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PSYCO 239 > Sleep-Wake Disorders and Feeding-Eating Disorders > Flashcards

Sleep-Wake Disorders and Feeding-Eating Disorders Flashcards

1
Q

T or F. Drugs used to treat depression may also help curb bulimic binges

A

T

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2
Q

T or F. Sleeping pills are an awesome solution for insomnia

A

F! They are a short-term solution and can actually worsen insomnia

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3
Q

Two main types of eating disorders

A

Anorexia Nervosa and Bulimia Nervosa

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4
Q

Anorexia Nervosa

A
  • primarily affects young women
  • maintenance of an abnormally low body weight
  • distortion of body image
  • intense fears of gaining weight
  • amenorrhea (in females)
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5
Q

Amenorrhea

A

cessation of menses

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6
Q

DSM 5 - Anorexia Nervosa

A
  • Restriction of energy intake
  • Intense fear (almost phobic/panic) of gaining weight
  • Disturbance in the way in which one’s body weight or shape is experienced
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7
Q

Specifiers of Anorexia Nervosa (Types)

A
  • Restricting Type: go out of way not to eat that much; eat enough to stay alive
  • Binge-Eating/Purging Type: excessive eating then induce vomiting then go back to longer periods of self-starvation
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8
Q

Severity of Anorexia is largely based on this. Why is this a problem?

A

Body Mass Index (kg/m^2)(calculated from weight in kg and height in m); fails to take body composition into account!

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9
Q

According to WHO, what is the low end of normal range, etc.

A 
Normal - 25-18.5
Mild - greater than or equal to 17
Moderate - 16.99-16
Severe - 15.99-15
Extreme - less than 15
  1. 5 low end of normal
    * *Partial remission - some but not all criteria met for a sustained period of time
    * *Full remission - no criteria met for a sustained period of time
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10
Q

A better method than BMI

A

Displacement of tank when person sinks to the bottom

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11
Q

Medical complications of Anorexia:

A
  • Amenorrhea: low estrogen (can happen pretty quickly depending on caloric deprivation)
  • Osteoporosis: fractures, inadequate dietary calcium
  • Kidney damage: dehydration, laxative abuse
  • Heart arrhythmias: electrolyte imbalance; brady- and tachycardia
  • Hypotension
  • Anemia
  • Death (~15% of patients): malnutrition, suicide
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12
Q

Bulimia Nervosa

A

Recurrent pattern of binge eating followed by self-induced purging and accompanied by persistent over-concern with body weight and image

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13
Q

Bulimia Nervosa does NOT include anorexia

A

no severe caloric deprivation

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14
Q

Binge-Eating Disorder

A

New DSM-5 diagnostic category that involves the same binge-eating features found in Bulimia Nervosa but without the behaviour aiming to compensate for the bingeing (eg. purging)

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15
Q

Medical complications of Bulimia

A
  • tooth erosion, cavities, and gum problems
  • blockage of salivary ducts
  • pancreatitis
  • water retention, swelling, and abdominal bloating
  • acute stomach distress
  • fluid loss with low potassium levels (extreme weakness, near paralysis and heart arrhythmias)
  • irregular periods (esophagus damage, including rupture)
  • weakening of rectal walls (laxative use)
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16
Q

Behavioural complications of Bulimia

A
  • substance abuse (30-70%)

- impulsive behaviours (up to 50%): promiscuity, cutting (parasuicidal), theft

17
Q

Risk factors for both Anorexia and Bulimia

A
  • participation in competitive activities that emphasize endurance, aesthetics, and weight levels put athletes at risk for this
  • female gender
  • age in late teens to early 20s
  • having a first degree relative with an eating disorder
  • social pressures including distorted media portrayals
  • emotional issues such as: low self-esteem, perfectionism, anger issues, depression, anxiety, OCD, impulsivity
18
Q

Treatment of Anorexia and Bulimia

A
  • hospitalization
  • cognitive analytic therapy (CAT)
  • family therapy
  • CBT
  • interpersonal psychotherapy
19
Q

Infancy and Early Childhood Feeding and Eating Conditions

A
  • Pica: ingestion of non-nutritive substances
  • Rumination Disorder: food id regurgitated, chewed, and either spat out or re-swallowed
  • Feeding Disorder of Infancy or Early Childhood: difficulty in transitioning from breastmilk to real food
  • Prader-Willi Syndrome
  • Cyclic Vomiting Syndrome: food in stomach then throw up several times an hour over a period of hours or days; not bingeing or purging; infants
20
Q

