sleep-wake disorders

exam 3

stage 1 of sleep

very light sleep and easily woken up

stage 2 of sleep

deeper sleep but can be woken fairly easily

stage 3 of sleep

deep sleep that is usually achieved within 20-30 minutes of falling asleep

stage 4 of sleep

REM sleep where most dreaming THAT YOU CAN REMEMBER happens

Insomnia

does not require a sleep study to diagnose, characterized by difficulty falling asleep, staying asleep, or early waking for 3x a week at least for at least 3 months that causes impairment

Narcolepsy

requires 2 types of sleep studies to diagnose and is characterized by irresistible and overwhelming urge to sleep in the daytime for at least 3 months. People with this often get good sleep in the night and may fall asleep in inappropriate or dangerous places. they go straight into REM sleep

Cataplexy

the sudden loss of muscle function often triggered by extreme emotions but they are still conscious

Obstructive sleep apnea

the soft tissue of the throat collapses in sleep and obstructs the airway which causes beathing interferences or to completely stop which results in snoring or gasping for air

5x an hour = mild 30+ an hour = severe

Risk Factors for sleep apnea

STOP BANG

S - snoring

T - tired

O - obstructed airway

P - pressure (high blood pressure)

B - BMI

A - Age after 50

N - Neck circumference

G - Gender

2 factors = mind 3-4 = moderate 5+ = severe

Non-REM sleep arousal disorder

sleep terrors that occur in deep sleep and caused by sleep deficits

sleepwalking that occurs in deep sleep

Nightmare disorder

occurs during REM sleep and is characterized by dreams of danger that are frightening enough to be woken up (or unwanted dreams)

REM sleep behavior disorder

requires a sleep study and is similar to sleepwalking but involves more complex behaviors and vocalizations in your sleep. There is potential to harm yourself or others and is partially caused by lack of REM paralysis

Rhythmic movement sleep disorder

mostly occurs in infants and toddlers, characterized by a rocking motion to self sooth that doesn’t go away and is overall harmless but can cause distress

Idiopathic hypersomnia

aka hypersomnolence disorder and is characterized by the biological need to sleep for 10-12 hours. sleepy not fatigued

Circadian Rhythm disorder

when the daily schedule and circadian rhythm are misaligned that causes impairment

Central sleep apnea

needs a sleep study, breathing stops because of the brain and not due to an obstruction

Periodic limb movement disorder

happens during sleep, is linked to low iron, and characterized by pulsating limbs in a rhythmic and predictable way for about 30 seconds at a time

restless leg syndrome

a sensation in the legs that makes someone feel that they need to move and can be painful. it interrupts sleep and is also linked to low iron. has to occur at least 3x a week for 3 months

Biological

genetics, medical history, obesity, and naturally delayed sleep

psychological

depression, anxiety, poor sleep hygiene, irregular work shifts, and beliefs about sleep

social

low education, low income, and late night phone use (depending on the activity)

sociocultural

race (black people report more light or long sleepers) and whether napping is common in a culture

CBT-I

is better for long term effectiveness and gives life-long management skills. Stimulus control to only associate bed with sleep, sex, or sickness (3 Ss) and sleep restriction to temporarily restrict time spent in bed to extend the window for sleep. You should also consider sleep hygiene

Sleep hygiene

having good sleep habits that promote sleep

Good sleep hygiene

only using bed for the 3 Ss, removing naps if you don’t need them, keep a fixed bed and wake time, avoid caffeine and alcohol, do relaxing activities, make a worry list if you have too much anxiety, do fun but relaxing pre-sleep activities, etc etc

Medications

sodium oxybate for narcolepsy

clonazepam for REM Sleep behavior disorder

ambien, sonata, and lunesta for insomnia