Sleep Disorders (Somnipathy)

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Sleep Disorders (Somnipathy)
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Sleep Disorders 1 - Insomnia

• BATs
• A01 Outline the classification of sleep disorders
• A01 Explain the differences between primary and
  secondary insomnia
• A01Describe some of the explanations for insomnia
  and the role of personality
• Synoptic points
• research complications,
• real world application attribution theory
  (cognitive approach)

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INSOMNIA

• Traditionally, sleep disorders have been divided
  into primary and secondary disorders.
• Primary Insomnia - result from an endogenous
  disturbance in the sleeping mechanism, often
  complicated by learned behaviours and bad sleep
  habits. Insomnia the only problem. Insomnia
  occurs with no cause for more than 1 month (DSM)
• Secondary Insomnia - are said to be the result of
  another disorder e.g. depression, pregnancy,
  respiratory problems or gastroesophageal reflux
  disease, shift work, too much caffeine or alcohol

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BUT

• In 2007 Dr Ancoli-Israel suggested that this is a
  false distinction and that all sleep disorders
  should be regarded as comorbid, and receive the
  same emphasis in treatment.

Ohayon and Roth 2003 Studied 15,000 Europeans
found that insomnia preceded cases of mood
disorders. Therefore treat the insomnia whether
it is primary or secondary
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Major Classifications of Somnipathy

• Dyssomnias- a broad category including insomnia
  and hypersomnolence (too much sleep)
• Parasomnias strange behaviours during sleep
• Medical or psychiatric conditions that can
  produce somnipathy

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Dyssomnias- a broad category including insomnia
and hypersomnolence

• Insomnia
• Narcolepsy
• Obstructive sleep apnea
• Restless legs syndrome
• Klein-Levin Syndrome
• Post-traumatic hypersomnia

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Parasomnias strange behaviours during sleep

• Night terrors
• Bruxism (tooth grinding)
• Sleepwalking (somnambulism)
• Sleeptalking (somniloquy)
• Exploding head syndrome!

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Exploding head syndrome

• is a condition that causes the sufferer
  occasionally to experience a tremendously loud
  noise as originating from within his or her own
  head, usually described as the sound of an
  explosion, roar, waves crashing against rocks,
  loud voices or screams, a ringing noise, or the
  sound of an electrical short circuit (buzzing).
• This noise usually occurs within an hour or two
  of falling asleep, but is not necessarily the
  result of a dream and can happen while awake as
  well.1 Perceived as extremely loud, the sound
  is usually not accompanied by pain. Attacks
  appear to change in number over time, with
  several attacks occurring in a space of days or
  weeks followed by months of remission. Sufferers
  often feel a sense of fear and anxiety after an
  attack, accompanied by elevated heart rate.
  Attacks are also often accompanied by perceived
  flashes of light (when perceived on their own,
  known as a "visual sleep start") or difficulty in
  breathing. The condition is also known as
  "auditory sleep starts." It is not thought to be
  dangerous,1 although it is sometimes
  distressing to experience.
• Reference to the condition was made in an episode
  of the BBC TV drama "Doc Martin", which was
  instrumental in many sufferers becoming aware
  that the problem was in fact a known medical
  condition, and not one to be concerned about.

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Medical or psychiatric conditions that can
produce somnipathy

• Psychoses
• Anxiety
• Depression
• Panic
• Alcoholism
• Sleeping sickness

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Risk Factors Influencing Insomnia

• Age and Gender older people and women more
  likely illnesses (arthritis, diabetes) and
  menopause (hormone fluctuations)
• Parasomnias - increase likelihood of insomnia -
• -Sleep Apnoea
• -Sleep walking
• - Teeth grinding
• Personality Kales et al 1976 insomniacs more
  likely to internalise psychological disturbance
  than acting out problems or being aggressive

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Research Complications

• Synoptic point
• Chronic insomnia highly complex
• Lots of causes of insomnia stress, depression,
  poor sleep hygiene, age, gender e.t.c
• Unlikely to be explained by one factor
• Therefore - Difficult to draw conclusions

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Attribution Theory

• Synoptic Point (cognitive approach)
• One cause of Primary Insomnia is a persons
  belief that they are going to have difficulty
  sleeping.
• Self fulfilling tense before sleep
• Attribute sleep problems to insomnia
• Treatment
• Train them to be convinced the source of problem
  lies elsewhere
• Storms and Nisbett 1970 insomniacs given a pill
  half told it would stimulate them and the other
  half it would sedate them.
• Those expecting arousal went to sleep faster
  because they attributed their arousal to the pill
  and actually relaxed!!

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• Have a go at sleep dash!!
• http//www.bbc.co.uk/science/humanbody/sleep/sheep
  /

Now drink some caffeine!! Wait 15mins and try
again!! What do you predict will happen?
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Treatment of Insomnia

• Read p 17
• Create a problem page to give advice on why they
  may be suffering from insomnia and how to help
  it.

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Sleep Disorders 2 Narcolepsy and Sleep Walking

• BATs
• A01 Describe symptoms of sleep disorders sleep
• apnoea, narcolepsy and sleepwalking
• A02 Understand explanations for these sleep
  disorders
• Synoptic points
• Real world application sleep walking diagnosis
  used in cases of murder

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Narcolepsy

• http//www.youtube.com/watch?v3MBCeKn0Oeo
  narcolepsy 3 mins
• Cataplexy loss of muscular control during the
  day
• Feeling sleepy all the time
• Triggered by anger, fear, amusement or stress
• 1/2000 suffer, starts in adolescence

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Sleep Walking

• Most common in children 20 children, 3
  adults
• Only occurs during NREM/SWS sleep
• Related to Night Terrors
• Sleep walker not conscious and later has no
  knowledge of events during sleep walking

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Your mission, should you choose to accept it,
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• In groups, you will choose one category of
  disorder to research.
• You must produce a poster on the category, giving
  detailed examples, explanations and treatments.
• You must consider behavioural /psychotherapeutic
  treatments, management and drug treatments.
• AS WELL AS A POSTER, YOU MUST ALSO PREPARE AND
  PRESENT A 5 MINUTE POWERPOINT FOR THE REST OF THE
  GROUP ON THE CATEGORY YOU CHOSE

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Homework

• Finish presentation and/or
• Question 6 p19
• 600 word essay
• Outline and evaluate explanations of two or more
  sleep disorders
• The narcolepsy powerpoint on the blog is
  particularly good for essay prep (not done by me.
  Mores the pity!)