Sleep and Dreaming

Sleep Disorders

Insomnia

Insomnia is a chronic sleep condition characterized by difficulty sleeping. Some people have trouble falling asleep, others are unable to stay asleep, and some have trouble with both. Insomnia often causes excessive daytime sleepiness and fatigue.

Cognitive behavioral therapy (CBT) is the primary treatment for insomnia. CBT may also be combined with sleep medications, which are able to help people fall and stay asleep. For some people, improving sleep hygiene may also help.

Sleep apnea

Obstructive sleep apnea (OSA) is a condition in which the body stops breathing during sleep. These periods of no breathing, called apnea, happen because the airways of the throat become too narrow to allow air flow. Like insomnia, this condition can negatively affect sleep quality.

The first line of treatment for OSA is a continuous positive airway pressure (CPAP) machine. The CPAP creates enough airflow to allow a person with sleep apnea to breathe properly during sleep.

If the CPAP doesn’t help, bilevel positive airway pressure (BiPAP or BPAP) may be considered to help patients tolerate the pressures. In some cases, an oral appliance or surgery may be necessary for OSA.

Restless leg syndrome

Restless leg syndrome (RLS) is a neurological disorder that causes an uncomfortable feeling in the legs, which occurs in the evening as bedtime approaches and when the individual is resting or trying to fall asleep. People with RLS often have trouble getting enough sleep because of their symptoms.

Certain medications are FDA approved to help manage RLS symptoms. Practicing good sleep hygiene can also help relax the body before bed and make it easier to fall asleep.

Shift work disorder

Shift work disorder is a condition that commonly affects those who work outside of a regular 9-to-5 schedule. This disorder can cause an imbalance in the natural circadian rhythm, or sleep-wake cycle. People with this disorder are at a higher risk for increased daytime sleepiness and health issues.

Treatment for shift work disorder includes strategic napping, avoiding stimulants like light at the correct time, and, if possible, reducing the number of hours worked. For people who sleep during the day, it can also help to use light-blocking tools like eye shades or curtains.

Somnambulism

In 2012, researchers from the Stanford University School of Medicine estimated that 3.6 percent of U.S. adults (or more than 8.4 million people) had sleepwalked at least once in the previous year. That study, which was published in the academic journal Neurology, surveyed 19,136 individuals about their sleep and sleepwalking habits Happens during NREM sleep.

Sleepwalkers may sometimes

• Get out of their bed and walk around the room or house,

• Sit up in their bed and open their eyes,

• Have a glazed, glassy-eyed expression on their face,

• Complete routine daily tasks,

• Be difficult to wake up,

• Act confused,

• Quickly go back to sleep,

• Not recall what happened at all,

• Experience sleep terrors.

• Leave their house

• Get into and drive a car

• Engage in sexual activity without realizing it

• Injure themselves

• Become violent

• Engage in unusual behavior (such as urinating in a closet)

Narcolepsy

Narcolepsy is a chronic central nervous system disorder that causes extreme daytime sleepiness with “sleep attacks” along with poor sleep at night.

Type I narcolepsy also causes cataplexy, which is a sudden, physical collapse caused by loss of muscle control.

People with both type I and type II narcolepsy often experience extreme disruptions in their daily life.

Medications like stimulants and SSRIs (Selective serotonin reuptake inhibitors ) are used to treat the symptoms of narcolepsy.

At-home treatments, like good sleep hygiene, diet and exercising regularly, can help to promote healthful sleep.Dealing with narcolepsy can be challenging. Making adjustments in your daily schedule may help which include strategic napping. Support groups and counseling can help you and your loved ones cope with narcolepsy.

MCQ Examples (Answers here)

Which of the following groups of characteristics best describes the REM sleep stage?

A Fast breathing, relatively high heart rate, relatively high blood pressure Fast breathing, relatively high heart rate, relatively high blood pressure

B Possible muscle contractions and sensations of falling

C Likelihood of sleepwalking and sleep talking

D Slow breathing, low heart rate, low blood pressure

E Acting out dreams and bed-wetting

Sleep paralysis typically occurs in people who are

A Over the age of 65

B Woken up while sleep walking

C Overweight

D Snoring

E In REM sleep

The explanation that holds that dreams are merely the brain’s attempt to make sense of meaningless patterns of brain activity during sleep is called the

A Activation-synthesis theory

B Psychoanalytic theory

C Social learning theory

D Cognitive theory

E Evolutionary theory

An adult with a healthy sleep cycle is most likely to enter REM sleep

A immediately after falling asleep

B after the dream stage is completed

C after cycling through the NREM sleep stages

D only as necessary to prevent waking

E soon after falling asleep and then remain there for the majority of the night

The psychodynamic theory of dreaming would postulate that

A time spent dreaming helps with problem solving and creativity

B people sleep more after they have engaged in strenuous physical activity

C dreams are the brain’s way of making sense of random neural activity

D dreams fulfill unconscious wishes

E lions sleep more than deer

Waking up frequently, loud snoring, silent pauses in breathing, and sleepiness during the day are symptoms of

A Somnambulism

B Sleep apnea

C Narcolepsy

D Circadian rhythm sleep disorders

E Insomnia

The idea that there is a part of the mind that is not directly accessible to awareness but still drives a person’s thinking and behavior is most directly attributable to

A William James

B Edward Thorndike

C Margaret Floy Washburn

D Sigmund Freud

E Paul Broca