PSY3032 Study Guide - Final Guide: Sleep Onset Latency, Muscle Tone, Adrenocorticotropic Hormone
21 Jun 2018
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Week 4 Disorders of sleep
Healthy sleep in Humans
6.5- 8.5 hours
- There is a strong association between nightly sleep duration and mortality
risk
Increased morbidity and mortality
CVD & Type II Diabetes
Neural activity as measured by electro-encephalography during sleep/wake
Sleep disorders may be categorized using three diagnostic criteria:
1. The international classification of diseases (ICD-10)
2. The international classification of sleep disorder (ICSD-3)
3. The diagnostic and statistical manual of mental disorder currently using
DSM-5, but it is a transition period; many studies still refer to DSM-IV-TR.
International Classification of sleep disorder
1) Insomnias
2) Sleep-disordered breathing disorders
3) Hypersomnia not due to sleep-disordered breathing
4) Circadian-rhythm disorders
5) Parasomnias
6) Sleep-related movement disorders
7) Symptoms/normal variants
8) Other sleep disorders
Diagnostic and statistical manual of mental disorder (DSM-IV-TR)
1. Dysomnias
i. Primary insomnia
ii. Primary hypersomnia
iii. Narcolepsy
iv. Breathing related sleep disorder
v. Circadian rhythm sleep disorder
vi. Dysomnia not otherwise specified
2. Parasomnias
I. Nightmare Disorder
II. Sleep terror disorder
III. Sleep-walking disorder
IV. Parasomnias not otherwise specified
The Dyssomnias
- Disorders of initiating or maintaining sleep or of excessive daytime sleepiness, and
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Week 4 Disorders of sleep
are characterized by a disturbance in the amount, quality or timing of sleep
Three major groups:
Intrinsic sleep disorders
oE.g. narcolepsy, obstructive sleep apnea syndrome
Extrinsic sleep disorders
oE.g. inadequate sleep hygiene, stimulant-dependent sleep disorder,
alcohol-dependent sleep disorder
Circadian rhythm sleep disorders
Alerting effects of insomnia
PSG does not necessarily show changes in sleep staging or TST
Being “weird”- evidence
Increased Cortisol & ACTH
Functional Neuroimaging
Does the flip/flop switch not turn off?
Is Insomnia an alerting disorder and not a sleeping disorder?
1. Insomnia Disorder
Diagnosis: DSM-5
A. Initiation/maintenance of sleep (3mth)
B. Clinically significant distress/ impairment in social/cognitive
functioning
C. Disturbance is not due to another sleep disorder
D. Disturbance is not due to a mental disorder
E. Disturbance not associated to a general medical condition
Characteristics:
Repeated difficulty with:
oSleep initiation
oSleep consolidation
oSleep quality
oDaytime impairment
oDespite adequate opportunity for sleep
Primary insomnia- no longer in current DSM-5 but in DSM-IV TR
Diagnosis: DSM IV TR
A. Initiation/Maintenance of sleep (1mth)
B. Clinically significant distress/impairment in social/cognitive functioning
C. Disturbance is not due to another sleep disorder
D. Disturbance is not due to a mental disorder
E. Disturbance not associated to a general
Prevalence:
-Insomnia symptoms 30%
-Insomnia Symptoms with Daytime Sleepiness 9-15%
-Sleep Dissatisfaction 8-18%
-Insomnia Diagnosis 6%
Primary insomnia- an old DSM-IV-TR title
oGender effects
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Week 4 Disorders of sleep
oThe timing of sleep
oIs age a factor?
Types of Insomnia
oPsychophysiological
oSleep State Misperception (paradoxical insomnia)
oIdiopathic Insomnia
oInadequate Sleep Hygiene
oAdjustment sleep disorder
oBehavioral insomnia of childhood
Insomnia: The Spielman et al (1987) model
Predisposing: Family history, environment
Precipitating: stress-family/work/relationships. Fiannces, loss
Perpetuating: Staying in bed to make up for lost sleep, role of ‘worry’, sleep
anxiety
Consequences of insomnia
Global changes in cognitive and mental health
Insomnia = increased pain, emotional effects, and mental health effects
versus congestive heart failure (Katz et al., 2002)
Occupational accident risk
•2.5-4.5 more likely to have accident –Balter et al., 1992
•In 8,625 Ss -8% insomnia; 1% non-insomnia –Leger et al., 2002
Decreased work productivity
Mood disorders –56.2% of those who relapse into mood disorder have
insomnia
Changes in brain function
•PET scan –enhanced CMR during wake/sleep in insomniacs
•PET scan –smaller differences in sleep-wake activity in arousal centres
-Now it is thought that insomnia can coexist with many conditions, and
regardless of which came first we need to address the sleep problems in their
own right
Hypersomnia: Excessive daytime sleepiness (for at least one month) causing significant
problems in daytime functioning, which is exclusive of any other mental or physical
health disorder
Kleine- Levin Syndrome
oExcessive sleepiness (hypersomnolence)
oFood cravings
oHypersexuality
Idiopathic Hypersomnia
3. Narcolepsy
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find more resources at oneclass.com
Document Summary
There is a strong association between nightly sleep duration and mortality risk. Neural activity as measured by electro-encephalography during sleep/wake. Sleep disorders may be categorized using three diagnostic criteria: the international classification of diseases (icd-10, the international classification of sleep disorder (icsd-3, the diagnostic and statistical manual of mental disorder currently using. Dsm-5, but it is a transition period; many studies still refer to dsm-iv-tr. International classification of sleep disorder: insomnias, sleep-disordered breathing disorders, hypersomnia not due to sleep-disordered breathing, circadian-rhythm disorders, parasomnias, sleep-related movement disorders, symptoms/normal variants, other sleep disorders. Diagnostic and statistical manual of mental disorder (dsm-iv-tr: dysomnias i. ii. iii. iv. v. vi. Disorders of initiating or maintaining sleep or of excessive daytime sleepiness, and. Week 4 disorders of sleep are characterized by a disturbance in the amount, quality or timing of sleep. Intrinsic sleep disorders: e. g. narcolepsy, obstructive sleep apnea syndrome. Extrinsic sleep disorders: e. g. inadequate sleep hygiene, stimulant-dependent sleep disorder, alcohol-dependent sleep disorder.
