KHA 305 Lecture Notes - Lecture 11: Head Injury, Rebound Effect, Benzodiazepine
30 Jun 2018
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Department
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Professor
Clinical Psychology week 11: Sleep-wake disorders
Sleep survey:
- In clinical practice and literature knowledge, people overestimate how much
they know about sleep
- Having an awareness of what its like to be a client
- Clients may get overwhelmed by new graduates:
oIssues with sleep
oGiving too many homework and surveys
oClients may have low literacy and long work hours
oNeed to find a measure that gives the information you want, in the least
painful way possible
oExposing through experiential learning, what a client has to do
- Hobart answers:
oPeople need 8 hours or more
oCatching up with sleep after not having enough one day
oChronic insomnia may have serious effects
oWorried about losing control over ability to sleep
oBad sleep interferes with functioning next day
oBetter to take a sleeping pill rather than be bad the next day
oWhen feeling depressed or anxious its due to bad sleep
oI cant predict when I wont be able to sleep
oIdeas around medication
oSocial commitments effected by sleep
oSome questions apply more than others
oIf answered 6 or more on any item you are at risk of having
dysfunctional beliefs around sleep
oAll or nothing belief systems cause damage
oIssues:
Not sure to some of the answers (eg. How many times did I
wake up during the night)- results in guessing
Reflecting on it makes you think about it more, and worry
about it more- makes sleep worse
- Clinical context:
oIs it anxiety or is it a sleep as a primary disorder
oSleep often a secondary disorder
Eg. Behind anxiety
oPrimary sleep disorder:
Sleep is the main issue
If you rectify this issue, everything else will fall into place
oSecondary disorder:
First disorder (depression, anxiety) cause the sleep issues
Don’t give sleep much thought
Creates a cycle: if they don’t address the sleep then the
depression gets worse
oGives ideas of how and when to intervene
oChicken and egg
oIs sleep the symptom of something else
find more resources at oneclass.com
find more resources at oneclass.com
oQuestions tap into this and can be expanded on to get better ideas
- Just remember core features, etiology (how they started and why they kept
going)
Stages of sleep:
- Awake:
oBeta waves
oAlpha waves when we start to relax
- Non- REM sleep:
oStage 1:
Only just asleep
Very easily woken
Still hear things
Falling down the sleep
Very different to relaxation
Theta waves
oStage 2:
Deeper sleep
Still woken, but not as aware of
Spindles:
Briefs falls into deep sleep
K complexes
oStage 3:
Delta waves
Deep sleep
Waking up here leaves them aggression and disoriented
oStage 4:
Deep sleep
Completely disoriented if woke
Takes time to become oriented
Delta waves
- REM:
oSimilar to waking
oBeta waves
oAll intense and purposes our brain thinks we are awake
oDreaming
- Cycle through these stages
o1, 2, 3 , 4
oREM gets longer as the night goes on
oRelative amounts of times spent there vary
Increases body temperature: physiological activity increases
Each time you go back to stage one, you are temporarily alert
and wake up, but you don’t notice it
o90 minutes per cycle
vs. babies around 40 minutes per cycle
- what is normal sleep:
oNREM sleep: 80%
oREM: 20%
find more resources at oneclass.com
find more resources at oneclass.com
o7.5 hours a night (5-9 hours): for people who feel refreshed
varies between person
no universal golden numbers
ofree cycling:
DSM-5:
- Dyssomnias: refer to disturbances to the amount, timing, or quality of sleep
oInsomnia disorder:
oEtc.
- Parasomnias: refers to disturbances in arousal and sleep stage transitions and
intrusions that occur
oNon-rapid eye movement sleep arousal disorders
Sleep terror, sleep walking
oNightmare disorders
Insomnia disorders:
- DSM-5:
oPredominant complaints of dissatisfaction with sleep quantity or
quality associated with one or more of the following:
Difficulty initiating sleep
Onset latency
Maintaining:
Frequent wakening or problems returning to sleep after
waking
Early morning awakening with inability to return to sleep
oSleep disturbances causes clinically significant distress or impairment
to social, occupational, educational, academic, behavioural or other
areas of function (coordination)
At least 3 times a week
For at least 3 months
oSleep difficulty occurs despite adequate opportunity for sleep
Why does it say this
For example, war zones
- Prevalence:
o30-40% report in one year they’ve experienced
6-10% would meet diagnostic criteria
90% of people with this disorder present to GPs
of these people, 95% are prescribed a benzo
3% sent to naturopath
1% sent to psychiatrist
0.5% sent to psychologist
More able to help but less likely
oWestern phenomena
oMore prevalent in women:
Females hormones influence the process
More likely to experience an anxiety disorder: sleep is
secondary
o50% comorbid condition
opsychological factors play a primary role in triggering insomnia
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
In clinical practice and literature knowledge, people overestimate how much they know about sleep. Having an awareness of what its like to be a client. Not sure to some of the answers (eg. how many times did i wake up during the night)- results in guessing. Reflecting on it makes you think about it more, and worry about it more- makes sleep worse. Clinical context: is it anxiety or is it a sleep as a primary disorder, sleep often a secondary disorder. If you rectify this issue, everything else will fall into place: secondary disorder: First disorder (depression, anxiety) cause the sleep issues. Just remember core features, etiology (how they started and why they kept going) Awake: beta waves, alpha waves when we start to relax. Still woken, but not as aware of. Waking up here leaves them aggression and disoriented: stage 4: Rem: similar to waking, beta waves, all intense and purposes our brain thinks we are awake, dreaming.
