Sleep Disturbances

Question 1

What are the 4 types of brainwaves from least Hz to most

Answer 1

Delta
Theta
Alpha
Beta

Question 2

What is one of the most promising EEG neurofeedback treatments for PTSD

Answer 2

alpha theta training, makes use go the quality of alpha and theta waves to loosen frozen association and facilitate learning

Question 3

How does the DSM5, ICD10 and ICD11 classify sleep diorders

Answer 3

DSM5- sleep wake disorders chapter

ICD10- nonorganic sleep disorders

ICD11- does not classify sleep disorders as mental disorders

Question 4

What is insomnia and prevalence and age

Answer 4

Recurrent difficulty falling or staying asleep, waking up early and being unable to go back to sleep

6-10%
Highest among middle aged and older age

Question 5

what is hypersomnia and prevelence

Answer 5

Getting enough sleep but feeling perpetually tired and may fall asleep during the day

1% prev

Question 6

What is narcolepsy, what can it also involve and prevelence

Answer 6

Periods of unexplained and uncontrollable sleepiness, often result in abrupt lapses into sleep

Cataplexy- sudden ad temp loss of mm tone (can be involved)

0.02-0.04

Question 7

What are the stages of sleep

Answer 7

stages 1-3=non rem
stage 4=rem

go thru cycle roughly 5 times a night

Question 8

What happens in stage 1 of sleep and what are the wave types

Answer 8

1 (beta, alpha, theta)- <20Hz

Between wakefulness and sleep
lasts 5 mins

Question 9

What happens dueing stage 2 of sleep and what wave type

Answer 9

Theta (5-8hz)

May have bursts of electrical activity called sleep spindles which reflect brains effort to decrease response
-lasts 20mins

Question 10

What happens in stage 3 of sleep and what type of waves

Answer 10

Delta (2-5hz)
Beginning of deep sleep
30 mins

Question 11

What happens during rem sleep, what type of waves

Answer 11

Theta, Alpha, Some beta

-mm paralysis
dreaming
decreased frontal lobe
increased amygdala, hippocampus, limbic actibity

Question 12

Average duration of each sleep stage

Answer 12

1- %5
2- 45%
3- 25%
4-25%

Question 13

What is the hyperarousal theory of Insomnia

Answer 13

Biological perspective

• Hypothesizes that peple with chronic insomnia are genetically susceptible
• worrying at night etc

Question 14

What neurotransmitter is narcolepsy and cataplexy associated w/

Answer 14

decreased Hypocretin from the lateral hypothalmus

Question 15

Why do parasomnia disorders (sleep walking, night terrors) occur

Answer 15

caused do to an inadequate shift from non rem sleep to wakefulness

• disrupted sleep during delta wave periods
• potential genetic issue?

Question 16

Drug tx for lack of sleep

Answer 16

• Benzos (enhance GABA)
• Non benzo sleep aids (enhance gaba)
• Antidepresents (just tricyclics)
• Antihistamines
• Melatonin
• ORexin receptor antagonists (bloxes orexin which is a NT that promotes wakefullness)

Question 17

What are wake stimulants used when there is too much sleep (4)

Answer 17

1. Stimulants (amphetamines)
2. Modafinil ( non stim type drug)
3. Sodium Oxybate (CNS depressent that is used to reduce cataplexy by increasing night sleep)
4. Antidepressent (supresses REM sleep and can reduce cataplexy)

Question 18

What are some CBT interventions for insomnia

Answer 18

1. Stim control- must recondition bedroom to be associated w sleep
2. Sleep restriction- sets limit for bed for # of hours + 30 mins
3. Sleep hygiene education
4. Cognitive therapy (alter illogical beliefs about sleep)
5. Relaxation training

Question 19

Sociological causes of reduced sleep

Answer 19

working 2+ jobs
Longer commute
lower education
belonging to minority 
etc

Question 20

What are the two elimination issues

Answer 20

Enuresis- repeated wet bed or clothes over age of 5

Encopresis- Repeatedly having bowel movements in inappropriate places over the age of 4

Question 21

What are drug tx for enuresis

Answer 21

Vasopressin: reduces urin production

Desmopressin: synthetic version of vasopressin (may cause water intoxication)

Tricyclic antidepressents

Anticholinergic drugs; Blocks ach

Question 22

Behaviour therapy methods for enuresis

Answer 22

Enuresis alarm (works thru classic and opperent conditioning)

Dry bed training- Parents wake up the child during the night and either praise when they don’t wet and punish when they don’t

Question 23

CBT for encopresis

Answer 23

12 session structured therapy where:
-how to reinforce desired toilet behaviour
-child reinforced w stickers etc
skills training to teach child how to properly expel stool

Question 24

What are the 2 psychodynamic perspectives on enuresis

Answer 24

Primary- child never attained bladder control (idividualization issues)

Secondary- Seen as stressful events that lead to the defence mechanism of regression to a less anxiety provoking development lvl

Question 25

Alternative therapies for elimination issues

Answer 25

Acu

Hypnosis