Study Guide 3- Eating & Sleep-wake Disorders Questions

general descriptions related to Narcolepsy

(rare condition) Sleep disorder involving sudden and irresistible sleep attacks. recurrent need for sleep/napping. Individuals might have hypocretin deficiency which is a result of destroyed parts of the brain. Abnormally fast REM sleep.

Statistics related to Narcolepsy

0.3 - .16 %. Onset is adolescence . Course improves over time. Gender- Occurs equally to men and women.

Subtypes of bulimia nervosa

1) Purging type (Vomiting, laxatives, diuretics) and 2) non-purging type (Excessive exercising or fasting). Nonpurging type is VERY rare, only 6%-8% of all patients with bulimia do this.

subtypes of Anorexia

1) Restricting subtype: Limited calorie intake. Ex: dieting, fasting, exercise, 2) Binge-eating-purging Subtype. Ex: binge on small amounts, then purge. (unlike bulimia, their binge would be a normal-size meal which they'd immediately purge).

Stats Breathing-Related Disorders

10-20 % of common obstructive apnea

Stats Circadian Rhythm Sleep Disorder

10-20 % of common obstructive apnea

general descriptions related to hypersomnolence

Abnormal Excessive unexplainable sleepiness (requiring a great amount of sleep). Falls asleep several times during the day even when they've had a full night's sleep.

statistics related to insomnia

Almost 1/3 of the populations reports some symptoms of insomnia during any given year. 35 % of older adults report daytime sleepiness. Only diagnosed if is the main issue and other conditions are not present.

What is the specific description of obesity, including body mass index?

An excess of body fat resulting in a body mass index of 30 or greater.

treatments Nightmare Disorder

Antidepressants and/or relaxation training.

Medical treatment of Insomnia

Benzodiazepines and over the counter sleep meds can help initially but prolonged use can cause rebound insomnia, dependence and excessive sleepiness. Better left as a short term solution.

Major facts and statistics associated with bulimia nervosa

Between 1975 to 1986 bulimia rose dramatically from virtually none to more than 140 per year (Canadian Center Stats). Of the purging and nonpurging types, nonpurging is very rare, affecting only 6%-8% of all people with bulimia. Purging is by far the most common. Majority are women (90%+), has a lifetime prevalence of women (1.1%) vs men (0.1%), college women: 6-7% at some point will meet criteria. Age of onset: typically adolescence. Tends to be chronic of left untreated. In the past, the vast majority of recorded cases were male but that changed long long ago. -Lifetime prevalence is about 1%. Develops in non-western women after moving to western countries. rare in African American women.

Gender statistics related to insomnia

Black men report the most problems. Women report insomnia twice as often as men (might be hormonal)

Electroencephalograph

Brain wave activity, respiration and oxygen

Associated features & prevalence for sleep terror disorder

Child not easily awakened during episode and has little memory of incident the next day. Prevalence: More common in children (6%) than adults (2%) and more common in boys than in girls.

major characteristics of disordered eating including night eating syndrome

Consuming ⅓ or more of daily food intake after the evening meal and getting out of bed at least once during the night to have a high calorie snack. In the morning, however, the individual will not be hungry and will forgo breakfast. These individuals do not binge during their night eating and seldom purge. Occurs in 6% to 16% of obese individuals, and as high as 55% of those extreme cases seeking bariatric surgery.

types of treatment associated with binge-eating disorders

Drugs such as prozac (and antidepressants) can be a little helpful at the beginning but their effect is minimal and doesn't help in the long run. CBT targeting attitudes about overriding importance and significance of body weight and shape are the most effective. The prime objective is to teach individuals the consequences of binge eating as well as the ineffectiveness of laxatives and vomiting and coping strategies and altering dysfunctional thoughts and attitudes about body shape, weight and eating. Individuals are also instructed on how much and how often to eat. Family therapy is only effective in helping young girls with a short history of the disorder. Interpersonal therapy is equally effective as CBT.

main differences between dyssomnias and parasomnias

Dyssomnias: Problems in amount, quality or timing of sleep. Parasomnias: Abnormal behavioral and psychological events during sleep such as nightmares or sleepwalking.

specific physical measures used in a polysomnographic evaluation

EEG, EOG, EMG, & ECG

Medical treatment of Circadian Rhythm Sleep-wake disorders

Environmental treatments: phase advances: moving bedtime later is the best approach. phase advances: moving bedtime earlier is more difficult, very bright light- Tricks brain's biological clock.

major characteristics associated with binge-eating disorders?

