Sleep/Wake Disorders and Parasomnias
Sleep is essential for a healthy mind and body, and lack of quality sleep can cause distress during the daytime. Sleep disorders can involve difficulties with quality, timing, and amount of sleep and frequently accompany other disorders, especially depression, anxiety, and PTSD. Obtaining a good sleep history is essential to diagnosing sleep disorders, prescribing a treatment plan, and monitoring the plan’s effectiveness. Understanding and managing sleep problems frequently leads to improvement in other mental health disorders that the patient is experiencing.
This week, you will analyze the diagnostic criteria and treatment options of insomnia, hypersomnolence, narcolepsy, sleep apnea, non-rapid eye movement, nightmare disorder, sleep behavior disorder, and other DSM-5 sleep and parasomnic disorders.
Treatment of Sleep/Wake Disorders
The power of sleep to heal the body cannot be underestimated. Most research indicates that 7–8 hours of sleep are a minimum that people need to stay healthy. Clients who come to the PMHNP’s office frequently complain of sleep problems. It is estimated that 10–20% of patients report some type of sleeping problem.
In this Discussion, you will analyze the diagnostic criteria and evidence-based psychotherapy and psychopharmacologic treatment for sleep/wake disorders.
Learning Objectives
Students will:
· Analyze diagnostic criteria for sleep/wake disorders
· Analyze evidence-based psychotherapy and psychopharmacologic treatment for sleep/wake disorders
· Analyze criteria for referring clients to primary care physicians for treatment of sleep/wake disorders
· Compare differential diagnostic features of sleep/wake disorders
Learning Resources
Required Readings
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
· Chapter 13, “Psychosomatic Medicine” (pp. 465–503)
· Chapter 16, “Normal Sleep and Sleep-Wake Disorders” (pp. 533–563)
Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.
· Chapter 36, “Sleep-Wake Disorders”
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
· “Sleep-Wake Disorders”
Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.
| Excessive sleepiness in narcolepsy, obstructive sleep apnea/hypopnea syndrome, shift work sleep disorder | Insomnia | Narcolepsy | Restless leg syndrome |
| armodafinil modafinil sodium oxybate (in narcolepsy only) | agomelatine alprazolam amitriptyline amoxapine clomipramine clonazepam desipramine diazepam dothiepin doxepin estazolam eszopiclone flunitrazepam flurazepam hydroxyzine imipramine lofepramine lorazepam maprotiline mianserin nortriptyline quazepam ramelteon temazepam trazodone triazolam trimipramine zaleplon zolpidem zopiclone | amphetamine (d) amphetamine (d,l) lisdexamfetamine methylphenidate (d) methylphenidate (d,l) modafinil sodium oxybate | gabapentin ER |
Optional Resources
Bélanger, L., Harvey, A. G., Fortier-Brochu, É., Beaulieu-Bonneau, S., Eidelman, P., Talbot, L., . . . Morin, C. M. (2016). Impact of comorbid anxiety and depressive disorders on treatment response to cognitive behavior therapy for insomnia. Journal of Consulting and Clinical Psychology, 84(8), 659–667. doi:10.1037/ccp0000084
Olaithe, M., Nanthakumar, S., Eastwood, P. R., & Bucks, R. S. (2015). Cognitive and mood dysfunction in adult obstructive sleep apnoea (OSA): Implications for psychological research and practice. Translational Issues in Psychological Science, 1(1), 67–78. doi:10.1037/tps0000021
Assignment
· Explain the diagnostic criteria for INSOMNIA DISORDER?
· Explain the evidenced-based psychotherapy and psychopharmacologic treatment for INSOMNIA DISORDER?
· Describe at what point you would refer the client to their primary care physician for an additional referral to a neurologist, pulmonologist, or physician specializing in INSOMNIA DISORDER and explain why.
· Support your rationale with references to the Learning Resources or other academic resource.
