Sleep Disorders

Sigmund Freud

greatly emphasized dreams and discussed them with patients as a way of better understanding their emotional lives

Sleep problems

may cause the difficulties people experience in everyday life

limbic system

brain circuit in the ______ may be involved with anxiety

hippocampus

this region of the brain is also involved with our dream sleep, which is called

Insufficient sleep

can stimulate overeating and may contribute to the epidemic of obesity

Sleep abnormalities

are preceding signs of serious clinical depression, which may suggest that sleep problems

can help predict who is at risk for later mood disorders

sleep deprivation

has temporary antidepressant effects on some people, although in people who are not already depressed, ______ may bring on a depressed mood

Dyssomnias

involve difficulties in getting enough sleep, problems with sleeping when you want to and complaints about the quality of sleep, such as not feeling refreshed even though you have slept the whole night.

Parasomnias

are 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 your sleep habits can be determined only by a

respiration and oxygen desaturation

a measure of airflow

electroencephalogram

leg movements; brain wave activity, measured by an

electrooculogram

eye movements, measured by an

electromyogram;

muscle movements, measured by an

electrocardiogram.

and heart activity, measured by an

actigraph

One alternative to the comprehensive assessment of sleep is to use a wristwatch-size device

called an

actigraph

this instrument records movements, and the data can be downloaded into a computer to

determine the length and quality of sleep.

sleep efficiency (SE)

the percentage of time actually spent asleep, not just lying in bed trying to sleep.

dividing the amount of time sleeping by the amount of time in bed

how to calculate SE?

daytime sequelae, or behavior while awake

One way to determine whether a person has a problem with sleep is to observe his, WHAT?

Insomnia

is one of the most common sleep–wake disorders.

insomnia

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 loss of muscle tone (cataplexy).

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 (e.g., work schedules) that leads to excessive sleepiness or insomnia

Disorder of Arousal

Motor movements and behaviors that occur during NREM sleep including incomplete awakening (confusional arousals), sleep walking, or sleep terrors (abrupt awakening from sleep that begins with a panicky scream).

Nightmare Disorder

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

microsleeps

after being awake for one or two nights, a person _______ begins that last several seconds or longer

fatal familial insomnia

(a degenerative brain disorder), total lack of sleep eventually leads to death

insomnia

People are considered to have _____ if they have trouble falling asleep at night (difficulty

initiating sleep), if they wake up frequently or too early and can’t go back to sleep (difficulty maintaining sleep), or even if they sleep a reasonable number of hours but are still not rested the next day (nonrestorative sleep)

insomnia disorder

because her sleep problems were not related to other medical or psychiatric problems (read niyo yung abt kay sonja)

insomnia disorder

had trouble both initiating and maintaining sleep.

15%

of older adults report excessive daytime sleepiness, with older black men reporting the most problems, and this contributes to increased risk for falling

Alcohol

is often used to initiate sleep, it helps make people drowsy, but it also interrupts ongoing sleep

Anxiety, Depression, Substance use disorder and Dementia of the Alzheimer’s type

Sleep Disorder is Frequently associated with what?

women

more often report problems initiating sleep, which may be related to hormonal diffierences or to differential reporting of sleep problems, with women generally more negatively selected by poor sleep than men

pain, physical discomfort, physical inactivity during the day, and respiratory problems

what are the causes of insomnia?

delayed temperature rhythm

Some people who can’t fall asleep at night may have a _______ their body temperature doesn’t drop, and they don’t become drowsy until later at night.

higher body temperatures

than good sleepers, and their body temperatures seem to vary less; this lack of fluctuation may interfere with sleep

light, noises or temperature

Among the other factors that can interfere with sleeping are drug use and a variety of environmental influences such as

sleep apnea

a disorder that involves obstructed nighttime breathing

periodic limb movement disorde

excessive jerky leg movements

psychological stresses

an also disrupt your sleep. For example, one study looked at how medical and dental

school students were affected by a particularly stressful event— in this case, participating in cadaver dissection

parents practices

influenced infant night waking and child sleep negatively

personality characteristics, sleep difficulties, and parental reaction

what factors interact in a reciprocal manner to produce and maintain sleep problems?

predisposing conditions

they may not, by themselves, always cause problems, but as having too much alcohol or caffeine) can interfere with falling asleep

jet lag

in which people’s sleep patterns are disrupted, sometimes seriously, when they by across several time zones.

rebound insomnia

where sleep problems reappear, sometimes worse—may occur when the medication is withdrawn . this _____ leads people to think they still have a sleep problem, readminister the medicine, and go through the cycle repeatedly

naps

alleviate fatigue during the day can also disrupt sleep that night

anxiety

can also extend the problem. Lying in bed worrying about school, family problems, or even about not being able to sleep will interfere with sleep

parents behavior

can also help maintain these problems in children. Children who receive a great deal of positive attention at night when they wake up may wake up during the night more often.

