1. Sleep Disorders: Dyssomnias and Parasomnias
Chapter 19:
Sleep Disorders: Dyssomnias and Parasomnias
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

2. Sleep Basic human need Fundamental for survival
47 to 70 million Americans suffer from some type of sleep disorder

3. Some Causes of Sleep Deprivation
Insomnia
Narcolepsy
Breathing-related sleep disorders
Circadian rhythm sleep disturbances
Recurrent nightmares
Sleep terrors
Sleepwalking

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

5. Figure 18-2 Normal sleep cycles
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 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 time awake. (From McCance KL, Huether SE: Pathophysiology: the biologic basis for disease in adults and children, ed 5, St Louis, 2006, Elsevier.)

6. Sleep Disorders Primary Dyssomnias Parasomnias Secondary
Related to psychiatric illness, effect of substances, or secondary to a general medical condition

7. Etiology Biologic Genetic, hereditary, and familial factors
Psychiatric, cognitive, and behavioral factors
Direct physiologic effects of a general medical condition
Sociocultural and environmental factors

8. Dyssomnias Insomnia Narcolepsy, hypersomnias
Breathing-related sleep disorders
Circadian rhythm sleep disturbance

9. Insomnia Most common sleep disorder
Estimated 30 million adults are affected
More common in women
Link between insomnia and psychiatric illness (depression)

10. Narcolepsy Excessive daytime sleepiness
Between 135,000 and 250,000 people affected
Not common in children; generally initially recognized during adolescence

11. Breathing-Related Sleep Disorder
Sleep apnea
Affects 18 million Americans
More common in men ages 30 to 60
Prevalence:
4% adult male population
2% adult female population
1% to 3% of children, usually the result of adenotonsillar hypertrophy, craniofacial abnormalities, or allergic conditions

12. Parasomnias Nightmares Sleep terror disorder Sleepwalking disorder
Parasomnia not otherwise specified

13. Sleep Terror Disorder Occurs in 1% to 6% of children
Typically ages 3 to 8
More common in boys
Tends to run in families

14. Nightmares Any age, any gender
Child able to recall event (not typical with sleep terrors)

15. Sleepwalking Disorder
Occurs ages 4 to 8, with peak prevalence at 12 years of age
More common in boys
Tends to run in families