sleep wake disorders Flashcards
Sleep-wake disorders
Sleep problems that cause significant personal distress or impaired functioning in social, occupational or other rolls
Changed from sleep disorders because they involve problems occurring during sleep or at the threshold between sleep and wakefulness.
Often occur with other psychological disorders like depression, and medical conditions (cardiovascular problems
Insomnia Disorder description
Persistent difficulty falling asleep, remaining asleep or getting enough sleep accompanied by significant personal distress or impaired functioning
Affects 6-10% of US adults
How frequent insomnia problem occurs for diagnosis?
At least 3 nights/week for at least 3 months
Problems associated with insomnia disorder
Fatigue, low-energy; difficulties with memory, paying attention, concentrating, responding quickly, solve problems; behavioral disturbances (hyperactivity, impulsivity or aggression); health problems-weakened immune system functioning
Psychological factors contributing to insomnia
People bring their anxieties and worries to bed with them, which raises their bodily arousal.
Performance anxiety-pressure felt from thinking one must get a full night’s sleep to function properly
Hypersomnolence Disorder description
Persistent periods of Excessive sleepiness or sudden sleep episodes during the day.
“Sleep drunkenness”
They may sleep 9 hours or more a night but still not feel refreshed when waking up-sleepiness is not accounted for not enough sleep at night
Some cases may be caused by a substance in the brain that increases activity of GABA (creates feelings of drowsiness)
frequency of symptoms for Hypersomnolence diagnosis
At least 3 days/week for at least 3 months
Narcolepsy Description
Irresistible need to sleep or sudden sleep attacks/naps; remains asleep for about 15 minutes; person awakes feeling refreshed
Immediate transition from wakefulness to REM
Occurring at least 3/week for 3 months
Most common type of narcolepsy
Narcolepsy/hypocretin deficiency syndrome
Involves a deficiency in hypocretin in the brain; hypocretin is produced by hypothalamus and helps regulate sleep-wake cycle
Cataplexy
Medical condition in which a person experiences a loss of muscle tone (mild weakness to complete loss of control); remains conscious
Triggered by a strong emotional reaction (joy, crying, anger, terror, intense laughter)
Involves deficiency of the brain chemical hypocretin
Sleep paralysis
Temporary state after awakening where they feel unable to move or talk
Hypnagogic hallucinations
Frightening hallucinations occurring just before the onset of sleep or shortly after awakening
Breathing-related sleep disorders
Repeated disruptions of sleep due to respiratory problems;
Obstructive sleep apnea hypopnea syndrome (or obstructive sleep apnea)
Repeated episodes during sleep of snoring or gasping for breath, pauses of breath or abnormally shallow breather; complete or partial obstruction of breathing during sleep
Complete obstruction-sleeper may stop breathing for 15-90 seconds as many as 500 times during the night
People report impaired quality of life, higher levels of depression; associated with increased risks of hypertension; higher risks of cancer
Repeated lapses of oxygen may lead to some forms of brain damage
Hypopnea
shallow or reduced breathing; not as severe as full apnea
central sleep apnea
breathing problems during sleep are less dependent on respiratory resistance and my involve heart-related problems or chronic use of opiod drugs
sleep-related hypoventilation
breathing problems that often trace to lung diseases or neuromuscular problems that affect lung functioning
circadian rhythm sleep-wake disorders
involve a persistent disruption of the person’s natural sleep-wake cycle (due to time changes in sleep pattern)
frequent jet-lag or changes of work shifts may lead to this
treatment involves gradual adjustments in sleep schedule
Parasomnias
Signifies abnormal behaviors (involving partial arousals) occur around the boundary between wakefulness and sleep; person has no memory of episodes of partial arousal; partial arousal interrupts sleep
Sleep terrors
Repeated episodes of terror induced arousals (usually begin with panicked scream); most cases are children; person may be sitting up and show extreme arousal but is not fully awake; person may talk incoherently or thrash about; after a few minutes, person falls back asleep; doesn’t remember in the morning; occur in the first 1/3 of sleep; during non-REM sleep
Sleepwalking
Repeated episodes of walking around while asleep; partially awake and can perform complex motor responses without conscious awareness; person does not remember; occurs during deep non-REM sleep
REM sleep behavior disorder
Muscle paralysis is absent and the person may suddenly kick or flail the arms during REM sleep; acting out one’s dreams; normally during REM muscles are essentially paralyzed
Result from: Neurodegenerative disorders like Parkinsons; alcohol withdrawal; consequence of certain drugs
Nightmare disorder
Recurrent episodes of awaking from very disturbing and well-remembered nightmares during REM; little muscle activity
Treatment: Biological Approaches (for insomnia, narcolepsy/hypersomnolence, and sleep apnea)
Antianxiety drugs often used, including benzodiazepines (valium and Ativan); zolpidem (Ambien) reduces time to fall asleep and increases sleep duration
Sleep medications work by increasing activity of GABA
Stimulant drugs used to enhance wakefulness in people with narcolepsy and daytime sleepiness from hypersomnolence.
Medical devices to aid breathing for those with sleep apnea
Drawbacks of sleep medications
Suppress REM sleep; carry over or “hangover” the next day; rebound insomnia when medication is stoped; tolerance is built-more med. needed; chemical dependence possible; problem still there-does not teach person effective coping
Insomnia Treatment: Psychological Approaches
CBT: lower bodily arousal; replace anxiety-producing thoughts with more adaptive ones; adopting a regular sleep-wake cycle, relaxation training, rational restructuring and stimulus control. Better results than medications
Stimulus control
Changing the environment associated with sleeping; strengthens connection of the bed with sleep
