Sleep : Sleep Wake Disorders

Insomnia is the most common sleep disorder. It can have a devastating impact on one’s emotion, physical, occupation and social life. While it occasionally can be seen in the clinical setting as a primary diagnosis, it most often presents as a comorbidity to a medical or psychiatric issue;

Commonly known as Delayed Sleep Phase Disorder (DSPD) and other names, is a disorder in which the persons internal body clock is not in sync with the morning-rise evening-sleep pattern of the majority of people. Individuals with this disorder are not able to sleep and wake at the times that are regulated by normal work and school hours. They usually get enough sleep to keep them at a functional level through the day but not enough to be considered “well rested”. Polysomnography and actigraphy are tests commonly ordered for some sleep disorders to determine the illness. The cause of Delayed Sleep Phase can include a variety of reasons; puberty being one of the main causes, but some people are born with the disorder. The short term and long term effects of this illness is unfortunate for a person’s overall health. Overall cures to this disorder have not been found yet. Doctors have suggested sleeping pills to help or other alternatives. The disorder affects the timing of sleep, peak period of alertness, the core body temperature rhythm, hormonal and other daily cycles.

Sleep disorders alter ones sleep pattern and often results in the inability to either sleep or sleep soundly. They often cause you to feel restless, tired, fatigued, and irritable. It is estimated that nearly 75 percent of adult Americans experience sleep disorder symptoms at least a few nights per week. At the same time, sleep disturbances in some form are seen in as many as 25 to 30 percent of infants and children (“Sleep Disorders” 2013). Clearly a huge conundrum in the world, sleep disorders affect an inordinate amount of people. Millions of people suffer or have suffered from a sleep disorder at one point in their lives and if mistreated can impact organ systems functioning negatively. Physical disturbances, medical issues,

Sleep disturbance among the older adult population is known to be a prevalent issue (Gooneratne, Pack, Staley, Schutte-Rodin, Dinges, & Pack, 2011). Much study has

The accuracy of the diagnostic of narcolepsy is an important. First we need to determine if the cause of the narcolepsy is not another sleep disorder as OSA. Documentation of physical evaluation that should document degree of alertness and patients behavior. Medical history examination have to be analyzed. Use of questionnaires to assess subjective sleepiness and sleep patterns. The most used questionnaire is th Epworth Sleepiness scale and a MSLT study performed in an accredited Sleep Center.

Universal to every human from birth to death, sleep is a necessary function to survival, productivity, and happiness. While most fall asleep at night with ease, it is estimated that 50-70 million Americans battle sleep or wakefulness disorders. Although sleep disorders do not immediately present with a threat comparable to other common disorders such as depression, bipolar, or schizophrenia, sleep disorders prove very disruptive to one’s quality of life. Insufficient sleep may result in difficulty concentrating, difficulty with memory, trouble with personal care such as hygiene, driving, or managing finances, and poor performance in the workplace. While there is a wide array of sleep related illnesses that may plague any given individual,

Some 25 to 30 percent of American adults are affected by sleep disturbances of one type or another, according to the National Institutes of Health. In addition, disruption of the sleep-wake rhythm typifies many different neuropsychiatric disorders and is understood to exacerbate them.

Sleep has a major function in the physical and mental health of an individual. It is important to assess elements of sleep disorders when evaluating for any mental health condition. According to Perese (2012), “Psychiatric disorders characterized by sleep disturbances include anxiety disorders, depression, bipolar disorders, schizophrenia, and Alzheimer’s disease” (pp 222-223). Normal sleep length should be at least 7 or 7.5 hours per night and when poor sleep pattern exists, it could affect alertness, memory, cognition, creativity and quality of life (Perese, 2012). Sleep-wake disorders can be described as any problem with sleeping including; difficulty falling or staying asleep, sleeping too much, sleeping at the wrong time and abnormal behaviors during sleep (MedlinePlus, 2015). According to DSM-5 (2013), “Sleep-wake disorders encompasses 10 disorders or disorder groups: insomnia disorder, hypersomnolence disorder, narcolepsy, breathing-related sleep disorders, circadian rhythm sleep-wake disorders, non-rapid eye movement (NREM) sleep arousal disorders, nightmare disorder, rapid eye movement (REM) sleep behavior disorder, restless leg syndrome, and substance/medication-induced sleep disorder” (p. 361).

