Sleep Disorders and Theories

Insomnia

  • Definition: Insomnia is a sleep disorder characterized by:
    • An inability to initiate and maintain sleep.
    • Individuals may fall asleep but wake up a few hours later without the ability to resume sleeping for the remainder of the night.
  • Prevalence:
    • Affects approximately 10% of the general population.
    • More common in women than men.
  • Physiological Contributing Factors:
    • Increased muscle tension in the head and neck muscles.
    • Tension headaches.
    • Gastric/stomach issues.
  • Maladaptive Sleep Habits Contributing to Insomnia:
    • Excessive daytime napping.
    • Spending too much time in bed during the day, often linked to depression.
    • Erratic sleep schedules such as shift work.
    • Falling asleep to external stimuli like TV, music, or environmental factors (open windows or cold air).

Nightmares

  • Definition: Nightmares refer to frightening dreams that:
    • Are vivid and can be easily recalled.
    • Occur during REM sleep, typically in the early morning hours.
  • Triggers:
    • Staying up too late.
    • Eating heavy meals close to bedtime, especially those high in carbohydrates.
    • Overexcitement prior to sleep, such as watching a scary movie.
  • Prevalence: Nightmares are more common among girls than boys.

Sleep Disorders Overview

  • General Information:
    • Most individuals experience sleep issues from time to time.
    • Transient sleep problems often arise from external stressors.
    • Approximately 6% of the adult population seeks medical help for a sleep disorder.
  • List of Sleep Disorders to Discuss:
    1. Somnambulism (Sleepwalking)
    2. Somniloquy (Sleep talking)
    3. Sleep Apnea
    4. Narcolepsy
    5. Insomnia
    6. Nightmares
    7. Sleep Terrors
    8. Sleep Paralysis

Somnambulism and Somniloquy

  • Definitions:
    • Somnambulism: Sleepwalking.
    • Somniloquy: Sleep talking.
  • Occurrence: Both disorders occur during stages 3 and 4 of sleep (deepest sleep) within the first third of the night.
  • Characteristics:
    • Individuals may have their eyes open, displaying a blank expression, but show no response.
    • Individuals typically experience amnesia for the event upon waking.
    • Important: Awakening a sleepwalker can lead to confusion and disorientation.
  • Prevalence Among Children:
    • Approximately 30% of children under age 6 have experienced sleepwalking or talking once.
    • About 2-3% of children experience these episodes frequently.
    • Some teenagers may outgrow sleepwalking/talking after puberty, while others do not.
  • Genetic Patterns:
    • Familial patterns reported in up to 80% of individuals with somnambulism.
    • Often associated with sleep terrors.

Sleep Apnea

  • Definition: Sleep apnea is a disorder characterized by:
    • Repeated cessation of breathing during sleep.
  • Frequency:
    • Documented cases indicate individuals can stop and start breathing between 500 and 1000 times a night, with each episode lasting approximately 90 seconds.
  • Prevalence:
    • More common in men than in women (ratio 2:1).
    • Particularly prevalent among morbidly obese individuals.
  • Causes:
    • Structural defects such as enlarged tonsils.
    • Excess fat tissue around the neck.
    • An overly thick palate.

Subconscious and Unconscious Processing

  • Subconscious Processing:
    • Involves memory that is not currently in consciousness but can be retrieved later through specific recall methods.
    • Example: Forgetting someone's name and then recalling it later.
  • Unconscious Processing:
    • Refers to all processes and information that are not in consciousness.
    • According to Psychodynamic Theory (Freud), it consists of processes that are kept out of consciousness to avoid anxiety and/or guilt.
    • Such processes arise from the need to repress unpleasant memories or feelings.

The Nature of Sleep and Its Theories

  • Common Form of Altered Consciousness:
    • Sleep is regarded as the most common form of altered consciousness.
    • Humans spend approximately 1/3 (33%) of their lives asleep.
  • Theories Explaining the Need for Sleep:
    1. Preservation and Protection Theory of Sleep:
    • Sleep forces individuals to be inactive during periods of greatest personal risk (to prevent injury or death) and when expending energy yields the least benefit.
    • This perspective is evolutionary, suggesting sleep developed over time as a protective adaptation.
    1. Restorative Sleep Theory:
    • Sleep enables the repair and revitalization of the body and mind.
    • Sleep allows the brain to rest, consolidate memories, and facilitate clear cognitive functioning such as concentration, attention, and reasoning.
    • Also promotes tissue repair and maintains a healthy immune system.
    • Continuous lack of sleep adversely affects health.

Stages of Sleep

  • NREM (Non-Rapid Eye Movement) Stages: Stages 1, 2, 3, and 4 followed by REM (Rapid Eye Movement) considered Stage 5.
    • Stage 1: Drowsiness occurs as one drifts off to sleep; brain waves are still relatively fast.
    • Stage 2: The brain waves begin to slow down further, indicating deeper relaxation.
    • Stages 3 and 4: Characterized as the deepest stages of sleep with the slowest brain wave activity and most restorative value.
  • REM Sleep: Involves dreaming; occurs in cycles of sleep.
  • Cyclical Nature of Sleep:
    • One full cycle of sleep lasts approximately 90 minutes:
    • The average individual undergoes 5-6 cycles per night if achieving 7 to 8 hours of sleep.
    • First Sleep Cycle:
    • NREM Duration: 80 minutes
    • REM Duration: 10 minutes
    • Last Sleep Cycle:
    • NREM Duration: 60 minutes
    • REM Duration: 30 minutes
    • Note: REM sleep increases in duration as the night progresses, which is why dreams can often be recalled more vividly upon waking in the morning.