PSYC 3830 1st Edition Lecture 22 Outline of Last Lecture I. Elimination Disordersa. Enuresisb. EncopresisII. Sleep-Wake Disordersa. Insomnia Disorderb. Hypersomulence Disorderc. Circadian Rhythm Sleep-Wake Disorderd. TreatmentOutline of Current LectureI. Sleep Wake Disorders Continueda. NarcolepsyII. Breathing-Related Sleep Disordersa. Obstructive Sleep Apnea Hypopneab. Central Sleep Apneac. Sleep Related Hypoventilation III. Parasomniasa. Nightmare Disorderb. Non-Rapid Eye Movement Sleep Arousal Disorderc. Rapid Eye Movement Sleep Behavior Disorderd. Restless Leg Syndromee. Treatment Current LectureI. Sleep Wake Disorders Continueda. Narcolepsyi. Recurrent periods of irrepressible need for sleep, falling asleep, napping in same day ii. At least 1 of the following:1. Cataplexy – sudden loss of muscle tone while awake, falling down,grimacing 2. Hypocretin deficiency – spinal tap doesn’t look rightThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.3. Abnormal polysomnography for REM sleep iii. Commonly seeks help from a neurologist1. It’s a behavior related problem as wella. Stress and emotions make it worse II. Breathing-Related Sleep Wake Disordersa. Obstructive Sleep Apnea Hypopneai. Nocturnal breathing disturbances1. Snoring, gasping, pauses in breathing2. These symptoms are what the person comes in complaining aboutii. 5 or more apnea/hypopneas per hour of sleepiii. Daytime sleepiness, fatigue, unrefreshing sleep b. Central Sleep Apneai. Doesn’t have physical symptomsii. 5 or more apneas per hour of sleep iii. May or may not have daytime sleepinessiv. It’s a CNS issue  brain isn’t telling them to breathev. A common cause is use of opioids (causes decreased breathing) c. Sleep Related Hypoventilationi. Decreased breathing leading to increased CO2 levels in the bloodii. Possibly due to another disorderIII. Parasomniasa. Nightmare Disorderi. Regularly experiences nightmares1. Usually about things including threat to security or lifeii. Generally occur during REM sleep / second half of the cycleiii. Upon awakening, the person rapidly becomes oriented and alertiv. Causes distress and impairmentv. Rules out disorders that would explain nightmares (such as PTSD) unless the nightmares increase while symptoms go awayb. Non-Rapid Eye Movement Sleep Arousal Disorderi. Incomplete awakening of sleep ii. Don’t remember the episodes when awakenediii. Usually don’t remember much dream imageryiv. Amnesia from the episodesv. Causes distress and impairment vi. Subtypes:1. Sleep walkinga. Blank staring face, unresponsive, eating behaviors, sexual behaviors, possibly dangerous activities b. NOT in REM sleep2. Sleep terrorsa. Episodes of abrupt terror arousals from sleepi. Panic, autonomic arousal, unresponsive efforts to calm them, won’t remember it c. Rapid Eye Movement Sleep Behavior Disorderi. Vocalization or complex motor behaviors during a dreamii. Normally in REM sleepiii. Opposite of sleep paralysisiv. Upon awakening, they are completely awake and alertv. May or may not remember their dreamvi. Causes distress and impairment vii. They may get out of bed, but it’s not considered sleep walking because they are in REM sleep d. Restless Leg Syndromei. Urge to move legs in response to uncomfortable sensations1. Begins or worsens during rest or activity2. Removed partially or totally by movement3. Worse or only occurs during evening/night4. Causes distress and impairment e. Treatmenti. Make sure physiology and physical environment are cued for being awakeduring the day and asleep at