of a substance or a coexisting medical or mental disorder it is considered insomnia
False…it is not considered insomnia
Name some endogenous causes of insomnia?
Excitatory neurotransmitters in excess at night
Inhibitory neurotransmitter deficiency at night
Where can excess excitatory neurotransmitters come from at night? What neurotransmitters are involved?
Locus ceruleus–> NE
Raphe nucleus–> serotonin
VTA–> dopamine
Tubomamillary nucleus–> Histaime
What can cause an inhibitory neurotransmitter deficiency at night?
loss of GABA tone, loss of melatonergic tone, loss of andenosinergic tone
What are some physical causes of insomnia?
CNS stimulants, withdrawal from sedating agents, and medical conditions (chronic pain, pulm disease)
What are some psychiatric causes of insomnia?
Major depressive disorder, bipolar disorder, generalized anxiety disorder
What are some effects of insomnia? (4)
1- decreased quality of life
2- complaints of impaired daytime performance/ more accidents/ absenteeism
3- self medication/ substance abuse
4- association with psychiatric disorders
What is step 1 in insomnia management?
Diagnose, informed consent, education
What is step 2 in insomnia management?
Behavioral counseling (sleep hygiene and stimulus control)
What is step 3 in insomnia management?
Sleep restriction therapy and cognitive/ behavioral therapy
What is step 4 in insomnia management?
Pharmacologic therapy
