Insomnia Flashcards
What is secondary insomnia?
There is a single underlying physical, psychiatric or environmental cause.
Insomnia is a symptom if another main disorder.
What is primary insomnia?
Insomnia that occurs on its own with no know cause for more than one month. Insomnia is the primary problem an the person may feel stressed and depressed but it isn’t the main problem. May I had an identifiable cause but his has disappeared and the insomnia persists because the person expects sleep difficulty.
How can depression cause secondary insomnia?
Very common and insomnia is the symptom often sought help for. The depression can cause insomnia but can also fuel the depression.
Insomnia often persists after the depression has gone implying that it is not simply a side effect.
Depression alters REM sleep by increasing proportion of REM, reduction in time to enter and higher frequency of REMs.
Exact aide is unknown but believed to be linked through the neurotransmitters: serotonin, dopamine and norepinephrine.
Depression study in London?
A long study looking at the elderly found the best predictor of depression was insomnia.
Sleep problems preceded ether than followed he depression.
PTSD links to secondary insomnia?
Disrupted sleep is one f the hallmarks of PTSD and is often accompanied by recurring nightmares.
Sever cases can cause a late drop in TST, big deficit in REM sleep and absence of SWS.
Sufferers most sleep in nREM sleep.
PTSD cannot account for many cases of insomnia.
Medical causes for secondary insomnia?
Chronic pain: arthritis, asthma, heart problems, over active thyroid, gastrointestinal difficulties and heartburn.
Parkinson’s (motor symptoms and medication)
RLS and narcolepsy
Sleep apnoea
What is OSA?
Obstructive sleep apnoea is caused by the collapse of the airway DIY I lack if muscle tone causing person to awake gasping for air.
Cycle repeats but person rarely recalls OSA related awakenings.
A person with OSA may awake early in the mining and be unable to go back to sleep.
EDS is reported and it can range from mild to severe.
Caused by at back lower jaw, partially blocked nose, overweight, large tongue or alcoholism.
OSA is more common in adults
What is CSA?
Central sleep apnoea is associated with cerebral vascular condition, congestive heart failure and old age.
Different to to OSA as there is no airway restriction instead the person doesn’t receive the stimulus to breathe.
Greater rate of insomnia and EDS with CSA.
What is FFI?
Fatal familial insomnia is an inherited dominant disorder.
Begins with deterioration in memory and attention and a dreamlike state.
Sleep wake cycle becomes severely disrupted: sleep ceases and no sleep EEG patterns are produced.
Thalamus degenerates and death invariable ensues.
FFI is caused by accumulation if prions and there is no cure.
How does medication cause insomnia?
Most commonest cause of insomnia. Many drugs are unhelpful and many include caffeine or interfere with urination.
How does alcohol affect sleep?
Acts as a sedative but prevents deeper stages of sleep as when asleep the alcohol metabolises into the blood stream and makes the normal sleep cycle erratic.
Exacerbates sleep apnoea by relaxing muscles in the upper airway
Also increases need for urination but this is the same for all beverages. L
How does alcohol abuse affect sleep?
Insomnia is a notorious side affect of abuse and 61% of alcoholics experience insomnia.
Withdrawal also produces insomnia and sleep disturbance
Effects of caffeine?
Caffeine is a stimulant as is nicotine. Caffeine tolerance is an individual difference
How is primary insomnia learned?
It is a learned maladaptive sleep pattern, one way it is learn is via CC.
Associating the act of going to bed with feelings of anxiety will reduce sleep.
Person believes thy will have difficulty sleeping which becomes self fulfilling
How to treat primary insomnia?
Based on attribution theory.
Convinced the source of their difficulty lies elsewhere which will end their maladaptive attribution.
