2. Sleep Disorders
•Primary Sleep Disorders:
-Dyssomnias
- Insomnia
- Narcolepsy
- Breathing-Related Sleeping Disorders
- Circadian Rhythm Sleep Disorders
-Parasomnias
- Nightmares
- Night Terrors
- Sleepwalking
- Sleep Paralysis
Monday, May 21, 12
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3. Insomnia
•Difficulty falling asleep &
staying asleep.
•Not due to direct effects
of substance use or
general medical
condition.
•About 60 million
Americans have chronic
insomnia.
•Affects 40% of women
and 30 % of men.
•Acute or Chronic
•Treatment: medication or
behavior modification.
Monday, May 21, 12
3
7. Chronic Causes of Insomnia
• Medications
• Drug or alcohol use
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5
8. Chronic Causes of Insomnia
• Medications
• Drug or alcohol use
• Psychiatric disorders (e.g.,
depression, anxiety)
Monday, May 21, 12
5
9. Chronic Causes of Insomnia
• Medications
• Drug or alcohol use
• Psychiatric disorders (e.g.,
depression, anxiety)
• Medical disorders
Monday, May 21, 12
5
10. Chronic Causes of Insomnia
• Medications
• Drug or alcohol use
• Psychiatric disorders (e.g.,
depression, anxiety)
• Medical disorders
• Sleep apnea
Monday, May 21, 12
5
11. Chronic Causes of Insomnia
• Medications
• Drug or alcohol use
• Psychiatric disorders (e.g.,
depression, anxiety)
• Medical disorders
• Sleep apnea
• Restless leg syndrome
Monday, May 21, 12
5
12. Chronic Causes of Insomnia
• Medications
• Drug or alcohol use
• Psychiatric disorders (e.g.,
depression, anxiety)
• Medical disorders
• Sleep apnea
• Restless leg syndrome
• Poor sleep hygiene
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5
14. Insomnia Treatment
Lifestyle changes often can help relieve acute (short-term) insomnia. These
changes might make it easier to fall asleep and stay asleep.
A type of counseling called cognitive-behavioral therapy (CBT) can help
relieve the anxiety linked to chronic (ongoing) insomnia. Anxiety tends to prolong
insomnia.
Several medicines also can help relieve insomnia and re-establish a regular sleep
schedule.
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6
15. Sleep Apnea
Repeated stoppage in breathing
during sleep
Caused by lack of breathing
drive (central) or by blockage
(obstructive)
Signs/Symptoms:
Snoring, headaches, fatigue,
poor sleep, chronic
congestion, irritability,
obesity, sexual dysfunction
Monday, May 21, 12
Treatment: Continual Positive Airway Pressure
(CPAP), Lifestyle Changes, and Surgery.
7
17. Circadian Rhythm Sleep
Disorder
•Persistent pattern of sleep disruption
leading to excessive sleepiness or
insomnia due to mismatch between sleepwake schedule.
•Obvious distress/impairment in social
and occupational settings.
Delayed Sleep Phase Type
An unnatural sleeping pattern created by
falling asleep late and waking up late
which eventually establishes an inability
to fall asleep and awaken at a desired
earlier time.
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9
18. Narcolepsy
•Narcolepsy (NAR-ko-lep-se) is a
disorder that causes periods of extreme
daytime sleepiness due to trouble sleeping at
night and is sometimes accompanied by
paralysis and hallucinations
• Hallucinations: Vivid, life-like dreams
that occur while falling asleep or waking up.
• Sleep paralysis: This condition prevents
you from moving or speaking while waking up
and sometimes while falling asleep. Last from
a few seconds to a few minutes.
Monday, May 21, 12
10
19. Narcolepsy Causes
Hypocretin (hi-po-KREET-in), a chemical in
the brain that helps promote wakefulness. Most
people who have narcolepsy have low levels of this
chemical. What causes these low levels is unknown.
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Possible factors include:
•Heredity. Some people may inherit a gene that affects hypocretin. Up to 10% of people who
have narcolepsy report having a relative with the same symptoms.
•Infections
•Brain injuries caused by brain tumors, strokes, or trauma.
•Autoimmune disorders
•Low levels of histamine, a substance in the blood that promotes wakefulness.
Monday, May 21, 12
11
20. Narcoleptic
Cataplexy
Cataplexy (KAT-ahplek-se) This condition
causes a sudden loss of muscle
tone while you're awake.
Muscle weakness can affect
certain parts of your body or
your whole body. For example,
if cataplexy affects your hand,
you may drop what you're
holding. It may last seconds or
minutes.
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12
21. Sleepwalking
(somnambulism)
Sleepwalking is a disorder that
occurs when people walk or do
another activity while they are
still asleep.
•Sleepwalking most often occurs during
deep, non-REM sleep, early in the night.
•Sleepwalking happens most often in
children ages 5 - 12.
•The episode can last from a few seconds to
over 30 minutes.
Monday, May 21, 12
Symptoms of sleepwalking
include:
•Confusion/disorientation when woken up.
•A blank look on their face.
•Opening their eyes while still asleep.
•No memory of the episode.
•Performing a detailed activity of any type
while still asleep.
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22. Sleep Paralysis
•In the early stages of sleep.
•A person suddenly wakes
up and is aware of their
surroundings, but cannot
move.
•Treated with
antidepressants and SSRI’s
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14
23. Night Terrors
Night terrors (sleep terrors)
are a sleep disorder in which a
person quickly wakes from
sleep in a terrified state.
•The cause is unknown, but night
terrors may be triggered by:
•Fever
•Lack of sleep
•Periods of emotional tension,
stress, or conflict.
•Frightening movies or
TV shows.
Monday, May 21, 12
•Most common in children ages 3 - 7
between midnight and 2 a.m.
•A person may remember the details of
the dream and will not be disoriented after
the episode.
•Treatment: Reducing stress may reduce
night terrors.
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24. Nightmares
Prevalence by Age Group
• Extremely frightening dreams that
occur in REM sleep.
• Less intense then sleep terrors.
Young Adults
3%
Adults
47%
3-5 Year Olds
50%
• Person rapidly becomes aware and
alert almost immediately after waking
up.
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25. Restless Leg Syndrome
Neurological disorder that is characterized by unpleasant
sensations of legs and an urge to move them when at the
rest.
•The unpleasant feelings are described as creeping, crawling, pulling, itching,
tingling, burning, aching, or electric shocks.
•The urges to move happen when the body is at rest and inactive. Thus, being worse
in the evening which can cause chronic sleep disturbances and sleep deprivation.
•Causes: Mostly unknown (idiopathic)
•Treatment: underlying cause, some meds, and exercise.
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28. Sleep Hygiene
✓
✓
Monday, May 21, 12
Try to limit caffeine intake.
Have a light snack before bedtime. (no big meals
before bedtime)
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29. Sleep Hygiene
✓
✓
Have a light snack before bedtime. (no big meals
before bedtime)
✓
Monday, May 21, 12
Try to limit caffeine intake.
Set your bedroom for a comfortable temperature.
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30. Sleep Hygiene
✓
✓
Have a light snack before bedtime. (no big meals
before bedtime)
✓
Set your bedroom for a comfortable temperature.
✓
Monday, May 21, 12
Try to limit caffeine intake.
Minimize light exposure.
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31. Sleep Hygiene
✓
✓
Have a light snack before bedtime. (no big meals
before bedtime)
✓
Set your bedroom for a comfortable temperature.
✓
Minimize light exposure.
✓
Monday, May 21, 12
Try to limit caffeine intake.
Try to follow a regular and consistent sleep schedule.
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