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Unformatted text preview: SLEEP DISORDERS SLEEP DISORDERS SLEEP ® OVERVIEW OF SLEEP ® DYSSOMNIAS ® Primary Insomnia ® Primary Hypersomnia ® Narcolepsy ® Sleep Apnea ® Circadian Rhythm Sleep Disorder ® TREATMENT FOR DYSSOMNIAS ® PARASOMNIAS What is Sleep? ® “A reversible behavioral state of perceptual reversible disengagement from and reduced responsiveness to the environment” responsiveness OVERVIEW OF SLEEP OVERVIEW ® NON-RAPID EYE MOVEMENT SLEEP (NREM) ® Four stages: 1. 1. Stage 2 - In this stage blood presuare drops and heart rate Stage blood decreases (We are in this stage about 50 percent each night) decreases 1. ® Stage 1 - Transitional stage between waking and “light sleep” Stage where the body readies itself for sleep (between 10 and 15 minutes) (between Stages 3 and 4 - These stages are considered to be restorative sleep. Stages In these stages the person is in "deep sleep" and it is in these stages the body and mind repairs itself. These stages are very important repairs These in maintaining a person's health. in Low brain activity, normal (but slower) bodily functions OVERVIEW OF SLEEP OVERVIEW ® RAPID EYE MOVEMENT SLEEP (REM) RAPID ® ® ® ® ® Occurs usually between 70 – 90 after sleep onset Occurs after On average, we complete 5 cycles/night with the first period On lasting 15 to 20 minutes and the last 30 to 60 minutes Considerable mental activity (dreaming) The heart rate speeds up and blood pressure fluctuates The During REM sleep our bodies lose the ability to During regulate temperature and the body is semi-paralyzed and ® To prevent us from acting out our dreams? NREM and REM Sleep Polysomnographic Evaluation EEG: Electroencephalogram (Brain activity) EOG: Electro-oculogram Eye movement) EMG Electromyogram (Muscle activity) Stages of Sleep Sleep Deprivation ® Sleep deprivation can result in: ® Impaired concentration and motor coordination ® Bodily fatigue and suppressed response to stressors Bodily ® Similar to when alcohol-impaired Similar alcohol-impaired ® Eventually, preventing sleep (especially REM Eventually, sleep) can result in psychotic-like thoughts and behaviors behaviors OVERVIEW OF SLEEP OVERVIEW ® DYSSOMNIA ®Problems with quantity or quality of sleep ® Falling Falling asleep, staying asleep, etc. ® PARASOMNIA ®Abnormal behavior or events during sleep ® Nightmares, sleep-walking, etc. DYSSOMNIAS DYSSOMNIAS 1. PRIMARY INSOMNIA ® Difficulty initiating or maintaining sleep ® Most common sleep problem Most ® Associated with many psychological problems ® Women report more than men ® Age differences DYSSOMNIAS DYSSOMNIAS ® CAUSES OF PRIMARY INSOMNIA ® Medical disorders ® Body temperature problems ® Other environmental factors ® Learned phenomenon ® Integrated model DYSSOMNIAS DYSSOMNIAS 2. PRIMARY HYPERSOMNIA ® Chronic excessive sleepiness Chronic ® (At (At least one month) one ® Prolonged sleep episodes or daily daytime sleep ® NOT due to lack of sleep or other sleep disorder DYSSOMNIAS DYSSOMNIAS 3. NARCOLEPSY ® Irresistible attacks of sleep coupled with loss Irresistible of muscle tone (cataplexy) (cataplexy ® Cataplexy : onset of REM sleep ® Sleep paralysis ® Hypnogogic hallucinations ® Relatively rare (approximately 1/1000) ®Genetic Link? (Chromosome 6 in dogs) DYSSOMNIAS DYSSOMNIAS 4. BREATHING-RELATED SLEEP DISORDER 4. (SLEEP APNEA) (SLEEP ® Obstructive sleep apnea (blocks the air passage) ® Central sleep apnea (neurological base) Central sleep ® Mixed sleep apnea (combination of both of the above) ® Sleep disruption leading to insomnia or Sleep sleepiness sleepiness DYSSOMNIAS DYSSOMNIAS 5. CIRCADIAN RHYTHM SLEEP DISORDER ® Jet lag type Jet ® Shift-work type (work different times and shifts) ® Delayed sleep phase type (sleepy by 4 or 5 am but aware by 8 or 9 pm) aware ® Advanced sleep phase type (awake at 4 or 5 am but Advanced tired by 8 or 9 pm) tired ® Light and melatonin set internal biological clock Light melatonin DYSSOMNIAS DYSSOMNIAS ® TREATMENT -- BIOLOGICAL ® Insomnia: Benzodiazepines, Ambien, Sonata Insomnia: Benzodiazepines, ® Hypersomnia & narcolepsy: Amphetamines Amphetamines ® Cataplexy: Antidepressants Cataplexy: Antidepressants ® Breathing-related disorders: Weight loss, surgery, Breathing-related mechanical devices (CPAP Continuous Positive Airway Pressure) Continuous DYSSOMNIAS DYSSOMNIAS ® TREATMENT -- PSYCHOLOGICAL ® Relaxation training ® Cognitive therapy ® ® Sleep hygiene ® Stimulus control PARASOMNIAS PARASOMNIAS ® NIGHTMARE DISORDER (Dream Anxiety) ®May result after a traumatic event ®Common in children, only Common of adults of ®Treatment: Antidepressants, Relaxation PARASOMNIAS PARASOMNIAS ® SLEEP TERROR DISORDER ®Occurs mostly in children ®Cannot be easily awakened during episode ®Usually do not remember the event ®Spontaneous remission or, in severe cases, Spontaneous antidepressants or anxiolytics antidepressants ® as treatment PARASOMNIAS PARASOMNIAS ® SLEEPWALKING DISORDER ®Many children experience sleepwalking ®Only Only have multiple incidents ®Tends to dissipate in adolescence ®Not harmed by being awakened ®Cause: fatigue, sleep deprivation, drugs, Cause: stress, genetics stress, ...
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