Sleep DIsorders Flashcards
Recommended amount of hours of sleep
7-10 hours for adults 18-55
Two types of sleep
Non-rapid eye movement sleep (NREM)
Rapid Eye Movement Sleep (REM)
Stages of NREM
Falling Asleep
Light Sleep
Deeper Sleep
Deepest Sleep
How often do we swap between NREM and REM
90 minute cycles, NREM first usually then REM
What are the two internal systems we have to regulate wakefulness and sleep? Explain both.
Circadian Rhythms
sleep and wakefulness regulated by neurotransmitters released by our internal clock located in the suprachiasmatic nucleus within the hypothalamus
Sleep Drive Internal System
increases the buildup of chemical adenosine
caffeine blocks these adenosine receptors so we stay awake.
Process of Sleep (how we go through the stages of sleep)
Up and down the stages of sleep
stage 1 to 4 of NREM up to REM and back down
Usually wake up at REM
Sleep drive increases until we fall asleep which decreases rapidly when we do
Two types of Sleep Disorders in the DSM
Dyssomnia ( trouble falling/staying asleep)
Parasomnia (nightmares, sleep walking)
Criteria for Insomnia
Dissatisfaction with sleep quality or quantity
distress or impairment from sleep disturbance
3 nights per week, persisting for 3 months
despite having adequate opportunities for sleep, insomnia persists
3Ps of Insomnia
Predisposing
Complex bio-psycho-social factors that make some individuals more at risk
Precipitating
Triggers in the environment (e..g life stress, anxious thoughts at night)
Perpetuating
thoughts/behaviors that continue the cycle of insomnia
Medications for Insomnia
Commonly Prescribed Medications:
Benzodiazepines (can lead to dependence, short term prescription)
“Z” Drugs (less addictive)
Over-the Counter Medications
Melatonin: Hormone that is normally produced by the body to promote sleepiness, effects are modest, similar to placebo but do not dissipate with continued use
Alcohol: knocks you out, but sleep quality bad
Environmental and Psychological Internventions for sleep disorders
CBT
Sleep Tracking
gathering information on sleep and treatment outcomes
Stimulus Control
uses classical conditioning principles to reform the association between the bedroom and sleeping
General procedure
If the client is unable to fall asleep within 10-15 minutes, they are instructed to get up
Go do something quiet/not-to exciting and return to bed only when they are sleepy
Repeat as necessary
Sleep Restriction
limit the amount of time spent sleeping
Set a specific bedtime.
Set a specific wake-up time (and waking up regardless of how much the client slept).
Avoid daytime naps unless necessary for safety concerns.
Cognitive restructuring
Sleep Hygiene
Relaxation
What is Hypersomnolence
Excessive sleepiness despite adequate hours of sleep
What is Narcolepsy
irresistible need to sleep, lapsing into sleep or napping occurring within the same day
hypocretin deviancy
Why do people with Narcolepsy experience hallucinations?
Entering REM sleep, when dreams occur
Different types of sleep-related Hallucinations
Hypnagogic Hallucinations: These occur as you are falling asleep.
Hypnopompic Hallucinations: These happen as you are waking up.
Visual Hallucinations: Approximately 86% of these hallucinations are visual, characterized by “kaleidoscopically changing—possibly entoptic (within the eyeball)—phenomena such as geometric patterns, shapes, and light flashes.”
