13 (p2). health-related disorders

what kind of link does sleep have w psychological issues?

bidirectional link — sleep problems can cause or result from mental health disorders

2 types of sleep disorders + define

• dyssomnias - problems w sleep quantity/quality (e.g., insomnia, narcolepsy)

• parasomnias - abnormal behaviors during sleep (e.g., nightmares, sleep terrors, sleepwalking)

primary insomnia + type of sleep disorder

over 1 month of difficulty falling/maintaining sleep

dyssomnia

behavioral insomnia of childhood, 2 types + type of sleep disorder

• sleep-onset association - involves needing parent-specific actions (rocking, nursing) to fall asleep

• limit-setting - bedtime refusal, stalling, demands (extra story, water)

dyssomnia

narcolepsy + type of sleep disorder

irresistible sleep attacks + cataplexy/REM intrusions

dyssomnia

sleep apnea + type of sleep disorder

breathing-related disorder, airway blocked sometimes during sleep → daytime sleepiness/insomnia

dyssomnia

nightmare disorder + type of sleep disorder

frightening dreams

parasomnia

sleep terror disorder + type of sleep disorder

abrupt panicky awakenings, no dream recall

parasomnia

sleepwalking + type of sleep disorder

rising/walking w blank stare, no memory; occurs in deep sleep

parasomnia

psychosocial treatment approach examples

• graduated extinction

• scheduled awakenings

• CBT for insomnia in older youth

graduated extinction

parents attend to the child’s need for comfort and reassurance, but gradually withdraw more quickly from the child’s room after saying good night

enuresis + age of onset and when it’s seen as a problem

involuntary discharge of urine during day or night

5 yrs, when it occurs more than once a month

3 subtypes of enuresis

• nocturnal only - most common, wetting occurs only during sleep at night, typically during the first 3rd of the night, more common among boys

• diurnal only - passage of urine during waking hours, most often during the early afternoon on school days, more common among girls

• nocturnal and diurnal existing in combo

primary enuresis vs secondary enuresis

primary - starts at age 5, children have never attained at least 6 months of continuous nighttime control

secondary - less common, children who have previously established urinary continence but then relapse, usually btwn the ages of 5-8 yrs

what hormonal deficiency do children who need to urinate at night have?

ADH

is primary enuresis inherited?

yes

bed-wetting alarm

alarm that sounds at the first detection of urine

drybed training

parents get their child to drink more and more fluids during the day, and then delay urination for longer periods to strengthen bladder control, do hourly wakings for trips to the toilet, a cleanup routine for accidents, and positive reinforcement for dry nights

full-spectrum home training

dry-bed training methods + urine alarm

encopresis

passage of feces in inappropriate places

2 subtypes of encopresis

• with constipation and overflow incontinence - constipation produces a fecal impaction, and liquid stool above the impaction gradually develops sufficient pressure to leak around the impaction, thereby producing overflow incontinence in most cases

• without constipation and overflow incontinence

primary vs secondary encopresis

primary - children w this have reached age 4 without establishing fecal continence

secondary - children had established a period of continence before current episode of encopresis began

defecation dynamics

children w encopresis contract rather than relax the external sphincter when they attempt to defecate

optimal treatment for encopresis

combine medical and behavioral interventions

enemas, laxatives, or lubricants → behavioral methods to establish a better routine and healthy pattern of elimination