CHAPTER 12: HEALTH-RELATED AND SUBSTANCE USE DISORDERS
Sleep Disorders: Sleep is the primary activity of the brain during the early years of development
Abidirectional relationship exists between sleep problems and psychological adjustment.
Sleep has many regulatory functions.ADHD symptoms if not enough sleep.
Maturational Changes: Infants problem is staying asleep for long periods of time. Preschoolers
problem is to sleep within a short time. School aged problem is behavioural and going to sleep.
Ie/scared, hunger, need toys, prolong going to bed.Adolescence: getting enough sleep. Sleep
patterns, needs, and problems change over the course of maturation
Adolescents have increased physiological need for sleep; however, they often get
less sleep than needed and are chronically sleep-deprived
Features of Sleep Disorders: nightmare disorder and wont be able to sleep again,-having it so
much that it impedes their functioning. Sleep terror disorder-nightmare stage, calling for help
when asleep, not conscious, and will not have a memory of it. Parents become scared because
don’t realize child is sleep. If recurring state then becomes a disorder. Sleep walking and sleep
talking in same category.
Primary sleep disorders are the result of abnormalities in the body’s ability to regulate
sleep-wake mechanisms and the timing of sleep rather than the result of medical disorder,
mental disorder, or use of medication.
Dyssomnias: disorders of initiating or maintaining sleep, characterized by difficulty
getting enough sleep, not sleeping when one wants to, not feeling refreshed from sleep
Parasomnias: Disorders in which behavioral or physiological events intrude on ongoing
Involve physiological or cognitive arousal at inappropriate times during sleep-
wake cycle. Complaints of unusual behaviors while asleep.
Common afflictions of early to mid-childhood; children typically grow out of
Include nightmares (REM parasomnias) and sleep terrors and sleepwalking (often
referred to as arousal parasomnias)
Diagnosis for all sleep-related disorders requires clinically significant
distress/impairment; the disturbance cannot be better accounted for by another mental
disorder, effects of a substance, or general medical condition
Behavioral interventions teach parents to attend to child’s need for comfort and
reassurance, gradually withdraw more quickly after saying goodnight (extinction),
establish good sleep hygiene appropriate to child’s developmental stage and family’s
cultural values, and then use positive reinforcement for maintenance. Parents need to
have good sleep hygiene, set up bed rules, routine so it is predicatable and child needs to
know so there is a collaboration between parent and child. Extincting all night troubles
because not in the rules.
Identify suspected causes of disrupted sleep and involve other family members in
maintaining routine (e.g., bedtime rituals of reading, singing, etc.)
3 main behavioral approaches
Behavioral interventions for circadian rhythm disorders can be effective when adolescent
and family are highly motivated
Goals of behavioral intervention is to: Eliminate slee