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11 Sleep disorders.pptx

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11 Sleep disorders.pptx

  1. 1. MENTAL HEALTH FOR NURSING SLEEP DISORDERS BY:- KABTAMU N (BSC, MSC ICCMH) 1
  2. 2. Sleep 2  Sleep is a universal behavior that has been demonstrated in every animal species studied, from insects to mammals.  It is one of the most significant of human behaviors, occupying roughly one third of human life.  Although the exact functions of sleep are still unknown, it is clearly necessary for survival, because prolonged sleep deprivation leads to severe physical and cognitive impairment and, finally, death.
  3. 3. Advantages of Sleep 3  Are energy conservation  Restoration of cellular energy stores  Emotional regulation  Consolidation of memory, and  Preservation of context in which to organize memory of new stimuli.
  4. 4. Sleep disorders 4 It is a significant problem in 10% of medical out patients. It is associated with:  significant morbidity.  Poor daytime functioning  Injuries or deaths from motor vehicle accidents.
  5. 5. 5 The 3 Major Categories – DSM-IV 1. Primary sleep disorders 2. Sleep disorders related to another Mental Disorder. 3. Other sleep disorders. - Due to a general medical condition - Substance induced sleep disorder
  6. 6. 6 1.Primary Sleep Disorders - Sleep disorders caused by an abnormal sleep wake mechanism and often by conditioning. - Are not caused by another mental disorder, a physical condition, or a substance. - Primary sleep disorder Categorized as; * Dyssomnias * Parasomnias
  7. 7. 7 A. Dyssomnias:  The sleep itself is pretty normal.  But the client sleeps too little, too much, or at the wrong time.  So, the problem is with the amount (quantity), or with its timing, and sometimes with the quality of sleep.  divided into insomnia and hypersomnia
  8. 8. Parasomnias 8  Something abnormal occurs during sleep itself, or during the times when the client is falling asleep or waking up (e.g., bad dreams).  The quality, quantity, and timing of the sleep are essentially normal.
  9. 9. 9 1.Primary insomnia:- Diagnosed when the chief complaint is non- restorative sleep or difficulty in initiating or maintaining sleep for at least 1 month. C/C-‘not enough sleep’ ‘feeling tired’ MSE- moderate impairment of concentration and psychomotor function. a)Treatment - Relaxation tapes -Sedative-hypnotic drugs. E.eg diazepam, clonazepam for short term
  10. 10. 10 b) Non-specific measures (basic sleep hygiene) - Use the bed for sleeping only! - Avoid eating, reading, or watching TV in bed. - Keep a regular bed time and wake up time including on weekends. - Avoid naps - Avoid evening stimulation. - Leave the bed and bed room if unable to fall asleep after 15min. - And read or perform a quiet activity ( no TV!) ; return to bed only when sleepy.
  11. 11. 11 Sleep hyegine con’t  Bed: Lie down only when sleepy, and sleep only as much as necessary to feel refreshed; use the bed for sleep only  Time: Limit in bedtime to amount present before the sleep disturbance;  wake up at a regular time each day;  avoid day time naps  Environment: Maintain condition and avoid excessive warm and cold.  Substances: Limit sedatives; avoid alcohol, tobacco near bed time
  12. 12. 12  Meal: Eat at regular times daily  avoid large meals near bed time  eat a light snack if angry near bed time  Exercise: exercise regularly, but early in the day; practice evening relaxation routines, such as progressive muscle relaxation
  13. 13. 13 2. HYPERSOMNIA  Falling asleep inappropriately during the day or prolonged episodes of deep sleep.  Diagnosed when no other cause for excessive somnolence occurring for at least 1 month can be found. - Treatment-stimulant drugs - Amphetamines taken in the morning or early evening
  14. 14. 14 3. Narcolepsy  Sleeping at the wrong time  Characteristics  Sleep intrudes into wakefulness, causing clients to fall asleep almost instantly  Sleep is brief but refreshing  May also have sleep paralysis, sudden loss of strength, and hallucinations as fall asleep or awaken.  Treatment: Stimulants, sometimes antidepressants, with less success.
  15. 15. 15 3. Cataplexy brief episodes of sudden bilateral loss of muscle tone, or paralysis No loss of consciousness if episode is brief. When attack is over, the patient is completely normal Often triggered by the following: - Anger “ - Athletic Activity -Excitement /Elation - Sexual intercourse - Fear - Embarrassment
  16. 16. 16 4.Hypnagogic/hypnopompic Hallucinations: - vivid perceptual experiences, either auditory or visual, occurring at sleep onset or on awakening. - Appear several years after onset of sleep attacks.
  17. 17. Parasomnia 17 1. Nightmare Disorder  Usually occurs in early morning when REM sleep dominates.  The same nightmare may recur repeatedly or different ones may pop up three times a week.  Stress may induce 60% of nightmares.  Half of the cases of nightmare disorder appear before age 10; 2/3 before age 20.  Dreams are clearly remembered  Drugs can trigger nightmares.
  18. 18. 18 2. Sleep Terror Disorder Characteristics:  Abrupt awakening from sleep, usually beginning with a panicky scream or cry.  Intense fear and signs of autonomic arousal  Unresponsive to efforts from other to calm client  No detailed dream recalled  Amnesia for episode
  19. 19. 19 3. Sleep walking Disorder Characteristics:  Rising from bed during sleep and walking about.  Usually occurs early in the night.  On awakening, the person has amnesia for episode
  20. 20. 20 4. Sleep-Talking:  Often more annoying to partner than to sleeper.  Has no memory in morning.  Can be during REM or delta sleep.  In REM sleep, pronunciation is clear and understandable;  in deep sleep (delta) apt to be mumbled and unintelligible
  21. 21. 21 5. Sleep-Related Bruxism  Bruxism, tooth grinding, occurs throughout the night, most prominently in stage II sleep.  5 to 10 percent of the population has sufficient bruxism to produce noticeable damage to teeth.  The condition often goes unnoticed by the sleepers, except for an occasional jaw ache in the morning, but bed partners and roommates are consistently awakened by the sound.
  22. 22. 22 Thank You

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