Sleep Wake Disorders

Question 1

Sleep Wake Disorders

Answer 1

characterized by problems related to the quality, timing, and amount of sleep with resulting daytime distress and impairment

Question 2

Insomnia

Answer 2

requires dissatisfaction with sleep quality or quantity that is associated with at least one of the following symptoms:

• difficulty initiating sleep
• difficulty maintaining sleep
• early-morning awakening with an inability to return to sleep

Occurs at least three nights each week, has been present for at least three months; occurs despite sufficient opportunities for sleep, and causes significant distress or impaired functioning

Question 3

Treatment for Insomnia

Answer 3

primary non-pharmacological treatment is a CBT approach that incorporates the following:

• sleep-hygiene education
• stimulus control- used to strengthen the bed and bedroom as cues for sleep and weaken them as cues for other activities
• relaxation training
• cognitive therapy- to correct faulty attitudes and beliefs about sleep and counterproductive sleep strategies

Question 4

Hypersomnolence

Answer 4

involves excessive sleepiness despite a main sleep period of at least seven hours with at least one of the following symptoms:

• recurrent periods of sleep within the same day
• a prolonged but nonrestorative sleep period of more than nine hours each day
• difficulty becoming fully awake after an abrupt awakening
• occurs at least three times per week; has been present for at least 3 months; causes significant distress

Question 5

Narcolepsy

Answer 5

characterized by attacks of an irrepressible need to sleep with lapses into sleep or daytime naps that occur at least three times per week and have been present for at least three months
Requires symptoms of cataplexy (loss of muscle tone), a hypocretin deficiency, or a rapid eye movement latency less than or equal to 15 minutes as measured by nocturnal sleep polysomnography

Hypnogogic hallucinations- vivid hallucinations before or upon falling asleep

Hypnopompic hallucinations- hallucinations that occur after awakening

May try to prevent sleep attacks by controlling emotions since cataplexy is often triggered by anger, surprise, or other strong emotions

Question 6

Obstructive Sleep Apnea Hyponea

Answer 6

requires evidence by polysomnography of
1) at least five obstructive apneas (told absence of airflow)
2) hypnopneas (reduced airflow) during each hour of sleep plus either
A. Noctural breathing disturbances (snoring, gasping, or breathing pauses) or
B. Daytime sleepiness, fatigue, or unfreshing sleep despite opportunities to sleep

2. 15 or more obstructive apneas and/or hypopneas during each hour of sleep regardless of the presence of any other accompanying symptoms

Question 7

Non-Rapid Eye Movement Sleep Arousal Disorders

Answer 7

recurrent episodes of incomplete awakening that usually occur during the first third of the major sleep episode (most often during Stage 3 or 4 sleep) and are accompanied by sleepwalking and/or sleep terror

individual has limited or no recall of an episode upon awakening and the disturbance causes significant distress or impaired functioning

Question 8

Nightmare Disorder

Answer 8

characterized by repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that usually involve efforts to avoid threats to survival, security, or physical integrity

nightmares ordinarily occur during REM sleep in the second half of the major sleep period; and, on awakening from a nightmare, the individual is typically fully alert but may have a lingering sense of anxiety or fear

causes significant distress or impaired functioning