PSY 4127 Lecture 11: Insomnia
4 Jun 2018
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Department
Course
Professor
Insomnia: criteria for chronic insomnia.
• when sleep onset latency is over 30m
• total sleep time (TST) is under 6.5h
• at least three times a week there is issues with sleep
• more than one month
• psychological distress or impaired functioning in daily lives
• subclinical insomnia is very common
Causes
• medical or physiological
• psychological (aka it is in your head)
• 30-50% of patients seeking help for insomnia have a psychopathology
• correlates with MMPI scores in depression, somatization, and anxiety
• sleep state misperception
Behaviours and Lifestyle
• psychophysiological insomnia
• substance abuse (stimulants, alcohol, and drugs)
Idiopathic (aka unknown origin)
• only about 5% of chronic cases
• childhood onset, rests treatment with medication
Insomnia and Depression
• once viewed only as symptoms, sleep problems may actually contribute to psychological disorders
• 65-90% of depressed patients have sleeping problems
• usually insomnia, sometimes apnea
• sleep problems can increase risk for depression
• insomnia predicts lower success of treatment
• depressed patients with sleep disturbances are more likely to attempt and succeed at suicide compared to
those without
• convincing cases that we need more research and the change in medical programming
• doctors are not trained on sleep even though it could really assist treatment
Insomnia and Bipolar Depression
• insomnia episodes in 70-100% of cases of bipolar
• in bipolar depression 23-78% of patients have hypersomnia
• insomnia and sleep problems tend to get worse before either episode
• sleep deprivation can trigger manic episodes
• sleep problems affect mood and can trigger relapse
• basically every single case of bipolar has sleep issues
Anxiety Disorders
• sleep problems affect more that 50% of adults with generalized anxiety disorder
• core feature of ptsd
• can happen with panic disorders, ocd, and phobias
• also affects children and adolescents with high anxiety — they get less sleep and lighter sleep
• insomnia may be a risk factor for anxiety as well, though not as clear as with depression
• 27% of anxiety disorders preceded by sleep problems v. 69% for depression
• insomnia can worsen depression or be the source of it
• in PTSD, sleep disruptions may be preventing processing of negative emotional content and impair fear
extinguishing therapies
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Causes: medical or physiological, psychological (aka it is in your head, 30-50% of patients seeking help for insomnia have a psychopathology, correlates with mmpi scores in depression, somatization, and anxiety, sleep state misperception. Behaviours and lifestyle: psychophysiological insomnia, substance abuse (stimulants, alcohol, and drugs) Idiopathic (aka unknown origin: only about 5% of chronic cases, childhood onset, rests treatment with medication. Relaxation techniques: meditation, guided imagery, breathing exercises, progressive muscle relaxation, mindfulness, the can counter range thoughts and lower anxiety, about 40% effective after nine months, increases slow wave sleep and sleep satisfaction. More therapies: systematic desensitization (40-50% effective, assumes sleep has become an aversive stimulus, create a new association between bedtime and relaxation using classical conditioning, similar to treating phase but with your bed. Systematic desensitization: assumes sleep has become an aversive stimulus, create a new association between bedtime and relaxation using classical conditioning, similar to treating phobias, but with your end.
