Transcript Sleep Disorders (Somnipathy)

Sleep Disorders (Somnipathy)
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)
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
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
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

Dyssomnias- a broad category
including insomnia and
hypersomnolence

Insomnia
Narcolepsy
Obstructive sleep apnea
Restless legs syndrome
Klein-Levin Syndrome
Post-traumatic hypersomnia

Parasomnias – strange
behaviours during sleep
Night terrors
Bruxism (tooth grinding)
Sleepwalking (somnambulism)
Sleeptalking (somniloquy)
Exploding head syndrome!

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.
Medical or psychiatric conditions
that can produce somnipathy
Psychoses
Anxiety
Depression
Panic
Alcoholism
Sleeping sickness

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
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
Attribution Theory
Synoptic Point (cognitive approach)
One cause of Primary Insomnia is a person’s 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!!
Have a go at sleep dash!!
http://www.bbc.co.uk/scien
ce/humanbody/sleep/sh
eep/
Now drink some caffeine!!
Wait 15mins and try again!!
What do you predict will
happen?
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.
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
Narcolepsy
http://www.youtube.com/watch?v=3MBCeKn0Oeo
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
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
Your mission, should you choose to
accept it,
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
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. More’s the pity!)