Adolescents and Adults Feeding and Eating Conditions

A
  • Anorexia Athletica : reduction or no appetite + excessive exercise to lose weight
  • Muscle Dysmorphia (Bigorexia): misperception that muscles are incredibly small
  • Orthexia Nervosa: preoccupation with superfoods
  • Night-Eating Syndrome: eat more than half of daily caloric intake after supper but before breakfast the next day
  • Nocturnal Sleep-Related Eating Disorder: variant on sleep walking; not a fully awaken state; go to refrigerator (doesn’t involve preparation or cooking) but just grabbing and eating whatever they can
  • Gourmand Syndrome: often associated with brain damage; preparation and rituals
21
Q

Diagnostic category representing persistent or recurrent sleep-related problems that cause significant personal distress or impaired functioning

A

Sleep-wake disorders

22
Q

Dyssomnias

A
  • Insomnia Disorder
  • Hypersomnolence Disorder
  • Narcolepsy
23
Q

Breathing-Related Sleep Disorders

A
  • Central Sleep Apnea
  • Sleep-Related Hypoventilation
  • Circadian Rhythm Sleep-Wake Disorders
24
Q

Parasomnias

A
  • Nightmare Disorder (during REM stage)
  • Non-REM Sleep Arousal Disorders (Sleep terrors and sleepwalking)
  • REM Sleep Behaviour Disorder
  • Restless Leg Syndrome
  • Substance/Medication Induced
25
Q

As we age, slow wave ….

A

(stages 3 and 4) sleep decreases and stage 1 increases which makes us easier to wake

  • -> heighten incidence of insomnia
  • -> over 65
26
Q

Narcolepsy

A
  • loss of the chemical hypocretin in the hypothalamus
  • cataplexy
  • dysregulation of sleep stages (fast movement into deep sleep = muscle paralysis at dangerous times)
27
Q

Breathing-Related Sleep Disorders: Apnea and Snoring

A
  • airway closes partially or completely
  • more likely in obese or sedated individuals (sleeping pills or alcohol)
  • airway remain closed up to 90 seconds!
    > usually sleeper reflexively sits up
    > causes profound interruption in sleep as it occurs many times per night
    > poor oxygenation
    > highly disruptive to sleeping partner
28
Q

Sleep apnea can make __________ much worse

A

narcolepsy

29
Q

T or F. Typically, you can wake up from sleep apnea

A

T, up to 500x per night; more likely to occur in REM or stage 3/4

30
Q

Treatment for Sleep Apnea

A
  • Continuous positive air pressure (CPAP) machine - ensures that enough pressure in the back of throat so that tissue doesn’t collapse
  • surgery, typically laser to remove excess tissue enlargements
31
Q

Sleeping Beauty Syndrome

A

Kleine-Levin Syndrome (KLS): recurring periods of excessive amounts of sleep, behaviour changes, and impaired understanding of the world ; episodes may continue for ten years or more!

32
Q

Treatment of Sleep-Wake Disorders

A
  • Anxiolytics: should only be used short-term; many drugs can suppress REM sleep
  • Psychological Approaches: cognitive-behavioural techniques lower physiological arousal and address sleep hygiene and emotional state
33
Q

Sleep Terrors vs. Nightmares

A

Sleep terrors - more common in children and can increase their insomnia (tend to decrease overtime)

Nightmares - stay constant or increase over time

34
Q

Nightmare Disorder

A
  • during REM
  • wakes up
  • tend to remember dreams; true dreams
35
Q

Sleep Terror

A
  • Non-REM (stages 3 and 4)
  • dream not remembered
  • awaken confused and disoriented
36
Q

Sleepwalking

A
  • Non-REM
  • don’t usually wake up
  • often confused and disoriented if awoken
  • little recollection of dream content
  • ‘sexsomnia’ variant and nocturnal sleep-related eating disorder
37
Q

Treatment of sleep disorders

A
  • Biological: Benzodiazepines (anxiolytics - risk of dependence, diminished REM)
  • Psychological: cognitive-behavioural techniques (people can develop anticipatory anxiety that may respond to identifying rational alternate thoughts)

PSYCO 239 (7 decks)

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