PSYCH 257 - Chapter 10: Sleeping (Sleep-Wake Disorders)

breathing-related sleep disorders

people whose breathing is interrupted during theri sleep

ex. sleep apnea (10-30 seconds where breathing stops)

person doesnt notice the difficulties but has liek headaches in teh rmorning

nightmare disorder

• in children

• high comorbidity

• REM SLEEP

• vivid dreams, CHILDREN DO REMEMBER THEM

• emotional distress

• clinical signfiicant distress or impairment

disorder of arousal

motor movements and behaviours during NREM sleep

ex. sleepwalking, sleep terrors, icnomplete awakening

disorder of arousal —> arousal (awakening)

sleepwalking

• nrem sleep

• NOT ACTUALLY ACTING OUT A DREAM!!

• have to leave bed

• if woken up, wont remember what happened

REM sleep behaviour disorder

indivudal talks or moves while sleeping, sometimes acting out a dream. DURING THE REM ONE, THEYRE ACTING OUT A DREAM. when awoken, they are not confused or anxious.

1. c

2. b

3. a

1. scheduled awakening

2. benazodiapines

3. sleep hygeine

nocturnal eating syndrome

eat in teh middle of the nigth while hteyre still asleep

sleep terrors

• affect children most commonly

• screams, upset, sweating, fast heartrate,

• children dont remember them

scheduled awakenings: waking children up 30 minutes before episode.

sleep treatment: cognitive

focus on changing sleeper’s unrealistic expectations and beliefs of sleep

ex. if i get less than 8 hours of sleep i will be ill

sleep treatment: cognitive relaxation

uses meditation or imagery to help with relaxation at bedtime

sleep treatment: graduated extinction

used for children who have tantrums at bedtime, this treatment instructs parents to check on children after progressively longer periods until children fall asleep on their own

sleep treatment: paradoxical intention

instructs individuals in the opposite behaviour from desired outcome.

paradoxically = paradox = contradiction.

ex. put people who cant sleep in bed and tell them to STAY AWAKE AS LONG AS THEY CAN. removes the performance anxiety of trying to fall asleep

sleep treatment: progressive relaxation

relaxing the muscles of the body to introduce drowsiness.

(relaxing, slowly)

some psychological treatments for insomnia

1. cognitive

2. cognitive relaxation

3. graduated extinction

4. paradoxical intention

5. progressive relaxation

sleep paralysis

inability to move or speak when you’re falling asleep or waking up

• you’re mentally awake but you are frozen adn can experience vivid hallucinations (sleep paralysis demon)

• body is in a staet of REM sleep, and ur muscles are paralyzed to prevent you from acting out your dreams, but you wake up befor eyour body has come out of REM

cataplexy

sudden muscle weakness

hypnagogic hallucinations

very realistic sensory experiences that occur as your are falling asleep

they are linked ot narcolepsy, because the boundaries of sleep and wake are blurred

appetitive napping

napping for enjoyment, can improve mood, altertness and cognitive performance.

predisposing conditions

• biologically vulnerable to being a light sleeper

• or history of insomnia

• these factors are predispoing conditoins, which may combine with other factors to interfere with sleep

insomnia disorder

dyssomnia

• difficulty intiating + maintaining sleep

• sleep distrubance causes clincally signficant distress in functioning in life

• occurs at lesat 3 nights a week for 3 months

• cant be better explained by another sleep-wake disorder, or drug use

4 stages of sleep

1. stage 1: wakefulness —> drowsiness —> sleep (drift in and out of awareness)

2. stage 2: people ARE sleeping, but its light

3. stage 3: deep sleep (slow brain waves)

4. stage 4: VERY deep sleep (when awoken, are disoriented)

90 minute cycles

what are the 2 states of sleep?

1. slow wave (deep sleep)

2. REM (brain appears as if its awake, sleep dreams)

circadian rhythmn sleep-wake disorers

distrubed sleep brought on by the brain’s inability to synchronize its sleep patterns with the current patterns of day and night

ex. jet lag type —> from crossing time zones

ex. shift-work-type —> sleep problems associated with work schedules (ex. night shift as an emergency personnel like firefighter or doctor)

ex. delayed sleep phase type —> stay up late, sleep late

ex. irregular sleep-wake type: ppl who experience highly varied sleep cycles (sleep at 6am, wake up at 4pm)

ex. non-24-hour sleep-wake type: sleeping on a 26-hour cycle with later bedtimes and day times

disorder of arousal

dyssomnias

difficulties in

1. AMOUNT of sleep

2. QUALITY of sleep

hypersomnolence disorders

getting TOO much sleep. sleeping a the time!!

• 3 times a week for 3 months (same as insomnia)

• prolonged sleep episode of 9+ hours that is not refreshing

• accompanied by significant distress/impairment (remember the 3 D’s!!)

insomnia disorders

microsleeps

after being awake for 1-2 nights, person beings having microsleeps for up to 15 seconds. which is so dangerous!! like microsleeps while you’re driving, can definitely lead to an accident.

narcolepsy

• irresistable need to sleep

• sudden loss of muscle tone

• rem less than 15 minutes

nightmares

parasomnias

unusual events that occur during sleep or during time between sleeping and waking

polysomnographic evaluation (PSG)

patient spends a couple nights sleeping in a sleep lab, and are evaluated on various measures.

sensors are attached to your body to measure things (ex. eeg machine, breathing patterns, heart rate)

rapid eye movement (REM)

brain appears as if its awake, sleeper is dreaming.

rebound insomnia

when sleep problems get wose once youve stopped taking sleep meds

cause your body needs to adjust, but once it does you’ll get better

sleep apnea

difficulty breathing at night

• loud snoring, pauses between breahts, waking up with a headache

when you diagnose hypersomnolence, you need to rule out insomia, sleep apnea and other reasons for sleepiness during the day. its not that you’re sleep deprived, its that you sleep a sufficient amount and are still sleepy throughout the dya.

obstructuve sleep apnea: airflow stops despite continued activity in the respiratory system

central sleep apnea: complete step of respiratory activity —> associated iwth CNS disorders

sleep efficiency

the percentage of time actually spent slept, not just trying to go to sleep.

if you go to sleep as soon as you head hits the pillow and you don’t wake up at all, you have a 100% sleep efficency.