SLEEP-WAKE
DISORDERS
Prepared By: J. Ramirez
Sleep
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Sleep is essential for normal, healthy function
Sleep is essential for normal immune system
function to maintain the ability to fight
disease and sickness, for nervous system
function and for the ability to function both
physically and mentally.
Sleep is necessary for learning and for
normal, healthy cell growth.
HOW MANY HOURS OF SLEEP A PERSON NEED?
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INFANTS: Sleeps most of the day ( About 16 hours)
TEENAGERS: Needs about 9 hours of sleep/day
ADULTS: Need an average of 7-8 hours of sleep/day
OLDER ADULTS: Requires about as much sleep as younger
adults do, they usually sleep for a shorter periods and spend
less time in the Deep stages of sleep
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About 50% of adults over 65 have some type of sleep disorder
Understanding process of sleep
Stage 1: brief transitional stage of light sleep that usually lasts a few
minutes.
Hypnic jerks - muscular contractions that occur as people fall asleep.
Stage 2: brief bursts of higher-frequency brain waves called sleep spindles.
Stage 3 and 4 - slow-wave sleep in about a half-hour and stay there for
roughly 30 minutes.
** Then cycle reverse and gradually moves back upward through lighter
stage.
REM SLEEP
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Fifth stage of sleep
Rapid eye movement (little ripples move back and forth access his or her
closed eyelids)
Most dream reports come from REM stage, although REM dreams may be
more frequent, vivid and memorable.
**non REM consists of sleep stages 1-4 which are marked by an absence of rapid
eye movement. (little dream)
UNDERSTANDING SLEEP
Sleep Disorders
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Classified Into 10 conditions:
• Insomnia (lack of sleep)—most common disorder; more often in
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women & older adults
Breathing-related sleep disorders
Hypersomnolence disorder
Narcolepsy
Circadian-rhythm sleep–wake disorders
Nightmare disorder
NREM disorder
REM disorder
Willis-Ekbom disease
Substance/medication-induced sleep disorder
-Repeated
difficulty with sleep
initiation, maintenance,
consolidation, or quality that
occurs despite adequate time and
opportunity for sleep and results
in some form of daytime
impairment.
THREE TYPES:
1. ACUTE- lasts up to a month
2. TRANSIENT- less than a
week
3. CHRONIC- more than a
month
INSOMNIA
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Illness
medications
Caffeine
Stress
Anxiety
Depression
Lack of activity
Poor sleeping habits
Causes of Insomnia
Sleep Apnea - frequent reflexive
gasping for air that awakens a person
and disrupts sleep.
Apnea occurs when a person literally
stops breathing for a minimum of 10
seconds, accompanied by loud
snoring.
**Sleep Apnea often lead to insomnia
as side effect.
BREATHING RELATED SLEEP DISORDERS
HYPERSOMNOLENCE DISORDER
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NARCOLEPSY
It is a disease marked by
sudden and irresistible onset
of sleep during normal waking
period
A person suffering from
narcolepsy goes directly from
wakefulness to REM sleep,
usually for a short period of
time.
This is potentially dangerous
condition, some of the victims
fall asleep instantly, even
while driving a car or
operating machinery.
● Circadian-rhythms are
particularly influential in the
regulation of sleep.
● Circadian-rhythm sleep-wake
disorder - disruption in the
timing of sleep.
● Circadian in Latin means
“around or approximately”
(circa) “a day” (diem)
● “internal clock” - controls your
body’s sleep-wake cycle.
CIRCADIAN-RHYTHM SLEEP-WAKE DISORDER
1. Delayed Sleep Phase Disorder - you go to sleep and wake up more than two
hours later than what is typically considered a normal sleep-wake cycle.
you're a “night owl” who may not be able to fall asleep until 2 a.m. or later, but then sleep in until as late as
3 p.m.
Other common features of delayed sleep phase disorder are:
❏ You're often most alert, productive and creative late at night.
❏ If forced to get up early, you are sleepy during the day.
❏ You're often perceived as lazy, unmotivated, or a poor performer who is
always late for morning responsibilities.
❏ Is most commonly seen in adolescents and young adults.
❏ May run in families.
Common types of Circadian-Rhythm Disorder
2. Advanced Sleep Phase Disorder - You fall asleep in the early evening (6
p.m. to 9 p.m.) and wake up in the early morning (2 a.m. to 5 a.m.)
features of advanced sleep phase disorder are:
❏ You typically complain of early morning awakening or insomnia and are
sleepy in the late afternoon or early evening.
❏ Is most commonly seen in the middle age and older adults.
❏ May run in families.
Common types of Circadian-Rhythm Disorder
3. Jet Lag - Your body’s internal clock has been disturbed from long air travel time
to a destination that is two or more time zones different from your home. This
sleep-wake cycle disruption makes it difficult to adjust and function in the new time
zone.
features of jet lag are:
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Change in appetite.
Changes in gastrointestinal (stomach and bowel) function.
General tiredness.
General feeling of discomfort or uneasiness and mood disturbance.
Common types of Circadian-Rhythm Disorder
4. Shift Work Disorder - You may have this sleep disorder if you frequently
rotate shifts or work at night. These work schedules conflict with your
body’s natural circadian rhythm, making it difficult to adjust to the change.
features of shift work disorder are:
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Ongoing tiredness.
General feeling of discomfort or uneasiness, mood disorder.
Gastrointestinal problems.
Decreased sex drive.
Common types of Circadian-Rhythm Disorder
Nightmare Disorder
● Anxiety-arousing dreams that lead to awakening, usually from
REM sleep.
● Person who awakens from a nightmare recalls a vivid dream and
may have difficulty getting back to sleep.
● Children usually experience this.
NIGHTMARE DISORDER
Somnambulism or Sleepwalking
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Occurs when a person arises and wanders about while remaining asleep.
Tends to occur during the first two hours of sleep, when individuals are in
slow-wave sleep.
Sleepwalkers may awaken during their journey, or they may return to bed
without any recollection of their excursion.
**Sleepwalkers are prone to accidents.
Substance/Medication-induced Sleep Disorder
● staying up later than your usual bedtime or participating in tiring
activities during the time that alcohol or drugs are used
● A wide variety of psychoactive substances can cause
substance-induced sleep disorder, including:
● Alcohol
● Caffeine
● Cannabis
● Opioids
● Sedatives
● Hypnotics
● Cocaine
● Tobacco
NON-RAPID EYE MOVEMENT (NREM) DISORDER
RAPID EYE MOVEMENT (REM) DISORDER
WILLIS-EKBOM DISEASE (Restless Legs Syndrome)
Clients should avoid foods and medicines that
alter chemical balance (e.g., caffeine)
Encourage client to seek medical attention
Observe, report, and record how long the client
is sleeping during each stage of sleep; make
note of client’s use of prescription and
nonprescription drugs or alcohol
Supporting Clients With Sleep Disorders
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