Experiencing marked distress & functional impairment (health risks, feelings of guilt) due to binge eating but DO NOT engage in extreme compensatory behaviors (No purging, laxatives, exercising or fasting).

Electrooculograph

Eye movements

Associated features for Sleep Walking Disorder

Few people over the age of 15 continue it into adulthood. Usually resolves on own without treatment. Seems to run in families. May occur with nocturnal eating syndrome (person eats while asleep: unaware). Prevalence: More common in children (15%-30%) than adults.

Major facts and statistics associated with Anorexia

From 20% to 30% of anorexia-related deaths are suicides, which is 50 times higher risk than the risk of death from suicide in the general population. Majority are white women, middle to upper social class, age of onset is early adolescence and it tends to be more chronic and resistant than bulimia.

biological factors associated with obesity

Genetics play a role in about 30% of obesity cases. Genes also influence the number of fat storage cells an individual has.

Electrocardiograph

Heart activity.

Psychological treatment for Stimulus control procedures

Increase sleep hygiene/make bedroom as place for sleep only. Setting regular bedtime routines for children.

social factors are associated with obesity

Influence of friends and family: Family environments play a role: inactive, sedentary lifestyles & high fat, energy dense diets. In a social network study it was found that if a spouse/sibling or close friend was obese the person's own risk for obesity increased from 37% to 57% but not if a neighbor or coworker was obese.

Main characteristics of bulimia nervosa

Intense fear of weight gain and losing control of eating/relentless pursuit of thinness At least once a week for 3 months. Body weight less than 15% normal. Bulimics within 10% of normal weight.

main characteristics of Anorexia

Intense fear of weight gain and losing control of eating/relentless pursuit of thinness At least once a week for 3 months. Body weight less than 15% normal. Bulimics within 10% of normal weight.

major types Circadian Rhythm Sleep Disorder

Jet Lag Shift Work Delayed sleep phase Advanced sleep Irregular Sleep Wake Non-24 hr. sleep wake

Psychological causes associated with anorexia and bulimia nervosa

Low sense of control and self confidence (use of food/weight to compensate, handle stress), Perfectionist attitudes (Ex: I am a failure because I am fat), Distorted body image (Excess search for imperfections), Preoccupation with food (consistently thinking about food), Mood intolerance (moderate levels of depression).

prevalence of Anorexia

Majority are white women, middle to upper social class, age of onset is early adolescence and it tends to be more chronic and resistant than bulimia. Both: Lifetime prevalence is about 1%. Develops in non-western women after moving to western countries. rare in African American women.

Prevalence of bulimia nervosa

Majority are women (90%+), has a lifetime prevalence of women (1.1%) vs men (0.1%), college women: 6-7% will at some point meet criteria. Age of onset: typically adolescence. Tends to be chronic of left untreated.

associated features associated with binge-eating disorders?

Many people with BEDs are obese, some have concerns about shape and weigh, age of onset is often older than bulimics and more psychopathology than non-bingeing obese people. Roughly 33% binge to "alleviate bad moods". Lifetime prevalence is 2-3 times greater for females.

Sociocultural causes associated with anorexia and bulimia nervosa

Media portrayals, being thin is associated with success and happiness, cultural emphasis on dieting. The cultural standards have an ideal body size. The fashion industry presents a nearly impossible body size to achieve. Families can also apply significant pressure.

Facts & causes (i.e. medical & psychological)

Medical- Physical pain or discomfort, inactivity during the day, problems with the biological clock and its control with temperature, and respiratory problems. Drug use and environmental factor can also interfere with sleep. Psychological- Stress/stressful events cause inability to sleep. Anxiety of sleep within young children

Medical treatment Breathing-Related Sleep Disorder

Medication, weight-loss, or mechanical devices: Continuous Positive Air Pressure (CPAP).

associated features related to insomnia,

Microsleep- Brief seconds-long of sleep after long periods of having little sleep. Feels daytime sleepiness 35% of the time. It is only diagnosed if it is not better explained by another condition (such as Generalized anxiety).

