chapter 19: sleep disorders: dyssomnias and parasomnias copyright © 2012, 2007 mosby, inc., an...

Chapter 19:Chapter 19:

Sleep Disorders: Dyssomnias Sleep Disorders: Dyssomnias and Parasomniasand Parasomnias

Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

22Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

SleepSleep

Basic human needBasic human need Fundamental for survivalFundamental for survival 47 to 70 million Americans suffer from some 47 to 70 million Americans suffer from some

type of sleep disorder type of sleep disorder


Some Causes of Some Causes of Sleep DeprivationSleep Deprivation

InsomniaInsomnia NarcolepsyNarcolepsy Breathing-related sleep disordersBreathing-related sleep disorders Circadian rhythm sleep disturbancesCircadian rhythm sleep disturbances Recurrent nightmaresRecurrent nightmares Sleep terrorsSleep terrors SleepwalkingSleepwalking


Figure 18-1 The electroencephalogram (EEG). Figure 18-1 The electroencephalogram (EEG). AA, Photograph showing a person undergoing , Photograph showing a person undergoing an EEG test. Notice the scalp electrodes that detect voltage fluctuations within the cranium. an EEG test. Notice the scalp electrodes that detect voltage fluctuations within the cranium. BB, , Examples of alpha, beta, theta, and delta waves seen on an EEG. (From Lewis SM: Examples of alpha, beta, theta, and delta waves seen on an EEG. (From Lewis SM: Medical-Medical-surgical nursing: assessment and management of clinical problems,surgical nursing: assessment and management of clinical problems, ed 7, St Louis, 2007, ed 7, St Louis, 2007, Elsevier.)Elsevier.)


Figure 18-2 Normal sleep cycles. Rapid eye movement (REM) sleep occurs cyclically Figure 18-2 Normal sleep cycles. Rapid eye movement (REM) sleep occurs cyclically throughout the night at intervals of approximately 90 minutes in all age-groups. REM sleep throughout the night at intervals of approximately 90 minutes in all age-groups. REM sleep shows little variation in the different age-groups, whereas stage 4 sleep decreases with shows little variation in the different age-groups, whereas stage 4 sleep decreases with age. In addition, elderly persons awake frequently and show a marked increase in total age. In addition, elderly persons awake frequently and show a marked increase in total time awake. (From McCance KL, Huether SE: time awake. (From McCance KL, Huether SE: Pathophysiology: the biologic basis for Pathophysiology: the biologic basis for disease in adults and childrendisease in adults and children, ed 5, St Louis, 2006, Elsevier.), ed 5, St Louis, 2006, Elsevier.)


Sleep DisordersSleep Disorders

PrimaryPrimary DyssomniasDyssomnias ParasomniasParasomnias

SecondarySecondary Related to psychiatric illness, effect of substances, Related to psychiatric illness, effect of substances,

or secondary to a general medical conditionor secondary to a general medical condition


EtiologyEtiology

BiologicBiologic Genetic, hereditary, and familial factorsGenetic, hereditary, and familial factors Psychiatric, cognitive, and behavioral factorsPsychiatric, cognitive, and behavioral factors Direct physiologic effects of a general Direct physiologic effects of a general

medical conditionmedical condition Sociocultural and environmental factorsSociocultural and environmental factors


DyssomniasDyssomnias

InsomniaInsomnia Narcolepsy, hypersomniasNarcolepsy, hypersomnias Breathing-related sleep disordersBreathing-related sleep disorders Circadian rhythm sleep disturbanceCircadian rhythm sleep disturbance


InsomniaInsomnia

Most common sleep disorderMost common sleep disorder Estimated 30 million adults are affectedEstimated 30 million adults are affected More common in womenMore common in women Link between insomnia and psychiatric illness Link between insomnia and psychiatric illness

(depression)(depression)


NarcolepsyNarcolepsy

Excessive daytime sleepinessExcessive daytime sleepiness Between 135,000 and 250,000 people Between 135,000 and 250,000 people

affectedaffected Not common in children; generally initially Not common in children; generally initially

recognized during adolescencerecognized during adolescence


Breathing-Related Breathing-Related Sleep DisorderSleep Disorder

Sleep apneaSleep apnea Affects 18 million AmericansAffects 18 million Americans More common in men ages 30 to 60 More common in men ages 30 to 60 Prevalence: Prevalence:

4% adult male population4% adult male population 2% adult female population2% adult female population 1% to 3% of children, usually the result of 1% to 3% of children, usually the result of

adenotonsillar hypertrophy, craniofacial adenotonsillar hypertrophy, craniofacial abnormalities, or allergic conditionsabnormalities, or allergic conditions


ParasomniasParasomnias

NightmaresNightmares Sleep terror disorderSleep terror disorder Sleepwalking disorderSleepwalking disorder Parasomnia not otherwise specifiedParasomnia not otherwise specified


Sleep Terror DisorderSleep Terror Disorder

Occurs in 1% to 6% of childrenOccurs in 1% to 6% of children Typically ages 3 to 8Typically ages 3 to 8 More common in boysMore common in boys Tends to run in familiesTends to run in families


NightmaresNightmares

Any age, any genderAny age, any gender Child able to recall event (not typical with sleep Child able to recall event (not typical with sleep

terrors)terrors)


Sleepwalking DisorderSleepwalking Disorder

Occurs ages 4 to 8, with peak prevalence at Occurs ages 4 to 8, with peak prevalence at 12 years of age12 years of age

More common in boys More common in boys Tends to run in familiesTends to run in families

chapter 19: sleep disorders: dyssomnias and parasomnias copyright © 2012, 2007 mosby, inc., an...

Documents