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CHAPTER 12.docx

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Anna Grivas Matejka

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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 sleep  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 them.  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 Treatment:  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
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