OT 501 Diagnostics (Primary Sleep Disorders)

during the first two years of age....

a child spends more time asleep than awake

when do the majority of advances in the brain happen?

when asleep

lack of sleep can cause....

physiological difficulties

common behaviors of sleep deprived children

cranky

impulsive

distractible

emotionally labile (happy to sad fast)

memory retrieval impairments

how do sleep patterns/problems change throughout childhood?

-infants/toddlers have more night waking problems

-preschoolers have falling asleep difficulties

-adolescents and adults have difficulty going to or staying asleep

what are the two major types of sleep disorders?

dyssomnias and parasomnias

what are dyssomnias?

abnormalities in amount, quality or type of sleep

What are parasomnias?

abnormal sleep behaviors

what is insomnia disorder? requirements for diagnosis? coexists with which disorders? NOT induced by...

difficulty initiating or maintaining sleep

sleep disturbance causes distress (typically day time fatigue)

not drug induced or job induced

co-exists with/diagnosed with major depression

at least 3 nights a week, at least for 3 months

how common is insomnia disorder?

extremely common in adults

-1/3 of adults experience w/in the past year

-1-10% currently experience insomnia

what is Hypersomnolence Disorder? how often do symptoms have to occur to be diagnosed?

excessive sleepiness despite at least 7 hours of sleep with at least one:

-recurrent lapses into sleep during the day

-non-restorative 9 hours of sleep

-difficulty being awake after abrupt wakening

causes impairment of distress

3/ a week for 3 months

how common is hypersomnolence disorder?

5-10% of people who present at sleep clinics

what is narcolepsy?

irresistable attacks of sleep

either cataplexy (loss of muscle tone) or intrusions of REM into the transition between sleep and wakefulness (sleep paralysis or hypnagognic hallucinations)

how common is narcolepsy (prevelance)?

RARE - less than 1%

what are the breathing related sleep disorders & describe them?

sleep disturbances related to a breathing condition

-obstructive sleep apnea hypopnia

snoring, gasps, moans, mumbling

followed by 20 seconds of silence when the person has stopped breathing

-central sleep apnea

episodic sleep cessation without obstruction

-central alveolar hypoventilation syndrome

hypoventilation without apneas

what is the prevalence of breathing related sleep disorders & what population do they occur in?

1-10% in adults

1-2% children

more likely geriatrics /overweight populations

why are breathing related sleep disorders growing in children?

because of obesity

what is circadian rhythm sleep disorders?

sleep disruption due to a mismatch of sleep wake schedule and environment

-delayed sleep phase (later than desired sleep)

-advanced sleep phase (earlier than desired sleep)

-jet lag type

-shift work type

what are some types of parasomnias?

-non-rapid eye movement sleep arousal disorders

-sleep terrors (same diagnosis as above)

-sleep walking

-nightmare disorder

-REM sleep behavior disorder

-restless legs syndrome

sleep terrors: prevalence & possible cause/solution

prevalence: 3% of children ages 18 months to 6 years

cause: genetic component

solution: white noise/time them out - happens at similar time every night, stop them before they happen

sleep walking prevalence

15% of children have one attack

1-6% have one to four attacks per week