Sleep has been an important topic of research for many years. Early sleep literature only reported observations from sleep habits to compare and contrast with the data taken from the wake state. Before the majority of the science behind sleep was discovered, it was assumed that sleep was when the brain “turned off” and was in an entirely homogeneous state (Dement, 1998). Slowly, advancements were made in the study of sleep, including in 1729 when Jean Jacques d’Ortous deMairan demonstrated the persistence of circadian rhythms and in 1877 when narcolepsy was first described in medical literature (Dement, 1998; “Sleep Research Timeline”, 2017). Sleep research has since become much more advanced and is progressing quickly.

The sleeping disorder called Narcolepsy is defined as a neurological condition marked by uncontrollable sleep attacks, excessive daytime sleepiness, and cataplexy ( an abrupt loss of muscle tone) (Brandt and Laberge). It is the second most leading cause of daytime sleepiness and is a chronic brain disorder (Brandt and Laberge). The disorder affects over 200,000 Americans and is recognized when the individual experiences a sudden, uncontrollable need to sleep at any moment (“Sleep and Sleep Disorders”). Narcolepsy can occur in people who are born with it but most often seen sporadically. There are other factors that can cause the disorder like an infection, immune system deficiencies, stress, and change in hormones (Brandt and Laberge). Symptoms

Non-Rapid Eye Movement Sleep Arousal Disorders (NREM sleep arousal disorders) has six diagnostic criteria. The first criterion requires individuals to present recurrent episodes of incomplete awakening from sleep, that includes sleepwalking or sleep terrors. The second criteria require individuals to present no or little dream imagery that is remembered. The next two criteria require individuals to present amnesia for the episodes and the episodes to cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The fifth requirement is that the disturbance is not caused by substance use. The last requirement is that coexisting

Narcolepsy patients are Uncontrollable fell asleep and Unendurable drowsiness. The Narcolepsy came to in French, the meaning of ‘Narcolepsy’ is unbearable drowsiness.

Daytime sleepiness may seem universal as our work and school days are long, but when it is excessive, it can become a very debilitating disorder. The first patient that was given the diagnosis of narcolepsy was seen at the Mayo Clinic in 1919 (Longstreth, Koepsell, Ton, Hendrickson, & van Belle, 2007, p. 14). Diagnosing Narcolepsy is very complex. It is important to have a clinical examination and thorough review of medical history in order for proper diagnosis and treatment (NINDS,

Insomnia is one of the sleep-wake disorders and affects millions on a daily basis. Individuals affected by insomnia can have trouble falling asleep, staying asleep, and/or having non-restorative sleep. According to the American Psychiatric Association, insomnia symptoms are reported by one-third of all adults and 10-15% of those adults experience daytime impairments related to insomnia while 6-10% of them actually meet the criteria for insomnia disorder (2013, p. 364-365). The occurrence of insomnia is more prevalent in women, older adults, shift workers, those of lower socioeconomic status, and “those with poor physical and mental” (Morin, 2010). It can result from several causes, some of which include life stressors such as divorce and job loss, other psychological or medical disorders, environmental changes, and age. Cognitive-behavioral therapy (CBT), medication, or a combination of the two is used in treating insomnia.

Sleep disorders have always surrounded me through family and friends. though I never suffered with any sort of sleeping disorder, I was well aware of how unnerving it can be toothless who suffer from it. I did not know all of the different types there were, and was intrigued when reading chapter three of my psychology book. I had assumed that nigh terrors, which I used to think were the same as nightmares, were over exaggerations of a person’s scary dream. Sleepwalking also held interesting facts that I didn’t know prior. Having a best friend who occasionally sleepwalks, I was always interested in why she would seldom remember both walking and talking. I also appreciated learning about sleep apnea because my father used to struggle with it and would worry my mom about his breathing when he was asleep.