This document discusses various sleep and wake disorders, providing information on different types including insomnia, hypersomnolence, narcolepsy, breathing-related sleep disorders, circadian rhythm sleep-wake disorder, parasomnias, and substance-induced sleep disorders. It covers diagnostic criteria, causes, assessment tools and treatment options for each disorder. Examples of specific disorders covered are obstructive sleep apnea, central sleep apnea, sleep paralysis, nightmares, and delayed sleep phase type.
2. TABLE OF
CONTENTS
1. DREAMS
2. HOW SLEEP IS DIFFERENT FROM HYPNOSIS
3. DISORDERS
INSOMNIA
HYPERSOMNOLENCE
NARCOLEPSY
BREATHING RELATED
CIRCADIAN RHYTHAM SLEEP WAKE DISORDER
PARASOMNIAS
SUBSTANCE MEDICATION INDUCED SLEEP DISORDER
FUN FACTS ABOUT SLEEP DISORDER
MOVIES RELATED TO SLEEP WAKE DISORDER
LINKS AND REFERENCES
3. DREAMS ????
• A series of thoughts,
pictures, or feelings
occurring during
sleep.
• Dreams are the royal
road to the
unconscious where
we can treat our
disorders.
~Sigmund Freud.
Stages of sleep
Non-REM sleep happens first and
includes three stages. The last
two stage of non-REM sleep is
when you sleep deeply. It’s hard
to wake up from this stage of
sleep.
REM sleep
REM sleep is when you tend to
have vivid dreams.
4. HOW SLEEP IS DIFFERENT FROM
HYPNOSIS
• Sleep is natural process that occurs as a
part of our circadian rhythm. Hypnosis is
an induced state of consciousness guided
by a professional.
• Sleep can lasts for several hours whereas
hypnosis lasts for shorter period of time
from few minutes to few hours.
• During sleep our brain activity is largely
characterized by slow wave activity
whereas in hypnosis brain activity
becomes faster depending on the
individual’s focus.
5. Disorders
1. Insomnia
• Dissatisfaction with sleep
quantity and quality.
Criteria
1. Difficulty initiating sleep.
2. Characterized by
frequent awakenings or
problems returning to
sleep.
3. Early morning awakening.
Duration
Present for at least 3
months
Etiological factors
Genetic factors
Poor sleep hygiene
Environmental factors
Caffeine or nicotine
Chronic or neurological
factors
PTSD or anxiety
Assessment tools
Insomnia severity index
Polysomnography (PSG)
6. 2. Hypersomnolence
• Excessive sleepiness
despite a main sleep
period.
• Criteria
1. recurrent periods of
sleep or lapses into sleep.
2. A prolonged episode of
more than 9 hours per day.
3. Difficulty being fully
awake after abrupt
awakening.
Duration
3 times per week at least 3 months
Etiological factors
Medications such as antidepressants
Obesity diabetes parkinson’s disease
Brain injuries
Assessment tools
Epworth sleepiness scale(ESS)
Multisleep latency scale(MSLT)
7. 3. Narcolepsy
Cataplexy
A condition in which a
person’s muscles can
become weak or
paralyzed in response
to a strong emotion
like laughter, anger.
You may suddenly fall asleep during
the day, even if you had a good
sleep the night before.
Criteria
1. Episodes of cataplexy
2. Episodes of sudden bilateral loss
of muscle tone with
unconsciousness that are
precipitated by laughter or
joking.
3. Sleep paralysis.
4. Changes in rapid eye movement
(REM) sleep.
Duration
Over the past three months
Etiological factors
Genetic factors
Autoimmune disease
Infections such as flu virus
Age factors
Assessment tools
Hypocretin tests
ESS
PSG
8. 4. Breathing related disorders
1. Obstructive sleep apnea
hypopnea
• In which you can't breathe
normally because of upper
airway obstruction.
• Criteria
1. Nocturnal breathing
disturbances such as
snoring
2. Daytime sleepiness, fatigue.
Apnea
Sleep apnea is a
common condition
in which your
breathing stops and
restarts many times
while you sleep.
9. Contd…..
2. central sleep apnea
• Central sleep apnea is a
disorder in which your
breathing repeatedly stops
and starts during sleep.
