sleep wake disorders

Question 1

Sleep-wake disorders

Answer 1

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

Question 2

Insomnia Disorder description

Answer 2

Persistent difficulty falling asleep, remaining asleep or getting enough sleep accompanied by significant personal distress or impaired functioning

Affects 6-10% of US adults

Question 3

How frequent insomnia problem occurs for diagnosis?

Answer 3

At least 3 nights/week for at least 3 months

Question 4

Problems associated with insomnia disorder

Answer 4

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

Question 5

Psychological factors contributing to insomnia

Answer 5

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

Question 6

Hypersomnolence Disorder description

Answer 6

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)

Question 7

frequency of symptoms for Hypersomnolence diagnosis

Answer 7

At least 3 days/week for at least 3 months

Question 8

Narcolepsy Description

Answer 8

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

Question 9

Most common type of narcolepsy

Answer 9

Narcolepsy/hypocretin deficiency syndrome
Involves a deficiency in hypocretin in the brain; hypocretin is produced by hypothalamus and helps regulate sleep-wake cycle

Question 10

Cataplexy

Answer 10

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

Question 11

Sleep paralysis

Answer 11

Temporary state after awakening where they feel unable to move or talk

Question 12

Hypnagogic hallucinations

Answer 12

Frightening hallucinations occurring just before the onset of sleep or shortly after awakening

Question 13

Breathing-related sleep disorders

Answer 13

Repeated disruptions of sleep due to respiratory problems;

Question 14

Obstructive sleep apnea hypopnea syndrome (or obstructive sleep apnea)

Answer 14

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

Question 15

Hypopnea

Answer 15

shallow or reduced breathing; not as severe as full apnea

Question 16

central sleep apnea

Answer 16

breathing problems during sleep are less dependent on respiratory resistance and my involve heart-related problems or chronic use of opiod drugs

Question 17

sleep-related hypoventilation

Answer 17

breathing problems that often trace to lung diseases or neuromuscular problems that affect lung functioning

Question 18

circadian rhythm sleep-wake disorders

Answer 18

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

Question 19

Parasomnias

Answer 19

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

Question 20

Sleep terrors

Answer 20

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

Question 21

Sleepwalking

Answer 21

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

Question 22

REM sleep behavior disorder

Answer 22

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

Question 23

Nightmare disorder

Answer 23

Recurrent episodes of awaking from very disturbing and well-remembered nightmares during REM; little muscle activity

Question 24

Treatment: Biological Approaches (for insomnia, narcolepsy/hypersomnolence, and sleep apnea)

Answer 24

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

Question 25

Drawbacks of sleep medications

Answer 25

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

Question 26

Insomnia Treatment: Psychological Approaches

Answer 26

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

Question 27

Stimulus control

Answer 27

Changing the environment associated with sleeping; strengthens connection of the bed with sleep