Tuesday, March 27, 2012

Sleep Disorders – Types And Treatment

Sleep disorders are conditions that affect the normal sleeping patterns in humans or animals, which can, if manifested for a prolonged period of time, seriously affect one’s health and well functioning in a waking state.
Sleep disorders are usually accompanied by psychological dysfunctions (depression, schizophrenia, anxiety disorders etc.), but they may also come as a stand-alone dysfunction. In order to determine what type of sleep disorder a person has, polisomnography is used as a tool for diagnosing the patient by monitoring his physiological symptoms during sleep (eye moments, muscle activity, brain activity and heart rate).

Types:'

According to DSM-IV, there are three major types of sleep disorders:
1) primary sleep disorders, including:
hypersomnia – a person manifests excessive amounts of sleepiness during daytime. There is a difference between this and simple fatigue, in that patients often have great difficulty in handling their normal tasks from their work place, tasks which usually require minimal focus. There are various causes for this, from brain lesions to obesity and hypothyroidism.
Insomnia – the inability of an individual to fall asleep, despite the amount of accumulated fatigue and prolonged efforts (Roth, 2007). Insomnia may be transitory, acute or chronic.
Narcolepsy – excessive and prolonged sleep that can culminate with falling asleep spontaneously in the middle of daily activities
breathing related sleep disorders – sleep apnea, snoring.
circadian rhythm sleep disorder – Delayed sleep phase syndrome, advanced sleep phase syndrome, non-24-hour sleep-wake syndrome.

2) Parasomnias, including:
nightmare disorders – n increased frequency in nightmares, which leads to a disturbance in the sleeping pattern and fatigue
sleep terror disorder – usually encountered with children (2 to 6 years); the child wakes up in a state of unmotivated terror, which is apparently not caused by nightmares, usually during the first 4 hours of sleep
sleepwalking disorder

3) Other types (sleep problems caused by certain medical conditions):
bruxism – teeth grinding during sleep-time
restless leg syndrome – an imperious need of moving one’s leg during sleep.
Somniphobia – the fear of falling asleep
Nocturia – the need to wake up very often in order to use the bathroom without having a bladder disorder.
Sleep paralysis – the sensation of not being able to move for prolonged periods of time before falling asleep or immediately after waking up, despite a great desire to do so.
Treatment:
According to Poceta & Milter (1998), there are two kinds of treatment: one that relies on medication, is prescribed by a doctor, whose indications must be strictly and rigorously followed, as well an alternative one (based an teas, aromatherapy, relaxation techniques, breathing techniques, meditation, psychotherapy, biofeedback, etc.)

The most common used psychotherapies in treating sleep disorders are cognitive behavioral therapy, adlerian therapy, gestalt therapy and rational-emotive therapy. The approach can be oriented on treating or elimination the causes (for instance, quitting alcohol or certain drugs can lead to the restoration of a normal sleeping pattern) or on results (especially with behaviorist therapy that promotes assuming a certain routine that can allow the psyche to learn new behavioral patterns and, implicitly, new sleeping behaviors).

References:
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author
Poceta, J. S. & Mitler, M. M. (1998). Sleep disorders: Diagnosis and treatment. Totowa, New Jersey/US: Humana Press.

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