8- Eating and Sleep-Wake Disorders

bulimia nervosa

binges followed by self-induced vomiting, excessive use of laxatives, or other attempts to purge the food

binges

out-of-control binge eating episodes

anorexia nervosa

person eats nothing beyond minimal amounts of foods so body weight sometimes drops dangerously

binge-eating disorder

individuals may binge repeatedly and find it distressing but do not attempt to purge the food

overwhelming, all-encompassing drive to be thin

chief characteristic of all eating related disorders

20%

how much percentage of people with anorexia die as a result of the disorder

anorexia nervosa

has the highest mortality rate of any psychological disorder

DSM-IV

eating disorders were included the first time as a separate group of disorders in which edition of the DSM

obesity

not considered an official disorder but thought to be one of the most dangerous epidemics

purging techniques

another important criterion is that the individual attempts to compensate for the binge eating and potential weight gain, almost always by ____

• self-induced vomiting

• laxatives

• diuretics

• excessive exercise

purging techniques

• purging type

• nonpurging type

bulimia nervosa subtypes

purging types

subtype that includes vomiting, laxatives, or diuretics

nonpurging type

subtype that includes exercise and/or fasting

salivary gland enlargement

medical consequence of bulimia caused by repeated vomiting which gives the face a chubby appearance

electrolyte imbalance

continued vomiting may upset the the chemical balance of bodily fluids including sodium and potassium, a condition called ___; can result in serious medical complications if unattended such as cardiac arrhythmia, seizures, and renal failure

• restricting type

• binge-eating-purging type

subtypes of anorexia nervosa

significantly low weight

defined as a weight that is less than minimally normal or, for children and adolescents, less than minimally expected

amenorrhea

one common medical complication of anorexia nervosa which occurs relatively often in bulimia

lanugo

downy hair on the limbs and cheeks as a medical consequence of anorexia

night eating syndrome

individuals with ___ consume a third or more of their daily intake after their evening meal and get out of bed at least once during the night to have a hihg-calorie snack

bariatric surgery

surgical approach to extreme obesity

rapid eye movement (REM) sleep

region of the brain is also involved with our dream sleep

dyssomnias and parasomnias

sleep-wake disorders divided into two categories:

dyssomnias

involve difficulties in getting enough sleep, problems with sleeping when you want to, and complaints about the quality of sleep

parasomnias

characterized by abnormal behavioral or physiological events that occur during sleep, such as nightmares and sleepwalking

polysomnographic (PSG) evaluation

the clearest and most comprehensive picture of sleep habits

actigraph

alternative to comprehensive assessment of sleep is to use a wristwatch-size device; records the number of arm movements and the data can be downloaded into a computer to determine the length and quality of sleep

sleep efficiency (SE)

percentage of time actually spent asleep

insomnia disorder

difficulty falling asleep at bedtime, problems staying asleep throughout the night, or sleep that does not result in the person feeling rested even after normal amounts of sleep

hypersomnolence disorders

excessive sleepiness that is displayed as either sleeping longer than is typical or frequent falling asleep during the day

narcolepsy

episodes of irresistible attacks of refreshing sleep occurring daily accompanied by episodes of brief muscle tone

breathing-related sleep disorders

a variety of breathing disorders that occur sleep and that lead to excessive sleepiness or insomnia

circadian rhythm sleep-wake disorder

a discrepancy between the sleep-wake schedule required by a person to be rested and the requirements of the person’s environment that leads to excessive sleepiness or insomnia

disorder of arousal

motor movements and behaviors that occur during NREM sleep including incomplete awakening, sleep walking, or sleep terrors

nightmare disorder

frequently being awakened by extended and extremely frightening dreams that cause significant distress and impaired functioning