hypersomnolence disorders

sleeping too much

hyper

in great amount or abnormal excess

hypersomnolence

sleep through the night and appear rested upon awakening but still complain of being excessively tired throughout the day

sleep apnea

Another sleep problem that can cause a similar excessive sleepiness is a breathing-related sleep disorder

sleep apnea

people with this problem have difficulty breathing at night. they often snore loudly, pause between breaths, and wake in the morning with a dry mouth and headache.

hypersomnolence

In identifying _________ the clinician needs to rule out insomnia, sleep apnea, or other reasons for sleepiness during the day

Genetic influences

seem to be involved in a portion of cases, with individuals having an increased likelihood of having certain genetic factors

narcolepsy

daytime sleepiness

cataplexy

a sudden loss of muscle tone

cataplexy

occurs while the person is awake and can range from slight weakness in the facial muscles to complete physical collapse

cataplexy

lasts from several seconds to several minutes; it is usually preceded by strong emotion such as anger or happiness.

cataplexy

appears to result from a sudden onset of REM sleep. Instead of falling asleep normally and going through the four nonrapid eye movement (NREM) stages that typically precede REM

sleep, people with narcolepsy periodically progress right to this dream-sleep stage almost directly from the state of being awake.

REM sleep

One outcome of ________ is the inhibition of input to the muscles, and this seems to be the process that leads to cataplexy.

sleep paralysis

a brief period after awakening when they can’t move or speak that 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 because they include not only visual aspects but also touch, hearing, and even the sensation of body movement.

narcolepsy

usually are first seen during the teenage years.

Excessive sleepiness

usually occurs frrst, with cataplexy appearing either at the same time or with a delay

of up to 30 years

Sleep paralysis and hypnagogic hallucinations

may serve a role in explaining a phenomenon—unidentified flying object (UFO) or alien abduction experiences

narcolepsy

is associated with a cluster of genes on chromosome 6, and it may be an autosomal recessive trait

hypocretin neurons

It appears that there is a significant loss of a certain type of nerve cell in those with narcolepsy

breathing-related sleep disorders

People whose breathing is interrupted during their sleep often experience numerous brief arousals throughout the night and do not feel rested even after 8 or 9 hours asleep

hypoventilation

breathing is constricted a great deal and may be labored

sleep apnea

in the extreme, there may be short periods (10 to 30 seconds) when they stop breathing altogether, called

loud snoring

one sign of breathing-related sleep disorder

heavy sweating during the night, morning headaches, and episodes of falling

asleep during the day

Other signs that a person has breathing difficulties are?

sleep attacks

Other signs that a person has breathing difficulties are or also called what?

Obstructive sleep apnea hypopnea syndrome

occurs when airflow stops despite continued activity by the respiratory

system,. In some people, the airway is too narrow; in others, some abnormality or damage interferes with the ongoing effort to breathe.

obstructive sleep apnea hypopnea syndrome

Everyone in a group of people with reported snoring at night

obesity

is sometimes associated with this problem, as is increasing age

ecstasy

can lead to obstructive apnea hypopnea syndrome even in young and otherwise healthy adults

male

In which gender is obstructive sleep apnea most common?

Obstructive Sleep Apnea Hypopnea

Daytime sleepiness, fatigue, or unrefreshing sleep despite sufficient opportunities to sleep that is not better explained by another mental disorder (including a sleep disorder) and

is not attributable to another medical condition.

Obstructive Sleep Apnea Hypopnea

Nocturnal breathing disturbances: snoring, snorting/ gasping or breathing pauses during sleep

circadian rhythm sleep disorder

this disorder is 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.

Spring ahead; fall back

People in most of the United States use this mnemonic device to remind themselves to turn the clocks ahead 1 hour in the spring and back again 1 hour in the fall

Convention

says to go to sleep at this new time while our brains are saying something different.

suprachiasmatic nucleus

is a pathway that comes from our eyes, the light we see in the morning and the decreasing light at night signal the brain to reset the biological clock each day.

Jet lag type

is, as its name implies, caused by rapidly crossing multiple time zone. people with _____ usually report difficulty going to sleep at the proper time and feeling fatigued during the day.

westward

Traveling more than two time zones _______ usually affects people the most.

eastward

Traveling and/or less than three time zones are usually tolerated better

jet lag

Research with mice suggests that the effects of _______ can be quite serious—at least among older adults. When older mice were exposed to repeated artificial jet lag, a significant number of them lived shorter lives

Shift work type

sleep problems are associated with work schedules

shift work type

Many people, such as hospital employees, police, or emergency personnel, work at night or

must work irregular hours; as a result, they may have problems sleeping or experience excessive sleepiness during waking hours.

delayed sleep phase type

Extreme night owls, people who stay up late and sleep late, may have a problem

known as ______ where sleep is delayed or there is a later than normal bedtime.

advanced sleep phase type

early to bed and early to rise, 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 later and later bedtimes ultimately going throughout

the day

melatonin

Scientists believe the hormone ________ contributes to the setting of our biological clocks that tell us when to sleep.

Dracula hormone

has been nicknamed the _____ because its production is stimulated by darkness and ceases in daylight.