1. Sleep Disorders
By: Thu Le & Anh Phung

2. Sleep Disorders Background
0 Types of sleep disorder
0 Insomnia
0 The inability to get the amount of sleep you need to wake up feeling rested and
refreshed is the most common sleep complaint. Insomnia is often a symptom
of another problem, such as stress, anxiety, depression, or an underlying health
condition. It can also be caused by lifestyle choices, including the medications
you take, lack of exercise, jet lag, or even the amount of coffee you drink.
0 Signs and symptoms:
0 Difficulty falling asleep at night or getting back to sleep after waking
during the night.
0 Waking up frequently during the night.
0 Your sleep feels light, fragmented, or un-refreshing.
0 You need to take something (sleeping pills, nightcap, supplements) in order
to get to sleep.
0 Sleepiness and low energy during the day.

3. 0Sleep apnea
0 A common sleep disorder in which your breathing temporarily
stops during sleep due to blockage of the upper airways. These
pauses in breathing interrupt your sleep, leading to many
awakenings each hour. While most people with sleep apnea
don’t remember these awakenings, they feel the effects in
other ways, such as exhaustion during the day, irritability and
depression, and decreased productivity.
0 Signs and symptoms:
0 Loud, chronic snoring
0 Frequent pauses in breathing during sleep
0 Gasping, snorting, or choking during sleep
0 Feeling un-refreshed after waking and sleepy during the day, no matter
how much time you spent in bed
0 Waking up with shortness of breath, chest pains, headaches, nasal
congestion, or a dry throat.

4. o Restless legs syndrome (RLS)
• Sleep disorder that causes an almost irresistible urge to
move your legs (or arms). The urge to move occurs when
you’re resting or lying down and is usually due to
uncomfortable, tingly, aching, or creeping sensations.
• Signs and symptoms:
Uncomfortable sensations deep within the legs,
accompanied by a strong urge to move them.
The leg sensations are triggered by rest and get worse at
night.
The uncomfortable sensations temporarily get better
when you move, stretch, or massage your legs.
Repetitive cramping or jerking of the legs during sleep.

5. Narcolepsy
• A sleep disorder that involves excessive, uncontrollable
daytime sleepiness. It is caused by a dysfunction of the
brain mechanism that controls sleeping and waking. If you
have narcolepsy, you may have “sleep attacks” while in the
middle of talking, working, or even driving.
• Signs and symptoms:
• Seeing or hearing things when you’re drowsy or
starting to dream before you’re fully asleep.
• Suddenly feeling weak or losing control of your
muscles when you’re laughing, angry, or experiencing
other strong emotions.
• Dreaming right away after going to sleep or having
intense dreams
• Feeling paralyzed and unable to move when you’re
waking up or dozing off.

6. Sleep Shift Work Disorder
0 Circadian rhythms sleep disorder that occurs when your
work schedule and your biological clock are out of sync. In
our 24-hour society, many workers have to work night
shifts, early morning shifts, or rotating shifts. These
schedules force you to work when your body is telling you
to go to sleep, and sleep when your body is signaling you to
wake.

7. Things That Help To Get Better
0 Take regular breaks and minimize the frequency of shift
changes.
0 When changing shifts, request a shift that’s later, rather than
earlier as it’s easier to adjust forward in time, rather than
backward.
0 Naturally regulate your sleep-wake cycle by increasing light
exposure at work (use bright lights) and limiting light exposure
when it’s time to sleep. Avoid TV and computer screens, use
black-out shades or heavy curtains to block out daylight in your
bedroom.
0 Consider taking melatonin when it’s time for you to sleep.

8. Sleep Studies (Lab Findings&Differential
Diagnosis)
0 To tests that record what happens to your body during sleep;
studies are done to find out what is causing your sleep problems
0 Sleep apnea, when an adult regularly stops breathing during
sleep for 10 seconds or longer. This may be caused by blocked
airflow during sleep, such as from narrowed airways. Or it may
be caused by a problem with how the brain signals the breathing
muscles to work
0 Problems staying awake, such as narcolepsy
0 Problems with nighttime behaviors, such as sleepwalking, night
terrors, or bed-wetting.
0 Problems sleeping at night (insomnia). This may be caused by
stress, depression, hunger, physical discomfort, or other problem.
0 Conditions such as periodic limb movement disorder, which is
repeated muscle twitching of the feet, arms, or legs during sleep.

9. Sleep Studies (Lab Findings&Differential
Diagnosis)
0 Polysomnogram. This test records several body functions during sleep,
including brain activity, eye movement, oxygen and carbon dioxide
blood levels, heart rate and rhythm, breathing rate and rhythm, the
flow of air through your mouth and nose, snoring, body muscle
movements, and chest and belly movement.
0 Multiple sleep latency test (MSLT). This test measures how long it takes
you to fall asleep. It also determines whether you enter REM sleep.
0 Maintenance of wakefulness test (MWT). This test measures whether
you can stay awake during a time when you are normally awake.
0 Body’s internal clock (circadian rhythm), you may have a test called
actigraphy. For this test, you wear a device on your wrist that looks like
a watch. The device measures your movement during sleep and when
you are awake. It helps your doctor learn what times during the day you
are active and what times you are sleeping.

10. Treatment
0 Relaxation training
0 Cognitive therapy
0 Stimulus control (SC)
0 Sleep restriction therapy (SRT)
0 Sleep hygiene

11. Psychotherapy for Sleep
Disorders
0 Adlerian Therapy
0 Existential Therapy
0 Gestalt Therapy
0 Person-centered Therapy
0 Psychoanalytic
0 Reality Therapy
0 Transactional Analysis