Medical complications of bulimia nervosa

Most deadly mental disorder due to medical complications such as the body not being able to sustain itself so the body starts to eat away at internal organs to gain nutrients (usually the heart). Life-threatening: Cardiac damage leads to heart attacks, seizures, kidney failure. Poor Health: Lethargy, dry skin, brittle hair, puffy face, eroded enamel, tearing of the esophagus, electrolyte imbalances, colon damage from laxative use, callused fingers, cessation of menstruation. Psychological problems: High comorbidity with depression (71%) and with OCD, anxiety & mood disorders (80.6% for adults/66% for teens), and substance abuse (36.8% of bulimia, and 27% of anorexia).

medical complications of Anorexia

Most deadly mental disorder due to medical complications such as the body not being able to sustain itself so the body starts to eat away at internal organs to gain nutrients (usually the heart). Life-threatening: Cardiac damage leads to heart attacks, seizures, kidney failure. Poor Health: Lethargy, dry skin, brittle hair, puffy face, eroded enamel, tearing of the esophagus, electrolyte imbalances, colon damage from laxative use, callused fingers, cessation of menstruation. Psychological problems: High comorbidity with depression (71%) and with OCD, anxiety & mood disorders (80.6% for adults/66% for teens), and substance abuse (36.8% of bulimia, and 27% of anorexia).

Electromyography

Muscle movements

What are the general description and the two major subtypes of parasomnias

Nature of parasomnias is that the problem is not with sleep itself. Abnormal events happen during sleep or shortly after waking like sleep walking or nightmares. Problems during REM sleep: Non-REM sleep arousal Problem during Non-REM sleep: Nightmare disorder and REM sleep behavior disorder. New DSM

Delayed sleep phase

Night owls, stay up late and sleep late ( wake up later)

Problem during Non-REM sleep

Nightmare disorder and REM sleep behavior disorder. New DSM diagnosis. recurrent episodes with either sleep terrors (recurrent episodes of panic-like symptoms during non-REM sleep). and/or Sleepwalking. Lastly, the individual has no memory of the episode.

associated features Nightmare Disorder

Nightmares: Children (10%-50%) & adults (9%-30%%). Occurs during REM sleep. Prevalence: More common in children than adults.

Problems during REM sleep

Non-REM sleep arousal

major types Breathing-Related Disorders

Obstructive Sleep Apnea Hypoapnea Syndrome Central Sleep Apnea (CSA) Sleep-Related Hypoventilation

Obstructive Sleep Apnea Hypoapnea Syndrome

Occurs when airflow stops despite continued activity by the respiratory system. In some people the airway is too narrow, in others there's some abnormality or damage. Most common in males and is thought to occur in 10% to 20% of the population. Common in obese people. (Airflow stops despite respiratory system working well)

general descriptions related to insomnia,

One of the most common sleep disorders. Individuals unable to initiate/stay asleep or experience nonrestorative sleep. Often really tired and in low mood.

Associated characteristics of bulimia nervosa

Overly concerned with body shape & fear of weight gain. High comorbidity with other mental disorders. Ex: Anxiety (66%-80%) and mood (50%-70%) disorders.

associated characteristics of Anorexia

Overly concerned with body shape & fear of weight gain. High comorbidity with other mental disorders. Ex: Anxiety (66%-80%) and mood (50%-70%) disorders.

Biological causes associated with anorexia and bulimia nervosa

Partial genetic component. Relatives w/eating disorder have a 4X/5X higher risk for developing eating disorders themselves. Women have a higher risk for anorexia. Bulimia & twin studies: Identical (23%) vs fraternal (9%). Neurobiological abnormalities: hypothalamus. Irregularities in norepinephrine, dopamine and serotonin. The low serotonin levels lead to an increase in impulsivity and binge eating.

Psychological treatment for CBT of insomnia

Psychoeducation about sleep, changing beliefs about sleep, extensive monitoring using a sleep diary, practicing better sleep related habits.

Jet Lag

Rapidly changing time zones. Harder to go from West than East

Main distinction for sleep terror disorder

Recurrent panic-like symptoms during non-REM sleep.

main distinctions of Nightmare Disorder

Repeated episodes of extremely disturbing dreams that cause impairment. Leads to distress or impairment in daily life. Not adequately explained by other conditions.

What are the major influences of sleep deprivation on depression?

Sleep deprivation can severely create or worsen depression because not sleeping makes one anxious and anxiety further interrupts your sleep which in turn further increase anxiousness. (Vicious cycle).

