* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download SBS 04-19-05 - u.arizona.edu
Panic disorder wikipedia , lookup
Autism spectrum wikipedia , lookup
Depersonalization disorder wikipedia , lookup
Schizoaffective disorder wikipedia , lookup
Conversion disorder wikipedia , lookup
Memory disorder wikipedia , lookup
Eating disorders and memory wikipedia , lookup
Transient epileptic amnesia wikipedia , lookup
Antisocial personality disorder wikipedia , lookup
Eating disorder wikipedia , lookup
Mental disorder wikipedia , lookup
Separation anxiety disorder wikipedia , lookup
Conduct disorder wikipedia , lookup
Munchausen by Internet wikipedia , lookup
Biology of depression wikipedia , lookup
Generalized anxiety disorder wikipedia , lookup
Dissociative identity disorder wikipedia , lookup
Spectrum disorder wikipedia , lookup
Causes of mental disorders wikipedia , lookup
Diagnostic and Statistical Manual of Mental Disorders wikipedia , lookup
Diagnosis of Asperger syndrome wikipedia , lookup
Asperger syndrome wikipedia , lookup
Treatment of bipolar disorder wikipedia , lookup
History of mental disorders wikipedia , lookup
SBS 04-19-05 Sleep Disorders 1. Major Categories of Primary Sleep Disorder Dyssomnias - problems in the timing, quality, or amount of sleep Parasomnias - abnormalities in physiology or in behavior associated with sleep 2. Primary vs. Secondary Sleep Disorders Primary - sleeping disorders in which the difficulty is with the sleep itself - includes both dyssomnias and parasomnias Secondary - sleeping disorders resulting from some other medical or environmental situations 3. List and Define Sleep Disorders Under Each Major Category Dyssomnias Insomnia - difficulty falling asleep or staying asleep that occurs three times per week for at least one month o leads to sleepiness during the day o causes problems fulfilling social or occupational obligations - caused from a variety of things including: o caffeine or stimulants o pain, endocrine, and metabolic disorders o psychological conditions (depression, mood, anxiety) Breathing Related Sleeping Disorder - cessation of breathing for periods during sleep o leads to anoxia and nighttime awakenings o results in chronic daytime sleepiness - can be a central (brain) problem or an obstructive (nasopharyngeal) problem - treatment includes sleep diary, sleep studies, and use of a breathing machine (CPAP) Narcolepsy - episodes of sudden daytime sleepiness that occur daily for at least 3 months despite a normal amount of sleep at night o instant REM sleep - aggravated by emotions → cataplexy - may experience sleep paralysis, hypnagogic or hypnopompic hallucinations o strange perceptual experiences just as pt falls asleep or wakes up (respectively) - helped by daytime naps and stimulants Primary Hypersomnias - recurrent bouts of excessive sleepiness occurring almost daily for at least one month - not relieved by daytime naps - not better accounted for by narcolepsy or other disorder - treated w/stimulants and antidepressants Circadian Rhythm Sleep Disorders - sleepiness at inappropriate times during the day b/c of inability to sleep at appropriate times o delayed → waking later than desired o jet lag → 2-7 days after a change in time zones o shift work → schedule causes mixed insomnia and sleepiness Restless Leg Syndrome - uncomfortable sensation in the legs (and sometimes arms) necessitating frequent motion and causing insomnia and repetitive limb jerking during sleep - more common w/aging, pregnancy, and kidney disease - associated w/deficiencies in dopamine, iron, and magnesium Nocturnal Myoclonus - repetitive, abrupt muscular contraction in the legs from toes to hips causing nighttime awakenings - more common in the elderly Parasomnias Bruxism - tooth grinding, normally during stage 2 sleep - can lead to tooth damage and jaw pain - treated w/night guards Nightmare Disorder - repetitive, frightening dreams that occur during REM sleep o recalled on nightmare awakenings - treated with drugs that suppress REM sleep Sleep Terror - repetitive experiences of fright in which a person (usually a child) screams in fear but cannot be awakened o has no memory of dream - occurs during slow-wave sleep - may be an indication of epilepsy in adolescence Sleepwalking Disorder - repetitive walking during sleep o no memory of walking - occurs during slow-wave sleep - begins in childhood, may have genetic component REM Behavior Disorder - REM sleep and dreaming w/out skeletal muscle atonia - Pts may harm themselves and/or sleeping partners 4. Discuss Sleep Hygiene Regularity - going to bed and getting up at the same time everyday - having the same temperature, lighting, quality of bedding, noise level, etc. Bed is for Sleeping (and sex) - don’t use the bed for reading, watching television, working, etc - if not asleep w/in ½ hour, get up Control - use daytime naps to compensate for reduced night sleeping (but avoid insomnia due to naps) use of sleep restriction to improve sleep efficiency and sense of control 5. Medications and Sleeping Disorders Place of Medications - meds play an important role in the management of sleep - can be used to treat secondary sleep disorder to depression or anxiety - helpful in many primary sleep disorders as well - be aware of dependence, rebound on discontinuance, and occasional amnesia of the day following intake Anti-Anxiety Agents (clonazepam/lorazeapm) - help with insomnia, myoclonus, restless leg syndrome, sleep terror, and REM behavior disorder Stimulants/Provigil - used for narcolepsy - new drug that makes one feel as if they have slept Antiepileptic - used for REM behavior disorder, and nocturnal epilepsy Melatonin - limited and controversial use in the management of sleep disorders - used for jet lag or night shift work Hypnotics (triazolam, ambien) - used for short term management of primary or secondary insomnia Benzodiazepines Benzodiazepines ½ Life Dose (mg) Dalmane 40-250 hrs 15-20 Temazepam 8-27 7.5-15 Triazolam <6 0.125-0.5 Ambien 2.5 5, 10 Sonata 6 5, 10 Lunesta 1.0 1-3