• Difficulty staying asleep
(insomnia)
• Excessive daytime
sleepiness (hypersomnia)
• Difficulty concentrating.
• Mood changes.
10. Contd….
3. Sleep related
hypoventilation
• A clinical pattern in which the
ventilatory insufficiency
occurs primarily during sleep.
Criteria
• Episodes of decreased
respiration associated with
elevated CO2 levels.
• Fatigue.
• Morning headaches.
• Swelling of the ankles.
• Waking up many times at
night.
11. 5. Circadian rhythm sleep
wake disorder
• when your body's internal
clock, which tells you when
it's time to sleep or wake, is
out of sync with your
environment.
• Criteria
• Persistent or recurrent
pattern of sleep disruption
due to alteration in sleep
cycle.
• It leads to excessive
sleepiness or insomnia or
both.
Etiological factors
Certain genetic mutations
Exposure to light
People who work in night
swifts.
Age factors
Travelling
Assessment tools
Sleep diary
Actigraphy
Melatonin level testing
Pittsburgh sleep quality
questionnaire.
12. Contd….
Types of CRSWD
Delayed sleep
phase type
It occurs when
your sleep
pattern is
delayed two
hours
Advanced sleep
phase type
Awakenings that
are earlier than
desired.
Irregular
sleep wake
type
sleeping
without any real
schedule.
Non 24 hours
sleep wake
type
Someone typically
find their sleep
time gradually
delaying by
minutes to hours
every day.
Shift work type
Occurs in individuals
who work
nontraditional hours
like split shift,
graveyard shifts, early
morning shifts, or
rotating shifts.
13. 6. Parasomnias
• A parasomnia is a sleep
disorder that involves
unusual and undesirable
physical events or
experiences that disrupt
your sleep.
Assessment tools
• Wrist Warn device
• Multisleep latency test
• Sleep diary
Etiological factors
Runs in families
Lack of sleep
Sedatives or antidepressants
Noise temperature can disrupts
sleep.
14. Contd….
Types of parasomnias
1. NON RAPID EYE MOVEMENT
Three stages make up non-REM sleep.
Stage 1:
This stage of light sleeping lasts for five to
10 minutes.
You may remember pieces of images.
Stage 2:
Your eye movement stops, heart rate
slows and body temperature decreases.
Brain waves become slower.
Your body prepares to enter deep sleep.
Stages 3
This stage is deep sleep.
It’s hard for someone to wake you up
during this stage.
You have no eye movement or muscle
activity.
15. Contd…
2. RAPID EYE
MOVEMENT
• When you enter REM sleep,
brain activity increases
again, meaning sleep is not
as deep. The activity levels
are like when you’re awake.
• Major muscles that you
normally control (such as
arms and legs) can’t move.
• Faster breathing.
• Increased heart rate and
blood pressure.
• Penile erections.
3. Nightmare disorder
• Extremely dysphoric
• Well remembered dreams
that involes efforts to
avoid threats to survival,
security. the most
common conditions
associated with recurrent
nightmares are acute
stress disorder,
posttraumatic stress
disorder (PTSD),
depression, and anxiety.
16. Substance medication induced
sleep disorder
• Develops during or soon after
substance intoxication or
after withdrawl from or
exposure to a medication.
• Assessment tools
• Sleep disorder questionnaire
• Polysomnography
17. Fun facts about sleep disorders
• 1 in 4 married couples sleep in separate bed due to snoring
disorder.
• Sleep deprivation will kill you more quickly than food deprivation.
• Humans are the only mammals that willingly delay their sleep.
• 20% people can sleep without closing their eyes called nocturnal
disorder.
• Daytime nap is more healthiest for your body than night time.
• Big targets in life are completed by longer period of sleep.
19. Treatment of sleep
disorders
• Counseling: Some sleep specialists
recommend cognitive behavior
therapy.
• Medications and/or supplements.
• Practice sleep hygiene such as
keeping a regular sleep schedule.
• Get regular exercise.
• Minimize noise.
• Minimize light.
• Manage the temperature so that
you're comfortable.
20. Links and references
• https://my.clevelandclinic.org/he
alth/articles/12148-sleep-basics
• www.ncbi.nlm.nih.gov
• www.youtube.com
• DSM V
THANK YOU