Associated Features Circadian Rhythm Sleep Disorder

Sleep disturbances resulting in sleepiness or insomnia, caused by the body's inability to synchronize its sleep patterns with the current pattern of day and night.Leads to distress or functional impairment (ex: significantly decreased productivity at work). Circadian rhythms DO NOT follow 24 hour clock. We have a biological clock that simulates melatonin located in the suprachiasmatic nucleus in the hypothalamus.

Major distinctions for Sleep Walking Disorder

Somnambulism: occurs during non-REM sleep. Usually occurs during first few hours of deep sleep. Must leave the bed.

Medical treatment of Hypersomnia & Narcolepsy

Stimulants such as ritalin can help. Cataplexy is usually treated with antidepressants

psychological factors are associated with obesity

These individuals have addictive obese eating behaviors: Less eating control & withdrawal feelings if food is limited and have similar reward brain neuro-circuitry to substance abuse. Psychological processes of emotional regulation (eating to feel happy), impulse control, attitudes and motivation toward eating, and responsiveness to the consequences are also important.

major components of treatment

Treatment is usually organized from least to most intrusive depending on extent of obesity. 1) It starts with self-directed weight loss programs (exercise programs, atkins diets). 2) Commercial self-help programs such as Weight Watchers or Jenny Craig. 3) The most successful programs are professionally directed behavior modification programs. (portion control) Hunger reducing drugs can have positive effects if paired with behavioral approach targeting lifestyle, but cardiovascular side effects are a problem. 4) The last and most extreme approach is Bariatric surgery, for individuals with a BMI over 40.

statistics associated with obesity including body mass index?

US adults: 12% in 1991, 30.5% in 2000, 30.6% in 2002, 32.2% in 2004, 33.8% in 2008, 37.5% in 2010 with no difference in prevalence in men and women. Medical costs for obesity are estimated at $147 billion/9.1% of US healthcare expenditures.

effectiveness of treatment for obesity

Weight loss treatment seekers 7-19%, 50% tend to regain the weight after a year following treatment. Bariatric surgery- more successful losing approximately 20-30% of body weight. 80% of individuals are not successful in the long run with dieting alone.

Associated features related to Narcolepsy

cataplexy which is sudden loss of muscle. Sleep paralysis, unable to move,speak or react. Hypnagogic hallucinations that are frightening and vivid.

BMI Morality rates

close to those associated with smoking. At 30+ BMI mortality rate increases by 30%, and at 40+ BMI mortality rate increases by 100%. 6.3% of Americans have a BMI over 40. Rates in children/teens are increasing rapidly. 13.9% in 2000, to 17.1% in 2004 now leveling off at 16.9% in 2010. Stats in other countries also growing rapidly: Eastern/Southern Europe is up by 50%. Ethnic women in the US: African American 58%, Latinas 41% and white 32%. Obesity is the main driver of type 2 diabetes.

Advanced sleep

go to sleep and wake up earlier than normal

prevalence Breathing-Related Disorders

higher age, higher obesity. Obesity and age play a factor with sleep apnea disorders.

Irregular Sleep Wake

highly varied sleep cycles

Central Sleep Apnea (CSA)

involves the complete cessation of respiratory activity for brief periods and is often associated with certain nervous system disorders such as cerebral vascular disease, head trauma and degenerative disorders. (respiratory system stops for short periods).

Sleep-Related Hypoventilation

is a decrease in airflow without complete pause in breathing . This tends to cause an increase in carbon dioxide (CO2) levels, because insufficient air is exchanged with the environment. (decreased breathing during sleep that is not best described by other sleep disorder)

Gender statistics for Breathing-Related Disorders

males > females

Associated features Breathing-Related Disorders

min. awareness of apnea problem a lot of snoring, sweating and waking up frequently often has morning headaches fall asleep during the day due to poor quality of sleep at night.

associated features related to hypersomnolence

person complains about sleepiness during the day and is able to sleep during the night. Difficulty being awake after abrupt awakening. Occurs 3 times a week for at least 3 months, accompanied by distress and impairment

Shift Work

shifts in work times with irregular hrs. Might sleep during work or miss days from work b/c lack of sleep.

Non-24 hr. sleep wake

sleeping in 25-26 hr cycle with later bedtimes.

Psychological treatment for relaxation and stress reduction techniques

teach relaxation techniques to foster sleep. Modify unrealistic sleep expectations.

Treatment for sleep terror disorder

wait-and-see posture. Scheduled awakenings prior to sleep terror. Severe cases: antidepressants/benzodiazepines.