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GRACE
Personality factors
Insomnia
 Primary Insomnia
 Secondary Insomnia
RESEARCH –Primary Insomnia
RESEARCH – Secondary insomnia
Apnoea
Dispositional traits affecting normal sleep patterns.
A long term problem initiating and/or maintaining sleep.
 Insomnia not attributable to an underlying cause. Subtypes include: Psychophysiological insomnia,
idiopathic insomnia and sleep state misperception.
 Insomnia attributable to an underlying cause. (e.g hormonal changes in women, medical illness,
decreased melatonin production, psychiatric disorders, stimulants, lifestyle factors.)
 Dement (1999) reported several cases of sleep state misperception. One case involved a patient
who complained of severe insomnia being asked to sleep for 10 consecutive nights in the sleep
laboratory. Each morning he completed a questionnaire estimating how long it took to fall asleep at
night. Participant said 90mins on average. In reality it took an average of 15mins.
 Dauvilliers et al (2005) asked 256 primary insomniacs to complete a clinical interview, psychometric
questionnaires and a questionnaire on the family history of insomnia, and to undergo detailed
psychological sleep measurements. A control group of non-insomniacs were also tested. Of the
primary insomniacs, 72.7% reported a family history of insomnia compared with 24% of noninsomniacs, suggesting a familial link to primary insomnia.

Monti (2004) found many cases of insomnia could be treated successfully by treating the underlying
cause, such as a medical or psychiatric condition, which suggests that some forms of insomnia are
secondary – the result of other illnesses – and are not an illness themselves like primary insomnia is.
 Katz et al (2002) studied insomniacs with chronic medical conditions, such as diabetes, depression,
hypertension and heart conditions. 50% were found to suffer insomnia, 34% were found to suffer a
mild form and 16% were found to suffer a severe form.
Suffereres have persistent pauses in their breathing that lasts for minutes, as well as occasional loud snorts
as breathing recommences. Obstructive sleep apnoea (OSA) is often found in overweight middle aged men
when air is prevented from entering the lungs as a result of lack of muscle tone in the upper airway causing
it to collapse. It is considered severe if breathing ceases for more than 10 seconds and more than 10 seconds
every night.
 Chest (2001) found a significant positive correlation between insomnia and OSA, suggesting a
relationship between the two conditions.
 Stickgold (2009) believes a range of mental disorders, including depression and attention deficit
disorder, are caused by sleep apnoea and insomnia. Apnoeac insomniacs had twice the incidence of
depression than the normal population, suggesting the best way to treat mental disorders is to
GRACE
Sleepwalking
Narcolepsy
alleviate these.
Activities occurring unconsciously when someone is asleep that normally occur when awake. Sleepwalkers
are unaware of their activity and engage in automatic behaviour. Usually occurs in stage three or four at
early points in the night. Environmental factors that induce sleepwalking include stress, alcohol intoxication,
sleep deprivation, chaotic sleep schedule & drugs such as sedatives and antihistamines. There is thought to
be a genetic link as family some family histories demonstrate. It also occurs more frequently in identical
twins.
 Broughton (1968) found that the disorder is heritable, with sufferers 10 times more likely than the
general population to have a close relative with the disorder, suggesting a genetic factor.
 Hublin et al (1997) found the disorder to be more common among children, with up to 20% being
affected. In adults, the prevalence rate is about 2%. This indicates that the condition is linked to
development and maturation.
A disorder characterised by disruption to the sleep/wake cycle, whereby sufferers suddenly fall asleep at
unexpected times, often in the middle of activites. These sporadic micro-sleeps are common, with the
sufferer awaking without realising that he or she has been asleep. Type and severity of symptoms vary
between individuals and can improve or worsen over time. It appears to be a neurological condition
associated with a fault in brain mechanisms controlling wakefulness and sleep.
Another common symptom is cataplexy, where muscular control is lost, usually as a result of being aroused,
for example when excited. Cataplexy takes the form of attacks of muscle weakness or near total paralysis
occurring suddenly for a few seconds or minutes and then subsiding.
 Dement (1999) reported that a sleep research team in Texas found that mice who could not
produce hypocretin in their brains developed symptoms of narcolepsy, demonstrating the
importance of the neurotransmitter.
 Daniels et al (2001) gave questionnaires to 500 patients of the Narcolepsy Association and found
they had lower energy levels, reduced social functioning, and lessened physical activity, with 57% of
them depressed. The condition put limitations on their educational, work, home and social life,
matching results from other countries and demonstrating the extensive impact of the disorder on
health related quality of life.