Sleep Disorders Flashcards
(32 cards)
Sleep as an active process
Brain remains active while sleeping
5 stages of sleep
Stage 1, stage 2, stage 3, stage 4, REM
Stage 1 of sleep
Transition between sleep and awake
Person doesn’t know if he/she is awake or asleep
Hypnogogic hallucinations: dreams that happen while partially awake
Stage 2 of sleep
Shallow sleep
Brain slows down
Stage 3 of sleep
Transition between shallow sleep and deep sleep
Stage 4 of sleep
Deep sleep
Makes person feel rested when he/she wakes up
Hard to arouse- if person is awakened, then is really groggy
REM (rapid eye movement) sleep
Dreaming
Paradoxical: person is firmly asleep, but brain is active as if awake
Body is paralyzed to prevent acting out dream
Way brain cycles through sleep stages
1 -> 2-> 3 -> 4 -> 3 -> 2 -> REM -> 2 -> …
Cycle between REM stages lasts about 90 minutes
5-8 cycles per night
Objective methods of assessing sleep
Polysomnography (most common method): hook person up to several machines to measure brain waves, heartbeat, muscle movement, temperature, sounds produced, etc.
Actigraphy: measure movement during sleep
Subjective method of assessing sleep
Ask person how he/she is sleeping
Doesn’t always line up with objective (may actually sleep just fine)
Dyssomnias
Difficulties in amount, quality, or timing of sleep
Parasomnias
Abnormal behavioral and physiological events during sleep
Insomnia disorder
Difficulty initiating or maintaining sleep
Impairment during day
Unrelated to another condition
Epidemiology of insomnia
A good subset of people experience insomnia (30-45%), but only a small number experience insomnia not due to anything else (1-10%)
Sex: twice as common in females
Age of onset: young adult to middle age
Contributing factors to insomnia
Unrealistic expectations about sleep
Exaggerated belief about the negative impact of sleep difficulties
High levels of arousal
Poor sleep habits (staying up too late and sleeping in, drinking caffeine before bed)
Altered perception of sleep
Medications used to treat insomnia
Benzo/non-benzo hypnotics (Ambien): help to fall asleep, but don’t give good sleep; addictive
Antihistamines (benadryl)
Melatonin (hormone that controls circadian rhythym)
CBT treatments for insomnia
Reduce cognitive arousal prior to going to bed
Tell self to stay awake (makes person fall asleep)
Train person to associate bed with sleep (don’t do anything in bed other than sleep)
Fix sleep hygiene
Train person to spend as much time in bed as needed to sleep
Hypersomnolence disorder
Excessive sleepiness despite having had adequate sleep
Unrelated to another condition
Treatment: give person stimulant to help him/her stay awake
Narcolepsy
Falling asleep at inappropriate times
One of the following:
Cataplexy episodes (sudden loss of muscle tone while awake; often in response to strong emotions)
Hypocretin deficiency
Rapid transition to REM or falling asleep too rapidly
Sleep paralysis
Symptom of narcolepsy
As person is waking up, paralysis system stays on: person can’t move
Hypnopompic hallucinations
Symptom of narcolepsy
Like hypnogogic hallucinations (people with narcolepsy also have these), but happen as person is waking up
Treatments for narcolepsy
Treating sleepiness: give stimulant
Treating cataplexy: give anti-depressant
Sleep apneas
Stop breathing during middle of night
Gasping for air, increasingly louder snoring
2 types: obstructive (throat closes while sleeping), central (breathing stops for reason other than throat closure)
Treatments for sleep apneas
Weight loss
Hook person up to mechanical device such as CPAP (pushes air down throat to keep it from closing)