Rapid eye movement sleep behavior disorder

episodes of arousal during REM sleep that result in behaviors that can cause harm to the individual or others

restless legs syndrome

irresistible urges to more the legs as a result of unpleasant sensations

substance-induced sleep disorder

severe sleep disturbance that is the result of substance intoxication or withdrawal

microsleeps

sleep that lasts several seconds or longer

primary insomnia

sleep problems were not related to other medical or psychiatric problems

rebound insomnia

sleep problems re appear, sometimes worse; may occur when the medication is withdrawn

hypersomnolence disorders

involve sleeping too much

sleep apnea

breathing-related sleep disorder

cataplexy

sudden loss of muscle tone; occurs while the person is awake and can range from slight weakness in the facial muscles to complete physical collapse

sleep paralysis and hypnagogic hallucinations

two other characteristics distinguish people who have narcolepsy

sleep paralysis

brief period after awakening when they can’t move or speak tha is often frightening to those who go through it

hypnagogic hallucinations

vivid and often terrifying experiences that begin at the start of sleep and are said to be unbelievably realistic

isolated sleep paralysis

sleep paralysis commonly co-occurs with anxiety disorders, in which case the condition is termed ___

obstructive sleep apnea hyponea syndrome

occurs with airflow stops despite continued activity by the respiratory system

central sleep apnea

involves the complete cessation of respiratory activity for brief periods and is often associated with certain central nervous disorders

sleep-related hypoventilation

decrease in airflow without a complete pause in breathing; cause an increase in CO2 levels because insufficient air is exchanged with the environment

circadian rhythm sleep disorder

characterized by disturbed sleep (either insomnia or excessive sleepiness during the day) brought on by the brain’s inability to synchronize its sleep patterns with the current patterns of day and night

suprachiasmatic nucleus

the biological clock is in the ___ of the hypothalamus

jet lag type

type of circadian rhythm disorder caused by rapidly crossing multiple time zones

shift work type

type of circadian rhythm disorder associated with work schedules

delayed sleep phase type

extreme night owls that experience sleep that is delayed or later than normal time

advanced sleep phase type

type of circadian rhythm disorder where sleep is advanced or earlier than normal bedtime

irregular sleep-wake type

people who experience highly varied sleep cycles

non-24-hour sleep-wake type

sleeping on a 25 or 26 hour cycle with late bedtimes

medical

most common treatments for insomnia

short acting drugs

such as triazolan, zaleplon, and zolpidem

long-acting drugs

preferred when negative effects such as daytime anxiety are observed

cognitive sleep treatment

This approach focuses on changing

the sleepers’ unrealistic expectations and beliefs about sleep

(“I must have 8 hours of sleep

each night”; “If I get less than

8 hours of sleep, it will make me

ill”). The therapist attempts to alter

beliefs and attitudes about sleeping by providing information on

topics such as normal amounts

of sleep and a person’s ability to

compensate for lost sleep.

guided imagery relaxation

Because some people become anxious when they have difficulty sleeping, this approach uses meditation or imagery to help with relaxation at bedtime or after a night waking.

graduated extinction

Used for children who have

tantrums at bedtime or wake up

crying at night, this treatment

instructs the parent to check on

the child after progressively longer

periods until the child falls asleep

on his or her own.

paradoxical intention

This technique involves instructing

individuals in the opposite behavior

from the desired outcome. Telling

poor sleepers to lie in bed and try

to stay awake as long as they can

is used to try to relieve the performance anxiety surrounding efforts

to try to fall asleep.

progressive relaxation

This technique involves relaxing

the muscles of the body in an effort

to introduce drowsiness.

nightmares / nightmare disorder

experiences that occur during REM sleep or dream sleep that are so distressful that they impair a person’s ability to carry on normal activities

sleep terrors

recurrent episodes of abrupt terror arousal from sleep, usually beginning with a panicky scream

scheduled awakenings

one approach to reducing chronic sleep terrors

sleepwalking/somnambulism

repeated episodes of rising from bed during sleep and waking out

NREM sleep

which stage of sleep does sleepwalking occur

nocturnal eating syndrome

individuals rise from their beds and eat while asleep

sexsomnia

acting out sexual behaviors such as masturbation and sexual intercourse with no memory of the event

rapid eye movement sleep behavior disorder

repeated episodes of arousal during sleep associated with vocalization and/or complex motor behaviors